Shaikha 5/29 t.i.d. Day 3 + minicurves

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wombat88

wombat88

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Though she was up to 409 last night, this AM she was only 290, so I'm hoping that yesterday's results were a bounce. I kept her dose last night and this morning the same to see how things go, assuming we were seeing a bounce. It wouldn't surprise me as off as she's been. I imagine the greens and blues on Day 1 made her body wonder what was happening after all the reds and blacks before that. We'll see what today brings, but hoping for some more gentle results and maybe some blues her liver can get used to without freaking out. Will keep updating this during the day as I get new results. I've kept her food the same in order to isolate what is happening.

5/28 PMPS = 409, gave 0.8U

5/29 numbers:
AMPS = 290, gave 0.8U (did rising number check and it was going up as 10 min later at 300)
+1 = 377 (combo of rising numbers and food spike?)
+3 = 326 (ketone test done = zero)
+4 = 316
+6 = 263
MDPS= 259, gave 0.8U (hope this was okay; I tested a second time and it was higher but not much; will retest at +1 to ensure she is going up)
+1 = 206 (looks like she was not going up; hope she'll be okay despite the dose)
+2 = 182
+4.5 = 80 (fed snack after as her brother had dinner)
+6 = 114
PMPS = 193, gave 0.8U (hope this was okay too, but she was definitely going up; will test one more time at +2 as I think I'll be up late tonight)
+2 = 369 (so we are seeing a bit of a bounce up I guess; darn)
 
When should I test her again this AM? I checked at +1 and numbers were going up, but she always gets an uptick after eating too. Assuming she reaches nadir around +4 or +5, suggestions as to the timing of the next AM check? Am trying not to have to test her as often today if I can.
 
I'd say you could wait until like +3 to see where her nadir is headed and at +4. That isn't cutting back on testing much but then you could wait until MDPS.
 
Rob & Harley said:
I'd say you could wait until like +3 to see where her nadir is headed and at +4. That isn't cutting back on testing much but then you could wait until MDPS.
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Thanks Rob. Will do. That should work okay around church too.
 
As far as spot checks, I would focus on what you are looking for and let that dictate it.

If you want to be sure she doesn't go too low, then you check around what you think is her nadir time.

If you are suspecting rebound, then you are looking for a sharp rise between nadir and what would normally be around +9, followed by a drop after that (which is hard to discern on TID shooting). Or you see it in a high cycle after a good cycle, which you'll see with any spot test.

If you are trying to get a really good sense of the curve on TID, you can do a +2 +4 +6, or a mini-curve +3 +6.

If you are trying to pinpoint onset, nadir, or duration, then you can get 2 spot checks in any cycle to help you nail things down. For instance you might do a +4 +5 one day, and then based on which is lower, either a +3.5 +4.5 the next day, or a +4.5 +5.5 if the +5 was the lower reading the day before.

If it were me, looking at your planned spot tests for today, I would probably drop the +6 in your AM cycle (unless the +4 is low, which looks unlikely). In the mid-day cycle I would get either a +4 or a +5 and leave it at that, and I would skip the check in the nighttime cycle. Obviously still getting all the PSs.

If her #s aren't low and her nadir may be moving around, I'm not sure how much point there is in doing much testing to pin down the nadir - I'd probably just try varying the nadir check on different cycles (+4 one day, +5 another, +4.5 another, etc), and leave it at that for the moment. Ditto with trying to find onset & duration - I think there are too many variables and too much that can change cycle to cycle to really try to pin those down right now. And I would skip rebound checks unless you have reason to suspect that is a big issue.

Just curious do you have to go back to work Tuesday? Will you still be able to go with TID? If so I might do a couple more spot checks tomorrow than I would today, assuming you wouldn't be able to get in a lot of checks for the rest of the week. But still I don't think you need a full curve every day.
 
Joanna & Bix (GA) said:
Just curious do you have to go back to work Tuesday? Will you still be able to go with TID? If so I might do a couple more spot checks tomorrow than I would today, assuming you wouldn't be able to get in a lot of checks for the rest of the week. But still I don't think you need a full curve every day.
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Your intuition about her being very low at +4 was good, because she wasn't. She went down to 316 but not much of a change. I'm on a summer work schedule now and am actually off until later in June, so I'll have more time to play with this. The schedule will make t.i.d. easier at least through the end of July. After that, I'll have to figure out how to manage it but if it is working for her I'll manage it somehow. I don't live too far from work so if need be I can zip home to do the mid-day dose this fall though I may need to change it slowly to earlier times than I'm doing now to make it work with my schedule.
 
Take a look at her numbers this AM . She definitely went down, but seemed to still be falling by the mid-day dose but may not have been. I'd not tested at +7 so couldn't tell, but I did do a second test 15 min. after and she was slightly higher so I'm guessing she was starting to go up. Later nadir though than usual for her. I plan to retest at +1 to ensure she is indeed going up. If not, maybe the extra shot of insulin will get her to go down some. Hope it doesn't trigger a bigger bounce, though. I've been glad not to see the reds today, but hope we can get her into a more normal curve soon.

I did decide to try her on the rabbit just to see if she'd like it. She did. Hope it agrees with her. That's got protein 44 %, fat 28 %, and carbohydrate 28% so it is higher in carbs than the venison I've got on order but 9% lower in carbs than what she has been eating. I've only got two cans of it though. She seems to be having some food spikes with the other so was hoping a lower carb food would cause less of one. We'll see. I probably have changed too many variables again though.

Do you guys think this is still a bounce? She's going lower, which I guess is a good thing but not much of a curve yet.
 
Give Shaikha's sore little ears a kiss and a thank you for all the info she's provided.

Depending on what #'s she gets tonight this is what I see so far.

A .8u on a 400 PS gives you a U curve and a decent nadir. A .8U on a 200 PS gives you a slightly inverse curve both AM's suggesting that .8u is too much insulin on a 200 PS.

Lets see what others think.
 
Rob & Harley said:
Give Shaikha's sore little ears a kiss and a thank you for all the info she's provided. Depending on what #'s she gets tonight this is what I see so far. A .8u on a 400 PS gives you a U curve and a decent nadir. A .8U on a 200 PS gives you a slightly inverse curve both AM's suggesting that .8u is too much insulin on a 200 PS. Lets see what others think.
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I tested her again at +4.5 and she was at 80. Acting fine, so no sign of problems. She's come down, but at least no crash so far. I did feed her a snack after the test as her brother needed to eat dinner. I've tried feeding them both at the same times and he insists on eating again when it is dusk or he'll pick on her if I don't feed at his usual time. So, I may have to give her a small snack around +4 mid-day to keep them happy and not change his routine too much to keep the peace. Will be interesting to see how much she comes up before the next shot. Will need to make some decisions on dose I think if she's lower again. Not sure what to expect, but am hoping not to see zooming levels followed by crashes.
 
Yay, better #s!!!!

I'd test less. I think you can get away with just tonight's PS and nothing more today (barring some wonky happening). I don't think you need any hour by hour back-to-back tests unless she appears to be heading low or something. Just a pitch for the ears. :mrgreen:

If you get a 150 PS this round I'd consider pulling the dose back a hair. You're at a 70% drop, so that might actually be perfect - 150 PS would give you a 50 nadir, so maybe not. I don't have a lot of TID experience, so see what others think. Wouldn't want you to lose progress, but I'm also not sure what the cumulative overlap effect is. Looks like you got overlap on this cycle that you didn't have this morning, but with other factors involved I'm not 100% sure if it's just the insulin, or other things.
 
judy and squamee(GA) said:
Paws crossed for good numbers and not a lot of bouncing. You are doing some job with this!
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I've no idea what to expect so I'm testing more often. While I was overseas, it was nerve-wracking not knowing how her numbers were in between shots, especially with her being so high. When she was with my vet I wasn't so concerned, since he had to test her constantly since he was giving tiny doses of insulin based on her levels.

I really want this to work for her because she's had such a bad year between the pancreatitis attacks and infections, so getting her to lower levels of glucose would help a lot.

So far, so good this evening. She was up to 114 at +6, so no zooming yet. She's walking around oblivious to my concerns, and purring the whole time I hold her to do ear pricks. She really is a sweet cat and doesn't seem to really mind. No flinching, growling, etc. like you'd likely see with most kitties. She just sits there and lets you do what you need to do.

Will be interesting to see what happens by the PMPS. I am working on a project tonight so I may be up a while, so I'll try to get one reading after PMPS to see how she does.
 
Wow, sure did take a while for that bounce to clear! What a beautiful cycle for this afternoon!!!!! I personally would stick right there at 0.8u for a while until she settles in more. Obviously if she nose dives one cycle, then lower the dose though :-D
 
Rob & Harley said:
I would be happy to be your sponcer in our Testaholics Annonomous group. :-D
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ROTF!! When I first joined the insulin boards, I was reminded that I wasn't testing enough. Now I'm being too cautious. Thank goodness I have a very compliant kitty with sturdy ears! I will test her less though, promise. I got a little freaked out by the higher numbers this AM and then got scared the mid-day dose would be too much and she'd hypo. I'm actually pretty pleased with her numbers tonight though, and a bit surprised. Am hoping it goes well after the PM shot.
 
Kelly & Oscar said:
Wow, sure did take a while for that bounce to clear! What a beautiful cycle for this afternoon!!!!! I personally would stick right there at 0.8u for a while until she settles in more. Obviously if she nose dives one cycle, then lower the dose though :-D
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I'm thinking the same, Kelly. Will be interesting to see what her PMPS level is but she is going up so we'll see.
 
I think that the testing you have done for the tid trial was critical and invaluable, without it we wouldn't know which direction to go or be able to discern the difference between a bounce and too much insulin or wonky numbers and you will probably need to continue for a little while longer until things settle in.

Hi my name is Robin and I am a recovering testaholic.
 
Rob & Harley said:
I think that the testing you have done for the tid trial was critical and invaluable, without it we wouldn't know which direction to go or be able to discern the difference between a bounce and too much insulin or wonky numbers and you will probably need to continue for a little while longer until things settle in. Hi my name is Robin and I am a recovering testaholic.
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I don't feel so badly then. :) Nice to meet you, fellow testaholic! :lol:

I am still learning so much, so I figured more data was better than none. Seems like everyone is thinking this indeed was a bounce, so let's see if she proves us right. She gets another hour off before being retested for PMPS so her ears get a tiny break. That said, I've gone through an entire 50-pack of strips already that I just opened on 5/24... !
 
Okay, now what? She was 193 at the PMPS. Should I shoot 0.8U like before? She's definitely going up and it has been a nice slow steady increase. I cut back on Day 1 and got an okay value after that, but then we got what we thought was a delayed bounce from the AM that took a while to clear. I'm afraid to play with the dose again for fear I'll throw things off though. I'm leaning to giving 0.8U and seeing how she does since she's still settling into the t.i.d. dosing.

Thoughts? She's eating now, but I need to give insulin shortly.

edit: Gave 0.8U. Hope it works!
 
Just checking in and what nice numbers! She seems to be responding really well to t.i.d. ..... nice testing! you are gathering some useful data. I don't know why but some kits just need insulin more often but you are doing great!

Nancy and Payne
(who seems to feel that I type better with a cat on the keyboard :)
 
Nancy and Payne said:
Just checking in and what nice numbers! She seems to be responding really well to t.i.d. ..... nice testing! you are gathering some useful data. I don't know why but some kits just need insulin more often but you are doing great!

Nancy and Payne
(who seems to feel that I type better with a cat on the keyboard :)
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LOL. I've had cats that seem to think that too. The kitty I lost in April to renal failure and anemia used to love to lie on top of whatever I was working on. He'd just come over, plop his big fluffy self all over it, and then look at me pathetically if I tried to rearrange him so I could at least see something. We usually just gave up and worked around him. He had a way of snuggling in and over things that was so endearing you just felt badly moving him. I miss him. :(

I think she's doing well, but we probably need more time to settle in. Greens seem to make her liver want to work overtime. Hopefully it will figure out that lower glucose numbers are good, not bad. Unless she's really off in the AM we'll just keep on with the same dose, I guess. Your thoughts? I do think the more frequent dosing is working better, and we actually are able to use less insulin this way so far.

Think we should drop to 0.6U or should I just keep on with 0.8U? I don't want to lose momentum but it also seems that we haven't reached a happy medium yet. Hopefully tomorrow will be a more steady day for her.
 
Just give it some time, there are so many factors involved .... did you take her temp.? I know you were concerned she might still have an infection, do you still feel that way? But I like the numbers so far, she can go low, though. Remember you have only been doing this three days but so far very good.

Nancy and Payne
(who feels it is her job to personally guard keyboards, newspapers and such with her body ..... )
I understanding about missing our GA's .... I have so many snuggling in my heart .....
 
Nancy and Payne said:
Just give it some time, there are so many factors involved .... did you take her temp.? I know you were concerned she might still have an infection, do you still feel that way? But I like the numbers so far, she can go low, though. Remember you have only been doing this three days but so far very good.

Nancy and Payne
(who feels it is her job to personally guard keyboards, newspapers and such with her body ..... )
I understanding about missing our GA's .... I have so many snuggling in my heart .....
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Well, I think it is just plain warm in this house. I actually think she's better since all the antibiotics. The real trigger for her getting sick is pancreatitis flaring up badly and/or her IBD, which tends to make blood sugar wacky which leads to a UTI usually. I didn't take her temp, but I don't think that's an issue given her other lack of symptoms. I am now thinking that the reason she's settled out some is not just the dosing but also her pancreas calming down some, which in the past has also allowed me to lower the dose. That may be why she's gotten by on less rather than more in addition to the t.i.d. changes. Her stools are now normal, which is one clue. When her pancreatitis flares up, that's usually the first change I see before obvious pain and appetite loss. She's got nice normal stools now and also seems to be resting comfortably in various positions, another good sign. When pancreatitis is a mess, as it was several times this year, she tends to sleep in more guarded positions. She seems quite relaxed now, plus has a good appetite.

So.... what I decided to do was try going with 0.6U this AM and see how she does. She was at 192 again, so I didn't want her zooming up like she did last night. I'm thinking that a slightly lower dose spread out more often may just do the trick. May have to work around a bounce from last night again and let her settle in, but I think we are getting closer.
 
You fellow testaholics are a hoot :mrgreen: . With me it was all about trying to get some control in a situation which was basically out of my control. On ProZinc I was never able to establish her nadir or get a good dose, but that may have been due to her medical issues, I never really understood. anyhow, I just looked at your SS and what stood out was NO BLACK IN 3 DAYS!!! (anti-jinx, anti-jinx, anti-jinx). Wendy, what a great job you are doing.
 
judy and squamee(GA) said:
You fellow testaholics are a hoot :mrgreen: . With me it was all about trying to get some control in a situation which was basically out of my control. On ProZinc I was never able to establish her nadir or get a good dose, but that may have been due to her medical issues, I never really understood. anyhow, I just looked at your SS and what stood out was NO BLACK IN 3 DAYS!!! (anti-jinx, anti-jinx, anti-jinx). Wendy, what a great job you are doing.
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I'm pleased, and I'm sure she feels better too. I do think this will work out for her better than the b.i.d. dosing was. It just wasn't holding her consistently long enough and I think that led to the wide swings as a result. She's certainly more even on the more frequently dosing. I agree on trying to get control over the out of control part. I liked Rob's wish of having the BG numbers flash on their noses when you kiss them. Certainly would be much nicer than poking their ears, but we do what we have to. :)
 
I must have missed that wish of Robin's ---what a great idea--- nosesnthat light. Up with BG numbers when you kiss them! it would have been non stop fireworks around here.
 
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