Cliff Notes, pt 2

http://www.felinediabetes.com/FDMB/threads/cliff-notes-pt-1.172947/#post-1897499

Doing a mini curve tonight, per vet's request. She wanted us to test every HR for four hours after insulin:

Using AT2--
PMPS=329
7u
+1 380
+2 381
+3 319
+4 176
+5.5 129
+6.5. 129

Wow, I'm surprised to see this low at +4!

 

+7.5 168
+10 286

 

Amps=278 AT2
Ate good; 7 u

 

Nice cycle last night!

 

+2 486 ugh... I'm tired

 

Bounce! Very nice otherwise.

 

+7 451 (Relion)

PMPS=382 (Relion)
7 units

Let's see what tonight brings!

 

+3.5 281 (relion)
+5 260
+7.25 189

 

Lookin good!

 

+10.25 167
+12.25 152

I'm still not understanding this continued drop later in the pm cycle. Stalling to see if I can shoot, otherwise, I will feed and wait 2hrs.

 

Is that with the AT or human meter? If Human meter that 152 is 1 point off from the 20% variance on the 189 (right in the variance if you count it as 37.8) so it could be him surfing. Chuck was doing this with his higher doses. If I reduced the by just a tiny fraction he wouldn't surf as long and would going up at +12.
Could be an option but I'll leave that up to you and the pros might have more insight.
Adding: I'm not sure if the AT has the 20% variance.

 

It's the relion meter right now. I'm trying to switch over, but I've been doing curves for vet with at2, and then I've been more comfortable with at2 when looking at low Preshot #s. Still getting used to human meter readings, so thank you for insight! I think a slight dose decrease in pm might help get the am Preshot # in range at +12.

 

Stalled abt 30min and got 189 on human/relion meter; 240 on at2

Might wait until top of hour and test one more time before proceeding. It's good he is rising, I'm just more comfortable with a little higher pre-shot #s. I will be home all day to monitor.

 

Total stall=1hr

Amps=205 relion
Ate well
7 u

Since this is the 2nd big stall in 4 days, I think I will decrease pm dose slightly. Maybe 6.75 or 6.5? Just need to get that shootable am # without so much effort, esp during work week.

 

Whew! Getting a good response is nerve wracking! I agree with what Steph said about surfing at a higher dose. Higher doses can increase the duration of the insulin.

Re meters: it's really confusing to second guess yourself because two meters give different readings. I suggest you use the AT for:

1. doing a curve for the vet
2. double checking a very low number (<50 on a human meter and <68 on the AT).

Stalling is difficult during the work week. Maybe try 6.75 u this weekend to see how he does? You're finally getting a grip and you want to hang on as much as possible.

 

Thanks, @Kris & Teasel ! i think I will go with 6.75 tonight. I don't want to lose ground, but I also wonder if a decrease at night will help the am cycle? I still plan to keep the am at 7u, or should I raise AM to 7.25? I've been staying the course this week with work during day, but now I think I should've shot 7.25 this am.

 

It's hard, Michele, and you can second guess yourself over and over. I don't know what to tell you. It's all data gathering as Sue would say. Every time you get to a new phase in dosing you're almost at square one in figuring it out. I'm there with Teasel right now. Let's see how Cliff's day unfolds.

 

I was more just thinking out loud... But thank you, as always. Will continue to gather data!

 

+7.5 464

PMPS=381
Ate well
6.75 u --small decrease to see if it helps get shootable amps and maybe less bounce during am

 

+3 366
+6 322

Perhaps I should not have decreased by 0.25 tonight. I was reading the Prozinc protocols this afternoon, and was thinking perhaps a 13/11 dosing would work better. Essentially, committing to an hour later in the am, giving shot at +13 everyday, which is what I've been doing with the stalling anyways. And since he runs higher during the day, dosing earlier at +11.

Still hopeful that he'll surf later. Will test before bed or early am.

We're staying the course for now. sending the vet another curve in a week, so we will see how he's doing then.

 

Amps=205--->I had set my alarm for +13, but Cliff woke me at +12.25
Fed, ate v good
7 units

 

This is excellent progress with Cliff!

 

+3.75 302--> again, Cliff woke me up, so I tested 15 min early

Kinda wonder if I had waited until the actual +4 if he might have been in the yellows!

I am starting to feel like we may be making progress. At the very least, I will know we gave Prozinc our best effort, if we have to switch. But, it seems like we are starting to get a response between 7 & 8 units here. The vet had said last week with Cliff's weight, 8u would be our cutoff. If he didn't respond we would switch. Maybe cliff read my emails? Or heard my convos w/Dave?

 

You will learn that they ALWAYS read our condos.....

 

I think you're right about getting to Cliff's "good dose" range. You can get the acro/antibody tests done later if this doesn't work out. Even if you get those tests done and the results are postive, you'd just be dosing around the condition anyway.

 

Thanks! I'm definitely approaching this one thing at a time. I'm committed to Prozinc right now, and for at least the next week or so. Cliff seems to be responding, so this is my focus. If we need to switch insulin, I will ask for the tests then. My thought-an unnecessary vet visit right now (just for bloodwork/tests) might disrupt our recent progress.

 

I think you might consider 11/13. His amps is not too low to shoot so he might be up a bit more by +13 but giving insulin before the pmps shoots up might flatten things out overall. Nice to see the yelllows. And I agree with others - "generally" youu see very little movement with a high dose cat as you increase the dose until you get into quite high doses. The amps is encouraging.

 

+7.25 338. Gave him lunch.

We're going out to see La La Land. Trying to see all the Best Picture noms befor next Sunday. Will be home for pm shot.

 

Hidden Figures!!!

 

Hidden Figures was an early favorite. I think Arrival and Hell or High Water are now 1 & 2 for me. But all the ones I've seen so far were really good. Still need to watch 3 more before next w/e!

 

PMPS=344
Ate ok
7u. --going back up to 7u, alarm is set for +13 tomorrow.

He seems a little more content lately. I hope he feels a little better with the yellows and blues.

 

Glad he seems to be feeling a bit better. My guess is the lower numbers do make him feel better.

 

+4.25 266

 

+7.25 256

 

Amps=197--> cats woke me up, had been begging for two hrs. Even though I was hoping for +13 this am, I went ahead on this +12 #

Ok good
7u

 

+3.25 321

 

Hee haw!! Great blue AMPS. Expect some bounce numbers after this. This seems to be the good dose range for Cliff. You might have to play around with 0.25 u ups and downs or even fat/skinny doses but you're on your way.

 

Thank you for the encouragement! It's all very exciting and nerve-wracking at the same time.

 

Don't I know it!!

 

+8.25 426

Hm... it's going to be tricky trying to find the PM dose the allows him to surf throughout the evening/early morning without bouncing during the next day's AM cycle.

I'm decreasing slightly (0.25) back down to 6.75 for this evening's PM dose, because when I did that a couple days ago... he stayed in the pinks the following day's AM cycle, avoiding the reds.

 

Husband got home late, so pm shot was +12.75

PMPS=427
6.75

+3 332

 

+6.5 224

Off to bed. Cliff got fed.

 

+11 276
Amps=264
Gave fat 7.0

 

Those yellows are lovely!

 

+3 388
+7 398

 

Boing! Boing! Boing!

 

Just wish his am cycles would start to look more like his pm cycles. How to even him out/less bounce? ( i know there is no magic key... )

 

Pmps=357
6.75
+4 256

 

+6 214

 

Cliff woke us up, BG at +11.75 104

He is pretty mad that I'm stalling, stomping around. I'm waiting until +12.5 to test again. If he's not ok to shoot at next test, will probably feed and wait 2hrs for insulin.

 

Slept thru first alarm, so stalled longer... +13=132
fed them. Will test BG in 2hrs and hope for shootable #

 

Exciting times but very tense. You've hit his "magic zone" - now to figure it all out.

 

His BG two hours after food was 279

I gave him 6.75 units, and I think he'll be OK. I'm home in a few hours to check on him over lunch at +5

They were sharking/acting hungry after I gave him his shot, so I gave them a 2nd breakfast.

 

+4 304 came home a little early.

Dave should be home by +8 or 9. Will be shooting later tonight, because of "feed and wait 2hrs to shoot" in am.