NEW Update: Josie's bouncy return

Discussion in 'Prozinc / PZI' started by Jenna Josie, Oct 21, 2018.

  1. Jenna Josie

    Jenna Josie Member

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    Hi everyone.! Just wanted to check in after our trip. We got back Wednesday pm in time for Josie's shot, and her PMPS was "normal" for her (249), which was a happy surprise, actually, since she'd only been getting 1.2u for a week (a dose purposefully reduced from 1.6u since she wasn't going to be monitored).

    We worked her (too?) quickly back up to 1.6u and had a green today (although I suspect there was one on the pm of the 19th as well, given her +3 that night, and which would explain her pinks on the 20th), and so now of course she's up in the 290s for PMPS.

    Hoping she'll settle in . . .
     
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  2. Djamila

    Djamila Well-Known Member

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    Welcome back! How was your trip?

    I don't think the move to 1.6u was too fast, but knowing Josie, you might want to hang out there for another couple of cycles now and give her a chance to settle in before the next move (if one is needed).

    I hope you enjoyed your time away!
     
  3. Jenna Josie

    Jenna Josie Member

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    Well, she certainly seems to have “settled” ... essentially the same mid-yellow number all day, afaik. I’ll get a +3 in a couple of hours to see if this is one of those mysterious yellow runs that ends in a sudden drop. o_O
     
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  4. Djamila

    Djamila Well-Known Member

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    Maybe time for 1.8? If you are thinking about increasing, you might try going to 1.7 for one or two cycles and then 1.8. Kind of sneak in the increase and maybe she won't start bouncing ;)
     
  5. Jenna Josie

    Jenna Josie Member

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    Thanks, Djamila. I will do that if she doesn’t try something tricksy tonight.

    I *think* I’ve noticed that when she has these pancake-flat cycles, the third day (so, the 6th cycle) ends in a low- or mid-blue PMPS, at which point I’ve always pulled the dose at set her BG going back up again. So she is due for that if that’s indeed a pattern for her. (See SS dates around Sept 9, 17, 26, for example.)

    So if she tries that tonight, I may try being brave and shooting through the blues, maybe just skinnying up the 1.6. But if she’s still flat all day and into the PM, I’ll do 1.7, but probably not until the AM.

    The problem with going on vacation is that you lose too much consistency in the data gathering! :banghead:

    (The other problem is that there’s too much email to catch up on. :D)
     
  6. Jenna Josie

    Jenna Josie Member

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    PMPS is . . .427?? I have never seen that number before. I am so confused! :arghh:
     
  7. Djamila

    Djamila Well-Known Member

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    Yikes. any chance it was a bad test? Was the blood a little too much or too little?
     
  8. Jenna Josie

    Jenna Josie Member

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    Sadly, no. :( I tried a second one, and it was 435!

    She and the civvie were having quite a growling tussle maybe about 45 minutes before, but could that do it?
     
  9. Djamila

    Djamila Well-Known Member

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    I've heard that it can in some cats. I haven't noticed it in mine though. They seem to choose dinner time as their favorite time to get in a fight, and usually his PMPS (often done immediately after I pull him out of a wrestling match) is usually his lower PS number. But as with everything around here: ECID so maybe Josie gets riled up when she's in a tussle? I don't see any good reason for the high number, so assuming this is just a single red number, it could well be the fight.
     
  10. Jenna Josie

    Jenna Josie Member

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    I hope so! Cody was pouncing around at her pretty good (he got in trouble for it), and she got pretty riled up, but it wasn't immediately before the test, so I don't know how much to dis/count that.

    I really feel devastated by this. I would have been okay with it if it had been her number right when we got back, after a week of being on a dose that we knew was too low (but given for safety reasons while we were away). The only other thing I can think of is that I gave her the run of a room this afternoon where she was staying the week we were away. I know that the cat sitter had to bribe her with a Temptation or two, and I suppose there's a very off chance that Josie found (a) stray treat(s) somewhere, but I don't really believe that neither of the cats sniffed it out in the last 7 days.

    I will hope for a much better +3!
     
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  11. Djamila

    Djamila Well-Known Member

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    I know this is easier said then done, but try not to let it bother you too much. At this point it's just one number. And every once in awhile, weird numbers pop up. Especially in cats that are known to be less than consistent. Keep your eyes on the patterns, and toss out the outliers. You'll drive yourself crazy if you focus on individual numbers. :bighug::bighug::bighug:Hugs to you. Pour yourself a glass of wine/cup of tea and just enjoy your sweet furry little babies tonight.
     
  12. Jenna Josie

    Jenna Josie Member

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  13. Rachel

    Rachel Well-Known Member

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    Wow Josie! I'm going to go with "oh look a squirrel" syndrome. Djamila is right, until it becomes a pattern, one number is just one number. All cats throw these odd ones sometimes.
     
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  14. Jenna Josie

    Jenna Josie Member

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    And now this AMPS = 112. Immediate retest = 105.

    I can't even begin to think what/if anything her dose should be.

    :banghead::banghead::banghead:
     
  15. Djamila

    Djamila Well-Known Member

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    Are you home today? There are a few options:

    You could try 1u as it looks like you've done that before and been okay on lower numbers
    You could feed her, retest in a half hour, and decide your dose then after she's risen a little
    You could stall without feeding and keep retesting. This one would probably take longer, and it would throw off your schedule since Josie isnt' known to climb quickly at the end of her cycles.
     
  16. Jenna Josie

    Jenna Josie Member

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    I carved out time to check her at +5-6, but today is otherwise awful, including an event on campus this evening. I’m going to retest her in a minute ...
     
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  17. Jenna Josie

    Jenna Josie Member

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    After stalling : 92.

    Okay, at least I’m laughing now rather than crying!

    I fed her. I will test once more in 30 minutes and see what’s happening. If she’s climbing some, I’ll probably go with a token something, 1u or less.

    Current hypothesis: last night was, as Rachel suggests, a “squirrel!” moment brought on by the fight with the civvie and/or freaking out that she was in The Room where she was the week we were gone. The high number resulted in me going past 1.7 straight to 1.8, and this AMPS is just a really long cycle/response to the “large” (for her) increase.

    Too early for whisky, right? ;)
     
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  18. Jenna Josie

    Jenna Josie Member

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    127 thirty minutes after feeding. Went with 0.8u, half of what has been her "normal" dose.

    I left food in her timers, as usual, and am off to work with my fingers crossed but will be back to get what will now be her +4-5.

    EDIT: +4 = 238
     
    Last edited: Oct 25, 2018
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  19. Djamila

    Djamila Well-Known Member

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    Maybe she just didn't want you to go to work this morning, and that was the way she tried to keep you at home longer. ;) Her PMPS looks good considering the low dose this morning!
     
  20. Jenna Josie

    Jenna Josie Member

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    Ha! That may be, but only bc she knows that when I leave, she's going to have to stay in her room until I come back and let her out. (I have to do that bc the civvie is a grazer, and she'll scarf -- and barf -- all his food if I don't keep them separate. And then he eats her Zobaline-laced snacks, and everything's all messed up.)

    Re: her PMPS: I can't believe it after only a 1/2 AM dose! And now her +3 is 193, so yay!

    Maybe I should pretend the last 24 hours didn't happen?
     
  21. Djamila

    Djamila Well-Known Member

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    I don't know how to explain this, but one pattern I've noticed is that fairly often a bean will lower the dose for whatever reason, and then the next cycle will be really good - lower than normal. And then a cycle or two later the numbers will be back up again. But that reverse effect (lower dose = better cycle) happens fairly often. Looking at Josie's AMPS, it looks like that's what happened for her too. I don't think this morning's red is the same thing as the red from the day before yesterday. I think this one is an after-effect of the reduced dose. But I think we'll have a better idea after this weekend. Hopefully the reds will go far far away and never come back!
     
  22. Jenna Josie

    Jenna Josie Member

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    That’s what I was thinking/hoping, too, but I am glad to see that you think that may be the case as well: I do sometimes wonder if my “explanations” are just wishful thinking.
     
  23. Jenna Josie

    Jenna Josie Member

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    AMPS is much more her “normal,” thank goodness. I am going to do a mini-curve today and see if I can get a better picture of what’s going on with her. Hopefully yesterday was just a hangover of sorts from her odd high BG + the big drop, followed by the 1/2 dose.

    I have two questions: if a liver dumps sugars when the BG goes unusually low, is there some complementary physiological response when the BG goes unusually high? It just seems like going from 427 to 105 overnight on the 24th was too big a reaction to a 0.2u increase, even for her.

    Relatedly, if a BG is “stress-inflated,” is there a sense of how long it takes for that to clear vs a BG number that is high due to, say, a normal food spike?

    EDIT: I guess I’m wondering ... if the 427 wasn’t “real” or was just sort of temporary bc of the fight with the civvie, then dropping down to 105 would actually not surprise me given that she has tended to go lower/have a super-long cycle after about 5 or so pancake-flat cycles in the yellows. See post#5.
     
    Last edited: Oct 27, 2018
  24. Djamila

    Djamila Well-Known Member

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    I think the opposite process is part of the problem with our kitites. When BG goes high, the pancreas is supposed to pump out insulin. Our cats don't do that very well, so we inject them with insulin. However, it's not that their pancreases (pancreai? ;)) don't work at all, so sometimes they kick in a little more natural insulin than others, which can result in those weird cycles where you get more of a response than expected.

    For Sam, stress inflated numbers disappear pretty quickly, but ECID. Of course. It could take a couple of days to clear out the glucose dump.

    Teasel is similar to Josie in that he'll hang out in steady numbers for a good long while, and then all of a sudden he'll give Kris a lime green out of nowhere. So Kris gives Teasel more time at a given dose before changing him. The other side of that though is that in some cats, too long at a dose and they start to show insulin resistance. So you have to kind of figure out through time and data if Josie just needs more time at one dose, or if that will be bad for her. From your past data, holding her longer at a dose seemed to be working pretty well.

    I think right now your goal is to steady her again, and then go back to those sneaky, slow increases once she's done bouncing around so much.
     
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  25. Jenna Josie

    Jenna Josie Member

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    Good morning!

    Yes, I’m thinking that the “stress spike,” if that’s indeed what it was, was just extremely bad timing and derailed what would likely have been her pancake-flat-to-drop-off cycle (we should come up with a name for that!), and now she’s off bouncing, a bounce that is hopefully clearing some. We’ll see ...

    Just for the record, though, I just want to say that I don’t really think our cat is truly “bouncy,” at least not in the traditional sense! ;) Rather, she is “flat-and-dropsy.” (Kris once described it as having a sticky gas pedal, lol.). I would just like her to be flat-and-dropsy in the blues and dark greens rather than in the yellows and blues.

    But right now, yes, just hoping for some leveling out!

    P.S. It’s also occurred to me that all of this multi-colored nuttiness/bounciness, although certainly more dramatic in the last few days, also seems to have begun with the new ProZinc vial. With the week away (i.e., low dose, no data), though, I can’t do anything with that other than say, hmmm, that’s interesting.
     
  26. Jenna Josie

    Jenna Josie Member

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    Alrighty! So Josie has definitely leveled out, spending about 44 hours in the mid to low yellows.

    Her +10 is 170. Yay for blue!

    If she comes up by shot time, I think it’s time for a sneaky dose increase to 1.8 (we’ve given 1.7 for 5 cycles). If she is still around 170, I’m thinking to hold the 1.7 for one more cycle.

    But if she drops further — yes, I realize she should be rising between +10 and +12, but this is Josie :rolleyes: — I’m thinking 1.6, but I don’t want to mess her up again by giving her a chicken shot!

    Thoughts? Shot time will be about 7:15 CTD.
     
  27. Rachel

    Rachel Well-Known Member

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    Woohoo for a blue! :cool:

    I like your plan. I think an increase if she's gone up would be good and sticking to it if she sticks around where she is is good.

    Hopefully she won't drop further...yes I think the best thing to do is a tiny decrease if she does since we know how she tends to react when that happens usually!
     
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  28. Jenna Josie

    Jenna Josie Member

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    PMPS = 134. She has decided to be tricksy!

    I fed her and am going to retest in 20 or so minutes to be sure she is going up.

    Then, assuming she is at least 150, I will shoot 1.6.

    EDIT: I decided to shoot the 1.6. +20'ish minutes was essentially the same number -- 141 -- but that is also essentially the same number as the 150 I set for a 1.6 dose. I am nervous but have everything on hand and know what to do if she drops, and I will certainly get a +2 to see where she may be headed . . .

    Thanks, @Rachel, and @Djamila, too.

    EDIT #2: +2 is a surprisingly high 232.
     
    Last edited: Oct 28, 2018
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  29. Jenna Josie

    Jenna Josie Member

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    She is certainly bouncing this morning, back into the pinks for AMPS! Hopefully she’ll clear it in a cycle or two.

    I don’t know that we’ve shot through the blues successfully before. I usually lose my nerve and pull the dose. (I’m not counting last night’s 0.1u reduction against myself, lol.). I will be curious to see what happens, especially to see if she goes quickly back to flat-and-dropsy and, if so, if her pancake numbers are higher or lower than they were the last couple of days ...
     
  30. Jenna Josie

    Jenna Josie Member

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    Hey -- look at that! Two consecutive blue pre-shots! Looks like she cleared a bounce and may be settling in for some pancake numbers in the high blues/low yellows. Hopefully she'll settle in here for a couple of cycles before giving us one of her marathons that ends in a confoundingly low PS number. :rolleyes:
     
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  31. Djamila

    Djamila Well-Known Member

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    Yay! I was just going to suggest sneaking in just a teeny bit more insulin to see if you can get her to make a smile curve instead of these pancake flats, but maybe those are just Josie's way :cat:
     
  32. Jenna Josie

    Jenna Josie Member

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    I upped her to 1.9u yesterday morning, and she's been fairly high (yellows), including right at 200 at nadir last night. (EDIT: Make at ~200 at +6, since who knows when her nadir is!)

    AMPS = 126! <--- this is truly +13.25 because of daily savings/time change.

    This is her little trick! (See posts #14 and #28) I'm thinking to hold the dose or maybe to skinny it up just a little bit to 1.8. Will test again and see . . .

    Thoughts, if anyone's up?

    EDIT: 2nd test (+ 20 minutes) unchanged at 127. I am feeding her now and will get one more test in about 20 minutes (7:15 CDT), and decide on her dose then.
     
    Last edited: Nov 4, 2018
  33. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Maybe try 1.9 u again after feeding her and retesting (number permitting)?
     
  34. Jenna Josie

    Jenna Josie Member

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    Hi! Do you think “number permitting” would be pretty much anything higher than what’s she’s got now; I.e., something showing she’s on her way up, even it it is with food on board?

    EDIT: 179, so we're shooting the 1.9u.

    Thank you, Kris! Clearly not time-sensitive now, but I am curious to know your thoughts about the above since I'm still getting used to the idea of using food to raise the BG to a shootable number.
     
    Last edited: Nov 4, 2018
  35. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I did this stall/feed thing with Teasel when he was on ProZinc. He was usually higher after eating and waiting a bit. Sometimes I gave the full dose, sometimes a hair less. It depended on the other numbers preceding the stall. There are no hard and fast rules unfortunately. It's always an experiment.
     
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  36. Djamila

    Djamila Well-Known Member

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    Given that Josie has established this as a fairly typical response, and that you are able to test pretty regularly, I think the stall-with-food method could be good to help keep her dose consistent, and maybe even get the dose high enough that she could have some better nadirs....or any nadir really ;) She really does use prozinc like a slow release insulin, doesn't she? It's like she has a levemir nadir o_O
     
  37. Jenna Josie

    Jenna Josie Member

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    She's doing it again, only this time feed/stall didn't work: 155 and then 154. And her so-called "curve" yesterday had an apex rather than a nadir!

    I am worried that she's on her way *up* from something low overnight (and that the same thing happened overnight Sat/Sun . . . and that yesterday's mid-day pinks were actually a bounce from having a low number that I didn't know about overnight). I don't know that I really think that's true -- it seems pretty unlikely that she went from a 206 at +6 all the way down to, say, 50, and then back up to the 120s in the last half of the cycle over Saturday night/Sunday morning, but that's what I'm worried about. :(
     
  38. Djamila

    Djamila Well-Known Member

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    It's not impossible, but it does seem unlikely given the rest of your data. She could probably bounce just from hitting a green of any kind since it doesn't look like she's seen one in a while. But again you have enough data that I'm more inclined to think she just holds onto the insulin and has a very late nadir. There was another cat a few years back that did this with Prozinc. Certainly doesn't make it easy on you!

    Do you get the PM +4 before you go to bed? Or do you wake up for that? I'm wondering if you could get a couple of +8's or +9's instead just to make sure?
     
  39. Jenna Josie

    Jenna Josie Member

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    It’s the before bed test. I do think I’ll set an alarm to try to get +8 or +9 a few times. Hey, I’m already sleep deprived anyway, right? ;)

    I wish she’d get some greens! Looking at her SS, it appears she only ever had them when she was on 1.5/1.6, so I don’t know. :confused:

    One interesting thing: yesterday AM, when we were trying the patented Teasel feed-and-stall reverse technique, we can her some of the civvie’s food, which is 6 carbs vs Josie’s usual varieties of 3 or 4 carbs. She certainly came up more quickly on that, which is worth thinking about — is she really that carb sensitive? — but then, I can’t remember if yesterday I gave her 1/2 can or 1/4 can during feed-and-stall (did I mention sleep-deprivation?). I definitely gave her 1/4 this am. If I gave 1/2 can yesterday, I would think that would be the difference in her coming up more quickly before I think it would be the carb content.
     
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  40. Jenna Josie

    Jenna Josie Member

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    So 1.9u was interesting for awhile: 4 of 5 blue pre-shot, including three in a row! And then she bounced (I guess), and then instead of clearing it, after two days she hit a red, and so I snuck her up to 2u.

    And here we are, with her still going down -- now at 140 -- at +11. I felt good learning to shoot through the blues @ 1.9, but I am nervous b/c the last time I shot 2 on a blue (which was waaaaay back in August!), she ended up in the limes.

    Anyway, I'm going to get another test at her normal PS time -- about 7:00pm CST -- but if anyone has any ideas or advice in the meantime, that would be most welcome. :D

    EDIT: still haven’t shot ... she’s in the 120s, and so we’re trying the “Teasel Reverse”; aka, feed-then-test. So far no movement, so we’ll reassess in another 20 minutes.
     
    Last edited: Nov 10, 2018
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  41. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I'm glad the "Teasel Reverse" has been helpful! :smuggrin: I'm all for breaking a few rules when kitty isn't following the script.
     
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  42. Djamila

    Djamila Well-Known Member

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    Sorry no one was around last night. I was out at the ballet having a lovely evening away from FD :joyful: and away from worrying about my sick kitty :oops:.

    FWIW, I would have probably told you that if you can handle a little sleep deprivation, go for it. Give the dose, monitor, and see what happens. If you were tired and needed sleep, then the reduction was the way to go. She did have that big drop you mentioned, and those are always possible on Prozinc, but it's equally possible that she'll surf along just fine, and maybe even get some time in better numbers.

    Again though, sleep is important and it was a PM cycle, so the reduction was understandable. :)
     
  43. Jenna Josie

    Jenna Josie Member

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    Yep, I should have and even, I think, would have except that she didn't come up *at all* in 90 minutes, 60 of which were after eating. I thought she might actually still be going down and was only staying in the 120s b/c of feeding.

    Oh, well. Here's hoping she clears this soon, and I can try shooting through the blues this pm or tomorrow am.

    The ballet -- jealous! Was in PNB, by chance?
     
  44. Djamila

    Djamila Well-Known Member

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    Yes, indeed! They really are a fantastic company. I feel so lucky to live here and get to see so many amazing performances.
     
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  45. Jenna Josie

    Jenna Josie Member

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    @Djamila @Kris & Teasel

    Hi. If you are around, do you think you could weigh in on Josie this AM? Gave her 2.2 last night, and she was 103 at AMPS. Trying the Teasel Reverse, gave 1/2 can of food, but after 30 minutes = 108. Just gave another 1/4 can, and will wait till top of the hour to test again. (Top of the hour will be +13.)
     
  46. Djamila

    Djamila Well-Known Member

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    Any chance you're home today? My hunch is she's not going to come up fast enough for you to get to work, so probably start thinking about reducing the dose again. :confused:
     
  47. Djamila

    Djamila Well-Known Member

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    I want her to do this on a day when you're home and can just go ahead and shoot. I have a hunch Josie is just a late nadir cat and uses Prozinc like it's Levemir. IF that's true, then in theory you can shoot her regular dose and she'll rise for awhile and then lower again late in the cycle. But it's definitely not something to try when you're leaving because she could end up in margarita land ;) (get it? limes? :smuggrin:)
     
  48. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I agree with Djamila. She's holding flat so a reduction is in order. The eternal question ... how much? You dropped to 1 u on the evening of Nov 10 with a PS of 127. Maybe try that?
     
  49. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Beware of late nadirs. Teasel is fond of them. Sometimes he rises afterward and sometimes he doesn't. He's on Lantus and still tricks me. o_O
     
    Last edited: Nov 15, 2018 at 8:33 AM
  50. Djamila

    Djamila Well-Known Member

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    That's what I'm afraid of....that it would work until it didn't. It would sure be nice to have full-time caregivers for our tricky cats who could just watch over them and steer as needed.
     
  51. Jenna Josie

    Jenna Josie Member

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    I actually think I could play hooky today! I mean, "work from home."

    I'll see where she is in another 15 minutes and then decide. But surely the food should have kicked in already, right? Since when a cat is in low numbers, we feed and retest in 20 minutes, I assume that 30 mins is enough to start seeing an impact even when their [they’re] *not* in too-low numbers? But maybe the physiology is different when their numbers are "good" -- ?
     
    Last edited: Nov 15, 2018 at 8:04 AM
  52. Jenna Josie

    Jenna Josie Member

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    Me too! Every time I've reduced on a low PS, it's been the wrong decision . . . except that one time a few months ago when it wasn't and we were up with her till 2 am!

    Kris: you must have nerves of steel!
     
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  53. Jenna Josie

    Jenna Josie Member

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    (Also, at some other time, could someone explain to me how to tell/if it's possible to tell the difference between a late nadir that means the dose is too high and a late nadir that means the cat just has a late nadir?)
     
  54. Djamila

    Djamila Well-Known Member

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    There isn't an exact way to tell. Mostly you look at the big picture of the numbers over time. If the increases have been steady and appropriate, and the cat isn't getting any low mid-cycle numbers (and the human is testing enough to know that), then it's probably late nadir. If the increases have been too fast, too big, or the dosing inconsistent. Or if the kitty is swinging from greens to pinks to blues to blacks, then the dose is probably too big.

    The other way to tell that it's too high of a dose is if you see a low PS, reduce the dose, and get a better cycle.
    It's too low of a dose/late nadir if you see a low PS, lower the dose, and get a worse cycle.

    Honestly it's pretty rare for a kitty to be on too high of a dose if they've been here for awhile. That's more often seen in newly diagnosed cats when they show up here having been following bad vet advice for awhile.
     
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  55. Jenna Josie

    Jenna Josie Member

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    No change: she's at 105. I'm thinking 1.4, which is 2/3 of her dose.
     
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  56. Djamila

    Djamila Well-Known Member

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    You leave food out for her, right?
     
  57. Jenna Josie

    Jenna Josie Member

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    Yes, and also, I'm going to stay home today, I've decided.
     
  58. Djamila

    Djamila Well-Known Member

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    I want to decide to stay home! I'm jealous. Alas, my day is FULL of meetings, so no luck. I'm going to try to sneak home at lunch to give Sam a little more R. It seems to be the only thing holding his numbers down right now.
     
  59. Jenna Josie

    Jenna Josie Member

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    Would you go with 1.4? (2/3 reduction)
     
  60. Kris & Teasel

    Kris & Teasel Well-Known Member

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    The answer to this still eludes me. Maybe I have nerves of steel after almost 3 years of Teasel antics or maybe I've just charted a moderate course through choppy waters ... All I know is that I can't dose him close to the edge. Many would look at his SS and say, "What the heck is she doing??" :confused:;)
     
  61. Jenna Josie

    Jenna Josie Member

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    Kris: Or some might look at Teasel's SS and say, when will I ever know so much? ;)

    Djamila: I think we're even on the jealousy. I may get to work from home spontaneously most days, but you get to go see PNB whenever they're in season! And probably other concerts when they're not. :) I am sorry that Sam's BG is giving you so much trouble, though.
     
    Last edited: Nov 15, 2018 at 9:27 AM
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  62. Kris & Teasel

    Kris & Teasel Well-Known Member

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    OK! I'll look at this way! :smuggrin:
     
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  63. Jenna Josie

    Jenna Josie Member

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    I ended up giving Josie 1.6 this morning based on one last test that was at least a little higher than during the “Teasel Reverse” experiment. She had, for her, a nice long soak in the blues — about 15 hours, I think, beginning at her +3 last night.

    I’m not sure what to do for tonight. I think (though what do I know, really — she’ll do what she does! :rolleyes:) that she’ll be in the high yellows or even the pinks for her PS based on her +7 (231). My hypothesis is that she’s bouncing up after the blue stretch.

    So a week on 2u didn’t do much for long, but her first 2.2u dose last night resulted in this AM’s drama. Still, she does seem to have a pattern of big reactions (for her, anyway; I.e., very long cycles) in the first cycle of a dose increase, so I don’t know if I should keep the 2.2 and ride it out, or go back to 2, or maybe eyeball a 2.1? (A “fat 2u”). All assuming, of course, that her numbers stay headed in this trajectory ...

    On the plus side, she feels great! She insisted on being let out on the balcony and despite her neuropathy managed a three foot leap onto the covered balcony furniture (tough landing, that!) to find the last remnant of sunshine. I think she looks quite proud of herself.
     

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  64. Kris & Teasel

    Kris & Teasel Well-Known Member

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    An initial big reaction followed by a calmer response is a fairly common thing. You could try riding it out when you're home to monitor - more data for your reference library.

    She looks very cute sitting out on the covered furniture. :)
     
  65. Djamila

    Djamila Well-Known Member

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    I agree with Kris on both points: it's a fairly common pattern and I'd try to hold the 2.2u dose if she lets you.

    And yes, there are lots of great shows around here! :)
     
  66. Jenna Josie

    Jenna Josie Member

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    She's letting me! PS = 292 (which . . . is actually what I thought it would be! That almost *never* happens, lol!)

    Depending on her +3, I may set an alarm and see where she is later in the cycle. We have very little PM cycle data, except for that one +10 on election day, but that only happened b/c I left the house to vote and so didn't have to deal with her and the civvie pretending to be starving and begging for food for another two hours. :rolleyes:
     
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  67. Rachel

    Rachel Well-Known Member

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    Aug 25, 2013
    Haha! Yes I found that going on a walk or taking a long shower when everyone is begging for food has been very helpful for me in the past!
     
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  68. Jenna Josie

    Jenna Josie Member

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    Jun 30, 2018
    Well . . . now I have some PM cycle data! lol

    Josie went down 80% (!) of her PS value overnight, with a long nadir between +7 +8 +9. <--- I gave her a little bit of food at each of those tests since she was down to 60, and we think she has late nadirs.

    So now at least I know that yes, she is on her way back up when she has these low (for her) PS numbers. She's at 103 right now.

    Now is technically her shot time, but I am not giving her anything just yet. I'm super-happy to see greens, but wasn't that drop a little, um, dramatic?

    Aiming to shoot by 8:30 CDT (one hour) if anyone has any opinions on dosing after last night's data!
     
  69. Djamila

    Djamila Well-Known Member

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    Wow! Well isn't that interesting? At +4 she was giving no hint that she's spending her nights in lower numbers. And no hints during the AM cycles either. Good job staying up and testing! I hope you can get a nap today!

    Now that raises a few questions: is she doing that often? Is she low at night and bouncing during the day? Should you lower the dose? Or keep the dose until she settles out and we start to see some daytime greens? So many questions!
     
  70. Jenna Josie

    Jenna Josie Member

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    @Djamila Yes indeed, those are the questions! :D

    I’m definitely not shooting until +13. I really want to see where this prolonged cycle is heading. If it looks like the last couple of mornings, I will feel brave enough to shoot 2u, for sure, but I’ll have to wait and see about holding the 2.2u, primarily because she dropped 80%. I’m not sure about last night’s PS. I wish I had taken a 2nd test then to confirm but didn’t bc while it was a little higher than I had expected, it wasn’t completely out of line. I figured it was a delayed bounce from a soak in the blues the night before.

    Thoughts? (And I’ll post additional test here in a minute ...)

    The good news — beside, I mean, greens!!! — is that this upcoming week will be very flexible (bc all the students are headed out for thanksgiving break), so I can get nighttime tests with little daytime consequence for sleep deprivation.
     
  71. Djamila

    Djamila Well-Known Member

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    I wonder if it's time to try off-setting the doses a little. I had to do that with Sam for awhile at one point. Maybe a slightly lower dose at night (2u?) and staying with the 2.2u during the day? The lower dose at night would hopefully give you a slightly higher AMPS, and the higher dose during the day could help combat the high flats you're seeing after the PM cycles.

    It might not work at all, but for some cats it can be helpful.
     
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  72. Jenna Josie

    Jenna Josie Member

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    Jun 30, 2018
    Yes, that sounds like a good experiment right now!

    Her +12.5 = 108, so no change. I am feeding her a bit* and will test again in 30 minutes, likely shooting 2.2u assuming some upward movement. I am not worried about throwing the schedule off a bit.

    *"Teasel Reverse" <-- I always feel like I have to make a note of that b/c it's not the SOP, and I don't want anyone reading this who has a *normal* cat to think that's the standard protocol. I think I should add that to the sig block?
     
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  73. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I break a lot of rules! I'm glad this one has proven helpful to you. Maybe make a note in your signature.
     
  74. Djamila

    Djamila Well-Known Member

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    I love that we now have a strategy named after Teasel! :smuggrin:
     
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  75. Jenna Josie

    Jenna Josie Member

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    Man, what an ugly day this is shaping up to be for her, poor little thing. :(

    I am keen to try the AM = 2.2u/ PM = 2.0u experiment, but she has been *so* high and perfectly flat all day (and she still has at least 1.5 hrs to go before even the early range of shot time.) ... would you still recommend starting the PM 2.0u tonight?

    I get that we’re thinking the PM 2.2 is what set off this hideous bounce, but it always seems counterintuitive to me to reduce when she is so high. :confused:
     
  76. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Looks like a big bounce after those greens. Dosing aside you just have to ride it out. I think you could try 2 u tonight given the recent low AMPSs. With bouncing you almost have to look past those inflated numbers to see what lies beneath - the "true" insulin response. Easier said than done. :confused:
     
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  77. Jenna Josie

    Jenna Josie Member

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    Yeah, it just makes me sad for her bc she looks like she feels pretty crummy ... or she’s just tired because I kept waking her up all night!

    We’ll go with 2u and see what we see.
     
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  78. Jenna Josie

    Jenna Josie Member

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    Jun 30, 2018
    Oh! And something just occurred to me — not sure if it’s important or just one more complicating variable, but she does get fed slightly differently during the day: in the daytime, she gets her snack broken up, 1/4 of a three oz can at both +3 and +5 (in timers while at work), whereas at night she gets the entire 1/2 can snack at once, at +3 or +4, whenever we get her before bed test.

    That could possibly be constructing to the long PM cycles?
     
  79. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Hard to say. Have you experimented with setting up the timed feeder overnight to see if a different food schedule makes a difference?
     
  80. Jenna Josie

    Jenna Josie Member

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    No, I haven't. Nighttime feeding is complicated by the civvie, who will eat her food, and if I leave out too much food, she'll scarf-and-barf (trying to eat it before he does!). During the work day, I put her in her own room (letting her out at midday when I can get home), and so she has her timed feeders in there with her/away from him.

    I could try separating them at night for a few nights' experimenting if you think it might be worth trying -- ? (I suspect such things are harder on the humans than on the kitties!)
     
  81. Jenna Josie

    Jenna Josie Member

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    Jun 30, 2018
    I don't think Josie is getting a shot this am (which is nuts considering what her day looked like yesterday!).

    Gave the 2u last night after a whole day of flat, low-ish pinks; got a +10 a couple of hours ago: 115

    AMPS: 75 (Retest = 77)

    I supposed this is that high-and-flat then drop low phenomenon?

    :banghead: :confused:
     
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  82. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    Oh sweet Josie!

    Looks like she would like a bit less insulin these days!

    How far off schedule can you get? Could you wait until she rises in a few hours and then move it back over the next few days?
     
  83. Jenna Josie

    Jenna Josie Member

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    Jun 30, 2018
    She’s already 1.5 hours off! :D

    The latest I can shoot tomorrow am is 9:00 CDT. That would mean the latest I could shoot tonight would be 10:00 CDT, which would mean the latest this am would be 11:00. That is in 1.5 hours from right now.

    (And that of course assumes no stalling, 11-hour cycles. Not exactly her forte’. :rolleyes: )

    But if I tried that with reduced doses .... maybe that could work??

    EDIT: ps. I did feed her about 15 minutes ago.
     
  84. Djamila

    Djamila Well-Known Member

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    I think I'd test her again in 1.5 hours and decide at that point. If she's holding it down on her own still - then skip. If she's jumped up to the pinks, then I think reducing the dose, but giving her something might be better than a full skip.
     
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  85. Jenna Josie

    Jenna Josie Member

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    Jun 30, 2018
    Yeah, I really don’t want to skip, but I just have no idea what’s going on with her right now. Oh, Josie :rolleyes:

    By reduce ... serious reduction, like just one unit, or baby reduction to, say, 1.8 (since she got 2.0u last night, which was a reduction from the 2.2u she’s been getting the last couple of days)?
     
  86. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Your call on the reduction. It's really hard to know what to give. If she doesn't go much higher I'd give a serious reduction.
     
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  87. Djamila

    Djamila Well-Known Member

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    I was thinking serious reduction like 1u. That way it will wear off sooner and you can hopefully get back to your regular schedule more easily.
     
  88. Djamila

    Djamila Well-Known Member

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    (and also because I'm curious what she's doing right now and kind of want to see what she does with a serious reduction ;))
     
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  89. Jenna Josie

    Jenna Josie Member

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    Ha! Also! I can't do arithmetic! :facepalm: 11:00 CDT is still almost two hours away.
     
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  90. Djamila

    Djamila Well-Known Member

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    Haha! Well then, she has plenty of time to rise a bit!
     
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  91. Djamila

    Djamila Well-Known Member

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    You probably don't need to wait that long though. Are you at +14 yet? That seems to be the magic number for long cycles. (although ECID and all....)
     
  92. Jenna Josie

    Jenna Josie Member

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    She's at +13. She just finished her normal breakfast. I will test in one hour -- +14 -- and see where she is.

    (Double checking my math . . . 13 + 1 = 14 . . . Yes, one more hour will be +14 :D )
     
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  93. Djamila

    Djamila Well-Known Member

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  94. Jenna Josie

    Jenna Josie Member

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    This is sure interesting. Her +14 test = 105, and this is *with* her breakfast (3oz FF), on board for at least an hour.

    I'll wait another 45 minutes to the top of the hour (11:00 CDT).

    Current thought: If she's above 170, one unit; if she's between 120 and 170, 0.5u; if she's 120 or below, no shot.

    ?? (esp. on that middle range idea)
     
  95. Jenna Josie

    Jenna Josie Member

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    Jun 30, 2018
    +15 = 102!! I gave her the teeny-tiniest of doses, 0.1u. At least I think I did. It didn't feel like *anything* when I shot, but I did hold it under the skin with the plunger depressed for 10 seconds.

    I hope that was the right thing to do. I have read on here people doing such things and just decided to go for it.
     
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  96. Djamila

    Djamila Well-Known Member

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    Well now, Ms. Josie....what are you doing here?

    You've probably already figured this out, but I think I would suggest dropping her dose tonight, no matter what her PMPS looks like. Maybe down to 1u? Maybe draw up a list of doses and throw darts at it? Whatever you decide on is going to be a bit of a guess.

    It could be that she's just having one of those days. Sam gave me a lovely 24 hours, and then went right back up to his now-typical icky yellows. But it could also be that her pancreas has decided to kick in and help out a bit more and she's changing things up on you.

    This has often been compared to a dance - and only the kitty can hear the music :rolleyes:
     
  97. Jenna Josie

    Jenna Josie Member

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    This made me laugh out loud.

    Yes, she is going to be up. I just took her +17, which is 165. I am not going to test her again until 6:00pm CDT and plan to shoot -- one unit, probably, or whatever the ouija board tells me -- at 6:15, which is her "normal" Sunday evening shot time. At least then we can be back on schedule.
     
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  98. Jenna Josie

    Jenna Josie Member

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    Jun 30, 2018
    I forgot to ask: is this a sort of "reboot," so I hold the 1u for several cycles before increasing?

    (Why yes, I am up at 2:00am getting some PM-cycle data!)
     
  99. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    She certainly isn't making it easy for you but you're doing great! :) I'd try 1 u again today to see what happens. I wouldn't jump all the way up to 2 u right away. A little dose stability might be helpful.
     
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  100. Djamila

    Djamila Well-Known Member

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    I agree with Kris about not jumping straight to 2u, but starting tonight I'd start increasing fairly quickly if she doesn't show something better than that AMPS :confused:.
     
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