Thumper 6/19

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Barbara

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Well, she kept me up most of the night. It's a good thing she's not throwing up cause I have totally missed the vet being at the office, of course if she had been sick I would have gotten up, but I didn't get to sleep till 4:00 am! I updated her SS but will post them here. She's moving around more, actually when I first woke up 2 hrs. after I finally got to sleep she was missing. She left me & went to bed with my daughter, which is where she usually sleeps. Jen said she woke her up fussing cause her blanket wasn't in place like she likes it! :smile: I just had to get her from under the bed to check BG. I still haven't given insulin & am not quite sure what to do. She's rising but very slowly.

PMPS - 260
shot .8
+3 - 169
+5 - 114
+6 - 88
fed a tablesooon of food
+7 - 86
had more food
+8 - 90
45 mins. later - 85
+9.5 - 81
food
+11.5 - 119
+13.5 - 136
had at least a 1/2 can FF
+15.5 - 147 ate some turkey treats
 
Actually, those are very nice numbers---sorry you had to be up to get them. Wouldn't it be great if we could do this in our sleep?! The only problem is the low amps. If she hits 200 soon, would you think about .4 or so?
 
They are nice numbers but I was worried since she kept falling, she has done that before and I don't want another crisis. I don't know if either one of us could survive it.

+18.5 - 192

We are 5.5 hrs till PMPS I just don't know.
 
Hang in there, Barbara. You are doing a great job. I know this is exhausting, but she seems to be in good territory. What is your current vet plan?
 
I don't have any plans...everytime I think I have one she throws me a curve ball! I'm gonna go test her again.
 
+20.5 - 214

Where is everybody? I think at this point I'm just waiting till tonight, that's only 3.5 hrs away. Problem is what do I shoot tonight? I certainly can't afford to stay up again all night. Do I cut it in half, so just go with .4 or just go down to .6?
 
Let's see what the ps is. Also, is she eating ok? No more vomiting? I guess if you want to sleep soundly you should probably err on the lower side. But's let's see the numbers. If you want more people to weigh in, you could post on Health or pm particular people.
 
She is eating ok but I'm worried that will change due to her current condition. She's still not herself but she has improved some.
 
Looks pretty good!!! How about shooting 0.7 tonight so you don't have to worry, but still have a chance of keeping her in pretty good numbers?

Keep in mind that even if their numbers go lower towards the end of the cycle it is not a crisis. If you got a 50 at say +10, it's no worry at all. You could still feed some LC, but they are not going to hypo at the end of a cycle on a low dose - the insulin is wearing off, and 50 is still a good number not a hypo number. To me it says her pancreas is pitching in and she is utilizing the insulin well and keeping herself in good numbers, not that the dose is too high (assuming the normal nadir time was not below 50, that would be a different case).

If it were me I would shoot now so that if she is unshootable at a +12, your regular morning test will be more like a +15 and you have a better chance of being able to give her insulin. I would give her 0.7 since her PS is a little lower today. Or if that still makes you nervous you could do 0.6, but I wouldn't go lower than that.

Really this is the best cycle we have seen in a while, this is the stuff that lets their pancreas heal, it is exactly what you want. She didn't go low, and as long as she was acting like she felt ok (or at least as well as she ever feels in recent days), then it is perfect!!!! When I start to get worried is if you see signs like them really clamoring for food or something (more that what they usually do) - that is when their body is telling them they need to eat, which means they think they are heading low or are already there. If you aren't seeing anything like that or any other weird signs, then she was happy with the dose.

If it were me, I would shoot 0.7 now and leave food out, get a bedtime test in, and sleep soundly! I think you could even shoot 0.8 if you wanted to, but I don't want you up all night worried. I think anything under 0.7, will likely leave her sitting in yellows and higher blues all night, and I'd rather see greens!!!!! If you shot 0.7 and still have time for a couple spot tests tonight, that will give you some good data to confirm how she is doing on that dose. I just don't want to see you overreduce. I've been there and it doesn't work well, and I've seen a lot of people do it and it doesn't work well. Of course, follow what feels right to you though, and trust your instincts (don't trust the fear, but trust the sound instincts).
 
What Joanna is saying makes sense to me. I especially like the idea of shooting earlier than+12 now so that you will have time to wait if her ps is low in the morning. What is your reaction?
 
I hope your still here! I'm ok with shooting now. She just got up & had a little snack...probably no more than a tablespoon, but that't normal for her. She was fed dry all her life till April so she's used to grazing all day. So should I get a # then shoot? Not worry about her eating a full meal? If I shoot now I can get in plenty of tests before bedtime. I will be up at least 7 more hours.

I wondered about how long I had to worry about her going low, like last night, since I don't know much I was afraid to leave her alone even at +8 but by the +9.5 I couldn't hold my eyes open anymore. So, if I understand you right by that point she wouldn't go much further down? Is this even making sense?

I'm happy with her numbers, just puzzled by the whole situation & being new at all this it's all way over my head. If she didn't have the other strange things going on I would be loving these #'s.
 
They are good #'s .... scary if you haven't seen them before. I would shoot the 0.7 now and you have plenty of time to check on her. It seems as if her pancreas is kicking in a little! It will be fine and we are here, or at least around. Nancy
 
+22 - 258

I'm ready to shoot but should I worry that she has not had a full meal? Just little snacks? And go with .7? It will be about 14 hrs before I shoot again.
 
Ok, thanks! I'm a nervous wreck about this! Sorry....just been a lot these past few days...as you well know! Thank you all!
 
I know exactly how you feel. I have been there more than once. It is exhausting and sometimes you want to scream from frustration---constantly having to make decisions and never really being sure what to do.
 
And life is trying to get in the way....got a million things to do! I'm going to go update the SS & try to get some things done.
 
Looks like you got it all figured out, yay! The food is only an issue if she won't eat at all, like Judy said. If she didn't have a full meal now, I would just encourage her to eat some more along the way in the 1st half of the cycle. There's nothing magic about eating at shot time, the insulin hasn't even kicked in yet. I was told with PZI as long as you have food on board by +4 you are fine. She has eaten some, so if she will eat another teaspoon in a couple hours and then another in a couple hours after that (or whenever she wants it), she should be fine.

I wouldn't worry about testing a huge amount either tonight. I'd get in a couple spot tests if you can, but I wouldn't worry about every hour or two or anything like that. I mean you can if you want :) but sounds like you could both use some rest!

I know it is super-stressful, we have all been there, and if we don't seem stressed now, it's b/c we've already torn out our hair, and blown through more kleenex boxes than we can afford!!!! I think you can take comfort in knowing that her dose is pretty low. Not to say hypo is impossible, but it's not like just if they hit a low # (well, obviously at some point a low # is just too low) they will hypo. Bix tested at the vets once at 26, and he did just fine. And I had him in low #s a lot of hours over a few days during his food change due to some meter confusion & misunderstandings, and he just ate A LOT, and did fine.

So don't think that if she touches 49 or something that's it. I mean we don't want that, but on a small dose it's not a huge deal. At Lantus Land I don't think they even do dose reductions unless they go under 40. I don't agree with that, but then they have a lot of success over there, so what do I know.

Once the insulin is past peak (when they nadir, more or less), it is wearing off so the risk of hypo is going down minute by minute. Once you get to something like +11 or +12, if they are still in good numbers and didn't get some monster dose like 10u or something, it's just not something to stress over. Certainly if I saw a 40 at +12 I would feed something and test again periodically, but it's not a panic thing like it might be at a +4 or something when the insulin has not peaked yet. Even then though, food will keep them from going too low.
 
Hi Barbara,
Looks like some really nice numbers!
hopefully all is well and you will be able to get a good night sleep!
Sometimes that is all we need to rejuvenate!

Good Luck!
Denise and Shakes
 
Ugh...guess I should have stayed with .8 How in the world do you ever figure this all out?

+5 - 253
 
Don't agonize. Hind-site is 20/20. Easy to say now you should have shot higher, but it also could have gone the other way and you would be worried about dropping too low. You NEVER get it ALL figured out. You just keep having new experiences that increase your education for the next time. As long as you have not killed your cat, don't sweat it! Just say you are doing your best (which is a lot better than many vets, and that is without med school), and tomorrow is another day. At this point you may want to strangle Thumper, but that cat is very lucky to have a persevering mama. Sleep well tonight, you have earned it.
 
Wow you have had a wild ride. Judy is right, hindsight is 20/20 and a learning experience for next time, it could have gone either way.

Get a good nights sleep.
 
Believe me, I only got Bix regulated after I did everything wrong enough times that I finally got it right. I undershot, I overshot, I undershot again & again, and though it was really frustrating, I kept learning from it until finally I knew what dose was too low, what was too high, and then I was able to shoot effectively in between those brackets. I lucked out that he was pretty consistent and his dose did not seem to be too much of a moving target, which is not true of Thumper and of many kitties.

A lot of why I have stayed on the board is to try to help people not make the same mistakes I did, and hopefully get a quicker route to regulation. Bix was on insulin almost a year before I got him regulated - 6 months of working with the vet, shooting blind, and feeding dry food, then 5 months of me trying to get things under control either on my own or with the help of the board, then finally getting his food switched to LC and then still stumbling around a lot after that (though on much lower doses), and about a month then before I finally got him regulated.

You are in a tougher spot than I was b/c Thumper has had ketone problems, and she is having other health problems now. Bix didn't have either of those complications. So pat yourself on the back!!! You are doing awesome to have her seeing good numbers, and keeping those ketones at bay, and giving her the best care you can. There's no way anyone expects you to understand it all, or to have any magic answers. A lot of times when cats are doing well, it's either that they are "easy" cats - going to go OTJ almost no matter what you do - or their beans have some experience and can make the decisions more easily. Not to minimize the great job all those people are doing, but you can't compare your situation to a cat that goes OTJ in the first couple weeks or whatnot.

And like Judy said, this could have gone either way. Maybe the 0.8 was too much and this would have been perfect or even still too much. Now you know the 0.8 was good, and the 0.7 too little. And tomorrow's another day... new rules may apply :mrgreen:
 
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