Should I shoot again? 461 @+4
- Thread starter JenM
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Merlin
Very Active Member
Hi Jen. Are you on the west coast? If you are on a 12 hour schedule and if you already shot tonight, you won't be shooting again until your regularly schedule AM time tomorrow. It is not unusual to experience some ups and downs throughout the cycle until you get closer to the right dose. Sue and Jen always remind me "collecting data is good." So it is good that you are getting those numbers recorded. I usually like to feed before I go to bed and possibly leave some food out so Merlin can snack. This helps with your numbers as well throughout the night. But you don't want Tink to eat two hours before you test for your AMPS.
I hope I was able to help a little.
I hope I was able to help a little.
Sue and Oliver (GA)
Very Active Member
Hi Jenn,
I am glad Cindi was around to help last night. I am in Colorado and sometimes around to help at night, but not real late. You can't be sure what will happen shooting again at .4 because the insulin really doesn't peak until around +6. Although it looked like it was going to be a high cycle, you just can't be sure and it's not worth the risk. Yes, food does impact the bg levels and he could rise with the food and fall again.
Getting some numbers this weekend should help - anytime you can, just randomly, will help us see what might be going on. Again, nighttime numbers will really help to figure put why he is higher in the am.
I am glad Cindi was around to help last night. I am in Colorado and sometimes around to help at night, but not real late. You can't be sure what will happen shooting again at .4 because the insulin really doesn't peak until around +6. Although it looked like it was going to be a high cycle, you just can't be sure and it's not worth the risk. Yes, food does impact the bg levels and he could rise with the food and fall again.
Getting some numbers this weekend should help - anytime you can, just randomly, will help us see what might be going on. Again, nighttime numbers will really help to figure put why he is higher in the am.
JenM
Active Member
For whatever reason, my smart phone isn't smart enough to let me edit google docs. So I fired up the home computer, had to install Chrome and FINALLY was able to update the SS. Please review!
Today looks good, IMO. I have not yet given a PM shot due to him being at 186 currently. Figure I'll see what his +2 looks like and decide to shoot or not. Appreciate any thoughts. I find it odd that his AM dose seems to still be working strongly. He ate at +10 and his PMPS was only 34pts higher.
Last night had me a bit freaked out and feeling helpless - really didn't know what to do, but I was relieved to see his AMPS under 400 today. I will continue todays curve until at least +4 - will try to make myself get a couple sleeptime tests as well. It's hard to go find him in the dark house, without my contacts (he's black too, which doesn't make it easy!) without waking up every critter in the house. :shock: Plus I have a really hard time falling back asleep once I'm "that" awake. But... we gotta do what we gotta do.
Also, as for the secondary monitoring... most of those things dont work for me. I have 4 cats in the house. Measuring water is impossible as I have no way to know who drinks it. I also use a fountain as I find they drink more that way. I also cannot leave food out because Tink could rival a Dyson if cat food is involved. He gobbles up his 1.5oz meal in literally like 5 seconds. I have to stand guard for the next 5minutes while the others finish theirs or he will swoop in. I've never been able to free-feed, even when I fed dry. My cats are half pig. :roll: I do intend to check for ketones, but haven't caught him peeing yet. His hydration seems fine and his behavior is normal - other than he seems to have a slightly higher thirst drive (asking for the faucet again, which he hasn't done since pre-diagnosis - though not very often) and he's had a crazy appetite for the last month or so. ETA: Actually, I forgot... last night he did cuddle up under the covers with me for a short bit. Normally he exits my room and I close the door at bedtime. The only time he's really been a blanket cuddler was his first couple weeks home from the vet. But he did change his mind after about 5min and asked to be let out of my room. Maybe he just knew I was freaking out.
I REALLY appreciate you guys helping me figure this out.
Today looks good, IMO. I have not yet given a PM shot due to him being at 186 currently. Figure I'll see what his +2 looks like and decide to shoot or not. Appreciate any thoughts. I find it odd that his AM dose seems to still be working strongly. He ate at +10 and his PMPS was only 34pts higher.
Last night had me a bit freaked out and feeling helpless - really didn't know what to do, but I was relieved to see his AMPS under 400 today. I will continue todays curve until at least +4 - will try to make myself get a couple sleeptime tests as well. It's hard to go find him in the dark house, without my contacts (he's black too, which doesn't make it easy!) without waking up every critter in the house. :shock: Plus I have a really hard time falling back asleep once I'm "that" awake. But... we gotta do what we gotta do.
Also, as for the secondary monitoring... most of those things dont work for me. I have 4 cats in the house. Measuring water is impossible as I have no way to know who drinks it. I also use a fountain as I find they drink more that way. I also cannot leave food out because Tink could rival a Dyson if cat food is involved. He gobbles up his 1.5oz meal in literally like 5 seconds. I have to stand guard for the next 5minutes while the others finish theirs or he will swoop in. I've never been able to free-feed, even when I fed dry. My cats are half pig. :roll: I do intend to check for ketones, but haven't caught him peeing yet. His hydration seems fine and his behavior is normal - other than he seems to have a slightly higher thirst drive (asking for the faucet again, which he hasn't done since pre-diagnosis - though not very often) and he's had a crazy appetite for the last month or so. ETA: Actually, I forgot... last night he did cuddle up under the covers with me for a short bit. Normally he exits my room and I close the door at bedtime. The only time he's really been a blanket cuddler was his first couple weeks home from the vet. But he did change his mind after about 5min and asked to be let out of my room. Maybe he just knew I was freaking out.
I REALLY appreciate you guys helping me figure this out.
BJM
Very Active Member
With several cats, general water consumption won't identify who is drinking more, only that someone is. Your own observations of the cats drinking, plus observations on litterbox use when you can, will clue you in to who may have a problem.
That's why these are secondary tools - they aren't as precise as blood glucose or lab work. Short of crating each of them separately, your observations are the next best thing.
(Speaking of crates - in an emergency, have you got enough crates for each cat? Just a thought.)
That's why these are secondary tools - they aren't as precise as blood glucose or lab work. Short of crating each of them separately, your observations are the next best thing.
(Speaking of crates - in an emergency, have you got enough crates for each cat? Just a thought.)
Sue and Oliver (GA)
Very Active Member
Now that was an interesting cycle! It looks like .5 is more than enough. I am thinking your red amps numbers are bounces, Jenn. And he clears the bounce along with the insulin and so goes lower later in the cycle. I really am curious if there is a low overnight that causes the am jump.
Maybe wait till 200 and then give a small amount - less than .25 - maybe just a drop - and see if he is flatter overnight?
Maybe wait till 200 and then give a small amount - less than .25 - maybe just a drop - and see if he is flatter overnight?
Sue and Oliver (GA)
Very Active Member
Hmmmm. I definitely think he had a bounce for amps and then the insulin helped clear ir and more. maybe his pancreas even kicked in. I think I'd reduce the dose Jenn, even if you have a higher number this am, and see what happens. It may be that his body only needs a little bit of insulin to help out his pancreas and too much is creating issues - bounces and long cycles..
JenM
Active Member
Well crud. Didn't see this till now and already dosed .5 this morning. See SS. He never hit green yesterday, testing every 2hrs. Finally at PM +4, with no PM shot, he started going back up, but not high enough to shoot. At 2am (+8) he was plenty high to shoot, but by that time I thought it best to wait until morning. Was that the right thing to do? By morning he was extremely high again (especially since I overslept and didn't shoot till nearly 8am, rather than 6am - probably thanks to getting up at 2am to test). I thought about trying a .25 dose, but thought it wouldnt do much with his number that high, given that yesterday never saw green and we started with a much lower number.
Ideas?
For those suspecting a bounce... when do you feel like this bounce occurred? Based on yesterdays numbers, I dont see an extreme low being likely - but you guys are way more experienced than I am... so I will believe you!
I'm going to try to test every 3hrs today - but if we see a cycle similar to yesterday, what do you suggest I do for PM shot?
Ideas?
For those suspecting a bounce... when do you feel like this bounce occurred? Based on yesterdays numbers, I dont see an extreme low being likely - but you guys are way more experienced than I am... so I will believe you!
I'm going to try to test every 3hrs today - but if we see a cycle similar to yesterday, what do you suggest I do for PM shot?
JenM
Active Member
Should I still be doing 4 meals a day while we're figuring out dosage, or do you think that's causing problems with dialing in on a dosage? I can see how he COULD have gone low had he not eaten - especially at +10 (am) yesterday... Would it be best to go back to 2 meals a day to see what the insulin is REALLY doing? Or should I just stick with it since the goal is to have him OFF insulin and eating 4 meals a day has proven effective with that?
Hello Jen,
I'll describe my experience with ProZinc while, I hope, Sue will answer your specific questions, as I've been away from ProZinc for 2 years and have not kept my skills up by giving advice...
My Pudge spent some 6 months on ProZinc before going OTJ. His numbers were a rainbow of colors, we meandered between twice and thrice a day schedule, adjustable scale dosing, and went OTJ at 1 unit! Unique? So is every kitkat! A year later he got ill with some stomach bug: stopped drinking, eating, peeing much, just hid in my closet. I assist fed him, but thought he wasn't getting enough nutrients. For 2 days gave him dry kitten food, as he had always preferred dry, of course, his BG went up to 250. Started immediately on Levemir (had it in my fridge because of shortage of ProZinc - I always always keep insulin in my fridge in case of a need for subsequent remission - I believe insulin is needed stat). After a few days, Pudge went into his 2nd remission and has so remained since May 2013.
Jen, I'm writing to give you hope. During our insulin dance I lost hope many times, particularly, when exhausted. Deep in my heart I didn't believe that Pudge would go OTJ because I thought he had been diabetic long before I had noticed it.
Best wishes,
Sophie
I'll describe my experience with ProZinc while, I hope, Sue will answer your specific questions, as I've been away from ProZinc for 2 years and have not kept my skills up by giving advice...
My Pudge spent some 6 months on ProZinc before going OTJ. His numbers were a rainbow of colors, we meandered between twice and thrice a day schedule, adjustable scale dosing, and went OTJ at 1 unit! Unique? So is every kitkat! A year later he got ill with some stomach bug: stopped drinking, eating, peeing much, just hid in my closet. I assist fed him, but thought he wasn't getting enough nutrients. For 2 days gave him dry kitten food, as he had always preferred dry, of course, his BG went up to 250. Started immediately on Levemir (had it in my fridge because of shortage of ProZinc - I always always keep insulin in my fridge in case of a need for subsequent remission - I believe insulin is needed stat). After a few days, Pudge went into his 2nd remission and has so remained since May 2013.
Jen, I'm writing to give you hope. During our insulin dance I lost hope many times, particularly, when exhausted. Deep in my heart I didn't believe that Pudge would go OTJ because I thought he had been diabetic long before I had noticed it.
Best wishes,
Sophie
Sue and Oliver (GA)
Very Active Member
What I think I see in this last cycle, Jenn, is that either .5 was too high for the 352 or his pancreas kicked in to help. Or both. You got a long cycle which can result with a dose that is high or a pancreas that decides to help out and extends the cycle. It is really hard to figure out what to shoot if his pancreas "wakes up" during the cycle. But it is a good sign also, because the more his pancreas participates, the less insulin he needs.
I think I would lower the dose the next time you have a 350 or lower (.25?) and see if the dose gives you two shootable pre shots.
If not and if he continues with this extended pattern, then you have to try to work with it. It can mean "chasing the number" . So if the preshot is too low to shoot, you monitor until it is above 200 and then shoot a low dose (like the .25 or maybe less) and watch to see if the pancreas jumps in and helps him stay in lower numbers longer. Many beans whose cats went into remission did this dance and you can see that in their spreadsheets in the Remission thread. It is difficult because you may be shooting off the 12/12 schedule. The good news is that it usually doesn't last long.
So the way it could have worked last night would be to catch that 200+ number (probably around +18) and shoot .25 then. Then you see how long it lasts.
Clear as mud? Impossible with your life?
I think I would lower the dose the next time you have a 350 or lower (.25?) and see if the dose gives you two shootable pre shots.
If not and if he continues with this extended pattern, then you have to try to work with it. It can mean "chasing the number" . So if the preshot is too low to shoot, you monitor until it is above 200 and then shoot a low dose (like the .25 or maybe less) and watch to see if the pancreas jumps in and helps him stay in lower numbers longer. Many beans whose cats went into remission did this dance and you can see that in their spreadsheets in the Remission thread. It is difficult because you may be shooting off the 12/12 schedule. The good news is that it usually doesn't last long.
So the way it could have worked last night would be to catch that 200+ number (probably around +18) and shoot .25 then. Then you see how long it lasts.
Clear as mud? Impossible with your life?
JenM
Active Member
Thanks both of you. It's nice to know going back OTJ is possible. I am maintaining hope for that - but going day by day.
Chasing the number is definitely doable - more so because it seems to be needed at night versus in the morning (though I suppose a late night shot could change that too...). I just can't be home from 7:30-4ish, M-F - though if ABSOLUTELY necessary, I live close enough to go home at lunch (barely). If I'd win that darn lotto I could just stay home and dote on these guys all day... but I hear you have to "buy a ticket" or some garbage. :lol: As is, I'm gonna have to pick up a second job if these critter dont knock it off! :roll:
I went back to .25, which I was able to administer last night at about 9pm. He was in the mid 300s this morning... so I'll take it. Shot .25 this morning as well. I've got a couple more numbers to add to the SS but forgot to bring them with me, so will try to update tonight. Gonna have to go get more strips too - these curves sure eat them up fast! And Tink isn't very happy with me anymore either.
On the bright side, the dog is ALMOST done with her plethora of meds that got sent home with her... so my brain should be able to focus on Tink's schedule a little more reliably. I've been having a really hard time remembering his PMPS/dosage until an hour or two later. Guess it hasn't mattered since he's been too low to shoot anyway... but it bugs me that I forget.
Chasing the number is definitely doable - more so because it seems to be needed at night versus in the morning (though I suppose a late night shot could change that too...). I just can't be home from 7:30-4ish, M-F - though if ABSOLUTELY necessary, I live close enough to go home at lunch (barely). If I'd win that darn lotto I could just stay home and dote on these guys all day... but I hear you have to "buy a ticket" or some garbage. :lol: As is, I'm gonna have to pick up a second job if these critter dont knock it off! :roll:
I went back to .25, which I was able to administer last night at about 9pm. He was in the mid 300s this morning... so I'll take it. Shot .25 this morning as well. I've got a couple more numbers to add to the SS but forgot to bring them with me, so will try to update tonight. Gonna have to go get more strips too - these curves sure eat them up fast! And Tink isn't very happy with me anymore either.
On the bright side, the dog is ALMOST done with her plethora of meds that got sent home with her... so my brain should be able to focus on Tink's schedule a little more reliably. I've been having a really hard time remembering his PMPS/dosage until an hour or two later. Guess it hasn't mattered since he's been too low to shoot anyway... but it bugs me that I forget.
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