Curve day for Klinger

Hi everyone,

We did a curve today on Klinger...the results aren't pretty:
AMPS 387 2.0u
+1 503
+2 500
+3 462
+4 436
+5 432
+6 431
+7 352
+8 428
+9 461
+10 465
+11
PMPS

Anyone see an issue with me increasing his dose to 2.5u tonight? I don't usually like to increase at PMPS, but he's still high...
Thoughts?
Thanks,
Marcy & Klinger

 

No objections here. Yes, according to Tilly, a .5U increase is warranted. I don't see any dips anywhere on his spreadsheet that might indicate he's getting too much. Looks like not enough. Poor guy. Have you checked his urine with a ketone strip recently?

 

I was able to get in a test today. Luckily it was negative.

He's playing, eating, preening, peeing and pooping. Seems happy to me, so that's great. ;-)

 

Marcy, good job on the curve. It's not too "ugly" - no deep drops or spikes, so yeah looks like an increase is OK. If you don't want to increase tonight, maybe tomorrow? I don't think there is any reason to not increase tonight - just if you aren't comfortable.

 

Thanks Vicky and Sheila. I went with the increase.

 

Glad you went with the increase. Clearly not enough insulin. I know you were waiting to do a curve before increasing per your vet's instructions, but like we talked about before, maybe waiting a week between increases is too long. What did your vet say when you showed her this latest curve?

 

I haven't heard back from the vet yet. From my experience with the other vets at this same practice, they are of the mindset of full 1u increases. That makes me nervous.

 

Not only should it make you nervous, but increasing by 1U at a time can easily jump you past the optimum dose.

Tilly says this: "However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU. Alternatively, if the cat is continuously producing moderately elevated BGs (nadir always >=200 mg/dl), increase the dose every 2-3 days by 0.25 IU ( if the cat is getting a low dose) or 0.5 IU (if the cat is getting a higher dose). From this point onward test for ketones once per week, or more often if the nadirs are still >=200 mg/dl."

That's why Pamela made the suggestion she did about waiting less time.

 

If the vet argues for 1u increases once per week ---

you can counter-argue that you are increasing 0.5u twice per week -- so in the end it is the same, and a smoother journey

Looks like a good Lev curve that needs more insulin

((((((hugs))))))

 

Thanks so much, ladies. I appreciate all of your advice and support. Klinger broke through to the yellows today. It's been awhile.

 

Yayyy! Hey, we will take yellows here!! Weird that 401 food spike though and then back down again so quickly.

So did you shoot already tonight? Curious what his number was.

P.S. also weird how he was acting yesterday from your notes in your SS. Seems like he was constipated?

 

His PMPS was 448, 2.5 u just updated his ss.
I don't know if he was constipated...he went at least twice yesterday. We're coming up on the same time and I'm curious to see if he acts that way again. It was weird.

That food spike...he is so carb sensitive! Right now his food is 3-4% carbs FF classics. He can watch me eat pasta and have a food spike :lol:

 

Come on down Klinger! Yellow would be good.
Good job Marcy, It's a marathon, not a sprint, boy do we know that...

Pam & Alley

 

Hi Marcy -
I know I haven't checked in for awhile - but have thought of you and Klinger alot. Just thought I'd stop by - say hello - and just send some warm encouragement for you and your boy. :thumbup

 

Thanks Patti. It's great to hear from you.
Klinger just threw me a 162 @ 4.5...looks like I need to set the alarm tonight to get some spots checks in.

Hope everyone has a great night.

 

Looks like those are the first 100s he has had in a while, right? They may give him a little bounce because he is not used to them. And he is suddenly getting a big drop from 400s to 100s, so that may also cause a bit of bounce. In fact that 448 may be a bounce from yesterday's "blues".

As long as you can test, I'd hold the 2.75u for now and see if he can settle on that.

Nice to see some breakthrough numbers, isn't it?

 

Yes. Finally breakthrough...I can't tell you have amazing it is...but I guess I don't really have to because you know...you all know.
+8 128
fed him a little of his lc food and I'm heading back to bed.
G'night

 

+4.5 162 and +8 128 ...WHooHOO!!! NICE surf! :thumbup

Curious about today's AMPS...

 

Definitely!

 

Wow, 200 amPS? Awesome!

Get some tests today... that little snack at +8 probable helped to slow the bounce. I was expecting 300s at least.

Can't answer the dose question until I see how today goes. He is still adjusting to the dose. If you are uncomfortable with 2.75u because you are gone all day, than go with 2.5u. Can you leave food down during the day?

 

He was in the 400s all day and PMPS 510. Blah!

+2 367
+3 448
+5 465
+7 401
+10 475
PMPS 510
I can leave food out for him, but this seems like a huge bounce. Maybe he saw green last night? I'm leaning towards 2.5.
Thoughts...

 

Impossible to know if he was in the greens last night after the 128, but if he was it was probably no lower than 90s.

Remember that the nice blues happened on 3u. The reduction Friday night was because you were unsure how he would react, etc. But it would have depleted some of his reserves. We don't now that he was headed too low or not. He most likely still had some reserves, but not as much, last night when he dropped to 128. Now he could have completely depleted the reserves.

Look at today compared with yesterday. Yesterday he started higher, dropped lower, ended up lower - I am talking about the day time cycles. I think the bounce is over and now he is higher again.

I still think that his best dose is either 2.75u or 3u, but now he will need to rebuild his reserves because of the 2.5u doses.

Well, get a few spot checks tonight to see if he gets any action on the 2.5u., but I don't think it is enough. You had him on that does for 7 cycles before with little movement. The real breakthrough came on 3u, after 7 cycles.

 

Hi Marcy,

I think when you go the low blue and shot the 2.5 and still got good numbers, you were actually still seeing the work of the 3.0....then you shuffled back up to 2.75 and I think you saw dose wonkiness...that is to say, a culmination of a lower number than either of you are used to, coupled with 3 dose changes in less than 48 hours.

I don't think he went too low on the 2.75.

I think, if you can stomach it, you guys were heading in the right direction on the 3.0...If it were me, I'd go back to the 3.0 and hold the heck out of that dose barring any really low greens ( like 50 or under) or any really high reds (like 500 or over).

to me it seems like the 3.0 was leading him to be a late nadir kitty, so if it is possible to get checks any time after +6 to +10, I think you will be fine.

Also, the next low blue you get, please try to give the 3.0, but ONLY if you can be around to test or feed, okay?

I am hoping the 3.0 is going to get him to blues and let him hang there- in the blues or better ;-)

See what the others say...

 

Good morning,
Last night he was 460 at +4 and I really thought I would see a HI on my meter at AMPS and he gives a 303. Not the worst he's seen.
I'm going with 2.75u for a while. I felt horrible for him last night. Now that I know he can get these good numbers, I want them all the time!
Thanks for explaining his data and your advice Sheila and Melissa. I'll try not to be a weenie from now on. ohmygod_smile :smile:

Everyone have a great day!

 

Hi Marci and Klinger
I'm at work and had a chance to check in. As always you are doing such a great job together! Just wanted to send a warm hello! cat_pet_icon

 

Thanks Patti.

1/24 AMPS 303 2.75 u
Just heard from DH that
PMPS 176
Told him to shoot 2.75u
I'll set the alarm tonight to test.

So glad he's back in the blues.

 

Oh good, much better than yesterday!