6/20 Mr Tinkles +3 52 fighting a hypo!

AMPS 150 1.7u

I had to wait until +13 to get a shootable ps #, so I did a slightly larger dosage drop today...0.15u approximately. He likes to cruise those green #s now for long stretches, food doesn't give him much of a rise. Mr. P appears to be waking up.

He also is no longer eating like he's starving, he doesn't eat his whole breakfast in one sitting anymore. I would love to free feed, but that is darn near impossible at my zoo.

I'm now 3 hours off schedule, not sure how I'm going to get back on schedule, but I guess that's a happy problem to have, right? ;-) I might have to undershoot a dose or two....

 

Re: 6/20 Mr Tinkles

+3 52 Wow, big drop early, gave a FF snack! I'm thinking the dose drop isn't enough by a mile! :shock:

Fighting a hypo here....waited 15 min... 35! Broke out the HC, gave 1/2 can, wait 10 min...39. Gave 1/2 can FF, wait 10 min....41. Gave other 1/2 can HC, wait 10 min....50.

Now that I'm breathing again :!: ....he has shown no signs of hypo, just hungrier than usual when he was in the 30s.

 

Wow, Laurie. you're doing great.. breathe. Now check every 25 30 mins to make sure his not dropping again. I feel for you cuz a lot of us have been there with the hypo situation. Tinkles is going to be fine, but it looks like you should be going to about 1 unit. be right beck... gonna look at SS again.

 

If it were me, I'd wait til he was around 200 then give 1 unit. I wouldn't give shot if his PMPS is 150. I'd wait til about BG 200. I found with Pru that even if she went to 50ish... lc food was enough to bring numbers up w/out getting waonky numbers later. But, yeah... when they are hitting 30's I think HC is in the calling. Another thing you could do is not shoot tonight if lets say his +5 tonight is still around 150. I would just wait til the morning, but I am sure you will do what you feel is right. I am so glad I was able to jump on here today! You're doing AWESOME!!!! :YMHUG:

 

Ok, I'm breathing again. He was up to 109 twenty minutes ago. I probably went overboard on the HC FF, he's snoozing away now. I think he just did that so I would give him some FF, sneaky boy! :lol:

The really scary part is that I wasn't planning to test at +3, but decided to go out on an errand, so I tested early. I don't even want to think about what could have been...yikes!

Thanks Michelle, this is totally uncharted territory for me. He was moseying down the dosage steps and then all of a sudden, he wants to jump over the railing to the next floor! Sheesh, wait up for me, Tinkles! :mrgreen:

I'll see where he ends up tonight, I will certainly at least do a large decrease!

+6 148

 

WOW! Great job catching that +3 and heading off a possible crisis. When we were on a dose reduction path when I changed Bix over to LC, he gained a few unneeded pounds ohmygod_smile til I got caught up with reducing the dose fast enough. I'm sure you'll do great with it, even if someone keeps trying to trick you into the FF super-yum-fest! :lol: Seriously though, I'm really glad you got that test in & averted any lower #s, and that he is doing so great! FD is a wild ride!

 

Another thing to keep in mind. I forgot to mention before. Sometimes they will start to raise, but will fall again if Mr. P is showing some action. That's why I had suggested maybe a no shoot tonight. It's just cause he went so low this afternoon. Just my two cents. :mrgreen:

 

Laurie no matter what # he throws at you tonight do not shoot for THAT #, Most people do NOT shoot after an incident like this in pzi becuase tinkels is highly insulin sensitive right now.
you can actually skip next dose. If your not comfortable with that please shoot a minimal dose...you are bound to see a HIGH pm, don't react to it.
Believe me, this comes from 3 years experience with these things.
You don't want to set tinkles back by responding to his next #.

 

Joanna, I got so lucky, it's scary. ohmygod_smile

Kelly pointed out to me the overlap on the Health thread, and I think Michelle saw it too....I missed that, and made a mistake by shooting too early today. I feel better knowing the reason for it!

That's why this board is sooo valuable, getting other eyes on what I'm doing, getting feedback and advice...it helps me make better decisions and see my mistakes so I don't repeat them.

Michelle, he just jumped by 100 in a half an hour. I don't think he'll be too low to shoot tonight, but there's still plenty of time before I have to decide. Thanks for the input, I always appreciate it!

Lori, I don't shoot based on PS #s, and I don't plan on starting now. From the jump he just took, I would guess that he is going to have a reaction to this, so I will have to shoot low if I shoot at all. I do understand what you are saying.

Thank you all, I really do appreciate the help and support!

 

at this point it might be a good idea to shoot based on am's and pm's (not tonight of course) becuase 150 was a little low for that shot. i fear i may be getting on your nerves so if you want me to butt out i will, i just have been watching this sort of thing for so long. you get to know the dance better the longer you stick around. pzi really does'nt have overlap...it's a poop out insulin after about 8 or 9 hours.
anyway, i respect your choices and if you want i'll just offer up my experience every now and then.

 

I know a lot of us have had some different experiences because ECID. Mr. Tinkles' pattern reminded me a lot of when Oscar was dramatically getting his dose reduced. There was a couple of times that his insulin shot lasted 18 to 20 hours because the dose was too high. I reduced the dose way to fast and didn't allow his body to get used to a reduced dose before I reduced drastically again (insulin sensitivity mentioned before) and now I am going through re-conditioning his body to accept a higher dose in order to get any sort of response. I have noticed with Oscar that the higher the dose - the longer it stays with the body, which creates too much of an overlap when the pancreas starts to kick in. We lost that build up and its almost like we are starting all over again just like we switched insulins. So, in short, I would argue that ProZinc can create an overlap once you have reached the threshold of the optimal dose.

 

Lori, you absolutely are not getting on my nerves, and I do not want you to butt out! I value everyone's input. I was just stating that I don't dose according to ps #s, it doesn't work for me. Please don't be offended, I just don't do it that way. My strategy is different, and it's been working very well so far, so I see no reason to adopt a totally different approach. That doesn't mean that I won't consider tweaking what I'm doing based on other people's experience and opinions, that would be very shortsighted of me. And, I absolutely want to know what I did wrong, so I can learn from it.

PZI may not have overlap (I wouldn't know because I have no experience with it), but ProZinc does, and the overlap is extended longer if you shoot high. Overlap is what caused the hypo today with Tinkles. If you look at my SS, you will see that I have been shooting higher doses into similar ps #s with great results. Today, I made the mistake of failing to take into account that I shot a little high last night, so the overlap was greater than what I allowed for. This is the tricky part, reducing dose, because if I don't reduce enough at the right time, this is what can happen.

 

ok i get what you two are saying re: overlap. i thought of it differently. if your getting a long lasting dose, 14-20 hours lets say, i think that is becuase the pancrease is healing and taking over. it you consider that an insulin overlap perhaps you are foiling the pancrease's attempt at taking over. usually a hypo/near hypo is a result of pancreatic action. in this case i think it's the high dose with the low #. plus pancrease.
granted you shot early and maybe the # would have been higher +12....but if you have to shoot early i thought it's better to shoot at what you see.
glad i'm not aggravating you, sometimes it's hard to see newer beans go thru things you've seen repeatedly and not try to explain what you've seen/experienced.
my own tomtom hypo'd 3 years ago and i hesitantly followed the advise of the pzi'ers before me and shot NOTHING into his 380 the next morning----but was delighted to see him bring himself down. that began his 2.5 years in remission. :mrgreen:
that was then, i guess this is now.... ;-)

 

Kelly, thank you for pointing out the overlap, it made the pieces fit together for me.

I hope you will be able to get Oscar back on track soon. You should start posting about him on the PZI board. Maybe someone will have an idea that will help....or maybe my (previous) good luck will rub off on you! :mrgreen:

Lori, I didn't shoot early, I shot at +13. The number was rising, so I thought I was ok. But the nadir was at +9, indicating a too high dose, so I should have waited longer. That late nadir was the clue I missed....meaning the insulin would have a longer duration, more overlap...see what I'm saying? If I had waited 2 more hours, it would have been fine.

 

No problem! We are all doing a bit of data collection still since ProZinc is still very new to the market!

I have posted to the PZI forum quite frequently in the past few months. We are in a bit of a holding ground and there are only 2 outcomes - things will start to click again and we will see more blue numbers (and maybe even more greens!) or we will have to switch insulin. I still have faith that ProZinc will work for us - so I am giving it another month to see. We've been on it since the beginning of March.

 

Re: 6/20 Mr Tinkles post-hypo update

PMPS 492 1.2u

I went with the 1.2u, figuring that it might keep him from zooming even higher overnight, and headed to bed.

+6.5 149

Imagine my happy surprise to see this very respectable # this morning! Thanks again, Kelly, looks like it worked nicely. So, liver response, but no insulin resistance, I guess?

Update on Tinkles:
+7.5 112
+8 122 ate 2oz SK
+9 141
+9.75 ate 2oz (finished breakfast)
+10 154

My plan is to try to wait until +12 to shoot, and stick with the 1.2u....but if he starts to zoom up before +12, I'll shoot early. If he continues like he has previously, the second cycle on this dose should give him a lower nadir if it doesn't poop out early on this cycle because it's too low.

As always, all thoughts and suggestions are welcome and appreciated!

 

So happy to see non-scary numbers last night! You will probably see a small zoom into the 200's by +12. I personally would wait until then because you don't want the shots to overlap too much (which might cause mid-cycle problems for you today). I doubt you will see anything close to the 400's you saw for your preshot # last night.

 

+11 227
+11.5 226

Still looking good, nice gentle rise, flattening out. I'll wait for +12.

 

Looking good!

Just in the fine-tuning category & personal preference, you could also have shot on the +11 #, but lowered the dose a bit more. Perhaps 6 of one, 1/2 dozen of another, but just another option for reducing the overlap effect. Once you are over your no-shoot, you can take advantage of the overlap you might have, compensating by lowering the dose to take it into account, rather than waiting to actually reduce the overlap, if that makes sense. To some extent stuff like that depends on your schedule too of course, to pick the time you actually want to shoot to stay on a good schedule.

I'd also consider reducing the dose a hair more, depending on what #s you see today. If you look at the drop in terms of %, going from 492 to 112 is a bigger % drop than I like to see on PZI. Of course that high # was probably rebound and that clearing could have contributed to the big drop, i.e. it's probably not all from the insulin. Hard to say really, but I'd just keep an eye out for the possibility that the dose may still need to come down more.

 

Good points Joanna, I'll keep them in mind. I'm not ready to assess the the dose yet, although I like the +7.5 nadir. Being such a big dose decrease, I'm not sure what I'll see. I've seen big drops before with Tinkles, and it hasn't been a problem so far....it has always been after a wacky high #, like the one last night, so I'm not terribly concerned about that, He is running a little on the high side this cycle, which is also an encouraging sign to me. I know that sounds strange, but when I change dose, if the new dose is good, that's what I usually see...then the next cycle is perfect. So, I'm seeing good signs so far.

I am hesitant to reduce dose to shoot early, that isn't a strategy that I've used successfully. It's a perfectly fine strategy if it works for others. One problem Ihave with that is the variation of dose....every time I play with the dose more than a small amount, it takes Tinkles a few cycles or more to adjust. To me, that's lost time. Other cats may not be as sensitive to dose adjustments, although I've seen where Gator has commented about that effect also. I think ProZinc is more touchy about changing dose in general than PZI, JMHO.