Gracie has joined the sugar dance party

Discussion in 'Prozinc / PZI' started by Tina R, Dec 28, 2019.

  1. Tina R

    Tina R Member

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    Dec 27, 2017
    So, I woke up this morning planning to do a curve.

    Gracie is not due for inj until 10am but she was begging for food. I checked BG and it was 79.

    Do I pick up the food up at 8am and test again at AMPS?

    79 is too low to give insulin.
     
  2. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    Yes, please pick up the food.

    Take another test at shot time and post for advice. If you do not get a response, repost in the Health Forum.

    It would help tremendously if you could put what you shot AMPS and PMPS in the blue U column on the spreadsheet.
     
  3. Tina R

    Tina R Member

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    Dec 27, 2017
    I thought I was..... I will double check.
     
  4. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    You have the test numbers on your SS, but you only started to put the units on the SS for some of your most recent testing. We need to remember to take a closer look at the dates we are looking at. WAY DOWN, Down at the bottom of the SS.

    See you are doing the sugardance with your kitty Gracie for the second time. Should be easier the second time around.
     
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  5. Tina R

    Tina R Member

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    Dec 27, 2017
    Yes, she was OTJ and I became lazy and stopped testing.

    How does she increase after insulin. Ugh
     
  6. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    With that reported 79 this AM later in the PM cycle I'm guessing (it's not on the spreadsheet), I still have to wonder just how low Gracie is going mid cycle. Nadir (lowest point in cycle) with ProZinc is often between +4 and +7 in the cycle. The other day on this thread http://www.felinediabetes.com/FDMB/threads/bg-is-rising-post-surgery.222004/#post-2499195
    I suggested reducing the dose and it sounds like the dose may need to be reduced even more. Those higher numbers could be some bouncing from lows you aren't seeing or suggest dose is too high. I'd drop the dose back to 0.75u or if that's not possible, to 0.5u and grab some tests in the expected nadir hours when you can.

    Don't mean to sound like a broken record, but keeping the spreadsheet up to date and accurate makes it much easier for us to help because without the data it's impossible to know what is going on for sure and all we can do is speculate.
     
  7. Tina R

    Tina R Member

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    Dec 27, 2017
    I understand and I will try to update in real time. I've been out of practice for awhile. I have updated my SS with current numbers. I actually think she needs a higher dose (and I could be wrong). Why? She was so flat yesterday. There was virtually zero improvement in her BG. This morning I gave her 1.25 and I can already see an improvement in her numbers and her overall personality. She was hiding alot yesterday. I speculate that was from her BG, but again that is pure speculation. Who knows.

    I will be able to get a late test tonight....not just before bed test, but late enough that I will know or (should know) if her BG is going to drop again and hit the 70's.
     
  8. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Flat yellow cycles are often a sign that a bounce is about to break and therefore raising doses on those flat cycles is not advisable unless you can monitor closely. Knowing Gracie has had BGs in the 70s means a dose increase when the bounce clears could cause her BG to drop even more, possibly to dangerously low levels. Reacting to one day of numbers rather than the pattern over a few days or a week is not advisable either. When you have had a low reading at pre-shot and then don't test for a couple of days, you really need to be cautious about dosing. Hypoglycemia can be fatal and right now you have no idea how low Gracie's BG might be dropping on any dose.
    Are all the dose cells that are empty since the 25th of Dec indicating doses have been missed or are they just not filled in?
     
  9. Tina R

    Tina R Member

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    Dec 27, 2017
    I was not able to get a PMPS test and no insulin was given on the 25th and 26th. On the 27th there was no testing due to work.

    Everything on there is current. If Gracie's BG is below 100 at an AMPS or PMPS....and I will not be home to monitor I will not give insulin due to the risk of possible hypo.
     
  10. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    If you won't be home to monitor, and not knowing how low BG might be dropping, your no shoot number should be 200. Shooting a reading between 100 and 200 without knowing how low BG is dropping from the 200s could be extremely dangerous.
     
  11. Tina R

    Tina R Member

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    Dec 27, 2017
    Ok, I can make that my no shoot number. This was the case...in the early stages of first Dx. I assumed it would be a llittle different now.

    Ugh. I am so frustrated. I really expected her BG to get a little lower. Instead it peaked right back up. So, what is your recomendation right now? I can go back down to 1u but I felt like that did not do much of anything.
     
  12. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I still stand by dropping the dose to 0.75u for a few days to see what is going on. To be honest, if you can't get a few more tests at any time during the cycles, it makes it impossible to determine a good dose for Gracie. Right now most of her readings are below renal threshold so she is not in any danger and if you can't test her a little more, then having her run a little higher is better than letting her drop too low.

    This is a marathon not a sprint but testing is critical to getting your kitty down to better numbers. Increasing doses arbitrarily without knowing how low BG is going is dangerous so if you cannot get a few more tests consistently at least on days off in the timeframe when the insulin would normally be at peak activity (+4 to +7 post shot), then you are going to have to be happy with Gracie sitting in slightly higher numbers to keep her safe. You hold the needle so the final decision is of course yours to make. It looks to me like Gracie is bouncing from dropping into lower BGs than you are seeing from the testing you are doing and for that reason, I urge caution.
     
  13. Tina R

    Tina R Member

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    Dec 27, 2017
    My schedule makes it very difficult. Very difficult. I can only do so much. I can drop the dose to 0.75 tonight and for the next few cycles. It makes me nervous...only because I can generally tell when she is running high. More hiding, more h2o intake, increased appetite, but I am willing to try. After her dose tonight she will not get another shot until tomorrow at PMPS. I leave tonight (after PMPS) and will return tomororw afternoon.

    I could either give Gracie her dose tomorrow when I get home (roughly 4pm) or wait until my usual dose scheudle which is 9pm. My hunch is to stick with the normal dosing schedule.

    This week my schedule is more wonky than normal. I am usually home from work by 9am, but I agreed to cover extra hours in the monring (before BG issues)
     
  14. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    I understand that work scheduling makes it difficult to get tests at critical times but when you are home, grabbing a test no matter when it occurs in the cycle can help provide clues as to what is going on. I'm not trying to be difficult or unsympathetic but I am trying to keep Gracie safe and right now I am a bit concerned that she might be dropping lower than you are aware of at times. Try the lower dose and see how she does and grab tests when you can. You can't force this but you can keep Gracie safe by not reacting to a single higher BG.
     
  15. Tina R

    Tina R Member

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    Dec 27, 2017
    I do not think you are being difficult . I have been on the other side of this sugar dance trying to help others. It can be frustrating for both parties involved. I appreciate the help.
    I am not opposed to grabbing an extra test when I can. I have no objection to that.
    :)
     
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  16. Tina R

    Tina R Member

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    Dec 27, 2017
    What a week. SS is updated.

    What do you think about an increase in dose? I was thinking 1u. I'm not opposed to staying at the 0.75, but I do worry that the insulin is not doing much...but keeping her flat (still). I'm actually wondering if the insulin is doing anything. Yes, that could be my brain overrating. I know it could be much more worse.
     
    Last edited: Jan 4, 2020
  17. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    I agree it looks like Gracie may need a bit more insulin and you could try a dose of 1u and continue to try to get test whenever you can as that is the only way to know how each dose is working and how to make safe dose adjustments.
     
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  18. Tina R

    Tina R Member

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    Dec 27, 2017
    Will give her 1u tonight at PMPS (pending her numbers are ok). SS updated. Will get more tests whenever I can.

    I have to admit...I am slightly disappointed. I was hoping she would bounce back after her dental. Meh. So, it goes.
     
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  19. Tina R

    Tina R Member

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    Dec 27, 2017
    Holy moly. I did not expect that green this morning. I wish I would have rested a second time. I gave her HC food since I assumed I needed to shoot, but after thinking about it at the doctor I realized that I probably shouldn't have gave the HC food and just rested.

    It looks like she bounced. She's in the 300's now. I'll get another test in before I leave in a couple of hours.
     
  20. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Did Gracie get a shot last night? I know you planned to give her 1u but there is nothing on the spreadsheet for last night. If you did give the insulin, the question becomes how low was her pre-shot last night because that 61 is a lot lower than expected for AMPS. If last night's pre-shot wasn't lower, then it appears Gracie may have gone even lower last night and 1u is too much insulin.
     
  21. Tina R

    Tina R Member

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    Dec 27, 2017
    Ugh. I thought my original post posted. I'm pretty sure I gave her shot, but I don't know why it is not in my book. There must be a way to check my meter, but I want to say I gave her 1u.

    When I saw the 61 I thought her dose was too high as well. Are you thinking I should go back down to .75? I feel like I could, but she was so flat.

    SS is updated to the most current numbers.

    I will be able to get a PMPS tonight and I think I might do a curve tomorrow...or maybe get a few extra tests around +4 and +8. Thoughts?
     
  22. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Yes I think you should reduce the dose to 0.75u. Your meter has a memory feature and will tell you if you tested but it won't tell you if you gave Gracie a shot or not. We've all had those moments when we get sidetracked and a shot gets missed so if it did, it's water under the bridge but do try to keep the SS updated each time you test or shoot so you know for sure. I always kept a separate note system going for shots in the container I kept with a week's count of syringes. That way, I always had a second check on myself if I forgot to log a shot.
     
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  23. Tina R

    Tina R Member

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    Dec 27, 2017
    Really? Even if she was flat while on it? I'm not opposed....
    Should I start that tonight?
     
  24. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    You can't really say Gracie was flat. You missed pre-tests and shots so we don't really know. What we do know is that somehow despite missing shots her BG dropped to 61 which is low enough to know 1u is too much insulin. 075u may also be too much insulin. Too much insulin can cause slightly higher numbers but somewhere you'll see that low and you already saw it with the 61. the only way to know if 0.75u is too much is to get tests whenever you can to see how low that dose is taking Gracie. Unfortunately, with all the missed pre-shot tests and missed shots, it's really difficult to say what dose would be best for Gracie right now.
     
  25. Tina R

    Tina R Member

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    Dec 27, 2017
    I'm almost starting to doubt the 61PS number. I wish I would have retested a second time. I would expect to see more of the low PS numbers if that was a true number. It could be that I am overlooking something too. I know it is hard to know what to do beings my schedule is wonky.

    I gave her 1u today and have managed to get a +2, +5. I plan to get 4 more tests in. This should give me some good data. I'm not opposed to dropping the dose again (despite what it looks like). I dislike basing that decision on one test though (that I did not double check).
    I know I have been known to make impulsive decisions too.

    Very difficult to know what to do.

    Again, I appreciate your help. I hope you don't take my reply as me being unappreciative. :)
     
  26. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I don't take your response to be unappreciative but given your schedule and inability to test regularly you need to dose cautiously which is what I suggested. When you get a low unexpected BG it would be a good idea to recheck but if you didn't recheck second guessing it after the fact and continuing to give the same dose when it appears Grace may have dropped even lower than 61 in the previous cycle, is simply dangerous.

    Gracie is your cat and you hold the needle but any advice you get from me will be based on what I would do with my own cat in the same circumstances. It may seem conservative to you but with tests and shots missed on several occasions it's certainly safer for Gracie.

    I stand by my recommendation to reduce the dose to 0.75u because any higher readings you got today are probably a bounce which will pass and you run the risk that Gracie's BG will drop too low. Hypos can be fatal. Higher numbers for a few days are not.
     
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  27. Tina R

    Tina R Member

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    Dec 27, 2017
    Home curve is completed.

    Dose definitely needs to be lowered. I really expected her to start climbing up again. Ugh

    Should I try even a .5?
     
  28. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Methodically adjusting the dose by 0.25u at a time with monitoring ensures you don't skip over the best dose for Gracie but if you want to drop the dose to 0.5u that's fine. It may or may not be enough for her right now and you may find yourself increasing the dose again but you try it if you prefer.
     
  29. Tina R

    Tina R Member

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    Dec 27, 2017
    I gave her 0.75ish this morning. Very hard to eyeball with the u40 syringes. I always feel like I'm not injecting her, or giving FS with the low dose.
     
  30. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    The in between doses can be hard to eyeball. Do your syringes have half unit markings on them? If not, I would suggest getting some as it does make it considerably easier. In the meantime, you can make yourself a sample using coloured water in a used syringe for comparison to keep the dose consistent if not exactly accurate which is nearly impossible.
     
  31. Tina R

    Tina R Member

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    Dec 27, 2017
    I don't think they do. They might though. I can double check in the morning.
     
  32. Tina R

    Tina R Member

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    Dec 27, 2017
    Well, I didn't see that coming. I think she actually received a closer dose of 0.5 today. I have noticed since the reduction she seems to be feeling better. Not fully...but she is more social. I hope it is not a fluke.

    I am a little worried...that at +3 she was at 162. I know that is not a hypo...but it seems a little early to have dropped a whole 100pts.
     
  33. Tina R

    Tina R Member

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    Dec 27, 2017
    SS is updated finally. My ability to get mid-cycle numbers is hard right now partly due to schedule. I'm going to try and get some tomorrow, Thursday and Friday.
     
  34. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Hi Tina!

    Would you do one thing for us please? Go into your google account and drag that 2020 SS tab over to the left hand side. By default, that is the first one that opens for us when we view your SS.

    Any days where you skip insulin, put 0 in the units column.
    Thanks.
     
  35. Tina R

    Tina R Member

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    Dec 27, 2017
    Hi Deb!

    I didn't know I could do that. DONE!! and noted on units. Thanks for the tips
     

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