Slowly Dropping Dose

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Teresa and Poopy

Teresa and Poopy

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Lori with Copper and me with Poopy....doing the limbo!

With Poopy's numbers climbing when I raise the dose (after dropping for a bit), thought I'd try lowering the dose to see what happens.

Here's a recap, from when the numbers started climbing and then lowering the dose:

AMPS 217 1.4
PMPS 319 1.4

AMPS 260 1.4
PMPS 316 1.4

AMPS 269 1.2
PMPS 285 1.2

AMPS 291 1.2
+5.5 292
PMPS 256 1.2

AMPS 263 1.2
+6 192

Thought I'd wait until the numbers start rising again (getting consecutive higher numbers), before doing another decrease. Poopy is so hard to read, with his Mona Lisa smile dips. :dizcat
 
He is hard to figure, Teresa. The cycle before last was certainly flat; this one looks better. I think you know enough about this dance now, and you certainly know Poopy, so try it and see what works.
 
Looking good Teresa. Like those ps #'s. The same with copper. He seems to stay flat, but in low yellows when i first lower the dose. I know the nadir is supposed to be lower, but i don't like those high ps #'s either and rather have him in the low 200's vs down and up. I think it is harder on their bodies when it's such a rollar coaster in numbers. That's just my theory. copper seems to do better when not bouncing all around. He seems happier and healthier. So waiting to see what happens like you. We are still on the 1u and doing ok.

Good luck with the poopster!

lori
 
AMPS 269, shot 1.2u
PMPS (a half hour late) 319

Not going to panic and will stick with the same dose and see what morning brings.
 
Looks like you are getting closer to the 1u. You should give it a try. Coops is still on the 1u and going lower every cycle. Hope to start going lower by the weekend if all goes well.

Good luck!

lori
 
If I jump the gun, he'll just go up on BGs. I just need to be patient until his body tells me it's time. Hard for me to do. :cry:
 
paws crossed!

Yea, coops amps was 243 and i shot 1u. His pmps went up to 305. So i guess went too high on dosage. So hard to know the right amount. I'm like you with the limbo thing. So delicate of a balance.

Look forward to what his amps will be for the poopster.

lori
 
It will be nice when the weekend arrives and both you and Lori can get a curve and see more about what the numbers are doing midcycle. The preshot numbers are lower and that is great; it'll be interesting to see what the nadirs look like and where they come in the cycle.
 
I agree, Sue. I may need the curve for the vet as well. I'm getting down to the end of the vial and we're not sure the vet can get more in before Poopy runs out so may need to change insulins after all. For now, it's one day at a time to see what happens. (The manufacturer is saying it will be the end of September before the vet can expect the one vial and I doubt I've got enough to last that long.)
 
PMPS...not thrilling...306, shot 1u. I'll wait and see what AMPS is since they didn't eat all their food today and am really not sure how that may have altered things. They have been eating virtually all their food so this was odd.
 
I really expected another 300+ BG at PS and needing to go back up in dose.

AMPS 267. I'll take it! (Oh! And that was a half hour late, to boot!) Shot 1u.
 
Yea! GOoooo Poopster!!! So we are both on the 1u now. I agree with Sue and will do a curve tomorrow when i'm home all day.

Hope you can get some more insulin. Are they running out of the prozinc? Haven't heard that.

Look forward to what our kitties will do this weekend.

lori
 
It was posted a while back about the manufacturer having a shortage but thought they'd have it back under control come fall. I was going to talk with the vet a couple of weeks ago about ordering a new vial or changing insulins but had to cancel my appointment due to health, been so busy at work that time flew by and here we are. :oops:

PMPS 293, shot 1u but seriously thought about 1.2. Will see what AMPS brings. If still high (290s or above) will go with 1.2u. I may have moved to 1u too fast, or Poop may need that bit more.
 
AMPS 245 so shot 1u. Will be doing a curve today to see what goes on in the little food consuming factory during the day. :lol:
 
PMPS 269, shot 1u.

Will continue the 1u as long as he stays under 290. If he does his normal drops into the lower 200s, may consider dropping to .8 after he rises again.

I can't help but wonder, is his body reacting to the level of insulin and producing what he needs to "even out"? If so, I don't want to rush things.
 
I can't help but wonder, is his body reacting to the level of insulin and producing what he needs to "even out"? If so, I don't want to rush things.
Click to expand...

Possibly. Every time I think I've got a clue Cass pulls a weird one. Still haven't figured out why his numbers were worse at .8u than .6u.
 
I'm with you both in trying to figure FD out. It's a day by day thing with Cooper.

Looks like poops and Cooper like do the same thing. I'm with your thinking though as long as he is below the threshold, his body is healing and not rising in the ps number. I still think that the rollarcoaster is harder on the bodies than having them drop in the green for nadir. Not sure what the flat means, but cooper has those too. I'm sticking to the 1u now..

Look forward to see what poopster does next.

lori
 
AMPS 290. stuck with 1u as Poopy was hovering last night's crumbs half an hour before test time. Will check mid-cycle on progress.
 
Technically, that would be "into the blue" :lol:
I see no logical reason, but hey, who's complaining? One of those "just cuz" numbers that makes you smile a lot.

Carl
 
LOL. True, into the blue. :-D

20 minutes later, 245. On the hope Mr. P is pushing to fill in the lack of insulin from shots, shot .8u.

I figure Mr. P will either continue to push forward or he'll cry "Uncle" (anti-jinx).
 
Thinking I may need to bump back up to 1u.

Yesterday AMPS 290, shot 1u +5 297, +6 216 then PMPS at 184 (245 20 minutes later) and dropped to .8u
Today AMPS 256, shot .8u +5 266, +6 276...not liking this trend at all.

I know I'm rambling a bit here. Don't want to rush changing dose up or down, and with Poopy not having a dip during nadir just puzzles the heck outta me. Doesn't seem to matter how much or how little I give...IHOP, Mona Lisa, just flat, flat, flat. No rhyme or reason for numbers. Can't predict them at all.

Maybe this is a good time to consider changing insulins. :cry:

On the flip side, Poopy is doing great. cat_pet_icon
 
Give it time. Cass was flat for almost a week before.i saw any drop.on 0.6u. I stuck with it because the ps's were so.much better. Try to give it at least.3 days before you give up.
 
I stuck with the .8 but if AMPS is the same or worse, back up to 1u we go.

PMPS 310 :sad:

I think I heard "Uncle" being whispered.
 
All you can do is try a dose and see what happens. I like going back up to one unit. And don't lose sight of the fact that is a very small amount of insulin that tends to keep him in regulated numbers. :mrgreen:
 
I hope that people don't consider increase a dose as some sort of "fail". It is what it is. Not only is ECID true, but each cat is different every day as time goes on. Their insulin needs can change just because of some internal thing that is going on. Sometimes the pancreas helps, other times, not so much.

If Bob had not gone all the way up to 4u bid, he never would have gone OTJ. The only thing with him is that it was a "more logical" progression. He went up from 1u to 4u, then went back down more or less in gradual downward increments. But over the last ten days or so of his time on the juice, he got random shots ranging from skips, to .25u, to 1.5, just because that's what he needed. He was dosed on a sliding scale from day one, and I just winged it towards the end. I didn't do much of anything "right", but it worked for him.

My basic theory is that the dose doesn't matter - not in terms of how big or little it is. It just is what it is. I think the only flat cycle that is a really good flat cycle is when it's all green numbers. The "right dose" is the one that gets you a green nadir, no matter what the AMPS and the PMPS are. The mystery is trying to figure out if the PS numbers are caused by a bounce or not. If they are, then you sort of have to "wing it" and base the dose on what the PS reading would have been without that bounce, and lower the dose accordingly. And really, that's pure guesswork.

In LantusLand, I see often this: "Kitties bounce until they don't". And, I believe that is true. Eventually, they'll quit overreacting to "normal" numbers. But, in order to quit bouncing, they have to spend a lot of time in normal BG numbers, or they won't "get used" to them.

Just rambling...

Carl
 
Carl, you know me all too well. :lol:

In some ways I do see it as a failure, but in others I don't. I did expect to hear "uncle" at some point, knowing Poopy needs insulin, but I am the eternal optimist, too. I know I can hope for OTJ, even if it never happens. :-D

I stuck with .8u this morning since Poopy chimed in at 277 and I am on the last dregs of ProZinc. Will chat with the vet today about the order and Poopy's numbers and go from there. I may have enough for 3-4 more shots.

I hear what you are saying, about teaching kitty's body to adjust and accept lower numbers. I just can't seem to get Poopy there. Maybe I'm just not being aggressive enough.
 
Carl & Bob said:
In LantusLand, I see often this: "Kitties bounce until they don't".
Click to expand...

Cassie sure did...but (anti-jinx) I think he's mostly stopped. The only bounces I've seen lately have been fairly mild.
 
Lisa's right. Cass is was the king of bouncing. He even had a special emoticon last year that I think I still have on my computer....



Carl
 

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It's official...Poopy is moving to Lantus.

Had a long talk with the vet, going over the spreadsheet and the graph I made of Poopy's BGs, food and other variables. What amazed the vet the most was the lack of movement in BGs regardless of the amount of ProZinc. The scale tipped over the difficulty in getting ProZinc.

The vet prefers Lantus, but was willing to keep Poopy on ProZinc...if we could get it...and if it was doing something for Poopy's BGs - which it just plain isn't doing much at all.

I'll either finish out the ProZinc or this weekend, which ever comes first, to move Poopy to Lantus.

Yeah, the vet heard "uncle" too. :shock:

Off to read Lantus Land......
 
Teresa,
One thing that is important is to figure out his starting Lantus dose. Make sure to post that you are switching and ask for starting dose advice. It isn't going to be a whole lot. Did the vet suggest a dose? The "norm" is to start on 70% of whatever the current dose of Prozinc is. That might or might not be right for Poopy since he isn't getting great results from his current Prozinc dose at the moment.

Carl
 
The vet and I did talk about starting dose. He said he normally starts Lantus based on weight, which for Poopy would be 1.75u. However, based on his current .8u, the vet felt that would be a better starting point and work upward (start low, go slow approach).

Off to test, feed and shoot...bbiab.
 
PMPS 270, shot .8u.

Now here's a question for science geeks (and you know I say that with a ton of love!), if .8u is 2u in a u100 syringe...what dose would be 70% for Lantus?

I do plan on starting a conversation on Lantus before shooting it. :smile:
 
Just something to start thinking about. You'll be using u100 insulin, so no more conversion chart. BUT, now you'll really be measuring small doses "as is". Do your syringes have half-unit marks? You'll want them, and maybe a magnifying lens :lol:

And your standard dose adjustments will be in increments of .25u.

No more shaking or rolling the juice.

And nadir readings are critical, in case you need to rethink your shooting schedule.

Read the "dealing with low numbers" and the "safe/proper handling" stickies first ;-)

Carl
 
.56 of course:-)
So, .5 or .75, your choice. My guess is that the recommended dose will be .75u, mostly due to the .8 current dose not doing much in terms of a curve. But I have been wrong before, I think:-)
Carl
 
I've read all the stickies and watched the video on how to draw from a pen (which I'll be using. The local pharmacy sells them individually! Woot!). My syringes do have the half unit markings...my poor old eyes had to have them. :lol:

I think my current schedule will work out great, as I can get the +10 and +11 both morning and evening. :-D And I'll be able to come home at lunch to do a quick nadir test...once I know how Poopy reacts to Lantus.

I posed on Lantus, asking about dose suggestions.

The most terrible thing about switching? You guys. :cry:
 
With all the kitties who have switched this year, you'll see familiar faces there. I post a good bit there too. It's actually been enlightening learning how the two types of insulin can be similar yet very different in terms of how they work. You'll always have your pzi friends, and you'll meet plenty of new ones.
Carl
 
This may be one of the few consistent patterns with PZI cats. When their owners consider changing insulin, they suddenly throw nicer numbers. :mrgreen:
 
Teresa,
Have you come across the "shoot low to stay low" concept in your reading? I think the Poopster might be trying to help you grasp that :lol:
Sue's right. Just the mention of a switch or a dose increase usually gives us better numbers:-)

Carl
 
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