? Terry needs dosing advise PMPS 351

Discussion in 'Prozinc / PZI' started by Fabiënne, Sep 8, 2016.

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  1. Fabiënne

    Fabiënne Member

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    Could you please advise me? Do a have to shoot 3.25 IU or do you have an other advise?
     
  2. Ruby&Baco

    Ruby&Baco Well-Known Member

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  3. Alexi

    Alexi Member

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    My feeling is that might be a bit high as he dropped to 2.8 (50) with a similar pre shot number before the change to low carb food. From the data we have since the switch 3 units seems to offer more consistency.
     
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  4. Ruby&Baco

    Ruby&Baco Well-Known Member

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    Thanks Alexi, should Fabienne stick with 3U for the next couple of days? for example if the AMPS tomorrow is the around the same # she should stick to 3U? and if Terry goes lower, like 10mmol (180dg) then she comes online to ask for advise right? This is how we arranged it on the Dutch forum.
    Above 252 was 3U (or now it was 3.25U) and everything below she would come online asking for advise. Or would you say that it's better for her to get online every PS moment to ask for advise?
    The trick here is to hopefully get Terry more regulated, seeing nicer # within 2 weeks (because then the prozinc bottle will be empty and Fabienne needs to decide to switch to Lantus or stick with Prozinc) otherwise she will consider to switch to Lantus (again not saying that that's a bad thing) but we want to try and stick to Prozinc because he's already been on caninsulin for a short period and Prozinc is also not a long period of time yet..
    I believe his body still needs to adjust to Prozinc but maybe the way he's been dosed is not the right way.
    So the more eyes on Terry the better don't you think?o_O
     
  5. Fabiënne

    Fabiënne Member

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    Thanks Alexi!
     
  6. Alexi

    Alexi Member

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    I think if the numbers are shootable then I would say yes to your plan and stay with a consistent dose. Some +2 or +3 numbers would be helpful as well.
     
  7. Ruby&Baco

    Ruby&Baco Well-Known Member

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    +2 and +3 at AM or PM? or both? because at AM she can't test it, she's at work then.. Only maybe in the weekends.
     
  8. Alexi

    Alexi Member

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    one or the other - maybe evening time as I can't do daytime tests when I am at work either but we need to see if he is rising or falling in the hours after the insulin.
     
  9. Ruby&Baco

    Ruby&Baco Well-Known Member

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    @Fabiënne can you do that tonight? test +2 and +3?
     
  10. Fabiënne

    Fabiënne Member

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    Yes. I will test his +2 en +3 this evening.
     
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  11. Fabiënne

    Fabiënne Member

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    His +2 as well as his +3 were 360....
     
  12. Alexi

    Alexi Member

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    Looking good.
     
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  13. Callie & Patches

    Callie & Patches Well-Known Member

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    I looks like the dose is jumping around a lot. Terry might do better if his insulin dose was kept the same for a few days or a week. Terry 's system might be confused with the dose jumping up and down so much.
     
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  14. Kris & Teasel

    Kris & Teasel Well-Known Member

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    3.0 units seems to give some yellows and blues but too long a duration - ie., PMPS that required a large dose decrease. I've been told that this usually means the dose is a bit too high. Would it be worth trying 2.8 units (measured on a U100 syringe) or 2.75 units (estimated on a U40 syringe with half units) for several days (5 - 7?) with no changes and just ignore the odd black or red? If Terry is a cat who needs time to adjust to external insulin, he might be better off with some dose stability for now. Just a thought ...
     
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  15. Ruby&Baco

    Ruby&Baco Well-Known Member

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    I think that's a great tip Kris. @Fabiënne what do you think about Kris's thought?
     
  16. Fabiënne

    Fabiënne Member

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    That's sounds good Kris! Good tip!
    I will shot 2.75 ( u40) this night if he's shootable. But if he continues the same ( weird) pattern he could be in not shootable scores this evening. From wich score on should I shoot the 2.75? Higher than...?
     
  17. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Hi Fabienne,
    I'm not sure what to say about when you should shoot 2.75 u. I haven't enough experience with dosing yet. There are others on this board who do. What I did was look at Terry's SS to see what dose he was at when the yellows and blues showed up through the day and gave you a PMPS that was low and needed a dose reduction. The two things we have to do with our diabetic kitties are:

    1. look closely for patterns on the SS - whether a dose is too high or too low;

    2. learn over time and with experience what dose to give at what BG number - this is more difficult.

    To add to the difficulty, some cats do well with doses that change frequently in response to BG numbers and others are better if a dose is held several days. Some cats are regulated quickly in the early days when the owner is aggressive in responding to each PS with a dose suited to that number. Some cats need to get an "acceptable but maybe not ideal" dose that is held for some time. You find out which type of cat you have when you start giving insulin. The jumpy cats might become more predictable when they are regulated. I'm not there yet with my cat. o_O
     
    Last edited: Sep 9, 2016
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  18. Fabiënne

    Fabiënne Member

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    Thanks! We'll just see what happens tonight.
     
  19. TempestsMum

    TempestsMum Guest

    Hello! :) welcome to the forums both of you!

    It's good to see more yellows happening, so looks like the low carb food and your dosing are working well together. I would say you are well on your way now to getting some really good information as to what dosing will work for
    Terry. :)

    Hoping it works as well for Terry as it has for Tempest.
     
  20. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    I don't think I have posted on your thread before, Fabienne. It looks like the insulin is working better, along with the change to wet low carb food. I think I'd stick with the 2.75 for a few cycles. It may be that he needs a little more, but getting the data is always wise. Then you can make better decisions going forward.
     
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  21. Fabiënne

    Fabiënne Member

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    Thank you Sue! Now his amps is 194. I don't think I should shoot 2.75 at that. Because there's no one awake to advice me I've decided to wait and test again later. Maybe he will be shootable then. I hope that's the right decision. We haven't had such a morning score
     
    Last edited: Sep 10, 2016
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  22. Fabiënne

    Fabiënne Member

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    Thank you! Yess I really hope so! I want him to feel better so much...
     
  23. Fabiënne

    Fabiënne Member

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    I tested again 45 minutes later( amps 194) BG then 304
    So I did shoot 2.75iu
    Hope I did the right thing....
     
    Last edited: Sep 10, 2016
  24. Ruby&Baco

    Ruby&Baco Well-Known Member

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    I think you did right indeed! Try to get some midcycles again today to see how low he gets around +4 and +6.
     
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  25. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    What a nice surprise this morning. I like that his morning preshots are gradually lowering.

    Did you feed between the 194 and the 304? At these levels (304) , it doesn't matter but if you fed and got a 220 for example, it might be food influenced and you might want to skinny up the dose. If you stall, the not feeding part is difficult but important, especially at lower numbers.
     
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  26. TempestsMum

    TempestsMum Guest

    That sounds very promising! Looks like he just needs a bit of time - go Terry! :cat:
     
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  27. Fabiënne

    Fabiënne Member

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    Yes I did. I always feed him (raw food) before testing because he is always very hungry and that influences his Score. After testing he gets the rest of his meal. ( wet food) . So before the second test he already had his whole meal.
     
  28. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Try to avoid that if possible. You can always give him a tiny snack and then go take a shower and close the door. :p Being hungry might influence the level a little but not as much as a whole meal might. You want to shoot a 'true number". not food influenced, especially when the numbers lower and start to tighten.
     
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  29. Ruby&Baco

    Ruby&Baco Well-Known Member

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    I'm going to agree on what Sue is saying here, if you are going to give a shot earlier as from next Sunday you can try to test Terry when you get out of bed and then give him his food. Those numbers will be indeed 'real'
     
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  30. Fabiënne

    Fabiënne Member

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    I just tested before his meal. Pmps 175.
    I think I should wait and test again in 45 min like this morning?
     
  31. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    20 minutes without food should let you know if he is rising, not still falling and maybe a little higher.
     
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  32. Rachel

    Rachel Well-Known Member

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    He's looking good! Those are some nice preshots. Yep, as Sue said, 20 minutes without food is enough...then go from there.
     
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  33. Ruby&Baco

    Ruby&Baco Well-Known Member

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    @Sue and Oliver (GA) @Rachel can you please take a look at Terry's spreadsheet? Those +2 and +4 are extremely high comparing to his PMPS. This 'issue' is what Terry does often, he never gets lower in the evening when his pmps is low. What can this be and how can we fix this?
     
  34. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    It could be his pattern of bouncing. So he doesn't bounce right after the lower nadir, he bounces on the next cycle. I would not have shot higher on that yellow pmps. Remember - just data gathering. In general, the trend is downward.
     
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  35. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I wonder if it would help to get +2 and +4 each morning for a few days to compare? I see only one +2 in the AM on the SS and there are several +4 values, mostly mid to high-ish yellow, a pink and a red. Terry might have a prolonged food spike if his pancreas isn't working (yet). I also notice that his high evening +2 and +4 values are often preceded by low-ish (blue) mid-day or PS numbers. Could these be early bounces along with food spikes?
     
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  36. Ruby&Baco

    Ruby&Baco Well-Known Member

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    So we should ignore this? And wait for it to clear over time those night time weird higher numbers?
     
  37. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    I would just keep watching the numbers and see if there is a pattern we could use to help dosing. But for now, things are looking okay.
     
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  38. Rachel

    Rachel Well-Known Member

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    I agree. As we compile more data, the picture should become clearer.
     
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  39. Ruby&Baco

    Ruby&Baco Well-Known Member

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    It's really weird those pmps spikes don't you think?
    And if it is a late bounce like you are saying Sue, than that would be hard to dose on...?
    He does that really a lot it's doesn't seem like he wants to clear that...
     
  40. Kris & Teasel

    Kris & Teasel Well-Known Member

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    It's like a grey and white cat I know well ...
     
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  41. Fabiënne

    Fabiënne Member

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    Terry just had a real nice +6 95. Green zone !!!
    But I was thinking maybe we should decrease the dose a little bit to minimalize the chance of bouncing. His Amps was 326 but he had his insulin 1.5 hours later ( husband forgot !!!! ) , that means his BG was even higher at that time.
    What do you think?

    @Sue and Oliver (GA) @Kris & Teasel @Rachel @Ruby&Baco
     
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  42. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    I think that's a good idea. If he was 326 at 13.5, he certainly could have been lower at amps. How about - for now - 2.25 for the yellow 200s and 2.5 for the 300s. And the next shot should either be 30/45 minutes later than usual to work back to the schedule. (Shooting at the regular time would be 1.5 hours early). Make sense?
     
  43. Fabiënne

    Fabiënne Member

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    I looked at Teasel's SS. It's like looking at Terry's . ;-)
     
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  44. Fabiënne

    Fabiënne Member

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    He was tested normal time 7 am , only his shot should have been 7.30 in stead of 9 am.
    Oke thank you for your advise!
    This evening I will give him insulin at 8/8.15 pm
     
  45. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Gotcha. So the number was right, but the time/shot was off. He was probably higher when he got the insulin. So I would still work to get your schedule back, but not in one cycle.
     
  46. Fabiënne

    Fabiënne Member

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    Ok, so this evening round 8.15 and tomorrow morning 7.30?
     
  47. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Will that be close enough to your regular schedule for tomorrow, if you can't be around? If so, yes.
     
  48. Fabiënne

    Fabiënne Member

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    Yes it will. The normal schedule was 7.30 am and pm. We wanted to change that in 7 am and pm, so I can stall if nescessary. But we'll do that after tomorrow
     
  49. Ruby&Baco

    Ruby&Baco Well-Known Member

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    @Sue and Oliver (GA) @Rachel @Sharon14 @Alexi @Bobbie And Bubba @Kris & Teasel Hey!
    Can you take a look at Terry's spreadsheet for a second and tell us what you think of his progress?
    This morning he ate but vomited everything out, his +6 is not that great comparing to the 'normal' days.
    Do you still thing this dose is ok for now? or should there be a change in it?
     
  50. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Hi Ruby,
    I'm not an expert, except in my own cat's unpredictability, but maybe 2.00 u is a bit low. Maybe try 2.25 u again (fairly conservative) or even 2.50 u (being braver and monitoring) once he's over his upset tummy. I'll certainly defer to the dosing experts. Let's see what they have to say. :)
     
  51. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Maybe stick with pre shots 250 and under and up the dose a smidge for 350+? 2.75 gave you that unshootable pmps a few cycles. Probably old news but I'd vote for 2.25 with Kris.vThere could be a lower number in there on 9/13 before the 175 that would make that cycle look different?

    Time for a curve to get an idea where that nadir might sure be - not exact, of course but whether earlier or later than +6.
     
  52. Fabiënne

    Fabiënne Member

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    Terry had the same raw food ( first time other brand) as this morning and keeps vomiting. Can i shoot 2.25 safely?

    @Sue and Oliver (GA)
     
  53. Fabiënne

    Fabiënne Member

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    I gave 2 IU . He is now eating a little wet food. Hope he keeps it in....
     
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  54. Kris & Teasel

    Kris & Teasel Well-Known Member

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    It won't hurt to shoot less. Could the raw food be disagreeing with him? You said it was a different brand.
     
  55. Fabiënne

    Fabiënne Member

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    Yes the brand I normally have was out of stock. So I got the same flavour but another brand. This morning he ate it for the first time. It came out immediately. And he kept vomiting for a while. Later this morning a gave him some wet food. That stayed in. This evening I tried the raw food again. But the vomiting was even worse. About 15 times!! The tears were in his eyes. Pour thing...
     
  56. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Maybe they will take it back?
     
  57. Fabiënne

    Fabiënne Member

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    Yes I think they will. Maybe trade it for an other flavour from the brand I had before
     
  58. Fabiënne

    Fabiënne Member

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    I need some advice again.... This morning Terry's amps was 207 , so I shot 2 IU. I just came home and tested +7 bg 367!!
    How is this possible? Husband gave his shot amd is sure it wasn't a furshot. Could he have been lower before and is this a bounce? Has mr P came and visit again so he dropped lower after amps?

    What about the dosing now? Maybe 2 IU was to much ?

    Is it valuable to make the curve tomorrow, if he is recovering te bounce?

    What do you think??

    @Sue and Oliver (GA) @Alexi @Rachel @Kris & Teasel @Bobbie And Bubba @Sharon14
     
  59. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    I am not sure, and when I am not sure, I said that it's just one number, just one cycle. It is not a pattern. Maybe he dropped low early and bounced up. It could be that 2 units is too much for a number in the low 200s. Any chance he got into contraband?

    I think a curve is always valuable. If you can do one tomorrow and can't do one in another day or so, I would do it. If you can wait, try that?
     
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  60. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Good advice from Sue.
     
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  61. Rachel

    Rachel Well-Known Member

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    Yep! Remember that it really is just one number. Could be a hairball or a bounce or even just "look a squirrel" syndrome!
     
  62. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Sorry, I T/F/ S and went back to bed. And just now seeing this. I think Sue's explanation is as good as any. Every now and then these cats have to throw out a wonky number to confuse us. :confused:
     
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  63. Ruby&Baco

    Ruby&Baco Well-Known Member

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  64. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    It should have been : T/F/S which is test/feed/shoot
     
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  65. Fabiënne

    Fabiënne Member

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    Thank you all!! It lookes like the " squirrel" syndrome.. :joyful:Pmps was 304.
     
  66. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Or it could have been a bug on the floor, a change in the wind direction or ... :)
     
  67. Fabiënne

    Fabiënne Member

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    Haha great humour Kris :joyful:
     
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