1/4 Zeke PMPS 86;+2.2=40;+3.5= 60;Dose Advice for AMShot Plz

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by MrZ, Jan 4, 2014.

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  1. MrZ

    MrZ Well-Known Member

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    Good Morning LL :coffee: :coffee: :coffee: :coffee:

    Appy and healing vines to all

    Well Zeke's AMBG is a little higher than the last two morning's. I therefore decided to go a little lighter on the 7% (he only got 1/2T, the rest was 4%). I'm still experimenting with his food. I think he does not need the 7% as much on this lower dose. We'll see.

    These cold temperatures are definitely impacting the routine. Today's shot was delayed 5 minutes due to my having to do many pokes in order to get his ear to bleed. The rice sock needs fattening up. It's a little thin and not heating as well as the previous one. I'm so ready for warmer mornings.

    I am happy to report that Zeke had no problem keeping his food down this morning. I withheld both the pumpkin and the FD duck. He'll get both later at a less crucial time.

    Hoping for a few more greens today. They haven't been coming as often or hanging around as long on this dose. Need to turn that around soon.

    Have a great caturday.

    Zeke's Yesterday
     
  2. MrZ

    MrZ Well-Known Member

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    Re: 1/4 Zeke AMPS 147; +2 = 50

    Well, apparently he DOES still need that 7%. Just broke out the HC. 20% gravy 2t; 9% food1/2T and 17% food 1t.
     
  3. MrZ

    MrZ Well-Known Member

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    Re: 1/4 Zeke AMPS 147; +2 = 50; +3=49;+4= 59

    Well, Zeke did dip below 50 but at this time I'm not planning on taking the reduction. I'd like to see how he'll do on this dose without any incidences of throwing up and with my consistently feeding 7% at the shot and +1 feedings. Thoughts?
     
  4. mariko

    mariko Well-Known Member

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    Re: 1/4 Zeke AMPS 147; +2 = 50; +3=49;+4= 59

    Hi Laura!
    :mrgreen: :mrgreen: :mrgreen:
    Go Zeke! And surf safely!
    I am glad you are seeing more greens.
    And also happy to hear that he's keeping his food down. :D

    Thank you for your caring and checking in on Lucy.
    We are both very thankful to you for your support.
     
  5. Pam & Hoot

    Pam & Hoot Well-Known Member

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    Re: 1/4 Zeke AMPS 147; +2 = 50; +3=49;+4= 59

    Hi Laura,
    Looks like you got your "More Greens" wish ;-)
    Glad to hear he is keeping his fuds down.
    Good luck with the fuds experimenting ;-)
    Happy Caturday!
     
  6. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Re: 1/4 Zeke AMPS 147; +2 = 50; +3=49;+4= 59

    looking great, laura! nice little run of greens for Zeke today. he must've read your wish for him to see green. :mrgreen:
     
  7. MrZ

    MrZ Well-Known Member

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    Re: 1/4 Zeke AMPS 147; +2 = 50; +3=49;+4= 59

    Yeah, that and my comment about not needing 7%. Little stinky likes to mess with me. Getting me back for all those ear pokes I guess.

    So, he's holding steady in the 50s. He's 57 at +6. He hasn't eaten since +3.5. I'm waiting to see if he'll rise on his own before feeding again. He's been sleeping most of the morning but has now awoken for a noon bath. All the Ps are in order.
     
  8. Re: 1/4 Zeke AMPS 147; +2 = 50; +3=49;+4= 59; +6= 57

    If you had given 7% instead of cutting it by mixing with the 4%, I think that he still would have given you that 49. It would have just happened a little later in the cycle. It looks to me like you need to practice drawing up a .75u dose :)
     
  9. MrZ

    MrZ Well-Known Member

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    Re: 1/4 Zeke AMPS 147; +2 = 50; +3=49;Dose advice PLZ

    Zeke spent 6 hours of the cycle at 60 or below, sleeping pretty much all that time. At +9 he was at 73. We're out and won't be getting a reading before his +12. Because he did drop below 50 today, if he's still hanging in the 70s (which really I'm not expecting) come shot time would you advise that I only shoot a 0.75? I suppose it really won't matter for this cycle, but I thought I'd go ahead and throw the question out there. Would appreciate your thoughts.
     
  10. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Re: 1/4 Zeke AMPS 147; +2 = 50; +3=49;Dose advice PLZ

    He's a newly diagnosed diabetic. I'd try the reduction. The worst that can happen is that you need to increase back up.
     
  11. MrZ

    MrZ Well-Known Member

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    Aug 30, 2013
    Re: 1/4 Zeke PMPS 86 - Reducie

    Well, we decided to take your advice and take the reduction. Fingers and paws crossed that Zeke will work that JOOOOOCE.

    Come on, Zekey. Work it!
     

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  12. Cleo & Jane (GA)

    Cleo & Jane (GA) Well-Known Member

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    Re: 1/4 Zeke PMPS 86 - Reducie

    Wow, Laura, your wish was Zeke's command :mrgreen: :mrgreen: Good job working that juice Zeke!
    Good luck on the reducie!
     
  13. MrZ

    MrZ Well-Known Member

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    Re: 1/4 Zeke PMPS 86 - Reducie; +1 = 55

    Just gave him 17% (1t) and 2t of 20% gravy. I hope that's enough - he tends to drop a lot at +2. Will be testing every 30 minutes (at a minimum).
     
  14. MrZ

    MrZ Well-Known Member

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    Re: 1/4 Zeke PMPS 86 - Reducie; +1 = 55; +1.75 = 45

    Just gave him 20% Gravy (1t) and 5 drops of syrup. Will test again in 20 minutes. Would you advise more syrup?

    Added 911 to see if you have any additional advice. I've seen the hypo sticky and have gone through low numbers before but JIC, figured it couldn't hurt to have some expert advice handy.
     
  15. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Re: 1/4 Zeke PMPS 86 - Reducie; +1 = 55; +1.75 = 45

    Your test in 20 should tell you if that was enough syrup. Time to come up a little bit Zekey! :shock: :shock:

    Good thing you reduced tonight. Since he has nothing to prove, you can carb him up - provided you don't fill him up too early.
     
  16. MrZ

    MrZ Well-Known Member

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    Re: 1/4 Zeke PMPS 86 - Reducie; +1 = 55; +1.75 = 45

    Do you think I should start asking about another reduction come AM?
     
  17. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Re: 1/4 Zeke PMPS 86 - Reducie; +1 = 55; +1.75 = 45

    Let's see where he goes the rest of this cycle, but I think this is the depot from this morning's dose talking.
     
  18. Re: 1/4 Zeke PMPS 86 - Reducie; +1 = 55; +1.75 = 45

    Laura,
    This can be due to the 1u depot rather than an accurate measure of what this dose will do for him.

    But it might be an idea to consider skipping or doing a BCS dose in the morning to let the depot drain.

    Let's see how this plays out? All OK there?
    Carl
     
  19. MrZ

    MrZ Well-Known Member

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    Re: 1/4 Zeke PMPS 86 - Reducie; +1 = 55; +1.75 = 45

    He seems fine - sleeping again. He's been lower before and this is very similar to this morning's cycle so I think we'll be ok. Just prefer to be proactive and line up the help beforehand JIC. I'll be taking the 911 down shortly unless something comes up. Getting ready to take another reading.
     
  20. Angela & Blackie & 3 Others

    Angela & Blackie & 3 Others Well-Known Member

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    Re: 1/4 Zeke PMPS 86 - Reducie; +1 = 55; +1.75 = 45; +2.25 =

    He's looking great! Keep up the excellent work. :mrgreen:
     
  21. MrZ

    MrZ Well-Known Member

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    Re: 1/4 Zeke PMPS 86 - Reducie; +1 = 55; +1.75 = 45; +2.25 =

    He dropped a tad to 40. Had to coax him to finish the 1/2T gravy (plus 5 more drops of syrup). Hopefully, I'll see a rising number next test which I'll take in 20 minutes. Hopefully that will be enough time to let the gravy/syrup register. JIC - if he won't continuing eating and I need him to, is my only option syrup on the gums?
     
  22. Re: 1/4 Zeke PMPS 86 - Reducie; +1 = 55; +1.75 = 45; +2.25 =

    Do you have any food syringes? You could try gravy in one of those. Or a medicine dropper. Hopefully it won't come to that though.

    C'mon Zeke, eat your snacks!
     
  23. MrZ

    MrZ Well-Known Member

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    Re: 1/4 Zeke PMPS 86 - Reducie; +1 = 55; +1.75 = 45; +2.25 =

    I have syringes. Waiting to take the next test to see where he's at. I took his test 30 minutes ago but it was another 15 before he finished the gravy I'd given him. It's now 30 minutes since the test so I guess I'll take another reading. Would prefer to give the food a little more time but I don't want to be surprised with a much lower number than the 40. Hopefully, the gravy will be reflected in his number.
     
  24. MrZ

    MrZ Well-Known Member

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    Re: 1/4 Zeke PMPS 86 - Reducie; +1 = 55; +1.75 = 45; +2.25 =

    He's up to 47. I'm gonna offer him some 17% Weruva. He really likes the Love Me Tender formula. Hopefully, he'll take it. Do you think I should add more syrup? If so, how much?
     
  25. Re: 1/4 Zeke PMPS 86 - Reducie; +1 = 55; +1.75 = 45; +2.25 =

    You can add a few drops to it.
    Is he at +3.25 or so now?
     
  26. MrZ

    MrZ Well-Known Member

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    Aug 30, 2013
    Re: 1/4 Zeke PMPS 86 - Reducie; +1 = 55; +1.75 = 45; +2.25 =

    He's at +3. Had already fed him the 17% - so no syrup. He wolfed it down. Thought I'd wait and test again at +3.5 (~ 30 minutes after eating). If he drops, I give a little more 17% with the syrup.
     
  27. Re: 1/4 Zeke PMPS 86 - Reducie; +1 = 55; +1.75 = 45; +2.25 =

    Sounds like a good plan. :smile:
    Pretty awesome numbers lately, huh?
     
  28. MrZ

    MrZ Well-Known Member

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    Re: 1/4 Zeke PMPS 86 - Reducie; +1 = 55; +1.75 = 45; +2.25 =

    Yes, the numbers are very good. Thanks so much for the dosing advice. Your post today got me thinking about this evening's shot and today's reduction that I was planning on passing on. I'm so glad for you post. Seems I keep letting that depot get a little ahead of me, huh?

    Well, I'll be requesting dosing advice for tomorrow morning. I'll be curious to see what is advised - skip/BCS/shoot?
     
  29. Re: 1/4 Zeke PMPS 86 - Reducie; +1 = 55; +1.75 = 45; +2.25 =

    Before I posted earlier I was doing some deep thinking... :lol:


    I understood your concern about whether the 7% this morning vs. lower carb was behind what happened early in the cycle. But what's been in the back of my mind since back when Zeke was on 2u (If I remember right), and you started getting the low drops by +2 or +3 was how difficult a time you had getting his numbers to stop dropping or come up quickly. Even though you had been giving him a good bit of food and pretty high carb as well. Some days you were shoveling food at him, and it was 17% or more, and it was every 30 minutes, and it was all you could do to keep him flat, never mind getting him to climb up in numbers.

    So I thought "Wow, Zeke sure doesn't respond all that well to carbs" when he's low. Some kitties seem to be very "carb sensitive", but it didn't look like Zeke was. So when I saw your comments this morning all I could think was "well, he's either carb sensitive, or he isn't" and I leaned towards "he isn't". The way you mixed up his food at AMPS, mixing 4% and some 7% made me figure it was about 5% or so. So I looked at "how much of a difference will 2% make to Zeke?" And I felt "not really much different at all" after watching him stay in mid-range green numbers for hours at a time when he was getting regular snacks of medium or high carb food during the "early dive cycles".

    That's why I felt that the difference in carbs this morning probably didn't have much to do with his early drop today. A slight effect at most. I just think he was telling you that he was done with 1u and wanted to try something else. He's made a very nice gradual drop in dose for the past few weeks, and I'm thinking that is going to continue to happen going forward. :smile:
     
  30. Re: 1/4 Zeke PMPS 86 - Reducie;+1=55;+1.75=45;+2.2=4; +3.5 =

    Either that is the biggest fastest bounce ever, or there's a typo in your subject line. :lol:
     
  31. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Re: 1/4 Zeke PMPS 86 - Reducie;+1=55;+1.75=45;+2.2=4; +3.5 =

    Looks like a 60 on the SS. I had the same reaction to the subject line as Carl.
     
  32. MrZ

    MrZ Well-Known Member

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    Aug 30, 2013
    Re: 1/4 Zeke PMPS 86 - Reducie;+1=55;+1.75=45;+2.2=4; +3.5 =

    Oops. Yes, definitely a typo. I gave Zeke a break from the ear pokes. Just took a +5. Looks like he's settled into the 60s (he's 66). I will test one more time and then retire to bed. And so now I gotta ask. What should I shoot tomorrow morning? I know not too many people are logged on in the morning. Do you think you could provide some advice tonight? Would greatly appreciate.

    Thanks,
    Laura
     
  33. Re: 1/4 Zeke PMPS 86;+2.2=40;+3.5= 60; Dose Advice Plz

    I would definitely reduce to .75u.
     
  34. MrZ

    MrZ Well-Known Member

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    Aug 30, 2013
    Re: 1/4 Zeke PMPS 86 - Reducie; +1 = 55; +1.75 = 45

    So, what say you Carl and LL? What should I do in the morning?
     
  35. MrZ

    MrZ Well-Known Member

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    Re: 1/4 Zeke PMPS 86;+2.2=40;+3.5= 60; Dose Advice Plz

    That's what I gave him tonight. I took the reduction he earned today when he dropped to 49.
     
  36. Re: 1/4 Zeke PMPS 86;+2.2=40;+3.5= 60;Dose Advice for AMShot

    I am figuring you'll see a low blue AMPS, but that just a hunch on my part. In which case I'd shoot .75u. I'd probably go ahead with the reduction even if you see a higher number.

    That assumes you will be home during the AM cycle.
     
  37. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    Re: 1/4 Zeke PMPS 86;+2.2=40;+3.5= 60;Dose Advice for AMShot

    usually 2 cycles with back to back low numbers wouldn't mean you would reduce the dose twice. what i mean is, you had low numbers in the day cycle today and reduced tonight to 0.75u. i agree that low numbers tonight are probably still from this morning's dose. you probably want to stick with 0.75u as the dose for morning, unless you see a low preshot and want to skip or shoot a significantly reduced dose.

    likely if it's over 50 or so in the morning, and you will be home to monitor, you could still shoot the 0.75u dose. as the preshot numbers come down the cycle flattens out - you're seeing that already.

    if for some reason, you aren't comfortable giving the 0.75u in the morning, you could do the BCS or skip and then return to the 0.75u dose in the evening.
     
  38. Re: 1/4 Zeke PMPS 86;+2.2=40;+3.5= 60;Dose Advice for AMShot

    Sorry Laura, I missed something someplace.

    If you want the depot to drain, shoot less, just one time, in the AM, like .5u, or even .25u. Then go back to .75 at PMPS.
     
  39. MrZ

    MrZ Well-Known Member

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    Re: 1/4 Zeke PMPS 86;+2.2=40;+3.5= 60;Dose Advice for AMShot

    Julie - So, if I do shoot 0.75, do I still need to give high carbs like I did today despite you comment that I've bolded above? Is it counterintuitive to feed HC to a kitty whose pancreas you're hoping will heal? I know you have to do what you must when they're low but if skipping is an option and doing so may avoid giving the kitty HC, would it be preferable to skip and not overload the pancreas with HC? Does this make sense/know what I mean?

    Please note. I am not saying that I want to skip, I'm just trying to determine what would be in the kitty's best interest.
     
  40. MrZ

    MrZ Well-Known Member

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    Re: 1/4 Zeke PMPS 86;+2.2=40;+3.5= 60;Dose Advice for AMShot

    Would you recommend I drain the depot or would it be best to just stick with the program/protocol and shoot the current dose 0.75? Please consider my questions to Julie below when responding.

    Thanks,
    Laura
     
  41. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Re: 1/4 Zeke PMPS 86;+2.2=40;+3.5= 60;Dose Advice for AMShot

    high carbs don't hurt him. if you shoot and he goes low, give him carbs. it's that simple - it's more important to keep him safe than anything else.

    he's doing great. i think it's important to take your dose reductions, though, rather than skinnying the doses.
     
  42. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Re: 1/4 Zeke PMPS 86;+2.2=40;+3.5= 60;Dose Advice for AMShot

    i think these are your choices laura. we don't have a crystal ball to know what will happen if you do this or that choice.

    after you go through tonight's cycle and have your amps in the morning, know that you have these options available to you - shooting 0.75u, shooting a reduced dose, or skipping. i would make the decision in the morning, as best as you can, considering how tonight goes and what you are doing tomorrow. after you've made that decision, just go for it.

    zeke is doing great and what you do in the morning isn't going to change that. really! be confident and trust yourself - i think you know more than you think you do! :YMHUG:
     
  43. MrZ

    MrZ Well-Known Member

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    Re: 1/4 Zeke PMPS 86;+2.2=40;+3.5= 60;Dose Advice for AMShot

    If I shoot the 0.75 in the AM, and he goes below 50 again, I would then take the reduction, right? So in the PM I could possibly be shooting 0.5, correct?

    Should I stick with the same preshot feeding formula (7% 1.5T) or throw in higher carbs?

    Thanks for your advice Julie. It's greatly appreciated.
     
  44. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Re: 1/4 Zeke PMPS 86;+2.2=40;+3.5= 60;Dose Advice for AMShot

    hmmm, good question. fortunately, we have all day tomorrow to consider it! :D he does seem to be on a mission!

    we know that some cats can be affected by the depot for as many as 6 cycles after a dose reduction, but if he goes low again tomorrow day cycle, i'd probably reduce tomorrow night. you do a great job of monitoring him, but still, we don't want him skating too low. so i probably would. but let's see how he does tomorrow!
     
  45. Re: 1/4 Zeke PMPS 86;+2.2=40;+3.5= 60;Dose Advice for AMShot

    Laura, because my work schedule got changed suddenly today, I've been awake for 22 hours, so anything I say will probably sound like gibberish :lol:

    But it would attempt to resemble what Julie said above.

    Any of the 3 options are viable.

    If you shoot the .75u, I would advise that you feed the 7%, but also that you split it into two portions. One at AMPS, and the other at +1 or +1.5. That might help keep the numbers flatter for longer. And possibly prohibit a dive by +3.
    And I'd try to stick with the 7% unless you do see either an early and obvious drop, or he goes below 50 later in the cycle.
     
  46. MrZ

    MrZ Well-Known Member

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    Aug 30, 2013
    Re: 1/4 Zeke PMPS 86;+2.2=40;+3.5= 60;Dose Advice for AMShot

    Just curious, why are you throwing this out as an option?
    Is this so I can evaluate the new reduction quicker?
    Is it because I'm having to feed him HC for so much of the recent cycles?
    Is it because he skated low for much of today's cycles?
    Is it because he dropped to 40 tonight?

    Carl - I hope you get to catch up on your sleep.
     
  47. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Re: 1/4 Zeke PMPS 86;+2.2=40;+3.5= 60;Dose Advice for AMShot

    When some cats' pancreases start to kick in, it seems like the depot isn't draining quickly enough to keep up with the amount of insulin that the pancreas is producing. The only way to get ahead of the process is to skip a shot or temporarily reduce the dose. It helps to remember that the effect of a reduced dose isn't always seen during the current cycle. If you hold the dose, you're likely to end up with another cycle in low numbers. I think this is the rationale for what people are suggesting. We don't want the numbers to get away from you.
     
  48. Re: 1/4 Zeke PMPS 86;+2.2=40;+3.5= 60;Dose Advice for AMShot

    Sienne explained it very well. I've seen it called "the depot getting ahead of the dose" and I've seen it happen fairly often when a cat seems to be heading towards remission when the reductions are coming one after the other at a quick pace.

    Yes, it does let you evaluate the new reduction quicker, because it helps remove the depot as a possible reason for the low number.
    And yes, if you have to feed HC often on a regular basis, that indicates the dose may need to be less, so the quicker you can evaluate the "actual dose", the better.
    There's nothing wrong with skating low the whole cycle, but you want the dose to be the reason for the low skate of green numbers, rather than a constant manipulation of food.
    And yes, the 40 last night was a big factor that indicates that Zeke is still being influenced by the depot from the prior dose of 1.0.

    So skipping or giving the one time "BCS" dose is a good way to adjust the depot down and let you see what the .75 dose is really doing.
     
  49. MrZ

    MrZ Well-Known Member

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    Re: 1/4 Zeke PMPS 86;+2.2=40;+3.5= 60;Dose Advice for AMShot

    Thanks Sienne and Carl for your responses. I appreciate you providing this information for my edification. I should think this will help with the decision making process going forward and I won't feeL so :? confused_cat :dizcat . Hopefully ;-)
     
  50. Tigger's Friend

    Tigger's Friend Well-Known Member

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    May 23, 2013
    Re: 1/4 Zeke PMPS 86;+2.2=40;+3.5= 60;Dose Advice for AMShot

    Laura, what a great condo - so edifying, & you have some great experience from the BIG GUNS here - Carl, Julie, Sienne - you & Zeke are doing wonderfully, & I just learned alot, THANKS! :D Stay safe, Zeke, & keep healing!!!
     
  51. MrZ

    MrZ Well-Known Member

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    Re: 1/4 Zeke PMPS 86;+2.2=40;+3.5= 60;Dose Advice for AMShot

    Hi Suzanne. You're so right about the Big Guns - Zeke and all the other sugar babies here are so lucky to have them. I'm so glad you're learning along with me. I think it helps to be as educated as you can on the subject. Hear, hear on the staying safe and keep healing wishes. Sending healing vines to all!
     
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