12/28 Zeke PMPS 102;+1=106;+2=88;+3= 63; +4 = 53

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MrZ

MrZ

Member Since 2013
Zeke's Yesterday

See my comments regarding the 250 there.

I'm shooting early again. So test in next 20 minutes.

Guess I should hold this dose one more cycle. Unless of course he's diving and needs higher carbs, I think I should eliminate the 7% food variable and just see how he does on 1.0u without any food manipulation. Would you agree? Of the course the trade off is if he does drop a lot, the bounce may come again.
 
Re: 12/28 Zeke -1 = 250 (Reading @ 45 minutes to AMPS)

From your condo yesterday, I would call a 1.00 with the plunger right in the middle of the line marking and a fat 1.00 right below but touching the line marking. What you name it doesn't matter as much as being consistant. I would keep the f1.00 and if he's higher at AMPS, then try the lower carb food, but be ready just in case you need the 7% or 10%.
 
Re: 12/28 Zeke -1 = 250 (Reading @ 45 minutes to AMPS)

AMPS = 231. Is this considered dropping or flat?
 
Re: 12/28 Zeke +11 = 250; AMPS = 231 (FLAT?)

I would call it flat. But, he may be headed down.
 
Re: 12/28 Zeke +11 = 250; AMPS = 231 (FLAT?)

Does it make sense to withhold the 7% to be able to evaluate the dose?
 
Re: 12/28 Zeke +11 = 250; AMPS = 231 (FLAT?)

Yes, because of the AMPS, I think I would give him his regular lower carb food, and just be ready with the 7% should he continue downwards (faster than this) or dive.
 
Re: 12/28 Zeke +11 = 250; AMPS = 231 (FLAT?)

Oops - too late on the food. However, I only gave him 1/2T vs 1.5T of the 7%.

Thanks Dyana for the quick responses.
 
Re: 12/28 Zeke AMPS= 231;+1.5 = 179 (7% ??)

I guess 'cause he dropped 50 at +1.5, I should give him the 7% eventhough he's not low, correct?
 
Re: 12/28 Zeke AMPS= 231;+1.5 = 179 (7% ??)

Right now, you are experimenting with the food. Try the 7%. Any food manipulation is a matter of trial and error since each cat may or may not be particularly sensitive to carbs. Keep good notes on your SS.

And, could you please update your SS with the info from today when you have a chance?
 
Re: 12/28 Zeke AMPS= 231;+1.5 = 179 (7% ??)

Well, I feed him 4% (0.5 T) because I'm thinking I need to be able to evaluate this dose on it's own merits. However, if he were lower, I would have given him the 7%. I'll test in another hour. There's wiggle room right now but as you can see from his ss, he's been known to drop very quickly of late.

I've updated his ss.
 
Re: 12/28 Zeke AMPS= 231;+1.5 = 179 (7% ??)

I responded at the end of yesterday's condo so I'll copy/paste it here.

You asked -
What am I supposed to do about this 250? Ignore it or consider this a trending upwards pattern and call this a failed reduction?
Click to expand...
My reply -
You don't completely ignore it, but you don't focus on it either.

You look at the nadirs that he has had at this dose and use those the evaluate whether the dose is good or not.
Click to expand...
His nadirs don't look bad to me.
 
Re: 12/28 Zeke AMPS= 231;+1.5 = 179; +4.25 = 123

I have not fed him since +1.5 (179). At +3 he was at 130. An hour later he dropped only 7 to 123 (Remained flat). While his nadirs don't look too bad, should I consider that I skipped over a 1.25u dose when I reduced from 1.5u? My understanding is that reductions are evaluated differently (not just looking at nadirs).

As per the Protocol:

•If an attempted reduction fails, go right back up to the last good dose as soon as you see kitty's numbers trending upwards. You don't have to hold the reduced dose for a certain number of cycles before taking the dose right back up. The guidelines listed under the topic "Increasing the dose" do not apply to a failed reduction.

While obviously he was on too high a dose on the last good dose (1.5u) he was seeing a lot of greens and just a little blues. So, so far this dose is not doing as well. And therefore I have to wonder - is this a failed reduction? Should I increase to 1.25u?

I'm headed out soon so won't be taking any more readings for a few hours.
 
Re: 12/28 Zeke AMPS= 231;+1. =179;+4.25=123; DOSE?

Patience, Grasshopper.

Give him a chance to finish clearing this little bounce or whatever he has decided to do. Enjoy your time out.

My LBG is doing the same thing so we're going for a hike. Meet you back here later, gator. :-D
 
Re: 12/28 Zeke +9 = 145; PMPS= 123 - STALL?

Sorry. Using the 911 because I need an answer as soon as possible - Will remove as soon as possible. Shot due in less than 15 minutes. Do I need to wait and restest to make sure he's not dropping? I HAVE NOT FEED in over 2 hours.

Is this considered dropping or flat?
 
Re: 12/28 Zeke +9 = 145; PMPS=123;+12.20=104- STALL?

20 minutes he's down to 104. Don't feed, continue testing?
 
Re: 12/28 Zeke +9 = 145; PMPS=123;+12.25= 104 - STALL?

Are you OK with stalling for another 15 - 20 min?

This could be some surfing. The +12 and +12.25 are pretty much the same number. Remember, if you were to shoot now, you'd be feeding which might raise numbers a bit, although with Zeke, you never know.
 
Re: 12/28 Zeke +9 = 145; +12 =123; +12.25= 104 - STALL?

Yes, I can stall. Rather do that than fight the numbers all night. Can you hang out and let me know when ok to shoot? How much of a rise should I wait to see before shooting?

Once it's ok to shoot, can I shoot AND THEN FEED (simultaneously) or should I wait a few minutes to let the food kick in some? I'm thinking maybe some 10% might be a good idea. Thoughts?
 
Re: 12/28 Zeke +9 = 145; +12 =123; +12.25= 104 - STALL?

I can stick around. It's OK to shoot if you see a rise or if Zeke is surfing. Like I said, the 123 and the 104 are within the 20% meter variance range.

I think it's fine to shoot and feed simultaneously. It takes at least an hour for the insulin to kick in. What I would do, if you're nervous, is to grab a test at +0.5. Gabby is an early nadir kitty and I'll get a +0.5 test if I'm concerned about where her numbers are heading.
 
Re: 12/28 Zeke +9 = 145; +12 =123; +12.25= 104 - STALL?

What gave me pause what's that he had already dropped from the +9 of 145. So now, he's about 40 points lower. Want to make sure I understand correctly. You're saying ok to shoot? I'll be home with plenty of higher carb food. So I'm good to go if you think it's ok. Getting ready to take another test. Taking off the 911 since you'll be around.
 
Re: 12/28 Zeke +9 = 145; +12 =123; +12.25= 104 - STALL?

I'd like to see if he has dropped more at your next test. Let's see what the numbers tell you.
 
Re: 12/28 Zeke +9 = 145; +12 =123; +12.25= 104 - STALL?

Pretty much flat. Now 102 vs 104. Shoot?
 
Re: 12/28 Zeke +9 = 145; +12 =123;+12.25= 104;+12.5= 102 -ST

Done. Thanks Sienne.

Is it always considered flat if within 20%? So at night when I'm testing him to make sure it's ok to leave him (2 hours after eating), if he drops only within 20%, can I consider it flat and go to bed? Does it matter if he's dropped to say 62? Would the 20% not count then - in other words it's a drop to a low number and therefore he still should be monitored until numbers rise?


Was tonight's +9 of 145 to 123 considered flat because within 20%? In other words - there was no reason for me to stall, correct?
 
Re: 12/28 Zeke +9 = 145; +12 =123;+12.25= 104;+12.5= 102 -ST

Hi Laura,
The 145 to 123 was within 20%. And so was the 123 to 104.
But between +9 and +12.5, I see a downward trend. So I don't think stalling was a bad idea.

I think there is merit to considering meter variance. However, the lower the numbers are, the more likely I am to consider them at "face value".

If you were in the middle of the cycle, and you got numbers like 57, 49, 55 and 48, I'd call that "flat". But I'd also take the 48 and 49 at face value, and consider it worthy of a reduction.

If you saw a 70, then a 60, then a 51 however, even though they are within meter variance, I'd still say the number was dropping, or at least that it wasn't rising, and I'd encourage you to keep testing. Make any sense?
 
Re: 12/28 Zeke +9 = 145; +12 =123;+12.25= 104;+12.5= 102 -ST

Carl & Bob (GA) said:
Hi Laura,
The 145 to 123 was within 20%. And so was the 123 to 104.
But between +9 and +12.5, I see a downward trend. So I don't think stalling was a bad idea.
Click to expand...

Although not a bad idea to stall, since the number at +12 was within the 20% variance, it was not necessary to stall, correct? Because of the excitement on 12/24, which I felt was probably due in part to a dropping number, I just wanted to make sure he wasn't dropping tonight. Although it was not necessarily bad for me to have stalled, I'm curious - Would you have shot at +12 instead of stalling? If this happens again and I don't NEED to stall, I would rather not. Thoughts?


I think there is merit to considering meter variance. However, the lower the numbers are, the more likely I am to consider them at "face value".

If you saw a 70, then a 60, then a 51 however, even though they are within meter variance, I'd still say the number was dropping, or at least that it wasn't rising, and I'd encourage you to keep testing. Make any sense?
Click to expand...

Assuming he last ate 2 hours ago and 1 hour ago he was at 90 (up from say 85) but now an hour later he's at 79. Is it safe to consider this flat and therefore go to bed?
 
Re: 12/28 Zeke PMPS 102; +1 = 106

For someone experienced like you with your data, I think you could have shot at +12 and fed. I think Sienne was advising you to stall because you expressed worry about shooting a dropping number in light of the last time.

Shooting dropping numbers (above 50) allows you to take advantage of overlap and carryover. Also, it allows you to feed and let the numbers come up again. I've seen some members stall so long that the number became unshootable. If they had shot at the first number, they could fed, numbers would come up a bit, and they wouldn't have had to skip. Again....this is for members that have been here a while, have a lot of data, and test like you do.

I think with Zeke's propensity to drop early, it is wise for you to think about a number would would NOT want to shoot if it was dropping and that it might be worthwhile to stall.
 
Re: 12/28 Zeke PMPS 102; +1 = 106

Assuming he last ate 2 hours ago and 1 hour ago he was at 90 (up from say 85) but now an hour later he's at 79. Is it safe to consider this flat and therefore go to bed?
Click to expand...

Assuming you are past nadir, and it was me staying up late with you? I would say "put a spoonful of LC in a bowl in case he wants a snack while you are sleeping, and sweet dreams."

The answers from other L users will be more useful to you, but I never had to stall with PZI and Bob. If I saw an unexpected low number, I just shot less insulin. It was either shoot less on time, or skip completely for me. And I didn't skip until about a week before he went OTJ.

If it were me tonight, I probably would have shot on time, but the "shoot or stall" thing has to be the decision of the caregiver based on their first hand experience and data. The important thing, if you do decide to stall, is to keep in mind that a late shot can "act like" a dose reduction. Also keep in mind that the food you give him at shot time is going to cause the numbers to come up before the insulin kicks in. So by feeding him, you are providing a "buffer".

What might have made me hesitate tonight is Zeke's habit of dropping early in the cycle. I think this might have happened to you a week or so ago? You shot into a number that was dropping, and he did a bit of deep sea diving by +2? If you think a number is falling at shot time, keep that in the back of your mind.

The other factor is that you can use food to steer the early part of the cycle. Either feed higher carb at shot time, or feed him in portions at PMPS, +1 and +2 if you fear he might drop early.
 
Re: 12/28 Zeke PMPS 102; +1 = 106; +2 = 88

Well, I kinda had a knee jerk reaction and gave Zeke 20% gravy and 12% food, 1 tsp each. I wish I would have taken a breath and looked at the actual numbers (not just the fact that he was down at +2). Although his +2 is below his PS, it hasn't dropped that much, only 14. I'm hoping I didn't jump the gun with the gravy. I'm just trying to keep him from diving, causing me to have to test him frequently all night long. Hopefully this feeding will do just and not cause him to spike back up. Keeping fingers and paws crossed Zeke has a nice cycle this PM.
 
Re: 12/28 Zeke PMPS 102; +1 = 106; +2 = 88

The gravy should keep him from dropping. And it won't be around in a couple hours messing up his numbers.

You know how we tell people not to feed in the 2 hours leading up to a shot, so that their PS number isn't artificially high due to food? Same thing here, the gravy might push him up, but not for hours.

When you are "feeding a curve" like you have had plenty of experience with lately, the various levels of carbs are just going to push up the numbers in varying degrees. And in general, "liquids" like gravy and karo are going to do it faster and higher. Because they contain more carbs, and because liquids will be digested faster than solids.

What you gave him should do what you wanted it to do - keep him from diving. :smile:
 
Re: 12/28 Zeke PMPS 102; +1 = 106; +2 = 88

MrZ said:
Although his +2 is below his PS, it hasn't dropped that much, only 14.
Click to expand...

Actually, wouldn't you say he's flat compared to PS (as within 20% variance)? Should I maybe not have feed him? Or maybe just his normal 4%? I worry about feeding him the 4% as I don't want to fill him up without the benefit of the carbs necessary to keep him up or prevent him from diving. As I've said before, I find this whole feeding the curve process very difficult. Hopefully, I'll get good at it in no time.
 
Re: 12/28 Zeke PMPS 102; +1 = 106; +2 = 88

As Sienne said, you are experimenting with foods. Don't be so hard on yourself. You can use this as data and information that will help you know how to control early drops.
 
Re: 12/28 Zeke PMPS 102; +1 = 106; +2 = 88

Hopefully, I'll get good at it in no time.
Click to expand...

I have no doubt you will, and at some point, you'll be helping some new member by sharing your experiences.

The key is what Sienne and Marje said - experimentation. You're keeping really good notes on your spreadsheet and you'll be able to use them in future cycles.
 
Re: 12/28 Zeke PMPS 102; +1 = 106; +2 = 88; +3 = 66

You will but it just takes patience. It took me months to figure out what really worked for Gracie. I thought she ess not carb sensitive but when I finally hit on the right combo, she responds best to 10%.

As I said, everything you do you can use as data to figure out how you need to adjust it or when you've hit upon the right solution. Sometimes it isn't just the %carbs, it's also the amount of the food you give.
 
I could use some advice as to what you think I should do tomorrow night. My DH and I have plans for the evening and will be out as early as +1. We have a pet sitter staying with Zekey. She's actually a vet tech who has sat for us before. Unfortunately, Zeke will not let her get too close to him so ear pokes have not been possible to date. Highly unlikely tomorrow night will be different.

Do you think we should lower the dose (and if so to how much) OR should we just assume he'll go low and have her feed him MC every hour or so? As you can see from his ss, we've had to resort to HC gravy and occasionally syrup. I thought he might settled down on this lower dose but here we are again in the 50's two hours before nadir.
 
If you were going to reduce the dose, I'd probably start in the morning and shoot a reduced dose then and also in the evening. You don't want to wait and shoot a reduced dose just tomorrow night because he will still have a fairly full depot.
If you are going to try that, I'd probably shoot 0.5u tomorrow morning and tomorrow night.

You could also shoot just a little lower in the morning and then skip tomorrow night or shoot f1u in the morning, skip tomorrow night, and have the petsitter be sure he eats...say a 7% food.

Will you be gone overnight or just for several hours?
 
First observation.... looks to me like this dose is working just fine. Whatever that "blip" was last night and this morning, it seems to be over with. 4 points lower and you might be looking at reducing in the morning.

Hmmm, tomorrow evening you'll have a decision to make at PMPS. Of course it depends on what happens between now and then. But you could -

Shoot the normal dose, and feed higher carb food. Have her feed him at +1, +2 and/or +3.

Shoot a "BCS" dose. Like .5u?

Skip a shot.

What time will you and DH be home?
 
We'll be gone until +5 at least. Too many choices. If he were your cat, what would you do?
 
:lol: :lol: :lol: don't ask me because if Gracie was running like this, I wouldn't leave her. :lol: :lol: we don't have anyone here that we trust her with.

But that's extreme and you gotta have a life. Ask yourself this question: what would allow me to go out and have a good time and not worry? Because the last thing you want to do is go out and worry and fret and be looking at your watch.
 
If he were my cat?

I would hope that the next test I get tonight is below 50. In other words, I would would not feed HC to stop that from happening.
I would reduce in the morning, and probably do what Marje suggested - to .5u rather than .75u
Then I would shoot .5u tomorrow night.

And on Monday morning, I would think about going up to .75u again.

And I would feed him something higher than 10% at PMPS, and ask the sitter to feed at +1, +2 and +3.

ETA - I need a proofreader before I hit submit. changed "would" to "would not"
 
What would you say would be the least damaging to the run he's on? Would carbing him up without knowing whether he needs it or not would be better than changing the dose?
 
Carl & Bob (GA) said:
If he were my cat?

I would hope that the next test I get tonight is below 50. In other words, I would would not feed HC to stop that from happening.
Click to expand...

The gravy and 12% did the trick he's up to 68 now. No reduction (most likely) will be earned tonight.

So what would be the least damaging option in your opinion?
 
Well, in my opinion, Zeke doesn't respond very "well" to carbs. Just looking at tonight's cycle, he has had lots of food, and all MC or HC stuff. And still dropped to 53.

So just keeping the dose the same, and carbing him up without knowing his numbers doesn't mean he wouldn't do the same thing tomorrow night.


Here's what I think you should do, and I don't think it's going to set him back any -

If he doesn't get a reduction tonight, I'd stick with 1.0 in the morning, and see what happens.

Tomorrow night, I would skip the shot completely. Feed him, have the sitter feed him LC a couple of times. And test him when you get home.

Go out and have a relaxing time with your husband. No "cat worries", no stress, no calls home, no looking at your watch all night. For one evening, it will be like it was before Zeke got diabetes.

I think Zeke is "on a mission". I also think that when a cat is determined to get a reduction, he will do so. To me it looks like he's working hard on getting another one. That might happen during the AM cycle tomorrow, or it might not. But if you skip tomorrow night, you won't have to worry about him doing it when you aren't home.
 
I don't see it as damaging or not damaging. I see it as doing something for you. We have annually gone to a golf tournament and I don't want to be out there worrying. so I skip. Amy goes to see Bruce Springsteen concerts twice a year...she skips.

I have to put this back on you, Laura, to decide. Neither option is going to cause any permanent effect. Either way, he will get back on track within a cycle or two and seeing how he has done, it would probably be quick.

So I have to send you back to the question...if you shoot .5u tomorrow morning and tomorrow night, will you have a good time while you are out since the sitter can't test? Would you feel better carbing him up or just skipping?
 
So regardless of the option I decide to go with, I would resume with the 1.0u on Monday, correct?
 
MrZ said:
So regardless of the option I decide to go with, I would resume with the 1.0u on Monday, correct?
Click to expand...

Yes, unless he insists on a reduction between now and PMPS tomorrow.
 
I'm leaning towards the 0.5u both AM & PS. My DH can stay for a +1 & +2 and maybe a +2.5 or +3. Then we would be back for a +6. Since we can take those first couple of readings during the PM cycle, I think I would be ok leaving him basically "unmonitored" for about 3 hours.
 
MrZ said:
My DH can stay for a +1 & +2 and maybe a +2.5 or +3. Then we would be back for a +6.
Click to expand...

Would this make any difference as to what option might be preferable? I know it's my decision but I would appreciate the benefit of your experience and anything else you might like to add about my options.
 
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