Second curve results

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by Jenna & Kitsu, Jun 2, 2018.

  1. Jenna & Kitsu

    Jenna & Kitsu Member

    Joined:
    Apr 30, 2018
    Hello all,

    Life's been very busy lately, but I finally got around to getting Kitsu's second curve done on her new dose. Her previous curve was done at 1.5 unit twice a day, where it appeared to be that she was too low at PMPS to shoot every few nights. I reduced her dose down to 1 unit twice a day per the recommendation of a couple of users and for the first few days, it seemed to be working great, but now she's back to getting low readings at night again. And not just every few nights... it's almost every night now. If you check my signature for her spreadsheet, you'll see what I mean.

    Should I be decreasing her dose again? I feel like even at nadir, her BG levels are still a bit too high, but yet she's still way too low at night to shoot. I'm not sure how I should proceed. Any advice would be greatly appreciated!
     
  2. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    Hi Jenna and Kitsu!
    Looking at your spreadsheet, I would suggest a reduction to maybe 0.75U or 0.5U if you don't have half unit marked syringes, to see if that helps level out her Pre-shot numbers. Ideally, you want to her to be able to receive both shots :). Looks like you've been doing the sugar dance for a few months now, and you're doing very well! Has anyone mentioned that you may have to adjust your comfort level to give a shot when she is below PS of 200? Unfortunately, there's not straightforward number of "you can give a shot if she's ## low" because every cat is different. You have to learn how she responds. When we started, I never thought I'd be able to dose my boy with anything if he was green. I'm not suggesting you do either because we switched to Lantus and Kitsu might have a higher low PS number that you establish :cat:.

    I'm not around as much now a days because of my job so I'm sure one of the other veteran members will chime in for you. Essentially, I would reduce so you can even out the PS numbers and get some before bed tests if you are able. Kitties tend to run lower at nights anyway for an idiopathic reason :smuggrin:.

    It's also a good sign that she seems to nadir between +6 and +8. Not a common trait in Vetsulin. Definitely seems to be the working juice for your girl!
     
  3. Jenna & Kitsu

    Jenna & Kitsu Member

    Joined:
    Apr 30, 2018
    Thanks, Yong, I appreciate your reply! My syringes only have 1 unit markings, but I can estimate a 0.75 or 0.5 dose pretty well. I went ahead and gave her a 0.75 dose this morning (haven’t updated spreadsheet yet, will do so after work). We will see what she’s like for her PMPS tonight.

    As for shooting her below 200, I did that one night and she dropped to 72 at +4, and since she seems to nadir around +6 to +8, I was worried she would go into hypo. I gave her some higher carb dry food to make sure she didn’t, because I would be asleep during that time. I went ahead and set an alarm and tested her again later that night and she was back in the 100s, so I went back to sleep. Since then I have not shot her below 200 out of fear she will drop too hard while I’m asleep. I also don’t want to have to make it a habit to wake up in the middle of the night every night to do a BG test to make sure she’s safe.

    Let’s say she’s too low again today at PMPS. Let’s say she’s 180. Would it be better to just give her a tiny dose of insulin, even if it doesn’t match her morning dose? I know with some insulins, you can change doses as needed, but I wasn’t sure how safe or effective it would be to give different doses of Vetsulin each day. For example, 1 unit in the morning, 0.5 unit at night.

    Thanks again for your help!
     
  4. Jenna & Kitsu

    Jenna & Kitsu Member

    Joined:
    Apr 30, 2018
    No luck with the lower dosage (0.75) today, but I'll still give it a trial run to see how it goes. She was 155 at PMPS tonight, so I skipped her shot again. I'll do 0.75 doses for the next few days and see if her PMPS numbers change. Like you mentioned, I should probably learn to be more comfortable with shooting her under 200, but I need to know if it's okay to give her a lower dose at night if she keeps this up. If so, I could do 1 unit in the morning, and 0.5 (or maybe just 0.25) unit at night.
     
  5. Jenna & Kitsu

    Jenna & Kitsu Member

    Joined:
    Apr 30, 2018
    She was low again last night (haven’t updated spreadsheet yet). I think around 140 or something. I skipped her shot and gave her another 0.75 dose this morning. Can anyone answer my question about giving her a smaller dose in the evening? It looks like she needs 1 unit in the morning and maybe 0.25 or 0.5 in the evening, if this is advisable?
     
  6. Jenna & Kitsu

    Jenna & Kitsu Member

    Joined:
    Apr 30, 2018
    While I still want to know the answer to my question above, I do want to post an update on my findings tonight.

    She was high enough at tonight's PMPS to have an injection. There are two reasons to this:

    1. She was able to have a meal 2 hours before her shot.
    2. Her shot time was delayed by 45 minutes.

    Both of these reasons stem from my schedule change this week. Kitsu's normal shot time is 7:30am/pm. I had to adjust her to 6:45am/pm for the last few days because of a dentist appointment I had today at 7:30am (had to leave the house by 7:00). So tonight's PMPS was done at 7:30 instead of 6:45, giving her an additional 45 minutes for that BG level to rise.

    And because of the schedule going back to 7:30pm, I was able to give her a small meal right after I got home from work (5:15pm). I lifted her bowl up at 5:25pm and tested her at 7:30pm. This should be the primary reason she was high enough to shoot tonight. I'm thinking that earlier this week, when she was on the 6:45 schedule, she was eating the food I left for her in the morning and going all afternoon/evening without food until her shot time, which made her BG stay low. As for the previous nights where I had to skip, I think it was because she was eating so sporadically because I had a house guest from May 19 - June 1. Kitsu is very much used to her alone/quiet time, so she wasn't eating as much as she normally does. I live in a tiny apartment, so secluding her for her own comfort level wasn't an option, sadly.

    That being said, I'm going back to her 1 dose twice a day now that things are back to 'normal'. If she starts going too low at PMPS again, I'll put her back on 0.75. I just don't really like 0.75 because I feel like it's not getting her very low during the day when she needs it most.
     
  7. Jenna & Kitsu

    Jenna & Kitsu Member

    Joined:
    Apr 30, 2018
    I just realized that I won't be home until close to 7:00pm tomorrow, so Kitsu won't be getting her meal before PMPS. Her BG might be too low to shoot. Guess we will see. My schedule should get better soon, just a lot of things in the works right now.
     
  8. Jenna & Kitsu

    Jenna & Kitsu Member

    Joined:
    Apr 30, 2018
    Just checking in and bumping this thread for a potential person to answer my question above. Kitsu's BG levels are consistently under 300 every AMPS and PMPS after changing her dosing to 0.75 and feeding her only YAZ Mature. I know I should be incorporating wet food in, but I will try that again once I get done with my big move (moving to Europe in August). No reason to struggle feeding her wet food here when I will just have to struggle again to find something she likes over there. Another question - are Kitsu's AMPS/PMPS looking pretty good? I want to get her in the lower 200s, but if I go back to 1 unit per dose again, she'll be too low for her next shot. She seems to nadir around 145 when I do 0.75 doses. Are these good numbers for her? Is there anything I could be doing better to keep her BG levels regulated? Thanks!
     
  9. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

    Joined:
    Jun 16, 2017
    On the surface, Kitsu's preshot numbers are looking pretty good. My only issue is other than the PM +8 on 6/8, you have no mid-cycle tests since 6/2, so we have no idea how low the dose is bringing your kitty. Would you be able to get some in in the next few days? At minimum I would try to get a test within the +4 to +6 range and you might consider doing a mini or full curve soon as well. Testing, especially mid-cycle, is one of the biggest ways you will find out how your kitty reacts to a specific insulin dose. Knowing how Kitsu is metabolizing her insulin is a vital part on the path to regulation. So I would certainly hold the 0.75 dose for now, but get some mid-cycle tests so we can see what the next step for Kitsu should be. :cat:
     
  10. Jenna & Kitsu

    Jenna & Kitsu Member

    Joined:
    Apr 30, 2018
    Thanks, Amanda! I will do my best to get a mid-cycle test. Things have just been so busy with me not being home much. I honestly don't know when I'll be able to get a mid-cycle test done during the day. I may just have to set nightly alarms, wake up, and do tests then, since it's the only time I'm home during her mid-cycle. Would PM mid-cycle test still be okay, or are AM mid-cycle tests more accurate? I only ask because people often say that kitties run lower BG at night, so I just want to make sure I'm testing her at the right times. Thanks again for your response!
     
  11. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

    Joined:
    Jun 16, 2017
    I completely understand! I work 10 hour days 4 days per week, so the majority of my testing occurs on my day off and the weekends. Just do the best you can. PM mid-cycle tests are perfectly fine! I would try to get into the habit of getting a before bed test if you can (mine are generally always +3 and +4). You can set alarms for later testing on occasion and if the before bed test warrants further monitoring. Like I said, just do the best you can and grab tests when you can. :bighug:
     
  12. Jenna & Kitsu

    Jenna & Kitsu Member

    Joined:
    Apr 30, 2018
    I ended up staying up a bit later to get some other stuff done, so I went ahead and waited around for her +4 test, then did it. She came back at 113. I have my spreadsheet updated now. Unfortunately, I won't be able to stay up for a +5 or +6 test tonight - I really need to get some rest. I'll try to get a +4 and +6 test another night. Thanks again for your help!
     

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