? BG 81, should I be worried tonight?

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by mary hornbeck, Dec 17, 2017.

  1. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Today's numbers look like a bounce cycle. I find it hard to recommend a dose based on bounce numbers so i'm looking at yesterday's non-bounce BGs. The 1.5 u dose resulted in a low of 115 (might have been lower before that). On that basis, I think it's worth trying 1.5u again.
     
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  2. mary hornbeck

    mary hornbeck Member

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    K, I will stay with 1.5 for a couple of days. I thought today was a bounce too. I think that my vet thought that staying with the same units for sometime was better than changing it from day to day. But then again changing the dose makes sense as BG numbers fluctuate.When I looked back at marmalades spreadsheets his numbers weren’t that bad, yellows and purples and even blues, I am so afraid that the vet will be annoyed at me if I deviate from her suggestion of 1.5
     
  3. mary hornbeck

    mary hornbeck Member

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    Do you feel that 1/2 can of food twice a day is enough? I think that 1 3/4 - 2 cans would be more like it
     
  4. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Most of us feed several times a day. My vet originally told me twice a day but I knew it wouldn't work. Teasel gets 4 meals a day and a total of almost two 6 oz. cans a day. He weighs about 12 pounds.
     
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  5. mary hornbeck

    mary hornbeck Member

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    Are u working with a sliding scale?
     
  6. Kris & Teasel

    Kris & Teasel Well-Known Member

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    No, My cat is on Levemir insulin and it works best with consistent dosing.
     
  7. mary hornbeck

    mary hornbeck Member

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    I wonder if marmalade would do better on another insulin
     
  8. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Some cats have less extreme differences between PS and nadir with ProZinc or one of the depot insulins, Lantus or Levemir.
     
  9. mary hornbeck

    mary hornbeck Member

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    Do u think he would do better on levemir as it can be affective for 18 hours at the most
     
  10. Critter Mom

    Critter Mom Well-Known Member

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    Had a quick gander at Marmalade's spreadsheet.

    I'm very conservative and traditional in my approach to using Vetsulin. In particular:

    1. I don't go for dosing off the preshot with a sliding scale. I look to find a consistent dose which doesn't take the cat too low (both cycles) and which will keep it below the renal threshold for as much of each cycle as possible.

    2. For dosing decisions, I take into account the preshot but place more emphasis on nadir BG, especially when the nadir gets down into the medium to lower part of the normal BG range (low 100s as measured on a human meter - see point 3). My reason for this is based on a given dose of Vetsulin's ability to really yank numbers down from even unusually high preshot BGs to potentially worryingly low nadir values.

    3. Because there isn't really any linear correspondence between Vetsulin dose and steepness of drop from PS to nadir BG (hence my antipathy toward sliding scale dosing methods) if I were treating my cat with Vetsulin I would be targeting nadirs in the low 100s to allow a very good safety cushion against any BG curveballs the cat might throw. Should a given PS BG be a bit higher than usual I would not increase the dose. (ETA: Vetsulin is rather good at pulling down unusually high preshots without making changes to the current dose.)

    4. Once a dose meeting the above criteria was established I would not subsequently increase Vetsulin dose unless there was a clearly identifiable upward trend in average BG levels over a significant number of days.

    Looking at the spreadsheet I think that some of the higher PS BGs that result from the higher doses may be a bit bouncy (dropping too hard and bouncing right back up again to compensate). Marmalade's BG levels seem to be smoother on doses in the 1.25 to 1.50 IU range (yellow PS BGs with nadir in low 100s). I think if my cat were responding this way I'd be inclined to set the dose in this range and hold it for several cycles to see if she would even out.

    My two penn'orth. Other members may have very different suggestions.


    Mogs
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    Last edited: Jan 17, 2018
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  11. Critter Mom

    Critter Mom Well-Known Member

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    PS:

    If, after a reasonable period of treatment, I could not maintain my cat under the renal threshold for most of the day AND with safe nadirs on Vetsulin, I would be looking to discuss switching to Lantus or Levemir with my vet.


    Mogs
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  12. mary hornbeck

    mary hornbeck Member

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    What would his renal threshold be? Should I consider this change with vet by the numbers on his spreadsheet?
     
  13. Kris & Teasel

    Kris & Teasel Well-Known Member

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    To determine renal threshold you can test urine multiple times using urine glucose test strips. Any BG readings that are associated with a negative urine glucose are below renal threshold. What BG range this is varies with the cat but is somewhere around 200.
     
  14. mary hornbeck

    mary hornbeck Member

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    Oh my god, there is no way I could do that
     
  15. Critter Mom

    Critter Mom Well-Known Member

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    It varies from cat to cat. Also I've never seen a definitive reference range for it anywhere. For example:

    From Petdiabetes Wikia:

    From the Vetsulin Website:

    The vets I've dealt with here tend to use 11.1mmol/L / 200mg/dL (as measured on pet-calibrated equipment) as a nominal renal threshold.

    You can have a stab at establishing a rough idea of a given cat's renal threshold by testing its urine at home and analysing results alongside home BG tests but it's fairly crude. If the cat remains consistently negative for glycosuria over a series of tests then the highest BG values for the corresponding period will be under the renal threshold for that cat. As I said, crude.


    Didn't I read above that your vet already recommended the 1.5IU dose? (Sorry if I've got this wrong.)

    ETA: Mea culpa! I misunderstood your question. I see now that you're asking about whether you should consider discussing a change of insulin with your vet.

    I think if I were in this position I'd try holding the dose recommended by the vet for several days (up to a week) unless it needed reducing, and then re-evaluate.

    Vetsulin can work well for some cats, others not so much. Much of the time the problem is very often one of inadequate duration; the dose peters out too soon and numbers at preshot tend therefore to be a good deal higher than desirable. This then leads to setting doses which either drop the cat too fast (and often too far) or which don't move the BG into sufficiently effective ranges during the insulin's peak period of action.

    The L insulins (Lantus and Levemir) typically don't tend to produce such wide swings in BG (when a 'good' dose is established) and they have greater duration in cats. This means that they're better at keeping numbers down (cf. the likes of Vetsulin and Novolin N which typically yank numbers down) and the range in BG levels between PS and nadir tends to be narrower on average.

    Choice of insulin depends on the cat's response (is the current insulin keeping the cat properly regulated?) and the caregiver's situation (can caregiver test frequently enough and dose on a consistent 12/12 basis the vast majority of the time (as required by depot insulins) or is more flexibility required (an in-out with better duration such as Prozinc might be more suitable).

    A given vet's view of what constitutes satisfactory regulation in a diabetic cat will influence how they interpret a cat's BG data and the judgments they will make about the effectiveness of the insulin in use. Regulation goals can vary from vet to vet. For example, some vets are happy if BG levels stay under 300mg/dL for most of the day with the cat spending at least a fair proportion of each day under the renal threshold. Other vets may only consider the cat to be well-regulated if it remains under the renal threshold.

    Your objectives for Marmalade's treatment may perhaps be more ambitious than those of your vet, especially as you're home testing. It might be helpful to discuss treatment objectives with your vet so that you'll both be on the same page. With this established it should provide a good foundation for evaluating Vetsulin's effectiveness (or possible lack thereof) in adequately regulating Marmalade's blood glucose levels. Thereafter you could discuss other possible insulin choices.


    Mogs
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    Last edited: Jan 7, 2018
  16. mary hornbeck

    mary hornbeck Member

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    Yes, she did. I tend to repeat myself, sorry
     
  17. Critter Mom

    Critter Mom Well-Known Member

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    It's me who owes you the apology, Mary! :) (Not feeling very well so really not with it. :oops: )

    I've amended my previous post.


    Mogs
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    Last edited: Jan 8, 2018
  18. Critter Mom

    Critter Mom Well-Known Member

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    Hi Mary,

    Just popped in to have a look at Marmalade's spreadsheet. Marmalade seems to be settling somewhat and getting better mid-cycle numbers on the 1.5IU dose. How is he feeling/acting? Any better?

    What times do you feed Marmalade on the AM and PM cycles? (Times relative to insulin dose time.)


    Mogs
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  19. mary hornbeck

    mary hornbeck Member

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    Hi a Critter Mom:
    Thank you for taking a peak at marmalades SS. He seems to be doing very well on the 1.5IU dose. I have even gotten some blues inbetween the AMPS and PMPS. He is alert and hanging a lot with me on my bed. He is getting fed at 6a and 6p which seems to be working well. I have changed the amount of food to 1/2 cans twice a day. Prior, last week I was feeding him up to 4 cans of the friskies per day. It seems like the half can twice a day is keeping his numbers down. At first I didn’t think that this would hold him over but he is keeping the weight on and is showing no signs of bowel problems. He is always Hungary in his head so that’s nothing new. I just updated his SS if you want to take another peak.
     
    Last edited: Jan 13, 2018
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  20. Critter Mom

    Critter Mom Well-Known Member

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    Hi Mary,

    Glad to hear that Marmalade's doing well on the new feeding routine and that the 1.5IU dose seems to have evened him out a bit. Check out those improvements in the preshot BGs! :)

    Is there any time when you'd be able to snag some more BG checks between +3 and +6? These are the hours when nadir is more likely to occur in a Vetsulin kitty, although ECID. Especially with those lower PS values you're seeing you need to keep a close eye to see how low the dose is taking Marmalade mid-cycle to make sure he's safe. The Vetsulin seems to kick in fairly early in the cycle in Marmalade's case, as you can see by the drops in BG between the preshot and +2 readings.


    Mogs
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  21. mary hornbeck

    mary hornbeck Member

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    I can try tomorrow to get some +3 and +6, would that be at both am and pm, right
     
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  22. mary hornbeck

    mary hornbeck Member

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    Sep 22, 2017
    back in the purple, PMPS
     
  23. Critter Mom

    Critter Mom Well-Known Member

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    Better than red! :)

    I know it doesn't help much but keep remembering, "Marathon, not sprint!" :D


    Mogs
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  24. mary hornbeck

    mary hornbeck Member

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    Yes, I was glad that he wasn’t in the red. I was hoping for yellow though. I get so close to yellow, usually
     
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  25. Critter Mom

    Critter Mom Well-Known Member

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    A +5 might be more helpful than a +6, BTW, as it will help 'fill in the picture' a bit more. :) If you get the +3 and +5 on the AM cycle and a +3 on the PM cycle that would be great. :)


    Mogs
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  26. mary hornbeck

    mary hornbeck Member

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    You got it
     
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  27. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Looking good! :)
     
  28. mary hornbeck

    mary hornbeck Member

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    Thank u
     
  29. mary hornbeck

    mary hornbeck Member

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    Just got pm BG 199, I’ll get a +3 and +5 tomorrow morning
     
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  30. Critter Mom

    Critter Mom Well-Known Member

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    Nice to see Marmalade back in blues. Will try to check back in tomorrow evening to see how you both get on. :)


    Mogs
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  31. mary hornbeck

    mary hornbeck Member

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  32. mary hornbeck

    mary hornbeck Member

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    Hi critter mom, just wanted to get some feedback from you on marmalades numbers today and yesterday
     
  33. Critter Mom

    Critter Mom Well-Known Member

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    Hi Mary,

    Just had a gander at Marmalade's spreadsheet. What a sprag that he was too low to dose on yesterday's AM cycle! :rolleyes: I had hoped you'd be able to get a look at whether Marmalade goes lower earlier in the cycle on the current dose. Nevertheless, the data you gathered is still helpful because it gives you a snapshot of how he'd be doing if he wasn't getting any insulin at all. There's no such thing as bad data! :)

    The PM +3 was a little higher than in recent cycles but that may be due to the skipped AM dose. Although technically the effect of each Vetsulin dose is supposed to be out of the system within 12 hours it is possible to get a slight carryover of effect into the next cycle in some cats. Since Marmalade didn't have any insulin yesterday morning it is possible that he may be getting a teensy bit of carryover effect between doses and if so absence of that effect could account for the slightly higher than usual PM+3 yestereve. Or he may just have eaten a bit more early in the PM cycle. Impossible to draw any conclusions on only a few data points.


    Mogs
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  34. mary hornbeck

    mary hornbeck Member

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    Got a +3 today, the 15th, and he’s definately not going lower, which is a good thing.
     
  35. Critter Mom

    Critter Mom Well-Known Member

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    It's great that you got the test, Mary, but this AM cycle it was only a dose of 1.0 IU; unfortunately it doesn't shed any light on how Marmalade responds to the 1.5IU dose on the AM cycle. I was hoping that yesterday you might have been able to see whether Marmalade goes to a low-ish AM nadir on the 1.5IU dose, and whether as a consequence there might be a little bit of bounce influence to send him higher at PMPS.

    Looking at Marmalade's spreadsheet, on the 1.5IU dose of Vetsulin he seems to have a pattern of having AMPS values on the low side (too low to give Vetsulin yesterday AM), but then he has those high PMPS values.

    >> Is there any difference in his feeding routines between AM and PM cycles (particularly the 2nd part of each cycle)?

    >> Is there any way you might be able to get some BG tests done between +6 and +10 on the PM cycle some time over the next few days? (Suggesting this to better understand whether Marmalade is rising or falling when he gets blue AMPS numbers.)

    Sometimes when a cat has a pattern of 'lopsided' PS values where one of the PS BGs is frequently too low to safely dose, then dropping the dose down a little can sometimes lead to two 'shootable' PS numbers and more consistent dosing of insulin. PS levels and cycle nadirs (and ketone status, if applicable) all need to be assessed when considering such dosing decisions. There are still gaps in Marmalade's 'picture' so you don't know whether or not such a dosing strategy would help (1.0IU looks like that's too little insulin for him) but hopefully with a little more strategic testing you'll be able to fill in those gaps and better understand what's happening. This should hopefully make treatment decisions more straightforward. :)


    Mogs
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  36. mary hornbeck

    mary hornbeck Member

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    So that would be at 12a and 4a?,on the PMPS, he gets fed at 6p
     
  37. Critter Mom

    Critter Mom Well-Known Member

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    I don't know the clock times (we're all in different time zones). The reason we use the '+' notation is because of the need to know what the BG is doing at a certain time after the insulin has been given, since there are variations in the way different insulins work (their 'action profiles').

    In saying that, it would be very helpful to you to get readings in the period +6 to +10 it could be a +6, +7, +8, +9, or +10 reading. The time of day depends on the time you give the dose.

    Does he get any food later than that? If yes, then when?

    Also, when does he get fed on the AM cycle?


    Mogs
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    Last edited: Jan 17, 2018
  38. mary hornbeck

    mary hornbeck Member

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    There is no difference in his feeding routines. I’ll try to do some +6 and +10 done over the next couple of days if not the weekend. I have also been wondering if he’s rising or falling by the later end of
    PMPS but it’s rough when I am early for work
    sorry this is so late. After 6p he doesn’t get any food. On the am cycle he gets fed at 6a and in the evening he is a 6p. I just got a BG this evening and posted in main health forum but nobody responded so I went ahead and gave him 1.5u, see SS. Correction, someone just got back to me.
     
  39. mary hornbeck

    mary hornbeck Member

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    Hi, got somewhat of a curve last night but couldn’t keep my eyes open past 3a, any thoughts would be welcomed at this point. Updated SS for interpretation from any members
     
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  40. Critter Mom

    Critter Mom Well-Known Member

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    Hi Mary,

    You did great last night! I'm so glad that you caught that 82! Good job getting the additional tests today, too. :)

    I'll respond tomorrow (I've got chronic health issues and I'm in a lot of pain right now). When you next get a chance, it would be great if you could get some tests on the AM cycle between the hours of +4 and +7 after the dose, as your schedule permits.

    How is Marmalade feeling/behaving on the 1.5IU dose, BTW?

    Nice PMPS tonight, BTW. Be sure to get a 'before bed' test for safety - at +3 after PM dose.


    Mogs
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    Last edited: Jan 16, 2018
  41. mary hornbeck

    mary hornbeck Member

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    He is doing great, alert and feisty. He is a little uncooperative with the ear sticks so I think that I’ll give him a break for now. It seems that the 1.5IU is working well for him. I hope you feel better. He loves to,play with hair ties. I think over the weekend I’ll work on your suggestions for the am cycle in terms of data. Looking forward to hear your interpretation of last night.
     
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  42. Critter Mom

    Critter Mom Well-Known Member

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    Hi Mary,

    How many hours are you away from tonight's PMPS?


    Mogs
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  43. Kris & Teasel

    Kris & Teasel Well-Known Member

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    So far the 1.5 u dose seems to be a good one. :)
     
  44. JanetNJ

    JanetNJ Well-Known Member

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    Looks good
     
  45. Critter Mom

    Critter Mom Well-Known Member

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    Glad to see you here, Kris, because I'd appreciate it if you would review my thinking re Marmalade's current status.

    Holding the 1.5IU dose has, IMO, been far more successful than the 'sliding scale' approach. We're now getting a much better picture of Marmalade's response, and he has evened out a fair bit. However ...

    I've been keeping an eye on Marmalade's spreadsheet recently. Before Mary got all the recent, very helpful data I was already thinking that he might even out more on a lower dose (see post #235 above) and have more balanced preshot BGs which would, in turn, lessen the likelihood of needing to skip a dose. I was also very much wondering whether he might be going a bit low mid-cycle and getting bounce-influenced PS BGs as a consequence. As you can see from the spreadsheet, Marmalade has started seeing some PS BGs in much better numbers since Mary has been holding the dose at 1.5IU, which also lends weight to the suspicion that bouncing may be elevating some of the other PS readings.

    Mary has done a great job of monitoring over the last few days (great catch on the 56 last night, Mary!). The 82 nadir the night before last was, to my way of thinking, already too low for comfort for a cat on Vetsulin but last night's 56 nadir is, in my considered opinion, definitely way too low a nadir for a Vetsulin cat and therefore I think Marmalade's current dose of Vetsulin is now too high.

    If it were my cat, I would not be at all comfortable with Vetsulin nadirs as low as we now know Marmalade has been getting. I would instead seek to adjust the dose to target a nadir BG in the low 100s (human meter). This would leave a good safety buffer in case anything unexpected might cause a dip to a lower BG.

    This would be my approach:

    * If I was able to monitor closely I would reduce to 1.25IU BID for a few cycles and then reassess UNLESS the nadir got below the 90-100 range, in which case I would reduce again on the next cycle.

    * If I was not able to monitor closely, I'd be inclined to reduce to 1.0IU BID for a few cycles and then reassess the situation (again assuming that there were neither too-low nadirs nor sky-high BGs in the meantime).

    * I would monitor urine daily for ketones as a precaution.

    ETA: I would religiously do 'before bed' checks every night for safety. Indeed, I'd do my level best to get a nadir BG check on each cycle. (Obviously people's schedules vary but getting nadir data whenever possible is becoming increasingly important here).

    My hope would be that a reduced dose might reduce bounce influence on the PS BGs and also keep Marmalade in a safer range at nadir, evening him out overall.

    Kris, I'd very much welcome your feedback and comments on the above.


    Mogs
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    Last edited: Jan 17, 2018
  46. Critter Mom

    Critter Mom Well-Known Member

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    This is really good to hear, Mary. :)

    I hope the above post with my thoughts on Marmalade's response to his current Vetsulin dose is helpful to you.


    Mogs
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  47. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Your analysis is spot on, Mogs. :) I admit that I scanned the data quickly and neglected to factor in the insulin. Yes, I agree that a bit of a cushion at nadir is a good thing when using Vetsulin. I also think that consistent dosing has calmed things down. Thanks for doing this!
     
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  48. Critter Mom

    Critter Mom Well-Known Member

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    @Kris & Teasel - Thank you very much for reviewing and commenting on my input. I really don't feel comfortable being a voice in the wilderness when it comes to matters dose-related.


    Mogs
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  49. Critter Mom

    Critter Mom Well-Known Member

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    @mary hornbeck -

    I'm about to sign off but I just wanted to say that if Marmalade was my cat I would reduce his Vetsulin dose because I don't think the 1.5IU dose is safe. See my earlier post (#245) for reasoning, and suggestions on how to proceed. If you get stuck tonight, I suggest asking for help on the Feline Health board.

    ETA: I'd recommend getting tests at +3 as often as possible (especially on the PM cycle) and if he's already dropped a good bit by then I'd recommend further tests in that cycle to make sure Marmalade isn't going too low.


    Mogs
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    Last edited: Jan 17, 2018
  50. mary hornbeck

    mary hornbeck Member

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    Hi mogs,I’m so sorry that I missed you. I was really nervous last night when he got low so,I gave him some fancy feast with gravy and that brought him up to safer numbers. I was kind of thinking the same thing that the 1.5u was taking him to low.

    Since I didn’t see this message earlier I updated his SS and went with his 1.5Iu dose tonight. I also gave him a can of beyond pheasant and sweet potatoe food to see if his scratching would ease up. I plan to get at least a +3 tonight.
     
    Last edited: Jan 17, 2018
  51. mary hornbeck

    mary hornbeck Member

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  52. mary hornbeck

    mary hornbeck Member

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    Just took BG on marmalade, a +3. BG 127, insulin vetsulin, just gave more beyond cat food in case BG continues to drop. See SS as referance point. At this point more date highly suggests 1.25?
     
    Last edited: Jan 17, 2018
  53. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes. It seems the 1.5 u dose is too high. I’d go down to 1.25 u tomorrow AM. A few more BG tests over the next couple of hours would be good. She still has some time before hitting nadir.
     
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  54. Critter Mom

    Critter Mom Well-Known Member

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    Hi Mary,

    I see you've reduced the Vetsulin dose. Be sure to keep your vet in the loop on the nadir BGs and dosing, and also make sure you check regularly for urine ketones.

    Looking at Marmalade's pattern of response to Vetsulin with the data currently available it looks like he tends to be at his lowest somewhere between +3 and +7 after the dose was administered so that might be the best window for testing. If he were mine I'd want to get a +3 'before bed' test at minimum each PM cycle for safety. If the +3 is on the low side it would probably be advisable to test again later in the cycle to see just how low he goes.

    It may take several cycles before you start to see what the 1.25IU dose is doing.

    If the 1.25IU dose doesn't work well enough then it might be time to consider whether switching to a longer-acting insulin with a 'gentler' action profile (Lantus or Levemir) might work better for Marmalade than Vetsulin. (The 'L' insulins are typically better at holding numbers down in better ranges for longer and, again typically, don't tend to drop BG as fast and as far as Vetsulin tends to do at onset.) I'm only mentioning this as a possibility to consider for now.


    Mogs
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  55. mary hornbeck

    mary hornbeck Member

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    I think a longer acting insulin would be better but the cost is so far out of my budget for the two you have mentioned. It’s definately worth considering though.
     
  56. Critter Mom

    Critter Mom Well-Known Member

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    Have you checked the Supply Closet or considered ordering an L insulin from Canada?


    Mogs
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  57. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Just as a reference, evaluate Levemir. I obtain a 5-pack of pens, from Alan Hamman in the Supply Closet subforum ...whenever I do refills.
    300 units/pen, 5 pens = 1500 units
    If you used 4 units/day, that is 375 days worth (one year)

    If you purchased a single pen
    (300 units) / (4 units/day) = 75 days worth (2.5 months)

    5 pens are $180 inclusive of shipping.
    One pen would be around $35 (not sure about shipping). Let's call it $40.
    Over 75 days that would be about $0.50/day (50 cents).
     
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  58. Critter Mom

    Critter Mom Well-Known Member

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    @JeffJ - Ta oodles for the Levemir sourcing tips and cost analysis. :)


    Mogs
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  59. mary hornbeck

    mary hornbeck Member

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    Hi critter mom:
    B.B. I have been doing 1.25u for wboutb2 days now so can u please evaluate, see SS. Thanks. AMPS and PMPS still pretty high. Thank u

    Mary
     
  60. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Mary,

    Had a look at the spreadsheet.

    First up, it can take more than 2 days for a dose to 'settle' before you can get a picture of its efficacy.

    At the moment you don't yet have enough tests in to evaluate how low the current dose is taking Marmalade. Looking at Marmalade's pattern of response he tends to have his nadir at some time between +3 and +7 hours after the insulin dose was administered, so those are the periods during which you need test more to find out how he's responding mid-cycle (particularly around the +4 and +5 mark when the Vetsulin is at its most potent and it has been a while since Marmalade was fed).

    It's recommended to check nadirs on both AM and PM cycles because some cats have a marked tendency to run lower on one or the other.


    Mogs
    .
     
    Last edited: Jan 20, 2018
  61. mary hornbeck

    mary hornbeck Member

    Joined:
    Sep 22, 2017
    Just told k BG 201, at 12p
     
  62. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Mary,

    Been checking Marmalade's spreadsheet and you've done fabulously with getting data today. :) It would be a great help, provided your schedule allows, to get a +4 or thereabouts on tomorrow's AM cycle.


    Mogs
    .
     
  63. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    PS ...

    If today's AM+4 is significantly lower than of late, it would be great if you could get some additional tests during the period between +4 and +7 if your schedule allows.


    Mogs
    .
     
  64. mary hornbeck

    mary hornbeck Member

    Joined:
    Sep 22, 2017
    Hi critter mom, unfortunately I will be working until 3:30/4p tomorrow so I could get a +3 in the morning, hopefully.
     
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  65. mary hornbeck

    mary hornbeck Member

    Joined:
    Sep 22, 2017
    Hey critter mom, just updated marmalades SS. Numbers really good. What do you think marmalades 6p dose should be ? Stay at 1.25iu
     
    Critter Mom likes this.
  66. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I don't think Mogs is around today, Mary. I suggest you keep the 1.25 u dose for now and try for some mid cycle tests either tonight or tomorrow.
     
    JeffJ likes this.
  67. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Mary,

    Sorry I wasn't around yesterday.

    Glad to see Marmalade evening out a bit. I'd suggest keeping the 1.25IU dose for now, unless it needs to be reduced or numbers start showing a marked upward trend. Carry on getting the AMPS and PMPS tests and at least one mid-cycle test each day as close to the time you anticipate Marmalade is likely to reach his nadir BG. Any day that your schedule allows, try to get nadir checks on both the AM and PM cycles.

    How is Marmalade feeling/behaving at the better numbers; any changes?


    Mogs
    .
     
    Kris & Teasel likes this.
  68. mary hornbeck

    mary hornbeck Member

    Joined:
    Sep 22, 2017
    He is doing very well and is acting his normal self. He is now eating Merrick limited ingredient cat food and licks the plate clean. His melonoma is getting better as he is on terramycin two times a day for 10 days, for now. According to the vet he will have these flare up for life. I am definately sticking with the 1.25 units. No apologies necessary we all have things to do in life
     
    Last edited: Jan 23, 2018
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  69. mary hornbeck

    mary hornbeck Member

    Joined:
    Sep 22, 2017
    What happened? Back in the purple. Per SS update
     
  70. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Mary,

    One possibility is that Marmalade may be going lower at night and that might have caused a bounce to this morning's AMPS. That said, the pink was just a tad on the high side (though not totally out of kilter with other recent AMPS values after Marmalade dipped into the greens on the previous PM cycle). I'd suggest that if you get a reading that's a lot higher or lower than the recent trend values to immediately retest BG as a precaution to make sure it wasn't a dodgy reading. I'd also suggest that you get a before bed test (probably +3 hrs after insulin dose) on each PM cycle to get an idea of whether Marmalade might go lower during the night (safety precaution - ETA: Marmalade's shown that he can dip into double figures during the PM cycle on the 1.25IU dose already).

    I'm very glad to read that the antibiotic treatment is helping Marmalade's eye. (((Marmalade))) Also glad to hear he's generally feeling well in himself.


    Mogs
    .
     
    Last edited: Jan 25, 2018
  71. mary hornbeck

    mary hornbeck Member

    Joined:
    Sep 22, 2017
    Hi mogs:
    I feel so bad for my poor marmalade. He is getting a double whammy, between the testing and eye ointment he is cowering his head and tries to run away from me. I feel so overwhelmed with everything. Thank god the weekend is right around the corner.
     
    JeffJ likes this.
  72. Sharon14

    Sharon14 Well-Known Member

    Joined:
    Aug 16, 2015
    Poor Marmalade. How much longer does he need the eye meds? Maybe some extra attention with no meds or tests, just cuddle time with his mom. If he likes cat nip, sprinkle some around for him, I know that makes Colin happy.:bighug:
     
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  73. mary hornbeck

    mary hornbeck Member

    Joined:
    Sep 22, 2017
    I am hoping that the eye ointment will run its course by Monday but the last time this happened he was on the meds for two weeks. The first go about with this I switched the first ointment to another which was the terramycin. I miss so much seeing both eyes open.
     
  74. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    ((((Mary and Marmalade))))

    :bighug::bighug::bighug:


    Mogs
    .
     
  75. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Poor you and poor Marmalade. :(:bighug:
     
  76. mary hornbeck

    mary hornbeck Member

    Joined:
    Sep 22, 2017
    Marmalade still doing more squinting than opening eye. I am an emotional wreck
     
  77. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Mary,

    I really feel for you. From all your posts it shines how much you love your precious boy. Saying a little prayer for Marmalade's eye to improve very soon.

    (((Mary and Marmalade)))

    :bighug::bighug::bighug:


    Mogs
    .
     
    EricH. likes this.
  78. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Mary,

    Just checking in to ask how you and Marmalade are doing. (I know first hand how deeply distressing eye issues are - for both kitty and bean.) Sending positive healing vibes for Marmalade.

    :bighug::bighug::bighug:


    Mogs
    .
     
    EricH. likes this.
  79. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Worried about you two, Mary. If you get a chance an update on how Marmalade and yourself are doing would be welcome.

    :bighug:


    Mogs
    .
     

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