Seeking opinions and input on timing of dose increase, please

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by Dee Dee C, Aug 1, 2019.

  1. Dee Dee C

    Dee Dee C Member

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    @MrWorfMen's Mom

    Clarence had been staying in the 200s a lot of the day, BUT His PMPS is 383
    I would appreciate any thoughts, suggestions, etc.

    Thanks in advance for any advice on how much Vetsulin
     
    Last edited: Aug 1, 2019
    Reason for edit: Updated
  2. Dee Dee C

    Dee Dee C Member

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    PMPS 383 on ReliOn Meter
     
  3. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Sorry Dee Dee. The darn tag didn't come through...sometimes they don't work. Was just looking to see what Clarence was up to and found this and I wasn't on the board last night due to a personal matter.

    I see you gave Clarence 1u last night and this morning. I'd stay with that dose for tonight at least provided his pre-shot is high enough to shoot. I think he may be bouncing a bit right now so better to under dose a bit than give too much till you see what he's up to.
     
  4. Dee Dee C

    Dee Dee C Member

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    Hi Linda. I hope everything is alright with you. I had an appt. this morning and had to leave this morning.

    Yes, 1u last night and this morning. He seems to be sitting mostly in the 200s with that dose until late in the cycle, but does drop a lot in a relatively short period of time. I noticed him drinking water today, not excessively, the first time I've seen him actually drinking in a while, tho. I found a website that had an excellent explanation of 'bouncing' (Somogyi phenomenon) and it helped me a lot to understand it. Because of that I felt it a good idea to keep his dose at 1u for today and tonight and see how he does. BTW I did give him a little food after his +3 like I normally do.
    Should I be concerned about the water drinking?
     
  5. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I wouldn't worry too much about the water right now. When his BG was staying down in normal range for long periods, he wasn't trying to get rid of excess glucose in his urine so he peed less and wasn't as thirsty. Now with his numbers up, he probably is dumping some glucose into his urine and peeing more so he needs more water right now. Definitely something you can watch to make sure it drops off as numbers normalize again.

    I'm fine. Just got some bad news of a friend passing away last night so I was on the phone for some time and missed my normal evening time online.
     
  6. Dee Dee C

    Dee Dee C Member

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    I'm sorry to hear about your friend and hope that you will be blessed by lots of fond memories to honor your friend.
     
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  7. Dee Dee C

    Dee Dee C Member

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    Hi Linda, Clarence's PMPS is only 217. Do you think I should lower his dose on this low of a number?
     
  8. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Oh boy That's a tough one. He's obviously come out of the bounce which is great but whether 1u will drop him too much is a good question. How about trying 0.75u tonight and see what he does?
     
  9. Dee Dee C

    Dee Dee C Member

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    Okay, Thank you. I was thinking about doing that. (I've stalled a bit on feeding him, so maybe it came up a little while I was waiting). It makes me wonder how low he went, I tested him at +6.5 and he was at 165 and I figured he wouldn't be going super low. I'll do the .75 and see what he does - darn cat, really like the night-time company!
     
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  10. Dee Dee C

    Dee Dee C Member

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    Linda, if you are checking, his AMPS is 367
    At this number, I'm unsure - I don't want to give him too much, thinking about 1 unit but just not sure. What would you suggest??
     
  11. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    HMMM! Clarence is being a bit of a puzzle? When I saw that run of yellow last night I really expected you might get another yellow pre-shot this morning. Given Clarence's habit of late nadir's I wonder if he did drop a bit lower last night setting off another bounce to pink.
    If you can monitor today, then I think going with 1u is a good choice. If you can't monitor I'd stick with the 0.75u.
    Come on Clarence....stop messing with Dee Dee! :p
     
  12. Dee Dee C

    Dee Dee C Member

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    He was pretty anxious to eat this morning, I wonder if his hunger got him higher than he otherwise would have been. Here's my concern: if I give him .75 today, then I would prefer to give him .75 tonight as well inspite of what his number is just to keep things easier for me so I don't have to get up and test him. I've seen him go fairly low fairly quick when he is up pretty high.
     
  13. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    It's entirely up to you. Do what you are most comfortable with dose wise. He'll catch up if it turns out he needs the full unit dose. You know Clarence better than anyone else and your observation about his hunger suggests you may be right about that pre-shot. And that hunger could be from a lower BG last night than you are aware of.
     
  14. Dee Dee C

    Dee Dee C Member

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    I just don't like him spending too much time in higher numbers. But, maybe the .75 will keep him low enough to be out of danger. I think I will go with the .75 for today and maybe check him around +5 or +6 to see what its looking like. Then I can go ahead with the .75 tonight too and see what happens. If he'll catch up as you say, then .75 would be my choice.
     
  15. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    With Vetsulin being an in and out insulin, it's a bit more straight forward than other longer lasting depot insulins. With those, you could potentially set Clarence back a few days by going too low on the dose but with Vetsulin you see the results of dose changes almost immediately other than bounces which can muddy the water a bit.
    My rule of thumb with my girl was always to make sure I was not exhausting myself to keep her in optimal numbers. There are enough times that they surprise us and we have unplanned PJ parties. We shouldn't be intentionally causing them with dosing in the name of "normal" numbers. If you need to back off on the dose for a few cycles to recharge your batteries, Clarence will be fine. Right now you aren't sure whether the 1u is still too high or just right so backing off to 0.75u for a few cycles seems a perfect compromise for both of you.
     
  16. Dee Dee C

    Dee Dee C Member

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    Okie Dokie! I have been super anxious about all of this and on days after I've been up most of the night watching him and essentially being a helicopter kitty parent, I start to get even more anxious and feel like I'm basically doing more harm than good all the way around. I certainly am glad I got the human meter, tho, I'd be shelling out big bucks for those expensive strips otherwise!
    I hope you are doing well and have a good day. Thanks again.
     
  17. Dee Dee C

    Dee Dee C Member

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    Linda, Just wanted to update you a little In case you check in. I ended up doing a few more tests than I had intended :( because Clarence was seeming really hungry at a couple of points and I wanted to make sure he wasn't dropping too fast and possibly setting up for yet another high reading in reaction to it. He stayed I the 200s today and I did his PMPS a little earlier (but only by 10 minutes). Anyway, his PMPS was pretty-much the same as his +8. I will go ahead with the .75 tonight and see what that brings. Have a nice night. :)
     
  18. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Clarence has stayed pretty flat all day so I think sticking with 0.75u tonight is a good decision. SOmetimes those flat yellow cycles foretell an active cycle coming so just hold the course and see what he does. Thx for the update. :)
     
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  19. Dee Dee C

    Dee Dee C Member

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    Hi Linda,
    Clarence's AMPS was 211 this morning. I hope you are available to look at his SS and advise if .75 is what I should do this morning. I can maybe stall him on breakfast for a little just to bring it up if need be.

    Thanks! DeeDee
     
  20. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Stall for 15 minutes without feeding and see if he comes up at all.
     
  21. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I think you are fine to give 0.75u today as long as you can check at some point mid cycle. Probably don't really need to stall. I was thinking about the AT2 meter but you've switched to the human one now so over 200 you should be fine to shoot.
     
  22. Dee Dee C

    Dee Dee C Member

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    Thanks. Right after I sent that, I realized that I was doing the same, thinking about the pet meter, not the human one. :oops:

    I went ahead and fed him. He had a really good night, I could tell he was feeling good. Didn't rise too quickly. Didn't beg me to feed him, even after his almost +6 test.

    But he did come in and wake me up about an hour before his regular test/feeding time by knocking stuff off the headboard to wake me up! Back to his old tricks, at least he didn't sink his claws into my scalp like he often has done! lol!

    Just so I don't go into panic mode, how low should I let his readings get before maybe giving a bite to eat to slow it down? My concern here is another bounce...
     
  23. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Because Vetsulin tends to drop BG more in the first half of the cycle than the last, I'd try to keep feedings in the first half of the cycle if possible. If he gets down between 100 and 90 or thereabouts I'd feed him to keep him surfing rather than dropping as fast or too much. Clarence tends to nadir a bit later so you might find a snack around +4 or so could help keep him surfing. Timing of food is a bit of an experiment as every cat is unique in how they metabolize the insulin.
     
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  24. Dee Dee C

    Dee Dee C Member

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    Alright, thanks for that. I know you've said before to keep food in first half of cycle and I mostly try to, so I'll work on that. I need to work on my response to low numbers and keep thinking 'human meter'. I hope he is in a surfing mood today. Last night seemed to me like he was just gently going lower, especially judging by his behavior and lack of wanting to be fed anytime I headed for the kitchen. Thank you! Happy Sunday...
    :)
     
  25. Dee Dee C

    Dee Dee C Member

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    PMPS is 301
    Should I go ahead and give him just the .75? He was acting hungry so I did feed him a little later today (right before +4 hours). Usually he gets a little food well before that so I don't know if that influenced his numbers.
     
    Last edited: Aug 4, 2019
  26. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I would stick with 0.75u for tonight. If he's still up tomorrow you can consider bumping him up to 1u if pre-shot is high enough. Glad to see he hit some blue today but he can do better.
     
  27. Dee Dee C

    Dee Dee C Member

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    Great, will do! Thank You. Have a nice evening -- night there I suppose...
     
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  28. Dee Dee C

    Dee Dee C Member

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    Linda, I may be way off with this, but I've been wondering if his body was just so used to higher BG that it reacts easily when his BG starts going down a little quicker (like when he was so hungry today) or goes down to a level that his body perceives is too low. Because of that, I think it may be good to ease him into lower numbers (i.e. sticking with the .75 tonight) rather than bump him up when he has a higher reading like tonight. Is this crazy talk?
     
  29. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    No that is not crazy at all. It's often the case that easing them down works well because bounces are not only annoying but they make it harder to figure out what is going on. The saying around here is that this is a marathon not a sprint. Small incremental changes made methodically often work better than trying to push things along too quickly.:)
     
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  30. Dee Dee C

    Dee Dee C Member

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    So, Clarence was high again this morning: AMPS was 369 and from the looks of the 2 tests I did (one before bed and one mid-cycle-ish) he didn't drop very much in the night.
    I will go forward with 1 unit as we previously discussed.
     
    Last edited: Aug 5, 2019
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  31. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Good plan. You gave it a try and it's obvious Clarence needs a bit more juice. At least you got to catch up a bit on your sleep. :)
     
  32. Dee Dee C

    Dee Dee C Member

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    Yes, and I liked it!
    Cat pulled away just when I was injecting and I know a bit got on him, not in him, so we'll see... He (or probably me) has been better about the shots the past few days, but I have a lot of problems with the current needles I'm using, so I think I'm gonna order some different ones to try. I have some others that I think are a little better, but no numbers, just lines and I' prefer numbers so I don't make a mistake. Good Grief!
     
  33. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Syringes without numbers? YIKES! I agree....that sounds dangerous. What brand are those? I've never seen insulin syringes without numbers.

    Check your syringes for a good sharp point. Quite some time ago, someone here found the needles she had were blunter than they should be. We all know the markings on the syringes are all over the place so it seems the quality control on them is not what it should be and sometimes you may get a bad batch.
     
  34. Dee Dee C

    Dee Dee C Member

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    The ones without numbers actually have numbers, but only 5, 10, and so on - those are ulticare. The ones I am using now are Carepoint VET - they have 1, 2, 3, and so on as well as 1/2 unit marks, and I have some monoject I bought from the vet's office. Virtually all of these needles listed here I have had problems with the syringe pulling down a large 'bubble' because of the friction, no matter how slow I try to draw or no matter how many times I push the plunger up and down before I even put it in the vial. I have been checking the point on the needle, but even with my reading glasses, it is very hard for me to see it well because it is so small. Should I take a look at a couple under a magnifying glass to see what they are looking like? I probably should.
     
  35. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    It wouldn't hurt to check a few needles out under magnification although I doubt it's a big problem or I'm sure there would be "noise" on the internet and I've never seen anything. I once had a needle separate from the syringe barrel as I took the cap off the needle. That was a BD brand syringe. Started checking all the syringes before using them after that.

    The bubbles are a pain but they happen. I think insulin tends to get bubbles more than other injectables I've worked with. (retired R.N.) I tried drawing quickly, slowly, steadily etc. and there didn't seem to be a sure proof way to avoid tiny bubbles and they would happen one day with a vengeance and other days none. Who knows. All you can do is get any large bubbles out. You are injecting SubQ so a few miniscule bubbles don't matter although too many and it would affect dose a wee bit.
     
  36. Dee Dee C

    Dee Dee C Member

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    Exactly what I've learned with my limited experience. I've tried all that too, and it is just as you say, so I've figured I just have to live with that and get out the big ones but a tiny one that won't budge I gotta give up that struggle at some point and give the shot.
     
  37. Dee Dee C

    Dee Dee C Member

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    I was thinking of getting some BD ones but maybe I'll rethink that. The ones I'm using I like because of the numbers, less room for error. I still double check, but don't have to triple and quadruple check like the ulticare ones. Especially right now where I'm changing up his dosing so much.
     
  38. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    The BD brand is unfortunately the only ones available at retailers here. We could get Monojects many moons ago but they aren't stocked anywhere I've checked at this point in time. Only other place there is another choice is at the pet pharmacy but I never tried those and they are strictly U40 so wouldn't work for human or the really fine dosing. Our Walmarts don't carry the Relion brand. Have you tried those? A lot folks use them and they are very reasonably priced. Just check the box for half unit markings because apparently the staff don't always know they have half unit mark syringes and hand out the first ones they find on the shelf.:rolleyes:
     
  39. Dee Dee C

    Dee Dee C Member

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    The carepoint and ulticare ones I got online from ADW. I will need to get a written Rx from my vet unless Walmart will call them or otherwise obtain the Rx from them so I can buy the needles there. I will have to look into that and try the ReliOn ones. We don't have any pet pharms around here, other than the vet's offices and they charge a lot for supplies unfortunately. I'm blessed that I am in a position to not have to worry so much about the cost of keeping up with this right now, many people with diabetic pets (or even the humans with diabetes) are not so fortunate. I'm all for saving what and where I can, tho, because it really has impacted my pocket book a lot with all the vet costs.
     
  40. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    The costs do mount up. Here in Canada while we get the insulin cheap, we make up for it with the cost of syringes, test strips and lancets. Our AT2 strips are over $2 each. OUCH! Even human meter strips are almost $80 for 100 except for one meter that is slightly cheaper but only available at one dealer which like the AT2 strip availability is not ideal. Vets tend to add on a handling charge so better to find alternate suppliers. Thankfully, like you, I never worried about the costs but I can well imagine how difficult it is for a lot of folks.

    We're also lucky in that we can buy insulin and syringes over the counter without a script. Makes life so much easier.
     
  41. Dee Dee C

    Dee Dee C Member

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    Call me crazy, but I just find it so frustrating that MEDICAL SUPPLIES, human or pet, are not more affordable - people and animals need this stuff to live!
     
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  42. Dee Dee C

    Dee Dee C Member

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    Linda, I tested Clarence at +4.5 because he woke up from his slumber and seemed to want to eat. I don't like feeding him this late in his cycle and he had a good-sized meal this morning. His BG was at 181. Seems to me that isn't a huge drop, what is your opinion on this?
     
  43. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    That's about a 50% drop which is good. If Clarence is hungry, there is no harm feeding him a small snack. It might just get him to hang out in blue a little longer.

    ETA a bigger drop would probably result in a bounce so better to have a smooth slow drop than a large one all in the first few hours.
     
  44. Dee Dee C

    Dee Dee C Member

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    Thanks, he decided he wasn't so hungry after all, so I'm just letting him be for now. I'm hoping he hangs in the blue for awhile. With the human meter, blue and dark green are what we want, right?
     
  45. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Yes blue and green eventually with more high dark green than blue but blue is good.
     
  46. Dee Dee C

    Dee Dee C Member

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    That's what I thought. Thank you.

    So, at about +5.5 he decided he IS hungry. Didn't want to feed and test later, so I tested him now and he is 166. I gave him a teeny bit of food hoping it wouldn't linger long and disrupt the insulin too much. I'm hoping for a good day with him, a lower PMPS than his morning one, so I can feel comfortable with the same dose tonight and not have to set alarms or stay up until wee hours.
     
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  47. CandyH & Catcat

    CandyH & Catcat Well-Known Member

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    couple of thoughts -- if it's late in the cycle and he's hungry, get out some freeze dry treats or some non-fatty chicken, the protein-only treat may not affect the BG that much -- when Catcat gets miserable about "mom I'm hungry" I break out the bonito curls

    syringes -- and bubble -- have been getting a rash of those lately -- I've found that if you depress the plunger as hard as you can and hold it in while you are piercing the vial, then let it go after that, you get smaller bubbles -- with Vetsulin, the way the vet had me shake it vigorously, the real bubble problem was getting them to quit being froth on top of the liquid in the vial -- sometimes I'd have to flick it or roll it for as much as ten minutes before it dissipated

    the Relion syringes are a frustration since when you do get the bubble up to the top, it's still at the side of the syringe, not centered, and it won't just go out when you try to expel it, you have to pull plunger back to get more air in the barrel, then flick it to get all the air up to the top to eject it
     
  48. Dee Dee C

    Dee Dee C Member

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    I'll have to try the chicken maybe cuz I don't have any of the bonito flakes -- will need to make a trip to town to look for some, otherwise I'll have to go to a special Asian store.

    Thanks for the info on the syringes. I currently get bubbles that do the 'stick to the side' thing, very frustrating! And I can totally relate to what you are saying about the frothy bubbles in the vial. I pull it out of the fridge when I feed the cat or a little bit after, shake it, then put it back in the fridge for a while and when I take it out again I roll it and rock it just to make sure it is mixed well. The froth usually dissipates when I do it that way.
     
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  49. Dee Dee C

    Dee Dee C Member

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    Clarence's PMPS was 330, so I'm gonna go ahead and do the 1u for tonight.
     
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  50. CandyH & Catcat

    CandyH & Catcat Well-Known Member

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    for treats, check out NW-NATURALS.NET, out of Portland OR -- their Raw Rewards may be in the dog aisle but package says "for dogs and cats" -- Catcat loves the whitefish treats, and they're surprisingly inexpensive compared to some of the other treats, bag is the small (but not mini) potato chip size and the chunks are small enough for cat and crunchy enough that teeth aren't needed --
     
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  51. Dee Dee C

    Dee Dee C Member

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    Linda, how are you doing today?

    I'm not usually up this early. These test times are irregular because the first was a before bed test and the second was one I did when I woke up for a bathroom visit. The third one is because Clarence popped into my room to wake me up.

    +3.5 225
    +7.8 151
    +9.6 125 (this puzzled me so after waking up a bit more, I decided to retest in case this one was bad for some reason)
    +9.8 152

    I know you have said there is a second dip with Vetsulin, is that what I'm seeing with the 125? He went up a lot in just a few minutes, which is also something that puzzles me, but it might have been because he was wanting me to feed him and I was trying to get him to go outside until his regular morning test & feeding time.
     
  52. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Given the small difference (roughly 20%) between the 151/125/152, I would think that the lower reading is indeed at least in part the 2nd little dip from the Vetsulin possibly along with some meter variance. That was a nice surf Clarence got and late in the cycle compared to many using Vetsulin. A kitty getting anxious about getting their own way/hungry can experience an elevation in BG fairly quickly so your refusal to feed him and trying to put him out could have played into that last reading.
     
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  53. Dee Dee C

    Dee Dee C Member

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    His AMPS is 258 - that's good, right? Human meter and all, but since it isn't in the 300s, he should get into the blues and maybe dark greens?
     
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  54. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Definitely a better start to the day but whether he will honour you with blues and/or green numbers today remains to be seen. These guys have a habit of not always doing what we expect them to do and I'm not a gambler and don't want to jinx you! :p
     
  55. Dee Dee C

    Dee Dee C Member

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    Right? He has for sure proven over and over that he can and will do the unexpected. Rebel Cats! Gotta love 'em.
    I was hoping he would give me a chance to run down to town and see if the pet store has those treats Candy mentioned, I know they carry that brand - I got a dog food sample there and my dogs loved it.
     
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  56. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I'm sure Clarence will accommodate your desire to hit the pet store if you just explain you're doing it for him! :woot:
     
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  57. Dee Dee C

    Dee Dee C Member

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    Linda, I hope this doesn't cause a bounce... here is an update of Clarence's BG today during his low period. He did go down into the dark green and seemed a bit uncomfortable. He got very small amounts of his usual food in hopes that he would be able to maintain some low numbers without dropping too low. I tested him more than I have been just so I could monitor him in this range and trying to ward of a bounce later on.

    +5 115
    +5.7 90
    +6 93
    +6.3 88
    +7 105
     
    Last edited: Aug 6, 2019
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  58. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Sorry just seeing this now. I would have said yes to testing in an hour. +5 is later in the cycle and Clarence hadn't dropped a lot early from AMPS suggesting the drop was not likely to suddenly drop swiftly at this point in time. I see he made it to green. YEAH! :D
    Now I would test him 30 minutes from last test just to make sure he's not continuing to drop too much.
     
  59. Dee Dee C

    Dee Dee C Member

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    Linda, I updated my original post with his numbers. I left one off and got to get it on the ss: +3.4 175
     
  60. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Clarence is having a BEAUTIFUL cycle today. Nice smooth slide down and now hopefully a gentle rise. :joyful:
     
  61. Dee Dee C

    Dee Dee C Member

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    I'm hoping and praying! I got him some freeze-dried treats at the pet store, but they didn't have the brand Candy was suggesting (they just had that brand of dog food, no treats). I picked up some PureBites beef liver, some Vital Essentials minnows (already gave him a couple of these), Chicken Hearts, and a small sample packet of Vital Essentials Rabbit Mini Nibs. I hope he likes these treats and I hope they are no carb, they are for sure low-carb. If Clarence doesn't like them, I know the dogs will!
     
  62. Dee Dee C

    Dee Dee C Member

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    Jun 16, 2019
    @MrWorfMen's Mom

    Good evening Linda, Clarence's PMPS is 238, I'm thinking of stalling a bit, thoughts?

    Update: I stalled for 15 and tested again: 280
    Question: think I should maybe reduce for the night to .75 or go ahead and give 1 and monitor him a little more than I have been at night? I would appreciate your input...
     
    Last edited: Aug 6, 2019
    Reason for edit: Update
  63. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Sorry Dee Dee. Wasn't online as late last night. Looks like Clarence bounced last night from those beautiful numbers yesterday. He doesn't usually hold bounces long so hopefully there will be more blues and greens today or tomorrow. I think the 1u was the right decision last night and at least he didn't keep you up all night with low numbers.
     
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  64. Dee Dee C

    Dee Dee C Member

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    Jun 16, 2019
    Good Morning, Linda. Yes, he apparently did bounce from all the good numbers yesterday. Of note, though, he didn't bounce super high (yet anyway). I didn't recognize what was going on until after a couple more tests. And, he apparently bounced and maybe recovered from the bounce all in the same cycle because the few more tests I did showed he was basically flat. If that is the case, I'm hoping that means that he might be getting more used to the lower numbers. I could tell yesterday that he was uncomfortable in those dark green numbers.
    His AMPS was 344. I should go for the 1u again, don't you think?
     
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  65. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    YEs I'd stick to 1u for now.

    Don't be alarmed about Clarence not seeming to feel as well in the greens. They get so used to being in higher numbers that when they go down to normal range they have to adjust. My girl was always very comfortable in the yellows and high blues for the longest time but when she hit greens, she'd seem quiet and less active. Took awhile before I saw her "appreciating" the good numbers.
     
  66. Dee Dee C

    Dee Dee C Member

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    Jun 16, 2019
    Thanks, Linda. And it is good to know that it isn't just Clarence -- I do get concerned when he is uncomfortable and it feels like I'm hurting him somehow. I know that isn't the case. He likes the yellows and the higher blues, too. I suspect his BG was elevated for quite some time and he spent a long time in those numbers, without me ever knowing something was wrong with him until he went up even higher and started showing symptoms. He used to be active and alert, now he just sleeps ALOT. When he gets uncomfortable in lower numbers, he wants to go hide somewhere and just sleep.
     
  67. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Clarence is doing very well for 2 months into this journey. Those observations are as important as the BG readings. Not only can they alert you to falling/rising numbers but they give you an overall perspective of how Clarence is doing. Sometimes with Vetsulin it's the broad swings of BG experienced each cycle that causes them to feel off. Clarence is actually having relatively smooth cycles which is great but are still going to take some adjustment as his BG regulate better.
     
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  68. Dee Dee C

    Dee Dee C Member

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    Jun 16, 2019
    Thank you, that gives me so much hope and it means so much to me to have HOPE right now. Hope is everything!
     
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  69. Dee Dee C

    Dee Dee C Member

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    Jun 16, 2019
    Linda, I hope your day is going well.

    I don't know if you are checking in today or not, but I sort of think Clarence may be staying relatively flat today (Last test was at +5 and he was 195). When that happens, isn't it usually signaling the end of a bounce? Right now he is alert and not too uncomfortable, which usually indicates he is in the 200s or high 100s. I might test him one more time before his PMPS, but because of his behavior, I feel better just leaving him be. If you could weigh-in on whether I should continue to give him the 1 unit as long as his PMPS is high enough, I would appreciate it. And maybe what would be my options if his PMPS is lower than 200 or slightly above.
     
  70. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    I don't think I'd call today a flat cycle with that initial drop of 80+ points and then 50+ more however it is not a bad cycle at all given the lows of yesterday. Slight bounce but short lived. Looks to me like last night was even flatter and was perhaps predicting the bounce starting to clear today. If you can monitor then I would stick with 1u if BG is 200 or above. If PMPS is just under (190s), then you could try a small reduction to 0.75u. If he is below 180, I don't know if I'd chance giving insulin. Let's see what he does at PMPS.
     
  71. Dee Dee C

    Dee Dee C Member

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    Jun 16, 2019
    288

    Thank, Linda. I think he had a fairly decent day. He was alert most of the day, it was good to see him like that.
     
  72. Dee Dee C

    Dee Dee C Member

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    Jun 16, 2019
    Yes, you are correct, of course. It wasn't flat after all. Thank you for checking in. I know he felt pretty good today. With his PMPS being at 288, I will have to set some alarms to check on him.

    My son and I will be dog-sitting beginning tonight for a week. A young dog. Clarence knows her (we fostered her and dog-sit her occasionally), so I won't be too surprised if I see some increase in his numbers for a couple days while she is here. I hope not, tho.
     
  73. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    If they play together, the exercice will do him good. Nice start to the night.
     
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  74. Dee Dee C

    Dee Dee C Member

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    Jun 16, 2019
    AMPS was 274
    Rather hectic morning...
    Clarence's night-time readings last night were higher than I was expecting early on. He was at 215 on his +3.9 (almost +4) and was hungry, so I went ahead and fed him. At +5 he was 212 but up to 239 at +6 (maybe food and/or excitement influenced?) and I didn't test him after that. I checked in on him once and he was doing alright, so I didn't test him. Not sure if he dropped lower than the 212 at any point, but he may have.

    In any case, his AMPS was 274 this morning, so gave 1 unit. BUT he pulled away at the time of injecting and so it was a partial fur shot. We'll have to see what his readings are today.
     
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  75. Dee Dee C

    Dee Dee C Member

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    Jun 16, 2019
    Clarence will sometimes play with my terrier who is just a little bigger than him, but in general his attitude towards most dogs is one of: I'm the boss, see, and if you mess with me when I don't want you to, I will smack you! He was very interested in the visiting dog, but she is a large breed and more energetic than Clarence preferred last night, so he antagonized her a bit and then hissed and smacked her. She has cats at home, but I guess they steer clear of her while Clarence will not be intimidated by any dog. Anyway, I do think her presence will be good for him and keep him somewhat entertained and on his toes. :)
     
  76. Dee Dee C

    Dee Dee C Member

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    Jun 16, 2019
    @MrWorfMen's Mom

    Linda, I've been mostly testing Clarence in the early part of his cycle to try to catch any fast dropping early. I have only gotten a few tests later in the day. I know that today might be different because of a partial (and I have no idea how much) fur-shot. It looked like it was on the rise early today, but I did a test at 9.6 and it was basically the same as his +6. I just was hoping you might have some insight as to why. Anyway, I'm hoping it will come up more by his PMPS and pretty sure it will.
     
  77. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    He's looking pretty flat the last cycle or 2 which can be indicative of an upcoming active cycle. Let's see what he does tonight.
     
  78. Dee Dee C

    Dee Dee C Member

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    Jun 16, 2019
    So his AMPS was 367. He had been testing lower in the mornings the past couple of cycles. Do you think that is a small bounce? Also, what about increasing to 1.25 units? If it is a bounce, that might not be the best choice right now. I'm just not sure what to do. I've read that absorption of insulin is different depending on injecting site. I move it around -- that is what the vet tech told me to do--and lately I've been injecting around the 'scruff', could it make that much of a difference? I thought I'd ask because I don't know and I'm hoping that you (or someone that might be reading this) will know.
     
  79. Dee Dee C

    Dee Dee C Member

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    Jun 16, 2019
    @MrWorfMen's Mom

    @CandyH and Catcat

    I'm thinking I need to increase to 1.25 units and wondering: wouldn't it be better to do so on a morning rather than night dose? I am thinking of doing it tomorrow morning, since his numbers have mostly been in the yellow range for a few days now.

    Thank you for your consideration.

    DeeDee
     
    Last edited: Aug 10, 2019
  80. CandyH & Catcat

    CandyH & Catcat Well-Known Member

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    Apr 23, 2019
    couple of questions -- have you been using the same food for the past three days? is there anything going on at your place which could be stressing Clarence?

    I'm not the expert that Linda is, but it looks like he's "clearing the bounce" -- so I would leave him at this dosage one more day (today and tonight) then re-evaluate, if his system is like Catcat's he *may* be working towards a lower level

    if you do an increase, time it so you can be testing at or near his usual nadir, two things often happen
    1) we call it NDW -- new dose wonkiness -- he will suddenly test HIGHER than he has been, for a day or two
    or 2) he will suddenly drop more than you expected, then bounce

    those high AMPS values are sooo typical of Vetsulin, my experience, cats often go lower at night as you've seen, then in the morning there's a bounce plus the insulin action has worn off ...

    tagging Linda again -- I know she's been busy and there are several others needing her expertise as well -- I missed the tag, she might not have gotten it either

    @MrWorfMen's Mom
     
  81. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Sorry but as Candy said, I didn't get the tag yesterday.

    I like Candy's suggestion. My rule was always to do increases on a day cycle but then I had the luxury of being available to test during the day. I think your timing has to depend on your ability to monitor that first couple of cycles with the new dose. He does looks to be getting a bit stuck but as Candy mentioned, those flattish yellow cycles sometimes mean an active cycle in on the horizon. If he's still up today and you can monitor I'd increase to 1.25u.
    Come on Clarence. We know you can do better! :)
     
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  82. Dee Dee C

    Dee Dee C Member

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    Jun 16, 2019
    Thanks, Candy. He actually has been more active the last few days in the yellow zone, instead of sleeping all day and looking so miserable it would make me cry. I have been feeding the same food. There is a bit of stress with the young dog me and my son are pet-sitting, she is just such a rambunctious girl!
    I didn't get his numbers from last night into the spreadsheet, but he was really flat, with no real decrease in numbers at the times I tested. I'll get the ss updated.
    Anyway, because he was sooooo flat last night, and because I really want to get him back into some blues at least, I went ahead with the increase. I am able to monitor him today and can also monitor tonight as long as I can get a nap in at some point this afternoon! I can always back him off tonight if need be, right?

    Thanks for tagging Linda. Maybe I'm not doing the tags correctly?
     
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  83. Dee Dee C

    Dee Dee C Member

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    Jun 16, 2019
    Thanks, Linda. I went ahead with the increase and will monitor him. Maybe I'm jumping the gun a bit, but he really needs to start getting 'happy' at some lower numbers. And last night's numbers were high compared to what he has been. If necessary, I will reduce back to 1 tonight, but I'm gonna see how he does on the 1.25. If he would just listen to the encouraging words of me and you all... :)
     
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  84. CandyH & Catcat

    CandyH & Catcat Well-Known Member

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    Apr 23, 2019
    not sure about the timing, but I suspect Linda was off line when you tagged, and this is a busy weekend for her -- not sure why I missed the tag from you, but yesterday was a mess for me -- unexpected afternoon nap made me miss the food bank distribution, by time I got there they were all packed up, got only a couple of canned goods and several bags of potato chips -- they DID save me a can of cat food though, and it's nice to get the smaller can of Friskies -- I think one of the local stores donates the unsold cat food that's past pull date
     
  85. Dee Dee C

    Dee Dee C Member

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    Jun 16, 2019
    It is unfortunate that you missed the food bank distribution, but I guess the universe felt you needed some sleep!

    It was late when I edited my post and put the tags in, so not surprised. I'm still trying to learn how to use this forum -- I'm very computer literate, but have very little experience with social media (and that is deliberate!). Yummm...potato chips!
     
  86. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    For some reason, tags don't always work. I know putting them in a line one beside the other sometimes is a problem but you stacked them which I thought worked OK. Apparently not! Being signed on or not doesn't matter. They should show up when you sign on. There's been others having some issues to so not sure what is happening. :(
     
  87. Dee Dee C

    Dee Dee C Member

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    Jun 16, 2019
    No matter, It wasn't especially urgent, I appreciate both you and Candy weighing in on it.

    FYI, I will probably begin a NEW post with how Clarence is doing at the 1.25

    Thanks and Happy Sunday to both you and Candy. Have a blessed day!
     
  88. CandyH & Catcat

    CandyH & Catcat Well-Known Member

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    Apr 23, 2019
    computers have gremlins -- so does the internet --
     
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