11/6 Squamee AMPS 322 1U

Good morning, all! I won't be around much till later this afternoon. Hope you all enjoy your weekend!
AMPS 322 1U

 

AMPS 322 1U
+7.3 251

Have to go out around +10 and probably won't be back till about +16. So I think it makes sense to shoot early. Am thinking about 1.1 or 1.2, depending on how high she goes. Or even more if she goes "high"?

 

I'm trying not to back seat drive here too much. :mrgreen: If it were *meeee* lol I might have given 1.1 this morning. I didn't say anything because you mentioned the .1u increments are difficult for you to spot. I wouldn't do 1.2 unless she is in the 400's or higher tonight.

EDIT: just saw your SS and that you dosed 1.1 tonight just under 400 which is just about perfect. Well see where the 1.1 ends up tomorrow morning which will be a good test of 1.1. Hopefully 1.1 will bring her down just enough so that you can give 1.1 again tomorrow morning without going too low.

I think what you are seeing is what I talk about frequently with ProZinc, very small changes in dose seem to have very large differences in the outcomes.

 

Assuming she is back on the rise tonight (and you don't see some funky late drop to better #s) I'd agree 1u isn't cutting it. You got a nice U-curve yesterday if I remember right on 1.2. So either I was wrong in whatever I was seeing a week or so ago, or things have changed, or whatevs. :roll: My point being if you are hesitating on the dose from anything I said, just forget what I said. What Gator said makes sense to me. :mrgreen:

 

+7.5 107
I find your back seat driving most helpful, Gator. Also, thanks for the tip about the insert on the cells in the SS. That's pretty neat! Was out babysitting all evening and didn't get to test till now. She is giving me lots of experience in living with change and uncertainty! Seems likely I will stick to 1.1 or 1.2 tomorrow AM. It's almost 2am here, and I have to get up in the morning to shoot her (even though we are changing our clocks!) So goodnight and sweet dreams!

 

Crazy late nadirs. If she can have those crazy late nadirs then zoom back up at the end [and you can eventually keep the deltas reasonable - the change from peak to nadir] I would consider that very acceptable.

Seems like quite a big difference between 1.1 and 1u. Man!

 

Delta is the change from nadir to peak? Isn't that the same number?

 

The same number as what? I think so - delta is just a label for that change. The Greek character Δ ["Delta"] is often used in math to denote change. For instance: take the PS [like 300] and subtract the lowest number of the day cycle [like 175] so the "delta" would be 125.

Joanna talks sometimes about how one would *ideally* [real world is often not ideal] like to see deltas in the 50-65% range [so like deltas of 150-105 with a PS of 300]?? Am I getting that right Joanna?

Sometimes kitties that rebound exhibit large [% wise] deltas and/or fast drops. I don't think rebound is happening here, just providing some morning background/info to ponder. :smile:

 

delta is PS to nadir right? Peak = insulin peak, so yes peak is the same number as the nadir.

The delta % thing was something Chriscleo & Terri & Lucy used to talk about. I think maybe 60 - 65% was recommended - 50% is probably a little low, though sometimes I advocate for it depending on the PS. For instance if you have a 150 PS, a nice nadir to me is probably in the 50 - 80 range, so that's a drop around 50% - 65%. If the PS is 300, you'd want more in the 65% drop range, so going for a 100 nadir. Of course it varies by your cat, what you are aiming for, etc.

And with a cat like Bix who gets long duration, in part I use an approach similar to what Gator has been writing about, where you judge by how much the PS dropped from the shot. If Bix gives me say a 220 PS and then the next PS is 150, I'll pull the dose back by 0.1 or so because I don't want further drop in the PS, I want to switch more to a maintenance dose to keep the PSs steady rather than bringing them down from higher #s. Of course Bixie's patterns are generally different than Miss Squamee's.

 

Delta info is interesting stuff, except I hate percentages. Aside from being computer challenged, I am also numbers challenged.
But thanks for the explanation.

 

OK I just wanted to point out one thing here that happened today. That +3 with 300 and that +4 with 200. This is a pattern that I noticed in H were the BGs would continue to go up until onset as they seemingly did in Squamee's case today. I'm not sure if it is something specific to ProZinc BUT my psudo-conclusion [because I really did not test enough to nail it down] was that when that happened the dose was not enough. I don't know if that was really true or not or was a pattern that I got because I was not always faithful to the 12 hour shot interval or what. But I just know I saw it with H and ProZinc and did not really see it with PZI Vet. I'll be interested to see where she ends up tonight.

261 to 300 is not that big of a rise. But just keep an eye out for this in the future.

 

Not 100% sure I followed you, but w/PZI vet that's what I have called overlap - if the #s kept rising til onset & then dropped back down (= not much overlap), vs. flattish #s through the end of one cycle and into the first couple hours of the next (probably not super-flat, but no sharp rise) = good overlap. For Bix, that's where sometimes cycle 3 on a dose would be magic, where the rising #s between shots would settle down, and that's where I've seen some dramatic drops to nadir (for Bix & for other cats I've seen here) on that shot 3 or so, when overlap was built up. (If I understood what you were saying...)

To me that is one of the key things that gives many of us trouble when shooting on lower PSs. If you have a cat who will be zoomed up to high #s by onset time, you need to shoot pretty close to a full dose even on the lower PS in order to compensate for the higher #s that are coming. If the zoom isn't big though, then shooting something close to full dose can put you at a scary low nadir. And of course it's hard to tell in advance unless you have a really predictable cat (which I can't recall ever seeing here really).

Just musing.

 

Wow, I totally learned something today! I did not notice that with PZI Vet.

My observation is that with ProZinc that flat before the drop/onset seemed *perhaps* harder to achieve with my "variable" and required a dose high enough to happen. So basically my hypothesis is that if the BGs rise from PS until onset, then the dose is not high enough.

Overlap or insufficient dose - either way, they are things to explore.

 

I think it varies by cat. If they consistently get something like 400 down to 150 (or whatever) and then back to 400 by next PS, they may never get overlap, and if the swings are problematic, need either early shooting or a longer-acting insulin. For Bix, and my impression from what I learned when I got here, was that when you get to the right dose you get good overlap, and this is where PZI can really shine. So yes, no overlap = dose is too low. But again, I don't think it works for all cats, because with the monster drop and/or shorter duration cats, they may be getting a perfect nadir but no overlap, and in that case you can't really increase the dose b/c you don't want a lower nadir (though you can shoot early!).

With Bix I always looked for that flat # from PS to +2 as a sign we were at a good dose. If he rose from PS to +2, then it was a catch up game to get very good action that cycle. When it was flat, it was a Yippee! But then he has seemed to get better duration than many cats. That's why for him I used to increase the dose on a +13, since that chance at overlap was mostly lost, and usually reduced on a +10 or sometimes even +11, b/c the overlap tended to be quite good for him at that point. Of course now it's all out the window because he really doesn't zoom a lot anymore. Without a zoom factor, it's hard for me to tell overlap from pancreas action from who knows what.