Lewie low at +12... here we go again

Discussion in 'Prozinc / PZI' started by Kathy4Lewie, Oct 10, 2018.

  1. Kathy4Lewie

    Kathy4Lewie Member

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    Sep 1, 2018
    I was so excited to get back on schedule but it's not to be. I guess Lewie caught up after I missed his shot yesterday morning so he's back to making me stall again! Silly boy. +12.5=64
    Any thoughts?
    :bookworm:
     
  2. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Unless Lewie comes up a fair bit, I'd say it's another skip tonight. The amount of time you stall really depends on how it will effect your schedule going forward and if my math is correct, you are already an hour past planned shot time. I assume you have not fed Lewie...correct? Have you tested again since the +12.5 of 64? If not, test again now see where he's at.
     
  3. Kathy4Lewie

    Kathy4Lewie Member

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    Lewie ate at +10 so he had 2.5 hours before the +12.5=64 test. I just tested again at +13.5=86
    I'm guessing it will be at +16.5 (12:30am Central) before he is at shot range? What do you calculate? I can do this but I'm so tired of going to bed so late. But then I don't want to hurt his body by not giving him his shot if he needs it.
     
  4. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    One thing we always forget to tell folks around here is that your health & well being is just as important as your furbaby's. If you aren't in good shape, then you won't be able to look after the furkid. Having Lewie run high for a night isn't going to hurt him. If you give insulin and he goes too low, it might hurt him. There is no telling if he would be up to a shootable number 1 hour or 3 hours from now. Sometimes you just have to bite the bullet and skip for your own sake. The only reason I would advise otherwise is if Lewie has any history of DKA. If there is a history of DKA, then you might want to wait him out a bit, see what he does in an hour and then decide whether to give a reduced shot or usual dose.
     
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  5. Kathy4Lewie

    Kathy4Lewie Member

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    I need to feed him... he is really hungry. I think I'll skip the shot tonight and get up early tomorrow.
     
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  6. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I suggest you try 0.5 u (eyeballed half way between the marks representing 0.4 u and 0.6 u) today. It looks like he's dropping too low for comfort on 0.6 u.
     
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  7. Kathy4Lewie

    Kathy4Lewie Member

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    Thank you for your message last night. I ended up waiting for 3 hours... his number was 304... shootable... but I skipped so that the schedule wouldn't be wonky. Thank you.
     
  8. Kathy4Lewie

    Kathy4Lewie Member

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    I shot 0.5 u this morning and he had a better day... AND I was able to give him his shot on time this evening! I only was able to get one test in mid-cycle at +6 = 312 so I don't know if he went lower. His PMPS was respectable at 247. I'll plan on giving 0.5 u in the morning and see how tomorrow goes. Thank you for this suggestion... it was GREAT not to need to stall.:)
     
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  9. JL and Chip

    JL and Chip Well-Known Member

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    Hmm, I'm wondering whether he was still dropping at the PMPS. He does seem to be very responsive to insulin snd to have some long cycles. I'll be curious to see where his BG is in the morning!
     
  10. Rachel

    Rachel Well-Known Member

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    Yes not stalling is a great thing! That’s the goal...2 shootsble preshots without having to stall!
     
  11. Kathy4Lewie

    Kathy4Lewie Member

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    Lewie's BG number at +12.75 was 544. YIKES.
    NOTE: I was 45 minutes late giving his shot but I don't think it would shoot up that fast in 45 minutes right?
    Thoughts? I went ahead and gave him 0.5u this morning and I'll test more today.
    :bookworm:
     
  12. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Definitely a bounce. He might have dropped lower than his "normal" last night. I'd stick to 0.5 ufor now. Try to get at least one test in the +4 to +7 range today so we can better assess this dose.
     
  13. Rachel

    Rachel Well-Known Member

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    It actually can go up pretty high in a short amount of time when insulin has worn off but I agree that this is more likely a bounce.
     
  14. Kathy4Lewie

    Kathy4Lewie Member

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    Thank you. I'll test at +5 and +8 to get some data points.
     
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  15. JL and Chip

    JL and Chip Well-Known Member

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    It looks like a probable bounce to me, too. He hasn't shown a tendency to be bouncy so it really does makes wonder whether he continued dropping after the PM shot and exactly how low he went. Hmmm. Glad you're getting some more data points.
     
  16. Kathy4Lewie

    Kathy4Lewie Member

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    It's 45 minutes before shot time and I have 3 data points for today... don't know if it's enough to make a dose decision.
    Would you please look at Lewie's spreadsheet and let me now your thoughts? Thank you.
    :bookworm:
     
  17. Rachel

    Rachel Well-Known Member

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    Hmm...this is a tough one. 0.6 was giving you too much, but 0.5 seems like too little. You've been at 0.5 for 3 cycles, which means you could change tonight but I think I'd stick with 0.5. You started off at a black this morning, which was a clear bounce. Then you went down to a yellow...that's a pretty dang good drop for a bounce cycle. My gut is telling me that yesterday was a weird day and he might actually need to settle into a dose a bit before you can get good numbers. Yesterday was weird because you had that higher AMPS, then he seemed to drop all day...not normal. Then he bounced this morning, telling me he probably got into good numbers last night (and I don't blame you for not getting tests...you HAVE to sleep sometimes!). Today was more of a normal day with nadir at +8. So I would stick with 0.5 tonight to see what that gets you...maybe with luck it won't be a bounce. It looks like you plan to get a test in tonight which is good so we can get a better idea of what's going on.
     
  18. JL and Chip

    JL and Chip Well-Known Member

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    I too agree with sticking with 0.5u.
    In the past few days, you've had skipped shots, late shots, just lots of unusual stuff going on that could contribute to a bit of unsteadiness in his numbers. It makes sense to hold the dose and let the dust settle before evaluating whether to increase. And as Rachel said, you DO need to sleep. You've been doing great gathering data so far.

    How is Lewie acting these days? Does he seem to be feeling good?
     
  19. Kathy4Lewie

    Kathy4Lewie Member

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    Thank you Rachel and JL and Chip for your quick replies to stay with the 0.5u tonight so we can see how he settles out. Lewie has been feeling great and has been more active than a few weeks ago. He has back and leg problems, but he's going up and down the ramp to the bed multiple times a day which I'm very happy to see. He is a little dehydrated tonight so I will give him 100ml of fluids soon. Today I had all the cats out on my screened in porch and my outside semi-feral kitty came by for a bite... Lewie hasn't accepted him yet and was doing his territorial growling so he still has his spunk!
    :cat:
     
  20. Kathy4Lewie

    Kathy4Lewie Member

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    Lewie's +3=356. I'll test again in the morning at +10.
    Goodnight.
     
  21. Kathy4Lewie

    Kathy4Lewie Member

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    Well, I didn't wake up at +10... so the test at +11=334. I'm guessing he got down in the yellows last night? I'll test again in 45 minutes for his PS.
    :bookworm: Thoughts?
    UPDATE: At +12=324 so I gave him 0.5u.
     
    Last edited: Oct 13, 2018
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  22. Kathy4Lewie

    Kathy4Lewie Member

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    Looks like Lewie is settling out... +8=163 and this is with 0.5u. :)
     
  23. Kathy4Lewie

    Kathy4Lewie Member

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    Sep 1, 2018
    Stalling Again! :blackeye:
    I tested Lewie at +12 and his BG is 142, which is too low to shoot.
    What happened?... He finally settled out and 0.5 is still a little too much? Or is he just messing with me because I thought we had this dosage thing figured out? :woot:

    He last ate at 5pm Central so I do need to feed him and give him his pills so that will be a 2.5 hour stall and put us at midnight again. If I waited without feeding I doubt he would be within shooting range for a couple of hours, so we are looking at midnight regardless. I really hate to skip because he will be messed up for another 3 days.
    :(

    UPDATE 1: I went ahead and fed and gave him his pills. I'll test again at midnight when his pills and food should be worn off.
    UPDATE 2: Test at +15=335, gave 0.5u
    Thoughts and Ideas Welcomed!
    :bookworm:
     
    Last edited: Oct 14, 2018
  24. Kris & Teasel

    Kris & Teasel Well-Known Member

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    The good dose will change over time, unfortunately. For most kitties you won't find a single dose that works long term. It'll be a constant tweaking up or down to keep his BG in an acceptable range. If you had to wait 3 hours to get a BG that was high enough, I recommend a dose decrease to 0.4 u. You're getting ultra long duration from 0.5 u and that *can* be a sign that it's a tad too much insulin. Those tiny dose changes are the beauty of using U100 syringes!

    For your own benefit I'd stall no more than an hour so you don't mess up your schedule. If, after an hour, he's still well below your "comfort zone" shooting number (this number will change once you have lots of data) you have a few options:
    1. skip the shot - less desirable option
    2. give a reduced dose (half to 2/3 might be a good "rule of thumb")
    3. feed him, wait about 30-45 minutes, retest and, BG permitting, give a *slightly* lower dose - something I did with my bouncer/diver when he was on ProZinc and it got me out of quite a few of these jams.
    Like everything else FD related you have to try a few experiments to see what works best for you and Lewie. :)
     
  25. Kathy4Lewie

    Kathy4Lewie Member

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    Well, I didn't see this message until this morning so I'll print it out and use it for next time. Thank you for these options!
    Last night I stalled for 3 hours and gave his shot but I guess that strategy backfired on me.
    This morning at +7... I tested 3 times... 456, 516, 493 for an average of 488. Yikes.
    Is this another bounce? From your experience, would one of your options above have prevented this high number?
     
  26. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, it could well be. As for which option would prevent a high number - any or none. Bouncing is the bane of many FD kitty owners' existence. Over time it can settle, you learn to recognize patterns, you learn what frequency and magnitude (small!) of dose changing your kitty can tolerate and so on. Bouncers will bounce, many forever. If you're lucky the bouncing can become less dramatic and you learn to read the BG response pattern outside of the bounce numbers. I'm over two and a half years into this and have been through three insulins with Teasel and he still bounces. :confused: He's particularly unpredictable though so don't be disheartened by that ...
     
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  27. Kathy4Lewie

    Kathy4Lewie Member

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    This is good advice... thank you...
    I'll start experimenting next time this happens and I'm glad to have the options in your post #24 so that I don't mess up my schedule again. I'll have to try to study his patterns... that will be an art form to learn... do you know of any posts that talk about learning to watch BG trends?
     
  28. JL and Chip

    JL and Chip Well-Known Member

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    Couple of questions:
    1) you're drawing Prozinc to the 1.25 mark of the u-100 syringe, correct?

    2) is there any chance you gave a "fur shot" last night? (i.e., didn't get the needle in, shot through the skin tent and the insulin came out on the fur, etc)?

    Just ruling out a few other variables for higher numbers this morning.

    Also, are you still leaving food down overnight?
     
  29. Kathy4Lewie

    Kathy4Lewie Member

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    Sep 1, 2018
    Thank you for your questions.
    1.) Yes, 1.25
    2.) I would say 'no' on the fur shot... He's not very furry and I triple check.
    3.) Maybe there wasn't enough food out last night and the others ate it. That's a possibility.
    0.5 using u100 syringe BETTER cropped.jpg
     
  30. Kathy4Lewie

    Kathy4Lewie Member

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    Strangely, Lewie has stayed basically flat all afternoon. (is there a technical term for this?)
    +5=369
    +6=377
    +9=367
    I'm assuming that the best thing to do is give 0.5u at +12 (assuming he continues this flatness).
    Last night I gave his shot at midnight, this morning I gave his shot 30 minutes earlier at +11.5. It's probably best that I give his shot at exactly +12 since I don't know what's going on! What do you think about the steady numbers? I'm going to give him fluids now.
    :bookworm:
     
  31. Kathy4Lewie

    Kathy4Lewie Member

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    We're at +12 and he is dropping. He's at 308. I would think he would be rising as the insulin wears off. An hour ago, he ate a meal of 1g carb food. I'd like to go ahead and give 0.5u and go to bed.
    UPDATE: Tested 35 minutes later at +12.5 = 405! So I gave 0.5u
    :bookworm: Question: If you know why he was dropping at +12, then shot up 100 points 35 minutes later, please share. :confused:
     
    Last edited: Oct 15, 2018
  32. JL and Chip

    JL and Chip Well-Known Member

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    That's what I would do.
     
  33. JL and Chip

    JL and Chip Well-Known Member

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    Did you give fluids tonight? Sometimes that can lower BG a bit ... in some cats 75 points or so. I used to "time" fluid administration to coincide with a higher point in the BG cycle.

    Food can affect BG, as can certain meds or supplements. There can be up to 20 percent variance in meter results, which is a higher point difference at higher BGs (not that I think is what you saw tonight). And sometimes it's just the unpredictability of this thing we call a cat.

    Remember that, in general, catching a +2 can give you a clue as to whether you'll have an active cycle.

    I'll be curious to see what tomorrow brings. I hope you can get a good night's sleep. As others have said, you need to take care of you.
     
  34. Kathy4Lewie

    Kathy4Lewie Member

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    Yes, I did give him fluids... 125ml about 10pm. That's a really good tip to give fluids to coincide with a higher point in the BG cycle.
    Today at +4 he has a yellow number so I'm glad to see that!
     
  35. Kathy4Lewie

    Kathy4Lewie Member

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    I thought we had a good day yesterday. Last night I gave Lewie's shot 30 minutes early to try to adjust the schedule a little bit. If anything I thought he would be low this morning but he is HIGH with PM+9 = 500 :nailbiting:
    Is it time for a dose increase? Please look at his spreadsheet and share your thoughts. Thank you.
     
  36. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Could well be a bounce number if he dropped lower than his "normal" earlier in last night's cycle. I don't recommend a dose change based on a bounce number. I think it's best to look at a few days' numbers to decide. Those highs are scary looking but ignore them - unless you have cycle after cycle full of them.
     
  37. Kathy4Lewie

    Kathy4Lewie Member

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    One thing I wonder about is the eating late at night. Sometimes, not always, when I eat late at night, I feel sick the next morning. I have hypoglycemia and I'm sure the sick feeling is the due to my blood glucose... this feeling is worse when I eat a high carb meal. Can this be happening to Lewie? Since his schedule got messed up, his shot is 11-12midnight.
     
  38. Kathy4Lewie

    Kathy4Lewie Member

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    Lewie's AMPS value is 537... so he's been over 500 for at least 3 hours. Is this still considered a bounce?
     
  39. Kathy4Lewie

    Kathy4Lewie Member

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    Lewie still seems to be running high today. Didn't even get down to a blue. Does a bounce last the entire cycle?
    :bookworm:
     
  40. Kathy4Lewie

    Kathy4Lewie Member

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    I tested Lewie PM +6 = 394 so I don’t think he is bouncing anymore. I gave his shot at 10:30 Central last night. I will move the shot time up to 10:00am Central today. I suppose I’ll stay with the 0.5 u dose although it seems like it’s not quite enough. There may be some overlap with the 30 minute earlier shot time this morning. I don’t like keeping him in the higher numbers I don’t want to stall anymore...
     
  41. Kris & Teasel

    Kris & Teasel Well-Known Member

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    You can try 0.6 u today. The dose WILL drift up and down a bit and bounces can disrupt more than one cycle. A +2 test is often a good indicator of what might happen in a cycle.
     
  42. Kathy4Lewie

    Kathy4Lewie Member

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    Thank you... good to know that bounces can disrupt more than 1 cycle.
    Here we go again... again. I gave 0.6u this morning and it was too much...
    Tested at +12 and he is 139. Crazy. :confused: Maybe he still was coming off of his bounce? A 3-cycle bounce?
    So tonight, since he's low, I tried feeding him and he isn't all that hungry since he ate a ton at +9. I'll "wait about 30-45 minutes, retest and, BG permitting, give a *slightly* lower dose" as you mentioned in post #24 above.
    What is a "slightly" lower does? I gave 0.6u this morning so give 0.5u if he is above 200? 0.4u?
    :confused:
     
  43. Kathy4Lewie

    Kathy4Lewie Member

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    Well, disregard my question. +13=106 so it's going to be a skip night. I can't believe I have to skip! He was high for 3 days, so I thought increasing to 0.6 would be ok.
    :banghead:
     
  44. Kathy4Lewie

    Kathy4Lewie Member

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    Perhaps you can teach me how to give a "skinny" 0.6. I'm not sure I understand. Maybe someone can draw a 0.6 of air to the 0.6 skinny mark and post a picture?
     
  45. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    I can't help with that Kathy (no syringes). You could draw up to 0.6 and then let out a couple drops? If you do 1 drop at a time, you'll be able to see more clearly when it's halfway between 0.4 and 0.6 maybe?
     
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  46. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Instead of trying to draw up a skinny 0.6 u, why not go back to 0.5 u and leave it there for several cycles. Lewie is very sensitive to tiny dose changes and also likes to have long bounces. My guy is like that. At some point, if this continues, you might consider a depot insulin like Lantus. It *can* help to level out BG somewhat. It's not a magic bullet for bouncers though. What it can allow, though, is giving insulin on much lower PSs than with ProZinc. It's something you approach cautiously over time after you've learned a lot about your kitty's responses but experienced Lantus users will give insulin on any PS over 50.

    Your goal right now is not to optimize Lewie's dose but to find a dose that gets him as settled as possible. He has other health concerns that complicate the picture so you have to work around those. It'll be more challenging to find a good dose for him because of that.
     
    Last edited: Oct 18, 2018
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  47. Kathy4Lewie

    Kathy4Lewie Member

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    Just a quick update: Today was a much better day. I'm actually going to bed before midnight tonight and I'm so happy! Lewie is 70 points lower than PMPS, but I'll just trust that he is ok. Thanks for the great information and tips. I gave 0.5u today.
     

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