Steve had a really quick drop...need dose advise for AM

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Allie

Allie

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Take a look at this...
PMPS 386
+1 398
+3 198
+4 76 started feeding FF here
+5 61 fed a bit more here
+5.5 119
Still watching closely...no hypo symptoms.
I'm fairly certain that we are not going into a hypo situation. I didn't feed anything high carb. So I'm sure his liver is probably taking care of it.

At this point I'm concerned but not freaking out about a hypo. Thank God. Either way, I'm gonna stay awake for a little bit just to make sure.

So based on the steep drop at +4, I'm thinking that we are seeing a rebound situation maybe? What do you think? Should I drop his dose in the morning? Drop it by -1.0U or -0.5U what do you think and why? I'm hoping some West Coasters are still awake or we have some central and eastern insomniacs. Thanks for any thoughts.

Keep your fingers crossed that he rises again the next time we test so I can get at least four hours of sleep tonight. Putting the coffee on again! ~O) ~O) ~O)

EDIT: It might not be obvious, but the reason I'm concerned about the AM dose and lowering it, is I'm scared he won't eat enough while I'm not here and he won't stop the hypo by himself. He did awesome tonight. It was obvious he was hungry and he bugged me for food (he had some leftover dinner out, but he wanted a brand new can in a new bowl).
 
+6.5 was 166. This is like a theme park ride...sharp drops and steep climbs :smile:
Surely this isn't my imagination and this is actually rebound?
 
It looks like it is safe for you to sleep.

If you are concerned about shooting and leaving you might cut back .25 or .5 - whichever makes you most comfortable. Never shoot a dose that will cause you to worry while you are away from home.

Not sure that it is rebound as much as it is the nature of this insulin.

Good catch/call on your part!
Best,
Pam & Layla
 
Good job last night Allie! I don't know if I think it's rebound, either. Steve seems to like these steep deltas. And +4 is an acceptable time for a nadir on prozinc. Charlie usually nadirs between 4 and 5. Dropping down to the 50s would warrant a dose decrease in my (cautious & conservative) opinion. If his amps is similar to (or higher than) last nite's pmps, you'd probably be good just reducing by .25, but if it's lower you may want to post it and try to gather another opinion or 2. Don't increase the dose though if you get a wonky higher-than-normal number. You must be tired!!

Eta: I meant that most people reduce when the drop to 50s, but I would reduce dose at a slightly higher number.
 
Hard call, Allie.

Rebound: Rebound

Those were great numbers - not scary yet, and particularly not scary as you were home to feed them. The insulin does give him a sharper curve than I have usually seen with PZI. I wonder if the food overnight will mean a lower pmps this morning?

If you were going to be home, I would consider staying with your current dose, feed small meals all day and see if it would even out the curve.

If you will not be home, you could reduce the dose by .25 or more, if you are worried. I would still leave out food for the day.

There is no wrong or right answer here -you are gathering data and your first consideration is that he be safe. Go with your gut.

I can't remember - are there other cats who eat the food during the day or does he just not like to eat small meals?
 
Last night I went through everyone else's spreadsheets and anyone who had just a steep drop in their curve you guys started saying "it maybe rebound...maybe not." So with that in mind and Pam commenting "don't shoot something that will make you worry away from home", I decided to reduce by .25U. I'm still worried, because that is my nature...If I would have reduced to one...I would have worried about Ketones and we've never had those....yep...I'm crazy.

Anyway, I can't remember Steve's number from this morning. It was in the high 300's or low 400s (it's stored in the meter). I just forgot to put it in the SS..I'm so tired (up until 1 and awake at 5) I can barely spell my name right now ~O) ~O) ~O)

Sue, Steve is an eater, there are no other kitties to compete with. Food is left out all the time for him. He is free to eat anytime. He is by no means a obese cat he is just big and weighs 12-14lbs. We give him at least 4 cans of FF a day with more if he wants it. Often we throw away 1/2 a can...because he has decided it's stale...or something else about it offends his prissy food nature). Often at night he scratches the carpet outside our bedroom and hubby wakes up to go feed him. Food was left with Steve all day today. I fed him when I woke up (he didn't eat much) and hubby was instructed to leave an additional bowl out when he left for work. Feeding confuses me. He doesn't have a regular food pattern. Some days he eats everything in a gulp...other days I throw away most of his food. I don't know how to accomodate this with regard to insulin.

Anyway, when I get home I will test and post his numbers for the day. Since I reduced today....any ideas on how I should dose tonight? 1.5 or 1.25....anybody want to roll the dice?

Thanks!
Allie
 
I think you could make a case for either 1.25 or 1.5. The nadir was not scarey low, especially if he tends to eat when he goes low, and you leave food. And if your AMPS was in the upper 300s or low 400s,that is basically the same as last night. Guess you have to see what tonight's numbers bring. You are really doing a great job.
 
Allie, my guys are the same way with food. They routinely decide the food put out an hour ago is no longer acceptable and insist on a new can. I hate throwing food away but there isn't much I can do to get them to eat it once they've turned up their noses, you know? Buggers. :-D
 
Have you looked at automatic feeders, Allie? We love our PetSafe 5. It has 5 compartments and you can set it to go off exactly the way you want - especially in the middle of the night when Steve would come calling. :lol: You could put a little bit in at a time and have it go off every couple of hours or so.

Our civie would like his food at 6 am and we like to sleep later than that. We set it to go off at 6. He jumps off the bed and dashes in. Oliver used to sit and wait for it to open.
 
Hi Allie, I have not been following along closely so sorry for jumping in, but just wanted to say I would lower the dose if it were me. You got something like an 85% drop last night, which to my mind is too much. Also if he was extra-hungry and with lower #s like that on the early side (unless that is his usual nadir), that suggests you overshot.

It can be hard to distinguish rebound from simply lack of duration and #s shooting high after that. I wouldn't worry too much frankly about trying to figure it out, rebound debates will have you tearing your hair out! If it were me, I would try 1.25 for a couple days and if you lose the good nadirs, then I would try something more like 1.4. Unless you are trying to beat down ketones (and it doesn't sound like you are), I don't think there is a need to be super-aggressive with the dosing. I would take some deep breaths, enjoy the good #s you are often seeing, and relax the dose a hair and see if the PSs mellow out a little.

Just my 2c, and again I haven't been following closely so if I'm missing some key info [ETA like that this was yesterday's thread & I'm a day behind ohmygod_smile ], just ignore me. :) I peeked in b/c your thread title was too tempting to pass up. ;-)
 
Yep...sounds like we have a bunch of food dictators. Tonight, I stopped home to give steve his dose and had to run back out for a few hours. DH came home and Steve urgently tried to get new food (the food that was out was less than 45min old) so DH was trying to ignore Steve. DH was eating his dinner while Steve sat annoyed staring and whapping his tale waiting for new food. So later I come home...and notice a red spot on steve's leg. It looks like blood. I freak...there is a big clot of it on his back. I start looking for the wound. No obvious wound...then I smell a whiff of ketchup. Somehow the cat got ketchup on his tale from hubby's dinner. Thankfully, is was reduced sugar type...but still...any numbers from tonight after the PMPS might be skewed from Steve trying to clean up the ketchup. so no mini-curve tonight.

Would that be Catsup? ;-)

Sue, I've thought about the feeder...but I'd like to SEE one before I order one. Can you stick the whole thing in the dishwasher? I also worry about putting food in there and having it dry out a bit and steve determining it was too old to eat. Do you know if they are available at petsmart?

Joanna, I was considering changing to 1.25U anyway. The idea does have his merit. I dosed it tonight and I will dose it again in the morning. And even if you are late to the "party" every idea has merit. I learn from every opinion....the more the merrier. Thank you for taking your time to help me with my kitty.

Really, everyone thank you for taking your time, to help me with my Steve.
Steve says you guys are puurrr-rrrific,
Allie and Steve
 
The feeders are available at Petsmart, and you can find them on line. Just google PetSafe5. We just clean ours with a dishcloth because Niko licks it clean and leaves nothing. But the food section part does come off and is plastic so I would think you could put it in the dishwasher.

Catsup - the new kitty condiment.....
 
If you can free feed and kitty is not overweight this is 'best.' Mainly I believe this because when they go low they tend to "self correct" by eating food. Since you are aware of Dr. H, as I understand, one of her most controversial theories was that a cat fed a low carb diet cannot hypo on PZI. Well, I would not count on that - nonetheless, I think there is something to cats self correcting [or at least trying to] by eating food [if it is available].

If a cat is just a little overweight then I cannot make the proper judgment between the benefits of free feeding and the benefits of a proper weight.

As SACN 4th ed Chapter 6 [normal cats] says:
Cats typically eat 10 to 20 small meals throughout the day and night.
Click to expand...
If one has to go to timed feeding, maybe a 5 position feeder would allow 5 feedings every 12 hours which would allow for the lower end of that estimate. I don't know how the PetSafe 5 works and if it only allows 5 per 24 hours or if it would allow 5 per 12 hours?

Also the Purina body condition system is worth a look on the weight topic:
http://placervillevet.com/feline%20body%20condition.htm

And Dr. Pierson's page on obesity is IMHO a very good guide to the topic:
http://catinfo.org/?link=felineobesity
I like her depiction of a cat "waist" . :smile:

Per Pam:
"it is the nature of this insulin."
Can you provide more detail?
 
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