? Yemala 10/18 AMPS 358; +2 325*; +5.5 221*; +10 356; PMPS 419; +2 360; +3.5 298*; +6 164*; +7 134

We are still holding the .75 dose instead of increasing to 1 u. As advised, I have gotten a +2 to see how she's dropping this AM.

And now that she's awake again, she's demanding more breakfast. Feeding lc food.

http://www.felinediabetes.com/FDMB/...ps-409-2-358-4-237-6-168.205012/#post-2272787

 

Morning, good job with the extra testing.
She sure likes swinging about all over the place with those numbers.
Last night she dropped into blue (that's the lowest you saw, she may or may not have gone lower, remember that although we often talk about nadirs typically being about +6 they can and do nadir at any point in the cycle. George nadired as early as +2 and as late as +12 though he usually nadired at around +5.
One thing I did, because I hated any uncertainty, was that if my just before bed test showed that he was still dropping I would set an alarm and test again, you may want to consider doing this if at all possible, I feel bad suggesting it as I know you have your hands full with a house load of kitties and work full time.

That drop into blue at +6 from a red pmps in itself is enough to have triggered another bounce, which is what this mornings amps seems to be suggesting, hoping that the +2 which seems to be down a bit is an indication that she is coming back down again.

I am going to ask some folk to take a look at your ss. I'm thinking that as long as you don't see green this morning that perhaps it's time to take the dose up. But I'd like to get some other eyes on this.

 

Thank you. We held the .75 dose because her drops are so precipitous and I knew no one would be here much of the day to continue testing. I have given her more lc food at +2, and we're off to the vet in about a half hour. I should be able to feed and test her again once I get her home. Since she finished her breakfast this morning, she'll be getting boiled chicken.

I will check in on the board as I can today and gather advice.

 

I authorized blood work testing the kidney and liver functions, skipped the fructosamine, skipped the T4, her blood pressure is normal, and her temperature is normal.

The results will be called in later today.

Vet appointment lasted 1.5 hours - not expected. She is open to working with me on potassium and phosphate binders, I'll ask whether Mala needs more calcium as well.

Once Mala will allow it, I'll get another stick for a +5.5 or +6. As a reward for tolerating being poked, prodded, pricked, and driven across town, Mala is now eating 1 T of lc food.

 

100 point drop from +2 to +5.5.

Mala has just had a snack of plain chicken. She's had a rough morning.

 

That is not bad with vet stress thrown in!

 

No further testing will be possible until at least +7 or 8.

 

She's spiked back up into the pinks. 356 at +10.

Now what?

 

I think she could do with an increase, my one concern is the way she drops, if I were to take her up I would do it knowing that it would be important for me to follow up on drops, so if she's say blue and dropping at +6 I would want to grab another test, either 30min later to see if she's flattened out, or setting alarm and checking again at some later point in the cycle, I worry that she may be hitting some lower numbers after +6 in the night, there's a bit of a gap in that data.

Doesn't look like you missed anything today though.

Did you get a chance to read through those links to threads on bouncing? Any questions?

 

we did our best. I should get test results tomorrow, and start talking to the vet about where to go from here with the CKD.

I'm currently thinking along the same lines as you, but I would want to start the dose increase tomorrow AM. I should be around more tomorrow and can monitor more closely, and will have all weekend to watch her for responses.

I have read the links to threads. As far as I can tell, what is being advocated is using food plus insulin to flatten her drops, which will help to limit the high ranges, and then don't sweat the bounces too much. If her lows aren't in the low greens, watch the fast drops but don't fear them like one would a fast drop in the greens. Right?

Given how we feed her throughout the day, that's kinda what we're doing now. If you look at the subject line above, I'm marking times I know she's getting extra food with an asterisk. I didn't add the later cycle readings, and don't know whether she was fed at those times or not. I would guess that she was. If we need to do something different with food, I'm not sure what that would be.

Mala is a picky eater who won't touch any of the medium carb food we've tried. I have some which would be a slightly higher carbohydrate load, but the phosphates are insanely high and I have to walk that line, too. Gravy is spurned, broth is despised, only pate works for her.

Which limits our choices for food therapy. We're crazy generous with the low carb foods, and any time Mala asks for it, she receives it.


What am I missing here?

 

Tested again and fed 1 T lc food. 298 at test for +3.5.

 

+6 164. Feeding lc to curb the lows.

We're seeing a pattern. PS numbers in the high pinks or reds; drop of around 100 points mid-cycle, drop to the blues by around +6 or +8.

We'll raise the dose tomorrow and see where she is in 6 cycles.

 

Do you think you can get a +7? See if she's heading any lower ?

 

I'll see if she's willing to cooperate.

 

134 at +7.

I may be able to get a +8. Awfully tired, still have dishes to do and a shower to take, but if she's willing, I can do it.

 

+8 = 130. That's the last I can get tonight.

 

Looks like she's flat at +8.

Good job, glad she cooperated.

Night night

 

Good luck with the new dose tomorrow

 

Thanks. Up again at 6. Kill me now.