20/6 Rover 19/17 cycle; PMPS +19 208; +1 277; +3 265; +5 248; +8 259; +10 243

Yesterday: http://www.felinediabetes.com/FDMB/...217-9-225-pmps-322-2-281.159753/#post-1705194

Morning all. Happy first day of summer.

First time Rover has never been in the blue at this dosage of 1.75 units. There seems to be a difference of opinion about where early breakfast should have been fed. I could hear gurgling in his stomach while I was testing AMPS BG. I put him in front of food and he's eating. Don't feel comfortable shooting a blue and delaying. Waiting to see how much he had eaten and will test again.

Was fed 1/4 can FF @PM+4. Ate most of it. Remainder left for middle of the night snack. DH fed aprox +10. Food dish moved back to the kitchen. Rover didn't eat much.

 

What do you mean by this?

 

Over the weekend when Rover wasn't feeling well, his food was placed closer to where he was hanging out in the living room, next to his water dish. This morning, DH put food out for him @PM+10 in the usual spot in the kitchen. When I woke up and went downstairs to do AMPS test, Rover was sitting in the living room staring at where he thought the food dish should be.

 

So he didn't eat the food?
Was it still in the kitchen?

 

I see you have fed him his full meal then and not shot is that correct?

Usually when we get a lower than usual preshot we stall without feeding, retest again in 20min and see if numbers are coming up by themselves.
If you do need to feed usually it would only be a tiny amount of LC (a small teaspoon).
If you give the full meal and stall you can't tell if the numbers were heading up or if what you are seeing is a food spike.

 

Thought it was more important that he eats. He's lost weight in the last 4 weeks.

He's eaten roughly 1/4 can FF. No shot. So PM+12 reading of 176, PM+12.75 166.

 

I wasn't criticizing just an observation and giving you the info so that you know what to do when you have a similar situation in the future.

With that 166 at +12.75 likely to be food influenced and it having gone down a bit (but we dont' know by how much ) you have a couple of options.

You could withhold food now and test two hours from when he last had food, and see what his numbers are doing then. If he is safe to shoot you could shoot then at +14 and that would become your amps, you would be two hours of schedule then and would have to shoot two hours later tonight. To get back on schedule you would bring forward your PS by 30min a day or 15min per cycle.
Is this going to cause you problems?

The other option is to do two 18hour cycles back to back.
so if you usually shoot 7am/7pm this is how it would work
7am skip
1pm shoot
7pm skip
7am tomorrow back on schedule

You could of course skip altogether, but I don't like this option generally, but in Rovers case I like it even less, the main reason is that if you have an infection ( rovers tooth problems), kitty is not eating enough, high numbers and not enough insulin is a recipe for him to start throwing ketones and that's just a step away from DKA.

In Rover's case, if your schedule permits I would look to trying to shoot at +14 if numbers allow.

 

Dropped to PM+13.25 of 146.

Thanks for all the info. No problem shooting late. Going back down the stairs to remove food dish.

 

PM+14 146. Rover asking for food. Last fed PM+12. 1/4 can FF pate.

 

Still dropping.
+15 129 tested on FreeStyleLite metre (140 on Bravo back-up metre). Three hours since last feeding. Just fed 1 tsp FF to a hungry Rover to shut him up and so I could run upstairs now and post. Think I'll have to feed more now and hope for numbers at +18 that will allow for an 18 hour cycle.

 

Don't feed him after +16 so that the +18 test is not food influenced.

 

Yep, that's the plan. Putting LC FF out now. Will take it away in 40 minutes at +16.

 

Ate just over 1/3 can FF at +16. No BG taken. Will try for a test +17ish.

 

+17 142 (back-up metre Bravo 176). 2 hours since food.

Weighing options:

Shooting an 18-hr cycle would put him in the nice greens or dangerous greens - possibly HC food & corn syrup. Then a reduction.

Skipping a shot takes me to 9pm, and then 1) don't shoot if numbers still lower than usual for Rover; 2) shoot 1.75 or ?? units and test frequently until I can't stay up any longer.

I'm positive last night's PM shot was accurate.

Edit: I don't think I will have the oomph to stay up late tonight. A morning of not going back to sleep, followed by skipping my own meds to stay up. No chance of nap. Can't do it.

 

Just FYI: You can put all those numbers in today's row on the SS - just put "+12 176 +12.75 166 " in the cell for the AMPS number, put NS in the units cell, and then continue with the +13.25 in the +1 cell, etc. Much easier to see what's going on, for you and us.

So, did you shoot at +18? That would have been my choice. Then you can shoot at your usual time in the morning and be back on track.

BTW, a BCS is always any option if you are concerned about his going too low.

 

Cheers. Wondered about how to mark up a lot of +++++.

+18.5 is 208. Fed Rover. He came all the way upstairs and into my office (he never comes here) to say he was hungry. Eating now. I feel comfortable shooting, probably at +19 to make it an even 4 o'clock. I do have to go out a couple of times in the next 3 hours. Just dropping DS off and picking up from boathouse.

What is a BCS?

 

BCS = Big Chicken Shot. It's when you give a one-time reduced dose because you aren't comfortable shooting the usual dose for any of a number of reasons: can't monitor, cat not eating, etc. Usually around half normal dose, but can be whatever amount you feel comfortable shooting. We recommend it rather than skipping, especially if a cat has a history of DKA.

Since you are doing the 18 hour cycle, you can still give the next shot at the normal time on the clock, which would be +17 hours from when you actually shoot today. To indicate when you shot, put 1.75u@+19 in the cell that corresponds to when you shot (which I think would be +7,right?). I see you already have the hang of wrapping the text so it all fits.

 

+19 230 and he ate about 1/3 can. Gave 1.75 units.
Will test often.
Have all the usual suspects - strips, HC, corn syrup.

 

+1 277
Which is good because I might be called out at any moment to pick up soaking wet DS + bike from boathouse. Line of thunderstorms on its way. Hoping crew and coach boats get off the water beforehand.

 

+8 259 of 2nd half of 19/17 hr cycle. I was expecting a drop from the lovely blues after giving Lantus at +19. Instead, #s have increased and so far are a relatively flat yellow. Is the yellow a reaction to the NS? Is this really a bounce that should be higher but is being held down by the Lantus?

He's eating a lot. DH just told me no deposit in the litter boxes for the last 2 days even though 2 x 1/4 tsp mirilax onboard daily. I'll be looking for constipation signs.

I'm assuming that it is safe for me to go to sleep as soon as I finish work. Plan to set an alarm for the AMPS and hopefully, pretty please, be able to go to sleep after.

 

He's surfing yellow. Going to catch 6 hours sleep.

 

If he hasn't pooped by tomorrow morning, you might want to try putting 1/2 tsp of canola oil in his food. That worked with Cinco. Sending poo vines.

 

The 18 hour cycles do drain the depot a bit, so that's likely what's causing the yellows. On the up side, it's a good excuse to sleep.

I hope DS got home safe. T-storms and boats on the water are a bad combination.