http://www.felinediabetes.com/FDMB/threads/numbers-decent-with-1-2-the-dose.225964/#post-2534669 New thread
@Juls and Billy that's what I'm betting too. Unfortunately I sleep past my alarm and didn't get a test till +8 @121 by then back on the rise, can't say for sure that he dropped into the greens. I'm sure he did but don't know for sure. Will do better tomorrow.
Patty, remind yourself please that you work at night and need to get some sleep during the day. OK? Then proceed from there and forget about "missing" the +8 test. Go with the data you do have. You are harder on yourself than you need to be. Teal'c is getting better. Slowly but surely, he is getting better. Believe in yourself.
Hummm very high tonight 545. Threw up 30 minutes before test time. Clear liquid followed by brown the color of his food. Wouldn't eat what I put down tonight dumped that and put down his favorite ocean whitefish and tuna he is eating now. Would rather waste food then have him not eat.
That high is probably a little bounce. Poor kitty, no fun throwing up. But glad he ate, even if you did have to get out the favorite. And Deb's right. Sleep! Teal'c is doing well, (apart from the throwing up.)
Perhaps the most important guideline in shooting low is that any time you shoot your lowest ever number, you should get a +1 and +2 to give you an idea of how the cycle will go. If the +1 is not higher than PS, or if +2 is much lower than PS, that means “pay attention” over the next few hours. Those tests will also help you become even more data ready for the next time you are presented with a low preshot reading. Since I'm shooting lower I found this passage in the new stickies. Which made perfect since to me. Stayed up for the +1 and +2 both rising numbers think I did the right thing. Kind of knew this is what I was going to do before I posted. Going to lay down for a bit work tonight. Will check back later.
Good for you shooting your lowest pre-shot ever!!! And finding the relevant passage in the protocol to help guide you. How much you want to bet that Teal'c will have a green at +6?
Teal'c is running pretty flat today, but that's not a bad thing. Look at all the pretty blues! I'm very interested to see where the PMPS falls.
That's the kind of bet you want to lose! Oh, I hope it's true though. Would be lovely to see Teal'c getting closer to remission. Fingers crossed!
Yeah I've been think he needs less too. I even put that in my remarks this morning. Will have husband give 2.5 tonight and see where we are at in the morning. I would bet husband wouldn't have done 2.75 and done 2.5 anyway.
Husband did a pmps think he is worried cause we are shooting lower numbers. Went to vet clinic yesterday, had to get eye meds for the Shih Tzu. Vet asked how Teal'c was doing. Showed him my SS. He is suddenly interested in Teal'c's care. Told me to stay at 2.75 for the next two weeks. Told me not to worry over his numbers so much, and now wants to do a frutosimine test (misspelled of course) at the end of the two weeks. I wonder if in the beginning he just wrote Teal'c off and now that he is getting better he is ready to get involved. Should I let them do the test or is it just a waste of money? Oh and I'm not going to hold at 2.75 I'll do what Teal'c's numbers say I need to do. Oh and then he talks about cats under his care going in and out of remission. Same vet that was of no help in the beginning, wanted me to keep Teal'c on 36g dry food, same one who was like heres your Prozinc bye bye. No follow up appointments nothing. Ok end of rant sorry the man just makes me mad.
Yeah Bobby! for doing the PMPS test. I cheered when I read that! Vet rants. We know how you feel. Really? 2.75U for 2 weeks straight? When Teal'c is starting to get into good numbers and will need dose reductions WAAAAAAAY before that? My personal opinion is that since you are home testing, the fructosamine tests are a waste of money. You have much more accurate data from your daily tests than you would get from a fructosamine. Fructosamine "averages" the BG levels over the last 2-3 weeks. What do you think that would tell you? Oh @Juls and Billy Would you like to comment here on the value of the fructosamine test? Please be gentle and kind. We know what you really think.
Lol! Fructosamine test is for the vet, not us. My vet wanted Billy, who had been off insulin for over 20 days, to put him back on 2 units twice a day because his fruc test was a single point too high. Nope. Billy's am test Thursday was 77. Think I should have pumped 2 units of insulin into him? Only if I like rushing to the emergency vet! Vets are awesome in many ways, but most suck rabid wombats at feline diabetes . Huzzah for hubby doing the PM test! Awesome accomplishment!
Got another green below 90 going to drop down to 2.25 unless @Deb & Wink or @Juls and Billy either of you think I should wait.
No waiting. Drop the dose again. I might even drop it to 2U. Since you have switched Teal'c to Friskies pates, you've had to give a lot of reduced doses. 1U, 1.5U. Please be sure to test Teal'c for ketones every day. We just had a 3rd kitty with ketones and DKA post on the message board. Third one in the last 2 weeks. p.s. Juls and Billy are having internet connection issues. She managed to PM me late last night from her cell phone, that she will be unavailable at least until this evening, maybe longer.
Ok will drop to 2u tonight. Yes it is amazing how taking away even a reported low carb dry food helped. Will keep checking for ketones none present at the moment. Have been following the kitties with DKA closely and hoping they are all safe and recover from it. I have learned so much from you and Juls that some day I hope I feel comfortable enough to help others with my experience.
Moral support is important too. Anyone can do that part fairly easily. Pick one person here in the Prozinc forum and read and maybe comment on their thread. Even liking someones posts gives them a bit of support if you don't have the time to comment. That lets them know that people are paying attention and have read their post. Super easy to click on the "Like" in the lower right hand corner of a post. Katie BDZ and her cat Arya are in the Lantus ISG and is doing better. Chloe007 and is a bit touch and go, but doing better. She is in Feline Health forum. Marissa Bella. Her cat Bella is newly diagnosed DKA and HL and is in the vet hospital. Outcome unknown there. Also in Feline Health forum. She could really use some emotional support right now. She is feeling really guilty right now, single mom, young daughter, starts a new part time job next week. Really, really overwhelmed. http://www.felinediabetes.com/FDMB/threads/new-member-introduction.226362/#post-2536010
Thought I'd check in and let you know how he is doing. Since the dose change he has been high in the 400's at pmps. Been kind of back and forth amps yellow, blue and pink this morning. Not seeing any greens unless he is dropping greens while I sleep. No ketones present with the amount of cases in DKA recently keeping close eye on that. Had quite a scare last night pmps. Poked him and went to catch blood on end of test strip, he moved and only got a small amount of blood. Told him alright buddy you moved going to fault out and going to have to do it again. Could tell by amount in window on strip. Didn't fault out but came back HI. Almost freaked. Having never seen that before I calmed myself and tested again. 488 whice is high but better than that 2 letter word. Only slept 4 hours yesterday so I'm blaming my next mistake on that. This morning I picked up the food 30 mins late so was 1&1/2 hours before shot. When I remembered I hadn't picked it up. As I rushed to pick it up I saw him walking away from bowl, so pretty sure he ate something. Still food in bowl so he didn't eat much. I'm explaining this because his pmps was 322 could be slightly food influenced. He isn't eating like he was but we also are down to food he isn't wild about. Going to go get some he likes today. He is acting like he feels really well. Rolling around on floor playing with Shefoo. I even got 2 hugs from him this morning. He ran out the backdoor today and we walked around the backyard as he explored. He even jumped the gate. He would sit at it and meow for me to open it. Today I saw him at the gate so was heading to open it before he meowed and he jumped it clearing it. WOW. Haven't had concrete feet for quite awhile now and am using less litter. Still have to clean the self cleaning box twice a day but it is less of a mess. So my dilemma, he is obviously doing well, feeling well. However, I have seen no greens and only higher blues, with over 400 pmps. Thinking it's time to go up to 2.25 see if I can get some greens and lower blues and less red pmps. Thinking about starting 2.25 tonight.
Such a good sign that he's starting to feel better! That 489 last night looks suspiciously like bounce to me. Has me wondering if he might not have dipped into the green yesterday during the am cycle. Okay, this is just my gut reaction based on that possible bounce yesterday. I'd be tempted to hold at 2 units for at least a cycle or two. You're still getting some nice blues. Maybe a couple more cycles would clear that bounce. I'd wait to see what Deb has to say as well. She knows more about all this than I do.
Yeah for Teal'c jumping the fence and no "cement paws" from the litter! Feeling better, and showing you that he feels better is so encouraging and gratifying for you. I think Teal'c looked ok on the 2U. But only ok. You know he can do better than those higher blues at mid-cycle. May be a bit of a bounce there, both cycles yesterday and today's AMPS. Plus another bounce up to the reds at PMPS tonight, 3/3/20. No problem with going back to 2.25U dose. Teal'c has not been getting any greens at the lower 2U dose. So bumping the dose back up to 2.25U was the right thing to do. I think the 443 at PMPS tonight 3/3/20 is also a bounce. No harm done with the dose increase. In fact, hold the 2.25U dose for at least 3-6 cycles if you can. Dose has been fluctuating in the last week or so. You had to do that because of the low pre-shot tests. p.s. Been away most of the afternoon. Errands. Trying to catch back up with people. This may be late getting back to you.
Nah not too late. I think I've got this when it comes to dealing with Teal'c's diabetes and you are so busy with others this was more of a fyi. I also figured if I was wrong you would let me know.
Everytime I think I know what to expect Teal'c changes the rules. He likes to keep me guessing. So last night Bobby didn't give him his shot cause Teal'c was sleeping in the dinning room window. He made it sound like Teal'c wasn't interested. This morning I expected a high number and it was at 461 no worse then the day before. I fed him gave his shot 2.25 and took him to bed with me. Figured he would stay fairly high since no shot last night. Before I left for work I tested and got a 95. I'm like what?? Finished getting ready thinking about the 95 decided to retest and got a 101 so that reading was good. Can't know how low he went. Told Bobby no shot tonight. Hate doing that but no choice. Expecting high in morning not sure if this is trying to tell me something.
2 shots a day is optimal, but I know it can't always happen. Might be telling you it's time to reduce the dose again, but you can see how he does tomorrow and evaluate then. He has certainly been bouncing a bit. Don't forget to check for ketones with those skipped doses.
Dropping the dose tonight if we have a shootable number. 126@+8. Thought that the 95 @ + 11 yesterday could have been influenced by me taking him to bed with me and him having no access to his food. Today I had to choose take him and his food to the bedroom with me or leave him on the other side of the door. I ended up leaving him out of the bedroom. He cried outside the door only for a few minutes. When I got up checked his food bowl and it was empty checked his BG that's the 126. I did then give him another can of food hoping it brings BG up to a shootable number. I'm thinking the 95 was partially because of lack of access to food but even with access to food the difference was not as great as I thought it would be. Was hoping I could wait till Monday my next day off to lower the dose but don't want to keep skipping doses. So tonight giving 2 units. My question is can you still see bouncing with a lower dose. I don't want to freak out over higher numbers and consequently raise it back up. Wondering if last time we lowered the dose if I just didn't give him time to get settled into the lower dose.
Yes, you can see absolutely see bouncing from a lower dose. Bouncing can happen anytime a cat is in lower BG numbers than their body is used to. Bouncing and insulin doses are really only slightly connected. It's the low BG's that really determine if a cat will bounce. Not the amount of the insulin dose. The lower BG number does not even have to be low enough to be concerned about hypoglycemc numbers. A cat that is used to 200's at nadir, can bounce as high and for as long as a cat getting blues or greens at nadir time. Some cats will bounce all the way down the insulin dose reduction scale. And then again if the dose needs to be brought back up slightly and then lowered again, and then...................ad infinitum. If you look back at Teal'cs SS, you'll see what I'm talking about. Try to identify a few times when you think Teal'c was bouncing. Let me know the dates and cycles, and I'll tell you if I agree. Think of this as practice of looking at Teal'cs SS and trying to interpret the waves and patterns that you see. I'm not always right, but can spot a bounce fairly often. No rush on doing this. When you have some time.
These are the dates of what I think are bounces. 2/22 Amps off the lower numbers for 2/21 2/24 I shot a reduced dose on a 140 then had a high number at Pmps Thinking had greens the night of 2/23 based on the 140 Amps so the Pmps could be a bounce 2/25 Amps & Pmps off the greens on 2/24 PM cycle Continuation of bounce for Pmps 2/27 Pmps off what was possible greens in the AM based off the 121 @ +7 3/01 unsure not enough data but gave a dose of 2 units on a 285 also guessing could have had some nice greens on 2/29 PM so possible bounce 3/02 Pmps shot full dose on the Amps of 188 with a 192 @ +7 causing a bounce Pmps 3/03 Pmps suspect some lower numbers in the AM cycle based on the 154 @ +7 causing a bounce Pmps 3/04 Amps bounce off lower numbers PM cycle on 3/03 Pmps Suspect greens in the AM cycle on this day as well causing a bounce or continuation of bounce 3/05 Amps continuation of bounce from 3/04 3//07 Pmps possible greens based on the 129 @ +7 Those are what I think are bounces. I know where I went wrong when I held the 1.75 for 24 days. I wish there was a reset button and I could start over as if he had just been diagnosed. Not making the same mistakes I made in the beginning.
Don't fret about the past. I don't think there's a single person in here who didn't make any mistakes. I know I sure did! You are taking great care of Teal'c. It takes time to gain the knowledge and confidence and ECID data that you need. Personally, I think you rock.
This morning he was at 192 Amps I felt close enough to 200 should be safe so gave 2 units. He ate very well almost a whole can. Decided to stay up and test +1 looking for a rising number as expected from the food he ate. Instead he had dropped to 124. I have giving him 1 teaspoon of MC food to steer the drop back up a bit since we are fairly early in cycle. Will stay up and test in 1 hr to see where he is. Hope I have done the right thing.
Retested at +2 still dropping down to 67 +2 going to give more MC food or should I give HC food at this point
Went with medium carb food. I'm wondering do I need to drop the dose and if so how much. I have to work again tonight and am worried he might fall like a rock again but I won't be home to intervene. I'm also expecting a bounce. Not sure why I stayed up shooting a 192 but something told me too.
He was very happy to eat the medium food lol. Ate like he hadn't eaten in weeks back up to 91 @ +3.75. Think we are out of the woods got to get some sleep have to work 12 hrs tonight.
Looks like you handled the unexpected early drop very well and got Teal'c's BGL coming back up. I'm guessing his pancreas decided it was ready to make some insulin. I would have shot at the 192, you didn't do anything wrong. But I'm so glad you tested after! If it were me, I'd lower the dose again, as he dropped below 90. Maybe try 1.75 at PMPS, or even 1.5 if you're worried. Yes, he might be a bouncy boy again, but you two will ride it out. Well done!
Agree with Juls on dropping the dose again. Down to 1.75U. Teal'c is coming down the dosing ladder. This time at 1.75U is not like the last time you had Teal'c at that same dose. For one thing, you know not to hold the dose there for so long this time. For another thing, you have both Juls and Deb to watch over you. We're in your corner. p.s. Have not had time to look at SS for all the bounces you ID'd. Wanted to get this response back first. Here are a couple from the last 10 days. 2/27 - that PM black was a bounce 3/2 - that PM red was a bounce 3/3 - that PM red was a bounce which continued all the way through 3/5 PM 3/7 - that +11 for the AM was a bounce
For sure dropping the dose told Bobby 1.75 but being over 60 he complains about being able to focus on the small lines (both wear bifocals or readers to see lol) I told him if he was more comfortable with 1.5 that was fine just let me know. He wasn't as high at +11 as I thought he would be. Im off the next 3 days. Will be able to see how he does on new dose. So glad I decided to stay up to see where his BG went this morning.
Checking in on Teal'c to see how he is doing lately. Looked at the SS. 2 possibilities 1. Still bouncing. 2. Failed reduction I 'd like to see Teal'c at this reduced dose for 2 or 3 more cycles. If he's still high at mid-cycle , then I think he needs an increase again.
Ok, I going to do a curve tonight to see what he is doing through out the whole cycle. I was beginning to think the same thing. What I'm seeing now is very flat cycle holding in the 300 range. I tried to get a ketone test today but scared him. The strip ended up with litter on it so right now waiting for him to go again a litter box stalker lol.
Got some Blues +6 and +8. Just when you think it isn't going to get any better at this dose. Albeit, they are high blues, but blues none the less. I still have one more test in the curve before done then the preshot test. Wondering where that might end if he is clearing a bounce. Was happy to not see all pink numbers tonight.
Sometimes, it seems like our cats read our minds when we talk about a dose increase. Nice blues this evening. Let's see what he does for the AM. Bounce do you think?
Big bounce this morning thinking because he hadn't seen blues in a few days hoping after this clears he has better numbers.
Can't stay up this morning Gizmo (shih tzu) has a hair cut this afternoon that I have to get up for but will test him before I take Gizzie to her hair appointment.
You saw that bounce coming, and so did I. Waiting for those bounces to clear is so hard. Sometimes, you can "fatten" the dose a bit, say to just a smidge more than 1.75 a fat 1.75U and that will "kick" them out of the dive/bounce cycle and get things to improve. Send us a picture of Gizzie after her haircut.
Had thought about a F1.75 had seen others doing fat or skinny shots. Guessing a fat 1.75 I would pull up to just below the 2 unit mark. Will try that tonight. I'm home till +1 so I am giving shot tonight can get a +1 pm before I leave. Won't be home till shot time tomorrow morning. Rest of the week I'm gone by shot time. Friday I'm home by +10.5 pm so can get a test at that time. Saturday and Sunday I work full 12's so no pm test and Bobby will be doing the shots I'll prep the syringes for him. I'll be home for amps and shot everyday. Gizzie girl just before her hair cut. Lol she rolled in a mud puddle just before I took her.
Hoping the F1.75U helps Teal'c. Do your best to estimate the plunger positioning and keep it consistent. Some people even measure with calipers, to get those doses consistent. More common with people using lantus and U100 syringes. You can use U100 syringes with a U40 insulin. Takes a conversion chart, plus some adjustments/change in your mindset of how much to draw up in the syringe. I hear you on your work schedule. Dogs and mud puddles are like magnets. My golden retriever would seek out mud puddles and caper through them with glee. Liked to eat the ramps in the woods too, and they really stink when "regurgitated."
Had been thinking of u100 syringes from what I've been reading it is easier to micro dose with them I only have 30 u40 syringes left almost time to reorder so will get u100 this time. Do they come with the shorter needles I prefer the shorter 31 gauge needles I worry less about going through the tent.
Yes, I think you can get the shorter needles with U100 syringes. It's been so long since I had to buy any, I forget what the available needle lengths are. You DEFINITELY want to find ones that have the 1/2 unit markings on the barrel, 3/10 cc capacity (holds a maximum volume of 30 units)
Gizzie after hair cut. She is 14. Also included a pic of Fefe a chuwennie and Shefoo lynx point and now you have met the whole fur family.
Looks like the F1.75 cleared the bounce trying to decide what I should give him this morning lol. It's always early morning lol. Wondering if I hadn't worked would I have seen some greens. Going with 1 cause I don't want to skip.
Dang automatic litterbox came on in the middle of giving him his shot startling him. He took off with the needle still in him. Think he got the whole shot will mark it as a possible fur shot anyway.
Oh no! I always used to give Wink his insulin in my small hallway bathroom. Keeping the door closed kept the other cats out and helped keep the testing and shot routine a bit calmer. Mostly.
Getting ready to do a +2 the timing of the litterbox was bad and I knew someone had recently used it just wasn't thinking might have to think of moving things to a quieter location. Probably will lay down afterwards depending on results.
