1/15 spicey update #s

Hello Everyone.

1-12-10
Pmps 521 - 1 unit pzi vet 9pm
+ 4 - 317

1-13-10
Amps 298- 1 unit pzi vet 8 am
+10 - 198
Pmps 229 - .5 unit pzi vet 8:30 pm
+2 - 399
+4 342

1-14-10
Amps 486 - 1 unit pzi vet 8:30 am

Pmps 417 - 1 unit pzi vet 8 pm
+2 - 216
+5 - 56
+5.5 - 51
+6.5 - 48
+7 - 64

1-15-10
Amps 241 - .5 unit pzi vet 10am

Pmps 596 - .5 unit pzi vet 8:30 pm

Just to let everyone know i will be working on that spreadsheet this weekend while i get some #s for the nadir or cycle.
I am more calm tonite since i think i got some sleep.
I have taken under consideration and decided to keep the .5 unit of pzi vet for a few days and see what happens. The highs scare me a little but the lows terrify me nailbite_smile

 

i will get a +3.5 reading in about 40 mins.

 

Better to be too high for a day, than too low for even one minute...

The correct dosing *will* be worked out for Spice, it is just going to take a bit of time as you see how she reacts to a particular dose. Start low - go slow. Much safer that way.
Doesn't this little amount of insulin she is now taking, in comparison with what the vet ordered for you, surprise you at how well she is doing on it?

~M

 

David... good job... I know the highs are scary but you've been on a roller coaster this week. You need to sleep tonight and you will be able to do that. She's went pretty low last night for a while so I'm not surprised by tonight's number... Glad you shot the lower dose so that you can get on a steady dose over the weekend with some spot check tests.

The only way to find the correct dose is to work towards it... It can't be found randomly. I'm sure that this dose will settle and in a few days the numbers will steadily decrease. Let's wait it out.

Have a nice sleep tonight...

 

She is doing so much better and yes suprising on the dose. One thing I have noticed about all of this is Spicey doesn't want to eat around her amps or pmps times and, I think I weant her to eat due to the vet telling me that she needed to eat before those. Spicey seems to like to eat around her nadir times so that will be hard during the days that i work. At nite that is a little more managable and it makes more sense for her to eat at the nadir times or before. I think.

 

Hey David,

I leave wet food out for up to 12 hours at a time. If you have to leave it out this long, it helps to add water to it so it does not dry out.

Some people freeze the wet food in ice cube trays then let it thaw over the period it is out.

Ultimately you have to come to your own comfort level of how long you are willing to leave the food out.

 

I had that issue with Stormy. What I wound up doing was teaching him to eat right after his tests. I would test, feed, shoot. I had to with-hold his food overnight to do that, then offer him his breakfast immediately after his test. He got to where he scarfed it right up. I did the same with his dinner. It took time, but eventually it worked.

Now he is fed just twice a day (all of the quads are fed twice a day) and gets a mid-afternoon snack of 1/2 of a Fancy Feast appetizer and a late night snack of the other half.

~M

 

Spicey's +3.5

1-15-10
Amps 241 - .5 unit pzi vet 10am

Pmps 596 - .5 unit pzi vet 8:30 pm
+3.5 403 No food

 

Cats should eat many small meals a day. With PZI you should not withhold food [unless weight is an issue]. The feeding routine for other shorter acting insulins may be different. Free feeding is the best policy [unless they start gaining too much weight]. Even then, they should receive as many meals as possible just in smaller quantities.

Small Animal Clinical Nutrition 4th ed chapter 6 page 4 states, "Cats typically eat 10 to 20 small meals throughout the day and night.3,4 This eating pattern probably reflects the evolutionary relationship of cats and their prey."

When they are free fed and eat smaller but more often the effect of feeding on the curve is minimized.

 

spice will have food for the rest of the nite. I was just curious to see what the result would be without food at +3.5 and after looking at all my notes she always eats between +4 and +5

 

Hey David... this is great!! Seriously, that is quite a dip on .5 but not a crash. And it is good practice to give or leave a bit of food for nadir. The only time we say take up the food is about 2 hours before the shot so that they eat around shot time. The reason we do that is that some cats who are not eating will crash on the insulin if they don't have food. And some cats puke a lot so we want to make sure that they don't puke the food prior to the shot.

Having said all that... every cat is different and we all know our cats. For example, Sundance was not a puker... she was sick once when she was 11 months and had worms, again when she was 5 and had pancreatitis, and then four years later when she was diabetic. While I had to give her insulin in the last 7 months of her life, she still was not a puker... So, I could comfortably test, put food down and while she was eating give her the shot. I knew she would not vomit the food. She also had frozen food left for her for mid-cycle.

Your numbers are great... and safe. How are you feeling?

 

Exhausted and more relaxed about all of this and feeling like i have more patience today . i think spicey is happy she isn't getting poked all the time. And a part of me wants to know more and more about this to help her but everyday is a new day.
With that said i have to get some sleep. I think I might be able to get a + 10 number we will see.

 

That is not necessary for PZI--it's a Vetsulin practice. Vetsulin peaks around +2 and generally has a steeper dip from preshot to peak. PZI is gentler. I never worried about when or how much Lucy was eating at shot time.

 

That may be related to these big drops she is getting. As I understand it, lower BG#s or a steep drop, in both people & cats, naturally triggers hunger - the body's way of automatically protecting itself by getting some food in there to keep the BG from going too low.

With Bix I can usually tell I have overshot if he heads for the food dish (he free-feeds) and eats up a storm - he usually shows up around +4 if I overdid it on the dose. Depending on how much I overshot he will keep returning to the food on his own every 1/2 hour or so until sometime around +6 or +7 he will wander off and sleep off the rest of the cycle. I'm not recommending that as a practice (!!!) just sharing it as an example of how the eating patterns can give you some clues about how the dose is working. I've learned with him that if he's heading for the food bowl around +3 or +4, it's time to get a test in and keep an eye on things to be sure he's ok.

On the reverse side, he will go off and sleep & not want to eat much if his BG goes higher. Once when he was a little low around +4 and I gave him some HC, he slept off the rest of the cycle from there, and when I tested him he was pretty high, so I realized I had overdone it with the HC. With him (and Spice seems quite different, as I haven't seen much quick food response with her - I think perhaps Bix either gets more food spike, or gets it quicker than she does) I have found a couple bites of HC periodically (if I overshot) will keep him in steady #s through the cycle, while letting him eat a lot of it at once will send him too high.

As you do this more (hopefully no more scary cycles, but just fine-tuning!) you will get a better feel for her patterns and with more data you may see correlations between BG and eating or non-eating patterns. I think when you get a dose that is working well for her, her eating will even out more.

 

Vetsulin peaks around +4 mostly... I've read a lot of the vetsulin threads and used it on Sundance and never seen a +2 nadir.

My post was explaining why the food is taken up at that time. I was not saying it must be, but when people do it, that is why. Because Sundance was not a puker, even though it's a practice with using vetsulin, I didn't do it regularly.

 

On Stormy Blue, vetsulin peaked around + 6 to +7. That is why I made sure he ate a full meal just after testing and had his snack at nadir, but did not snack constantly thru the day. If he was going to have an issue, it was going to happen AFTER nadir and I needed him to be able to eat if there was an issue. And Stormy was not a puker, either. ECID - and you learn what works best for your cat over time.

~M