9/12 Zeke-PMPS=112:+1=103;+2=84;+4=85;+5=115;+6=122;+10=157

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MrZ

MrZ

Member Since 2013
Here's yesterdays condo: Zeke 9/11

Well, going on 5th day of dose reduction to 1.0u. Over the last 4 days, Zeke's had some bounce pink, along with some daily BGs >200. Is it time for an increase or should we perhaps give the 1u a total of 7 days to see if the > 200 start to drop off? If you advise to increase, typically, how long does it take to see the depot effects of a dose increase - maybe 2 days?

Please note I am now using the Relion Micro
 
Re: 9/12 Zeke - Dose Increase?

Since you're using the Alpha Trak, I think I would give him another day (2 cycles) on this dose and see if he doesn't come down into the greens again. If this is a small bounce, they can take up to 3 days to clear.

To answer your question about how long the depot takes to fill up, I believe it is about 2 to 3 days.
 
Re: 9/12 Zeke - AMPS=334 (ReliOn)

Is the AMPS of 334 correct or is the number on Zeke's SS correct?

This may be a bounce or a high before a break. I would look to see how the cycle plays out. Either way, I do think Zeke could use more insulin unless, of course, he drops below 50 just to prove me wrong!
 
Re: 9/12 Zeke - AMPS=334 (ReliOn)

I've updated Zeke's ss to reflect the switch to the ReliOn Micro glucometer. I don't understand why there's such a huge disparity between the AlphaTrak and the ReliOn. It's not even close to ~ + 30. Today's AMPS was the difference between Red and Pink.

Anymore advice on dosage? I gave him 1u this AM. Would you suggest I see how today goes with 1u (PM as well)? Barring any BGs <50 or >200 TODAY an increase seems just about due.
 
Re: 9/12 Zeke - AMPS=334;+7=260(ReliOn);Little change-what's

Well today's been very different. A very slow drop since AMPS = 334 to +8 = 260. The cycle is not yet over but highly unlikely Zeke's gonna drop to <200. We'll see how high he spike's once the insulin wears off.

I'm still not sure what dose to inject tonight. Is it still too early to decide?

Should I stick with the 1u or increase to 1.25? Zeke's been on 1u for going on 9 cycles. Tonight will be 5th day and 10 cycles if I hold the dose. The Protocol says if nadir <200 but highest > 200, increase every 5-7 days. Would it be best to stay at the dose for the 7 days to see how Zeke reacts or "have we seen enough"? I really don't know what to base this decision on as far as holding for 5 days or 7. Please let me know what you think based on Zeke's ss. I would greatly appreciate it.

Thanks,
Laura
 
Re: 9/12 Zeke - AMPS=334;+7=260(ReliOn);Little change-what's

Laura

I'd try to not get too wrapped up in the difference between the AT and Micro because at high numbers, it can easily be that much (20%). I know it's hard; I was stuck at my vet's office the other day because they were backed up and I needed to test Gracie so I had to use their AT and it gave me a very non-Gracie number. When I got home, I tested her with her OT and Micro and they were more in line with what we're used to.....and I'm sure the vet stress wasn't starting to dissipate. Switching meters is always a challenge because you want to keep testing with the old one but i think it's best to go cold turkey and that's what I've been doing. Except the other day. :lol: :lol: :lol:

Let's see what Zeke does at +11 ok? He's clearing a bounce and you might get a dropping number at PMPS. Whether you increase or not depends on whether he is dropping at shot time, how much he's dropped, where he is, etc. So if you could please post the +11 when you get it, that would be great. There should be lots of folks on then and if I can get back on, I will. Can you let me know what time your +11 is YOUR time and I'll try to pop back on and check on you just in case it's quiet on the board.

Doing great!!!
 
Re: 9/12 Zeke - AMPS=334;+7=260(ReliOn);Still drop' @+9.5

I just took his +9.5 and it's the lowest of the day (=169). He typically is on the rise at this time but today's been a very usual day. He just ate right before I picked up the food for the 2 hour fast before PMPS reading. I will continue to test - I am curious to see if he will continue to drop. That's never happened. Maybe he's just ready to shake things up a bit. If here's clearing a bounce I am more inclined to not increase his dose but I would greatly appreciate the benefit of the member's expertise in helping me make the call. However, I would definitely appreciate a clear explanation for the reason why I should, or shouldn't - I want to learn as much as possible about managing Zeke's diabetes.

The PMPS shot is planned for 7:00 PM CST. I will take the +11 reading at 6:00 PM and the PS reading at 6:45PM (15 minutes before shooting).

If I can provide any additional information, please let me know.

Thanks,
Laura
 
Re: 9/12 Zeke - AMPS=334;+7=260;+9.5=169(Lowest today)

Thanks Laura. You are two hours ahead of me so I'll check in with you at 4 my time which is less than an hour. And then I'll also be around to help you at 6:45 your time.

The best example I can give you is the same thing happened to me this morning. My plan was to give Gracie an increase at AMPS. But she dropped from 181 at +9 to 116 at AMPS. So I held off on the increase for now. Sometimes after coming down like that and after me holding off on the increase, she didn't do a darn thing and I had to increase the next cycle. But if you notice on her SS today, she kept dropping and gave me a 48 at +2. This all just comes from knowing your cat.

With where you and Zeke are at this stage, if he continues to drop into PMPS, I'd hold off on the increase. It's not a good idea to increase the dose on a bounce clearing cycle until you know your cat and have a ton of data. Why? Because bounce clearing cycles can be extremely active cycles (look how Zeke cleared his bounce on 9/7). You don't want extra insulin in the mix if it's going to be an active cycle. I have increased the dose on a bounce clearing cycle depending on how much she dropped during the cycle but, in general, I hold off and let her clear, see where she nadirs, and then decide.

I would suggest we just see where he is and if he continues to drop, let's let him clear and have a cycle tonight where we can see where he nadirs. If he doesn't get into green tonight, you can increase the dose tomorrow. It's better to wait and be safe then increase on a bounce clearing and end up fighting numbers all night.

Does that help and please let me know if you have other questions. See you soon.
 
Re: 9/12 Zeke - AMPS=334 (ReliOn)

Sienne and Gabby said:
This may be a bounce or a high before a break.
Click to expand...

What's a "break"? I would take that to mean his BGs are gonna drop. Is this correct?
What's the difference between a bounce and a high before a break?
 
Re: 9/12 Zeke - AMPS=334;+7=260;+9.5=169(Lowest today)

A bounce is when the liver releases counterregulatory hormones and glucagon to bring the BG up to a number it believes is "safe". When our kitties are dx, they have been at high numbers and the body has adjusted. So when the numbers suddenly drop or come lower (not even necessarily really low) than the kitty's body is used to, the liver releases it's goodies and the kitty bounces up. In some cats, right before the bounce clears, the BG goes up even a little higher and this is known as the "high before the break". So it's the high number right before the bounce clears.

If you look at Gracie's SS on 8/21, she had a 340 (which is super high for her) but I recognized it as the high before the break and so I let her clear her bounce without shooting a bolus insulin like R (which I will do on occasion to keep her from going higher). In this case, i did increase as a bounce cleared and she dropped into the 40s but I knew she would. I raised her dose to "kickstart" her knowing the increase might only be for a couple cycles.

So if we see a high number like that, we need to recognize it could be the high number before the BG starts to come down and the bounce clears. Make sense?
 
Re: 9/12 Zeke - AMPS=334;+7=260;+9.5=169(Lowest today)

BG still dropping. +11=119; immediate retest with different blood sample = 126. Help - not crazy about shooting a dropping low number. I'm reviewing the Shooting low numbers docs now. Today was totally different then any other Zeke's ever hard. That said, I'm not at all comfortable that I know what his BG are gonna do tonight. Typically rise @+1 and then start dropping with nadir between 6 - 7 (but that's changing).
 
Re: 9/12 Zeke - AMPS=334;+7=260;+9.5=169;+11=119 (lowest)

Ok....hold on and let me look at his SS again and see how many times you have a +1, etc. If I think it's not safe to shoot a dropping number, I'll give you some options and you can decide. But it's a good thing to learn to shoot dropping numbers when it's safe because you can take advantage of carryover and overlap. I'll BRB. You still have some time. Just post his +11.45 and we'll talk options but please do not feed him :-D :-D

ETA: please take down the 911. I have you. I won't leave you, ok? You're fine and this isn't an emergency. ;-)
 
Re: 9/12 Zeke - AMPS=334;+7=260;+9.5=169;+11=119 (lowest)

Whew. I see you are in the best possible hands you could be in. Marje is the BEST. I'll be reading because I always learn from Marje.
 
Re: 9/12 Zeke - AMPS=334;+7=260;+9.5=169;+11=119; PMPS=119

Same as +11; PMPS = 119. Should I stall to see what his BGs gonna do? Test again in 15?
 
Re: 9/12 Zeke - AMPS=334;+7=260;+9.5=169;+11=119; PMPS=119

Ok....here's the fun part :-D :-D :-D

He has stopped dropping and is flat. If you stall, he could continue to drop to the point where you can't shoot. If you feel comfortable shooting, you could then get some food in him and, hopefully, stop him from dropping.

I think there is a good chance you will see an active cycle tonight but I can't guarantee it. What I can guarantee is that I will stay with you and we'll work the numbers.

What do you think? (Take a deep breath first).
 
Re: 9/12 Zeke-AMPS=334;+7=260;+9.5=169;+11=119; PMPS=11;Stal

You think I should shoot? What do you mean he could continue to drop low enough I can't shot?

Do you think I should retest now or Shoot?
 
Re: 9/12 Zeke-AMPS=334;+7=260;+9.5=169;+11=119; PMPS=11;Stal

If you keep stalling without food he could drop more. If you shoot the insulin and feed him, then the food will bring his numbers up a little.
 
Re: 9/12 Zeke-AMPS=334;+7=260;+9.5=169;+11=119; PMPS=11;Stal

There comes a point when they continue dropping that it becomes unsafe to shoot or you are too uncomfortable to shoot.

You can test once more if you want but I wouldn't be too surprised if he was lower now. You can check. I probably (even as a new member) would have shot while he was flat so i could feed and get the numbers coming up.
 
Re: 9/12 Zeke-AMPS=334;+7=260;+9.5=169;+11=119; PMPS=11;Stal

can I feed as I shoot?
 
Re: 9/12 Zeke-AMPS=334;+7=260;+9.5=169;+11=119; PMPS=11;Stal

He's 109. Do I shoot?
 
Re: 9/12 Zeke-AMPS=334;+7=260;+9.5=169;+11=119; PMPS=11;Stal

did you see the 109? Can I feed while I shoot?
 
Re: 9/12 Zeke-AMPS=334;+7=260;+9.5=169;+11=119; PMPS=11;Stal

Yes on both. i know there have been alot of posts since you asked about feeding but i responded that yes, you can feed while shooting. That's what most of us do any way.

Are you going to be ok if you shoot? I will lead you through it. I promise I've done this hundreds of times with my own cats and other members'.

ETA: Laura....I understand this is really, really scary. I was a new member once before, too. But you don't need the 911 once members are on your condo unless you'd like another member to jump in and help you. If you keep testing, he's going to keep dropping. If you aren't comfortable shooting, you can skip.
 
Re: 9/12 Zeke-AMPS=334;Stall=102-HELP TOO LATE?

Laura....you just need LC right now....give him a good couple of tsp of LC.

Then I'd like you to test at +1 ok? And if you really are super worried, you can test at +0.5 but you need to give at least 30 mins for the food to affect the BG.
 
Re: 9/12 Zeke-AMPS=334;Stall=102-HELP TOO LATE?

He's not eating. I freaked him out. Very nervous but I'm still willing to go if you say ok. Sorry, I need to know you say this post first.
 
Re: 9/12 Zeke-AMPS=334;Stall=102-HELP TOO LATE?

He needs to eat so we know he'll eat tonight when we need him to.

Remember he will pick up on your anxiety so you have to be calm. Could you please try to get him to eat and then give his insulin? Thanks, Laura.
 
Re: 9/12 Zeke-AMPS=334;Stall=102-HELP TOO LATE?

Shot at 7:23 PM CST. Just 23 minutes past schedule.
 
Re: 9/12 Zeke-PMPS=112

Great job!!! He ate?

Ok...here's some tips for tonight:
  • Sometimes we are posting back and forth and other members will also pop in for support. So I suggest that you always read my current post to you as well as read back to my LAST post to you to be sure you don't miss something.
  • If he decides to come down, I'll ask you to feed an amount of food and retest and I'll tell you how long between tests; if I say "lather, rinse, repeat" that means do the same thing over. The sequence is to test, feed if necessary, wait a prescribed amount of time and then test again. I'l be specific on instructions, ok?
  • Stay calm; be sure you have all your supplies (lots of strips, LC and HC food/karo) handy. You don't want to have to go looking for it when we need it. Do you know how many strips you have?
  • It would be greatly appreciated if you can respond if I have a question so I know everything is ok and you understand what needs to be done and it's also really great if you can keep the subject line updated because I'll also be helping others if they need it.
  • Other members may also help and offer support/suggestions. We're a family and it takes a family to dance the dance!
  • Relax and have some chocolate or whatever you think is yummy :-D

Can you get a +1 please and post? I'm going to be offline for just a bit as I have to test Gracie and feed my other kitties but I'll be back by your +1. If you have a question, go ahead and post it now and I will check in between my chores.
 
Re: 9/12 Zeke-PMPS=112

Plenty of strips. Probably about 80.
Yes - HC, MC, LC & Honey/Maple Syrup (No Karo), Also have pill pockets
I will update ss constantly
 
Re: 9/12 Zeke-PMPS=112

Well, Ozy is at 61 at +10, which is the lowest +10 I've seen yet....

I shot a 104 a few cycles ago. I am still learning how Ozy does at low numbers and still working to regulate him. I've had a few nights where I was up very late because I was uncomfortable going to sleep when his numbers were so low. I had a little company from members who stayed up with me, which I found reassuring. It's looking to me like tonight is going to be a late night. So I'd be glad to be some company for you.

donaleen
 
Re: 9/12 Zeke-PMPS=112:+1=103

Donaleen, thanks for checking with me. I just got Zeke's +1 = 103. Lower than PMPS so it's gonna be a long night for me as well. I'm still shaking from the excitement of trying to decide whether to shot or not tonight. Forgive me if I don't respond immediately. I'm still trying to calm down. Zekey dropping already isn't helping. When I get through this night I'd like to correspond to see how the process is going for you.
Gotta go now.

Regards,
Laura
 
Re: 9/12 Zeke-PMPS=112:+1=103

Laura

Yes, we like to see a food spike but its ok. Can you please feed Zeke a couple tsp of LC and recheck at +2. If he's down alot at +2, don't panic, just post :-D I will be watching for you.
 
Re: 9/12 Zeke-PMPS=112:+1=103

ok - feed him 2 tsp. Can I get Zeke to play with me a bit? Would that help any?
 
Re: 9/12 Zeke-PMPS=112:+1=103

Marje and Gracie said:
Laura

Yes, we like to see a food spike but its ok. Can you please feed Zeke a couple tsp of LC and recheck at +2. If he's down alot at +2, don't panic, just post :-D I will be watching for you.
Click to expand...

If here's real low can I go ahead and feed him or is it best to wait to hear back from you with very specific instructions as to what and how much to feed?
 
Re: 9/12 Zeke-PMPS=112:+1=103

Playing can cause the BG to drop ;-)

I'd rather you post and then we can decide what to feed. I wonder if he likes to onset a little more towards +3 than +2 but we'll see.

Ok....time to get ready for the PJ Party with donaleen and Lara!!

cats-pajamas.jpg
 
Re: 9/12 Zeke-PMPS=112:+1=103;+2=84

The first time he dropped low, the +2.5 was a good drop (56, on AT). +3 is also a very active hour. Standing by for instructions. Let me know if I should test at +2.5.

Question - How many times can I reuse the lancets?
 
Re: 9/12 Zeke-PMPS=112:+1=103;+2=84

That's still not too bad of a drop. If he's doing ok with eating, I'd give him a couple more tsp LC. We won't reach for the HC unless he goes below 50 or starts to drop fast, early.

I only use my lancets once.

eta: we may have to test every 30 mins later so it's ok to wait an hour. Yes he might drop but I don't want to start poking him every 30 mins just yet.
 
Re: 9/12 Zeke-PMPS=112:+1=103;+2=84

Did you see my post above about the lancets and testing at +3? I think we cross posted.
 
Re: 9/12 Zeke-PMPS=112:+1=103;+2=84

Yes, I saw it. I'll hold off until +3. I get nervous and tend to over test (sometimes).

BTW - I do reuse the lancets about three times (if testing close together). Is that a problem? I have about 40 lancets currently
 
Re: 9/12 Zeke-PMPS=112:+1=103;+2=84

I understand. It's normal! Remember you are in control because you test and can feed.
 
Re: 9/12 Zeke-PMPS=112:+1=103;+2=84

Don't worry. You're in good hands. At first this seems so scary, like if you don't feed him THIS MOMENT it's a big deal - he's going to go hypo. That's how I felt.

In reality, it isn't like that at all. Trust Marje. When she says that you're in charge, you really are. I found with my cat that mixing a teaspoon of low carb and a teaspoon of high carb, to make medium carb (MC) was really effective. It would get his numbers up a bit so he would coast without a big bounce the next day.

Welcome to the pajama party. I'll make the popcorn.
 
Re: 9/12 Zeke-PMPS=112:+1=103;+2=84

By the way, I love Gracie's tiara. Does she feel special when she wears it? Our civvie Mia love's bows. She's very girly like that. She even loved the little soft floppy collar (instead of the hard cone) she had to wear after surgery to remove a mass along her jaw.
 
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