@FrostD , I hate to bother you as Spike has been doing good for a couple of days, but tonight threw a kink in consistency. I went shopping and got home 1.25 hrs late for Spikes PM shot, but after seeing his BG, it all worked out...lol. I Tested Spike for his PMPS & it was down to 148 @+13.25 hrs. Tested again @+13.75 hrs and it dropped to 144. Tested at +14.25 hrs and it was 143. I feel better skipping until AM rather than giving a token dose of .125u--.25u. I'm nervous that they are still trending downward. I will eventually fall asleep anyway and couldn't monitor or test. BTW, his poor left ear is getting sensitive and looks like a pin-cushion. I hope that I've made the right call on just skipping the dose entirely and seeing where we land at AMPS time. He is doing this late nadir carryover effect thing I think. I can see that I really need to nail down his nadir times with more data.
He bounced overnight, curious how low he went last night. I would actually give 0.25U if you see this, though no big harm in skipping. And probably grab a +3. His numbers are flat (remember meter variance). Only way to know how he does with these late nadirs is to shoot them and then get some tests. When he starts pink (or possibly very high yellow), it's pretty much a guarantee his nadir is +10 to +12. 4/6 was similar, though not sure where he went before or after the 132 that night, so we don't quite know what he did with the 0.75U. I know you thought the pink the other day was contraband, but his nadir that day shows otherwise...probably a bounce/food combo. 0.25U should allow you to shoot on your normal time tomorrow morning...I hope.
Spikes been doing good and I was used to seeing mid-yellows and blues recently. Tonight he was up to 414 @+12hrs. Sadly, not much test data mid-cycle due to work and sleep. @FrostD what is the crystal ball saying these days? I hope you have been doing great this week. Thank you.
Hmm I suspect a bounce from a lower number earlier, but I doubt it was lower than mid blue. Next day you're home I'd increase again. I would expect a blue preshot tomorrow morning, I would try to give at least something if you feel comfortable with it (based on wherever those guidelines I originally posted are lol). Truthfully, I think a 0.5U increase is worth considering. These smaller ones, held for a week, leave too much time for toxicity to build back up. That said, I understand your constraints, you understand all the risks at this point, not sure how low he went today, so it is totally up to you. SLGS as written only allows for 0.25U increases (MPM allows for 0.5 if nadirs are above 200, with the gray area of only a smattering of high blues we usually say try the 0.5U).
I'll be home Saturday and Sunday and can monitor more mid-cycle times. I gave him his regular 1.25u this am. He was up at 329, so no mid-blue PS today. I hope that he will level out with some consistent lower numbers. He was starving as usual this morning, but today he was eating it as fast as I could put it down for him. I left him 1/4 small can of his urinary tract wet and put 5 pieces of temptations treats in his lil sunning spot that he'll find by 1 or 2pm in case he gets low. I hate seeing these high numbers, but the low ones scare me too...lol I was really hoping he would level out at 1.25u. It seems like we are going the opposite direction. So, it's glucose toxicity that has built up, or???
Hmm then looking at that 331 middle of the night the PMPS last night wasn't a bounce, just a high number. That said, some cats on ProZinc do bounce for a few cycles, but that hasn't exactly been his trend. So, bounce or glucose toxicity, not sure. Either way you should be good for a 0.25U increase.
So, assuming another high pink number tonite, go ahead and bump him back to 1.5u? Are there any other issues I should be aware of at this point. I'd like to test more mid cycle to see how low he gets...I recall last time he was on 1.5u, he had a pretty low nadir. Should I maybe just continue with the 1.25u until Saturday am so I can monitor?
I would bump him as long as preshot is over 200, tonight is good if you can monitor. You can wait til Saturday if that makes you feel better, I just hate to keep him at doses longer than necessary. Even with the blues he saw you still have room for increase. I'm guessing you read Cleo's thread? If you're asking about something like IAA or other underlying stuff, no I don't quite see that in Spikes spreadsheet just yet. I suspect his good dose will be somewhere between 1.5-2U and hopefully he can stay there. We'll give him about another month or two on ProZinc and see how he's doing.
Yes, I did read her latest thread. I'm comfortable with raising him to 1.5u tonite if he's above 200. I say I can monitor tonite but I see myself falling asleep at 10pm tho. And yes, I was wondering if when it's time to refill, if Lantus (depot) would be better for him. That's all downrange right now tho, but t was meaning to get your thoughts on it when the time came.
He was 308 BG at PMPS, so I bumped him up .25u to a 1.5u dose. It would be great if he would cruise into sum safe numbers and stay there, but I guess that isn't how this dance usually works. What would you expect to happen with the small increase? Honestly, I expect to be asleep by 10 or 11 PM and miss the nadir number. Hopefully, he will go into the blues and stay there and I can keep him low but safe. It's been a 400 mile day...whew! Totally unrelated question: My Vet sold me a box of syringes that are U40, 1/2CC, 29 Gauge, 12.7MM. These are different than the Prozinc ones which are 3/10CC, 29 Gauge, 12.7MM. These new ones have the half markings on one side and 7nit marking on other side. Is there any difference that I need to be aware of b4 I have to start using them? Thank you so much, @FrostD for your wealth of help and guidance.
I'd say test at +3/+4 and if you see more than a 50 pt drop set an alarm for +7/+8 just to see. Obviously a bigger drop would warrant an earlier test. Long day! The only difference is the volume (number of units?) So it's marked up to 20 units instead of 12-ish if my math is right? That should be fine, might be harder to draw fine doses. just be sure it's U40 (printed on barrel plus red cap)
Affirmative on U40 on barrel and red cap on new syringes. They all seem so cheaply made...will test at +3 & +4. So, watch for a greater than 50 drop to be on alert for more to come later in the night. Roger that, Ma'am. He's being good for some reason...lol. He let me get a ketone strip wet after he ate. NEGATIVE YAY!♡! He also cuddled with me all last night, which he sometimes does sleep with me, but he was extra loving last night. Yes, I shifted the same 18 gears like 3 million times today and I'm beat.
Spike was @114 at PMPS+11.5 this morning and after finally having to feed him at PMPS +12.25, he only climbed to 141, so i decided to skip since i can't monitor until at least 6pm tonite. He was literally demanding food at that point so I fed when I know I should have withheld. I considered a token 20% shot but ultimately decided I couldn't feel safe about it while leaving him to himself all day. What are your thoughts on all of this @FrostD ??? I know I shouldn't have fed, but he was going batcrap crazy for me to feed him. This caused me to not know if he was rising due to food or the PM **** wearing off. I just said "better high for today than hypo while I'm at work". I'm so glad that you are here and being so awesum for all of us that are trying to help our furbabies. Your analytical skillset is amazing.
I'm glad.to see more yellows and blues! I think that was the right call, likely a food bump. Better safe than sorry. I would try to hold the dose a few more days and see how he does, he's flirting with a reduction. And you're welcome as always!
Hope you had a great Friday @FrostD and an awesum weekend planned. I know there is limited data points on his SS, but tonite I had to give him a half dose of .75u as he was a fair amount below 200. There are explanatory remarks on SS & notations on the time columns. Please give it a look and as always, I value and trust your thoughts. Other than that, we've been cruising along pretty good. I had to start using those new U40 syringes and the larger diameter barrel truly makes .25U fine dosing difficult as there just isn't much tolerance. I hate them, but it is what it is and I always triple check what I'm doing b4 injecting. Have a great evening.
Handled perfectly with the retest, and I'm glad you tried to shoot something higher to see how he does. Curious to see what he does!
I was gone shopping until +13.0 and Spike did exactly what he did last Saturday evening shopping day. After being very high all day, he was at 156 and 140 on two back to back tests. Following your advice from last Saturdays post, I gave him a token dose of .25u (more like .35u). Fine dosing is impossible with these bigger syringes. Just touching base with you, @FrostD and hoping that I did the right thing tonight. Any thoughts other than get a +3 or +4 test before I crash for the night. Naturally, I'm gonna worry. Thank you for holding our hands through all of this. But hey, at least he is consistent at doing this every Saturday afternoon when I duck out for wallyworld supplies.
Yes good move because he's still sliding down. I would try to get a +3 or so. Good news is lots of opportunities to gather data in different scenarios! Nest week tell him you're going shopping on Sunday
Well, he knows I duck out from 10:30am to 12:30pm then again from 5:30pm to 7:30pm for church...is there anything I should be looking for with this current scenario, as I know you'll be going to bed soon? I'm assuming (uneducated guess) that he will start climbing in an hour or two then the token dose will come into effect at some point and do something like hopefully keep him from skyrocketing up in the morning. It's been a long week for me and for Spike too...lol. I just can't bear the thought of messing up with my little buddy. He is such a sweet old gentleman.
His usual nadir is +4 to +6... unfortunately not really any prior cycles go off that are similar and gave the tests. So what I would say is do your best to estimate trajectory downward, and assume a worst case of +6 nadir. We would want to catch any potential reductions, but realistically safety is the more important piece. I'd you don't think he's getting anywhere near 50, it's ok to go to bed - if you're not sure you can always ask for help - Bhooma (Bandit's Mom) and Bron (Bron and Sheba) are usually on the night watch and can help if you tag them. They may not be ProZinc users but they can definitely help manage a curve and low numbers. The best loose guidance I can give is: If +3 is lower than 90, tag Bhooma and Bron. You can also look at the very bottom of the Forums homepage and see who's online, and see if any "well known" members are online and tag them (they tend to be listed first in that list I think?). They may not be able to help, but may be able to find you someone that can. Another option is to post on Main Forum, just title it something like "HELP 4/23 Spike PMPS 140 and dropping, gave token, +3 xx" (xxx bring the test value). If the +3 is 90-110, I would give an LC snack and check at +3.5. If that +3 is about 110-120, test again at +4 - because it's a more gradual drop, it's ok to wait longer between tests, but because you're nearing green it's a good idea to get another test. If it's still a gradual drop to +4, ok to go to bed if you don't think he'll end up near 50s/60s. Just leave food. If it's higher than that, I'd say a +6 just as a safety spot check.
As always, if in doubt, test more frequently and throw carbs at him. I don't see hypo territory, but it is possible you might get some mid greens (70s).
Wow. Kinda scary new territory for me shooting a token dose at a lower number. Giving him carb snacks won't be a problem as eating food and treats is his favorite pastime 24/7. I'll probably stay up to 2am cst or so anyway tonite, so testing won't be a problem this Saturday nite...hey, what else was I gonna do....bahahaha!!! I just wish I could get him low (normal bg) and somehow KEEP him normal and let him get used to the normal...and for gosh sakes, for him to quit bouncing all over the map constantly. The farther we go, the more I know that I need to learn. As always, your guidance is such a blessing to me and Spike. Wish I knew how to repay you for holding our hand through it all. Have a pleasant night.
It's pretty normal... we'll give him about another month or two and if he doesn't start to settle down we'll talk about maybe a depot insulin instead. It's also a little wonky since we're still working in gathering data on these lower/dropping preshots. If those can get fine tuned it should help (minus his bounces )
Well, he was at 176 @+3 and I fell asleep and slept through the alarm I set for +6.. Now at +11 he is up to 379. I totally missed seeing what the token dose did or didn't do. @FrostD all seems well but he is right back up to 379.
@FrostD this is just FYI. He loves his late nadirs. It was climbing and I finally relented and fed, rechecked and it was 205, so I figured a half dose of .75u. Hope I didn't screw up. He was rising on his own but I figured with food bump, he didn't need full 1.5u dose. Your thoughts are always valued.
Spike! With how fast that climbed I would have done full dose. A "normal" rise in blues is more like 10-30 points an hour, more than that can indicate a bounce incoming (or lost duration ). No harm no foul, all data is good data! We'll see what he does.
