weird numbers, can you take a look?

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codyraja

codyraja

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Can someone take a look at Cody's numbers and give me some feedback....I'm trying to figure out what's going on the past few days, the last cycle specifically. I've been slowly ramping up his dose because his pre shot numbers have crept steadily into the 300s and his mid cycle numbers are high too, generally in the 150-200 range. Last night at pre shot, he was at 335 and I increased his dose to 1.5. At +5 he was at 279, +10=130 and AMPS=88 ---why did he keep decreasing through the cycle? I feed him 2x/day at shot time. The only thing that has changed is that we've started letting him outside for little romps around the yard in the evening. He's been peeing in the house a lot and so we've been keeping him in the bathroom during the day while we're gone (his litter and water is in there too). To make up for it, we let him out with us in the evening for a couple of hours at most. He eats some grass, but pukes that up pretty quickly.

Also, I'm taking him to a new vet next week...any suggestions on issues to discuss or tests I should request?

Thanks!
 
He may have a pattern of dropping more overnight than during the day. That isn't uncommon for them to have one cycle lower or higher than the other. One thing you could try is to give a little less insulin at pmps to compensate. Usually, a long cycle with dropping numbers is an indication of too much insulin. I don't think I'd increase any more. I'd get some more data and consider lowering the dose, at least a little.

If you changed food recently, he may also just be getting the food and insulin working together. You are doing a great job getting data. Now to start looking for patterns. If the evening cycle is consistently lower (which it has been several times) then adjust the insulin accordingly. In general, he is doing fine, dropping nicely at nadir (usually 50% or more) and maybe a little higher for some preshots, but usually near or at yellow preshots. Now for some tweaking.

I don't see any red flags for the vet, if he is eating well and feeling well. I'd tell the vet you are gathering data and trying to see trends and patterns.

Will ypu just skip today or consider a tiny dose once he rises over 200?
 
Thanks, Sue. I skipped the shot, but now he's crept up to 295 and I'm wondering how to proceed. I could do a small dose with a snack - but will that really screw things up for tonight? Any experience shooting mid cycle and staying on schedule for the pm?
 
You really should have 8 hours between shots, minimum, so you'd need that for the one after.
You could do a token like .5 now and then be sure he is rising and +8 for the next, and then shoot less than normal. Might be easier to wait till +11 and shoot, even though he will be higher than usual (but don't raise the dose)
 
sounds good, thanks for the input! I will feed and shoot at +11 an back off the dose a little bit. One more question...I was working off of the idea that the goal was low 200s for pre shot and 50-100 nadir. You mentioned that a 50% reduction was good...is % reduction an indicator that I have found a good dose?
 
You've previously held the same dose or skipped, when you had a green preshot. Though I'm often aggressive, I've tended to be more conservative at the low numbers. I like to shoot SOMETHING, but not usually a full dose (unless I've got more data to work from). Often I'll do a 50% or 75% dose for a low preshot. But when you shot the 62, you still had a couple of good cycles. The difference between the pink and yellow preshots (am/pm), you may want to adjust your shooting schedule to an 11/13 instead of a 12/12 if you can make that work in your schedule. That's one of the really nice things about ProZinc.

Good luck,
Lu-Ann

I should read all the comments before responding. The adjusting the cycle to 11/13 or modifying the shots from AM to PM basically do the same thing - either will work, but don't do both.

Also, you said you're feeding 2x/day. Human diabetics eat multiple mini-meals throughout the day. I found with Grayson that he would spike 25-50u from a single can of Fancy Feast. I bought an auto-feeder: Petsafe 5 (Petsmart will price match Petco's web price - $49). It has 5 bowls that rotate on the schedule you establish. I did +2, +4,+6 and +8. He ate through the night and while I was at work. Spiking was minimized. When he was ravenous, he was eating a lot, but most people could do 1/4 can spread out over each of those 4 feeding times. The other option, since he's confined during the day, is that you can free-feed him. Grayson got to the point of laying by his feeder when it was about to rotate. He LOVES it!
 
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