3/20 Chino|AMPS=373|+4=316|PMPS=333|+2=273|+4=148|+5=107|+5.5=89|+7=79

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Adrian and Chino

Adrian and Chino

Member Since 2016
Yesterday...

First cycle on 10 units. 3rd day without R. Looks like he came down from a bounce yesterday morning, then bounced right back after a yellow +4. I'm still not sure when the Lantus is peaking. It appears to be happening at +4, where it was happening at +8 until recently.

His BG was 409 at 3 AM (PM +8). I was surprised to see 373 this morning.
 
Is there a way to delete a thread? I somehow managed to post this twice. Will be changing the title on the other one in the meantime.
 
Only moderators can delete a thread. If you want it deleted, you can "report" it and just say that it was a duplicate thread as your reason for reporting..

Work that juice, Chino!!
 
I was under the impression that you could delete a post as long as no one had responded to it . I guess you tried that with the edit tool?
 
When they are high and basically flat (with meter variance) it's harder to tell the onset/ nadir etc. Hope the increase keeps those yellows coming but blue or green Chino would be nice too buddy.
 
Having seen nearly the same number several hours in a row during some of the cycles with R, I believe the meter is closer to the truth than the highest allowed variability. Retests of numbers over 450 show more variability... though I test again when I don't trust that the first value was valid to begin with. But that's why I consider the difference between 409 and 373 to be significant, even though it could go as low as 327 and still be within 20% of 409.
 
AMPS=373 (1st meal)
[10 units L, no R]
+4 = 316 (2nd meal)
+6 = 330

Next check at +8. The +6 could be higher because it's only been 2 hours since he last ate... or it could be higher because the Lantus peak has already come and gone. I'm still hesitant to believe that it's really happening that much sooner, but we'll need another cycle or two to either confirm the pattern or determine that it's inconsistent. Though two insulins peaking at the same time would explain why the same amount of R that previously didn't take him under 300 suddenly started taking him there and keeping him there for several hours mid-cycle.
 
Or it could be NDW kicking in causing higher numbers. Patience. Like Karen said, there isn't really a definitive nadir when their numbers are high. It can move around cause of the bounce effect too. Once the numbers are over a certain level (ie pink), the blood sugar in my mind is just "too high" and the actual values aren't worth analyzing.

Good luck with the new dose.
 
What are the "rules" for adjusting the dose when green comes out of nowhere or approaches the lower limits of the safe range? I've been looking at spreadsheets and it looks like some people give a 66% dose for one or two cycles, then go back to the same dose... some do that and go back to a slightly lower dose... some go down a few units, then work their way back up to the same dose unless they find a lower one that's effective. I know Chino's nowhere near that point, but I want to learn now so I don't have to guess (or panic =P) when we get there.
 
If you see a safe green, hold the dose and celebrate. When you see people back off the dose, it was probably nerves. But there is also other things to factor in, like how well you can monitor. If you see a green, there's a chance of seeing green again at that dose. Or it could be a one time thing and you'll need to go higher. When Neko did her dose climb in the fall of 2015, she would occasionally give me a green, then lose the greens so I'd have to keep increasing to chase after them.

If kitty goes below 50 and earns a reduction, you can reduce the next dose by anywhere from 50-25%, to try to reduce the depot some. You don't want a large depot hanging around when kitty needs less insulin. Note that the first time Neko started earning reductions from a high dose, I never did the reduced dose thing, because she would promptly bounce and keep herself safe long enough for the depot to go down. Second time around, she wasn't bouncing nearly as much, so I sometimes did a BCS dose following a reduction - depending again on a few things. How low she got, how long since the last reduction, how much I could monitor, how easy she was to get up from the low, what my gut instinct said she was telling me.
 
I'm looking at how good the nights were and how horrible the days were during the week of 2/26, right before I started using R to try to lower his daytime BG. Seeing how horrible the nights became makes me wonder if one good cycle each day is the best I can hope for... he must've been bouncing each morning from the yellows and blues on the PM cycle.

The last time we had a yellow PM +2 was when a bounce was breaking and it dropped another 100 mg/dL between +2 and +4. He'll get his last meal at +4, so I'm not too concerned, but I'm prepared for a long night and a probable bounce by morning.
 
148 at +4. He just got his last meal. The checks will be hourly now, or every 30 minutes if the next one is green (or close to it).
 
107 at +5 (160 on the AT2). Gave 1/3 of what he just ate an hour ago (1/4 can Pro Plan 2%). Testing again in 30 minutes. On one hand, I'm happy that we're likely to see green tonight... on the other hand, I know it's only because he's coming down from a bounce. But it's been over a month since the last green, and at least he's able to use the food I'm giving him tonight.
 
Adrian, I'm curious how you shoot a high dose kitty? Do you shoot him in the scruf? How does Chino do with his injections? We get Ozzy in the middle of his meal and he literally will stop eating, sit back, let us shoot him, and then goes right back to eating. The funny part of this whole entire FD dance is that Ozzy takes his shots like a friggen pro (not so much with the BG tests). How does Chino do with his insulin shots? You have to shoot a good amount of insulin so just curious how Chino handles the injections. I hope he is a champ and knows you are giving him something to help him.
 
I've never used the scruff since it doesn't absorb as well from there. I rotate between the lateral thorax (side of chest) and flank, AM dose on the left, PM dose on the right. I don't know if he even notices that I'm giving a shot... he probably thinks I'm grooming him since I run my fingers through his fur a few times before and after giving the insulin. I do it while he's eating and I have my leg on the opposite side so if he tries to shuffle away for whatever reason, he can't go too far. Since I give a freeze-dried meat treat or meal after each test, he now purrs while I check his BG, though he moves/turns his head a lot, trying to get me to rub his chin while I'm trying to bring the strip to the blood drop e_e.
 
I'm actually amazed at how well he handles the testing. He had ear mites several times when he was younger, then had a bad ear infection for a while, so he used to shake his head violently anytime someone or something touched his ears.
 
Lookin' good Chino. :cool::cool::cool: Surf it buddy. Good to see he's slowing down a little.

Not sure what the AT will buy you. I've always heard that using two meters will drive you crazy. I just took the human meter values at face value and followed the protocol that uses human BG numbers.

I shot scruff/back of shoulders for 5 years, except a couple of times when I had given fluids and wanted to shoot separate locations. In hind sight, Neko did notice a bit the sting of Lantus when we got to higher doses. With Lev she often just purred at shot time. The only time I shot her when she was eating was when she was eating canned food. Raw got polished off in less than 30 seconds and I couldn't pick up the syringe fast enough.
 
Adrian and Chino said:
I've never used the scruff since it doesn't absorb as well from there. I rotate between the lateral thorax (side of chest) and flank, AM dose on the left, PM dose on the right. I don't know if he even notices that I'm giving a shot... he probably thinks I'm grooming him since I run my fingers through his fur a few times before and after giving the insulin. I do it while he's eating and I have my leg on the opposite side so if he tries to shuffle away for whatever reason, he can't go too far. Since I give a freeze-dried meat treat or meal after each test, he now purrs while I check his BG, though he moves/turns his head a lot, trying to get me to rub his chin while I'm trying to bring the strip to the blood drop e_e.
Click to expand...
Thanks for sharing your routine with me. I have always only shot Ozzy in the scruff because honestly it's the easiest spot for us. I tried a couple times to get him on the flank and he squealed out in pain. It broke my heart to hurt him and he has almost no reaction to the scruff shots and tolerates them so well. I do wonder about trying some other injection sites because I have read pros/cons on the scruff shots and the insulin absorption in this location.

Sounds like Chino is tolerating his BG tests and insulin shots well. I'm so happy to hear this. :):):)
 
PMPS: 333 (3rd meal)
[10 units Lantus]
+2 = 273
+4 = 148 (4th meal)
+5 = 107/AT: 160 (1/4 can PP - 1/3 of what he ate at +4)
+5.5 = 89/AT: 146 (same as above)

Getting MC and HC out in case it's needed at the next check in 30 minutes. The fuzzball was crying like he was trying to convince me that his BG was dropping, too, so I let him lick the spoon.
 
Adrian and Chino said:
PMPS: 333 (3rd meal)
[10 units Lantus]
+2 = 273
+4 = 148 (4th meal)
+5 = 107/AT: 160 (1/4 can PP - 1/3 of what he ate at +4)
+5.5 = 89/AT: 146 (same as above)

Getting MC and HC out in case it's needed at the next check in 30 minutes. The fuzzball was crying like he was trying to convince me that his BG was dropping, too, so I let him lick the spoon.
Click to expand...
Hoping for an uneventful night for little Chino. Nice to see a green again!!:D:D
 
Wendy&Neko said:
Not sure what the AT will buy you. I've always heard that using two meters will drive you crazy. I just took the human meter values at face value and followed the protocol that uses human BG numbers.
Click to expand...

If I only had the RC numbers, I would've gone for MC when I saw the 89 just now. I gave more LC because his true BG is still above 100. If it continues at the same rate, it will be 71 (human meter) at the next check, which is still safe... but I'll still be inclined to give MC or HC unless I know that it isn't necessary at this point. When I've done this enough times to know which human meter value usually corresponds with 99 or below on the AT2, I'll stop testing with the AlphaTrak. (He hasn't once shown green on the AT2 yet.)
 
The general guideline for human meters is to give LC when they first hit green, to try to encourage a surf.

What is the significance of green on the AT in your mind? He's still in safe numbers down to 68 on the AT.
 
PMPS: 333 (3rd meal)
[10 units Lantus]
+2 = 273
+4 = 148 (4th meal)
+5 = 107/AT: 160 (1/4 can PP - 1/3 of what he ate at +4)
+5.5 = 89/AT: 146 (same as above)
+6 = 82/AT: 147 (treat: small pc of freeze-dried chicken)
 
Wendy&Neko said:
What is the significance of green on the AT in your mind? He's still in safe numbers down to 68 on the AT.
Click to expand...

I will never be comfortable with anything under 70 on a human meter unless I know that his true BG is well above it because I've gathered data to that effect on Chino. While I know that 51 is still safe, it doesn't give me much time to react if my intervention doesn't stop him from dropping further by the next check. What's wrong with doing this if it makes me more comfortable with lower BG readings?
 
Nothing wrong with doing additional tests with the AT. I was just trying to figure out your rationale for doing so. Remember that down into the 40's (human meter) is still in normal range of a cat, we just don't want them their while on insulin. But having said that, some cats show hypo symptoms at higher numbers than others and it's good to know if that's the case ofr Chino. On the other hand, I once caught Neko in the 20's and she was just sleepy, but very glad to eat when I put food in front of her. ECID.

Keep surfing there Chino - those are good numbers. :D
 
PMPS: 333 (3rd meal)
[10 units Lantus]
+2 = 273
+4 = 148 (4th meal)
+5 = 107/AT: 160 (1/4 can PP - 1/3 of what he ate at +4)
+5.5 = 89/AT: 146 (same as above)
+6 = 82/AT: 147 (treat: small pc of freeze-dried chicken)
+7 = 79/AT: 131 (treat: same as above)

I have an appt for Chino with a new vet on Saturday. If nothing else, the AT readings will show her that what I'm doing with his insulin dosing/monitoring is safe. Staying up for a +8. If it's still dropping at a slow rate, I'll give him some LC before going to bed.
 
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