Alice 6/23 PMPS 107 +2 88 +3 67 +4 61 +5 57 +6 58 / AMPS 414

What’s with these awfully high numbers? We left her pen out for one cycle recently, I think. Could the insulin have lost efficacy? It is the lightly expired but previously stored properly and unopened one I had gotten from a friend. Maybe easier for it to lose efficacy since past expiry?
Maybe it’s just the dose change and missed dose.

Yesterday: http://www.felinediabetes.com/FDMB/threads/alice-6-22-amps-429-2-376-4-243.215978/

 

For the past two AM cycles:
Red at AMPS
Pink at +2-+4
Yellow at +6

Maybe a fat 3.75u would be better? Did I decrease too soon?

Also her appetite right now is ridiculous. And we are back to some polyuria with that annoying super sticky litter resulting from her shedding glucose in her urine. This is not where we want to be.

 

http://www.felinediabetes.com/FDMB/...ips-onetouch-ultramini-and-exp-strips.216022/

I have a supply closet post to cheaply sell meters and strips and salmon treats, just so I can turn these donated strips into the kind of strips for my meter, and maybe get Alice some freeze dried zesty paws chicken or the pure bites chicken and duck. Oh! I forgot to add the bonito flakes to the listing. She likes them but not enough.

 

I would hold the dose at least one more cycle. The depot is still building after that skip, plus she is sliding down nicely today. It is the sixth cycle after the skip. If you don’t see green tonight, call it a failed reduction and go back to 4.0 units.

People use pens out of the fridge for 28 days, should still be OK.

 

Thank you for popping in. I plan to wait at least one more cycle for sure. Would it help testing tonight then to check on her every couple of hours to see if I can catch her lowest? I have been struggling with my +6 alarm at night lately, between the +2.... that 4 hours isn’t enough time for me to both fall asleep and get a full sleep cycle in for myself.

 

Also @Wendy&Neko the one thing I really wondered about the pen getting left out is related to it having expired 10-2018. When insulin expires..... what happens first to it? Loss of efficacy, like many other medicines? As long as it is unopened and has been stored effectively, is that the primary issue with expired insulin?

I have three non-expired pens waiting and a hot summer ahead with use being about 1 pen a month ish. So I want to get as much as I can out of the expired one, plus save DCIN money.

 

I only had a pen/cartridge go off once. More often it’s the cat. What you see is a gradual loss of good numbers as the depot wears out.

As for testing at night, I got good at predicting what she’d do based on a +4. If it could be my last test, I still got a decent sleep. For many cats, if the +2 is higher than preshot, like your last couple nights, it’ll be a quiet cycle and you don’t need a later alarm. The same seems true for Alice, as long as she has food around. For Neko, the +4 was a better indicator. She onset late.

 

I agree that being left out for one night should not be an issue. But being out of date for 8 months could be more the issue. I would not trust it.

And when you start a new pen in date, the efficacy could be potent in comparison , so some careful monitoring would be a good idea.

 

I hope Alice keeps heading down for you.

 

Actually when we started this pen I thought I noticed some increased efficacy from the previous pen, and the previous pen had been stored through two nights of power outage, so I would believe that more!
But I agree, and I expect to monitor with each pen change. Anyway, it was certainly better than going without insulin for a few days, in the case of this one pen.

 

She is, she is doing the same thing as yesterday! +9 was blue.

 

I think I need to find a better schedule plan for nights because that five week post-DKA marathon of no sleep back in April was enough. I’m still behind on sleep.

She also only has one ear to test, so every poke can be that much more annoying. At the same time, I like having her data. So I am torn.

She also cries about food sometimes every couple of hours. She can eat SO much I don’t understand it. So I am up bleary-eyed doling out snacks intermittently for several hours sometimes. Easier to feed quickly and lay back down than to focus on testing too.

 

Weight 3.04kg—hasn’t really changed since surgery. She was gaining very quickly for awhile.

But she had a LOT of calories today.

She is starving so I felt bad for her and gave her a couple freeze dried bits. She is fasting until PMPS in 20 min.

Since I got AMPS, +3, +6, and +9 today, if I do PMPS and then +3 and +6 again, doesn’t that count as a curve? The 3 hour instead of 2 hour version? I don’t remember where I read of it being done this way but if every 3 hours, then for an 18-hour period....

 

PMPS 107, shot 3.75u

 

Looks like you might see that green tonight. Extra hunger can be a signal they are going down.

If following TR, curves are not as important as spot checks. Since she is sliding down o PMPS, I might start with a +2. You are right in the every three hour curve, but that is for dosing with SLGS.

 

Thank you for weighing in today. I value your experience!
/
But she is hungry like this fasting every night before PMPS. She had easily over 500 calories starting from PMPS last night to fasting evening, and she isn’t even 7lbs. She also cries throughout the night when she wants her food, lately I’ve been getting up and testing her or feeding her or both just because I’m not sure if she is low. She hasn’t been low. She eats more than the 18lb cat by far. Even when her numbers are stable I feel like she is so hungry, but she’s also not really gaining any weight now. It made sense when she was packing on the kilogram.

So lately I am not sure how to interpret her extra hunger moments. She’s still skinny, too. Just not emaciated. Needs to fill in on her hind muscle still.

 

In fact there she was just now crying at +1 pretty much like clockwork. Why are you so hungry, Miss Meowliss?

*she did have the motivation and strength to almost jump into my lap this evening though and it was great except post-surgery still I probably shouldn’t have let her even try. (Stitches should come out Wednesday though and it looks good.)
She used to be able to jump the baby gate with the most beautiful, beautiful arc. <3

 

Sigh. I got brave and tried to read about her cancer again, googled a couple little articles, and I went back to look at the report now that I can understand more, it says there is lymphovascular invasion. So from what I understand this is more likely to spread. I put off thinking about it for a week deciding it is removed what else can I do but focus on right now..... but now I think I need to start figuring out more again..... I don’t know how I can get her checked for metastasis or try to prevent it beyond the removal of the tumor itself.... the report sounds like metastasis is.... possible. Unless spaying and removing that whole hormonal factor shuts it down.

 

+2 is 88, LC fed only of course, I would appreciate testing recommendations for the night so I don’t overdo it or don’t underdo it or sleep at the wrong time....
Glad to see her back in green.

 

I would start with a +3. It of a drop to that +2, which usually means an active cycle.

 

Just seeing so testing now. Thanks @Wendy&Neko !

 

+3 is 67.... should I just presume to test hourly until she goes up two checks in a row?

 

lovely green +3! I would get a +4 and see where she's going.

 

+4 was 61, +5 was 57, 25 min to +6......

 

+6 remained stable at 58, I fed extra, for the past several hours she only had about 12-15% of a can at each hour for a snack after testing, all LC 4-5%.

So I gave her the remaining 3/8 of this can of friskies plus a Sheba snack and a little pumpkin on top for her tummy (she loves it so much, too, it’s like a treat!)....

I am going to have to learn when I can sleep when she is in the happy green. It would be weird for her to go into the danger zone at this point, I think. I hope it is not a bad idea but she isn’t crashing and we hit +6 and now it’s past 4am and I would like a nap. Left a note on Alice’s dry erase board for other CG to please give a last call snack before 2hr fasting time if possible.

 

You look after Alice so well. I hope you can get some sleep