MESSED UP THE SCHEDULE (yesterday night +7 57, +8 78, +14 385. Today +11.5 186, what to do?

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Silvina

Silvina

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Dear people,

This week I have experienced many many personal issues. Ive been not able to handle the schedule properly, actually I messed it up so much that I don´t even know how to complete the spread sheet.

I have some persnla health issues, together with my mom hospitalized. Then I have my facebook account blocked since I am involved in activism against animal cruelty and some protectionist were blocked and our accounts hacked (we are fighting against some mafia that kill cats).

My health issues required to be some hours hospitalized, and also doing many studies (MRI, blood work, etc.).

What I did with Markies is mostly dose late.. never earlier (I know this is very risky). I have made all the image studies that I was told to so schedule now I think will be back to normal. I am starting again with 01AM / 01PM.

Silvi
 
Hi Silvi:

Don't worry about "messing up" the spreadsheet. The important thing is that you're taking care of Markies. I'm sorry you've had health issues yourself. I hope they are being resolved.

I'm a little concerned about your shot times. Are you going to be able to get any post-shot tests with a PMPS of 1:00 am? A +2 or +3 is pretty important. Are you following TR or SLGS? Are you going to be able to keep a consistent schedule now, or do you anticipate more health issues/problems that might disrupt it?

Sorry to ask so many questions, but I'm trying to get a clear picture of where you are and how you are going to move forward with Markies' FD management.
 
Don't worry about being late with Markies dose. If that's what you have to do to accommodate your life, so be it. You have to take care of you so you can take care of him. It will impact his numbers as a late dose is like a decrease, but once you get back on schedule the numbers will improve again. Since you are following TR, any cycle counting will begin once you have some cycles a regular 12 hours apart.

@Tricia & Cinco - Markies is on Levemir so the +2 may not be as important as it is for Lantus. Marje finds a +2 useful for Gracie (on Lev) but I do not.
 
Hello dears!!

I am back with my computer so I can update the ss and answer your posts (still don´t have my facebook account).

I will start answering TRICIA´S questions (sorry I confused the names).

1. Are you going to be able to get any post-shot tests with a PMPS of 1:00 am? A +2 or +3 is pretty important.
Yes I can do that, I may do it tonight since I can stay up longer.

2. Are you following TR or SLGS?
Im following this forum TR protocol, I don´t know what SLGS is. Im giving Markies 2 units every shot time, no changing dose like I was doing before.


3. Are you going to be able to keep a consistent schedule now, or do you anticipate more health issues/problems that might disrupt it?
Hopefully yes. This starting week will be less crazy than the one ending. I only needed to change tonight dose time to 2 AM since I will get back home late, but the rest of the week will be pretty normal. No medical appointments that may require more shot times change, at least that I know in advance.
I will take some time to see what is the best shot time according to this week schedule, I guess going back to 1 AM / PM will be the best.

About the importance of testing at +2, Markies numbers usually keep increasing at +2. Is it better then to test at +3?

Silvi
 
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Hi Silvi.

I'm glad things are getting more calm at your house and you will be able to test more. It's hard to say whether a +2 or a +3 is better. It really depends on the cat. Some cats have a BG "spike" (their numbers go up) shortly after feeding, so the +2 is often higher than the PS, then they come back down. Other kitties don't. I would suggest you try a +2 one cycle and a +3 another cycle, and decide based on what kind of numbers you get. The lower the numbers you get, the more you probably want to test. If you aren't sure when to test next, post and (hopefully) someone will be able to help you. The time difference makes it a little complicated, but there are usually people on the Board at just about all hours.

Since you haven't been able to test consistently for a while, it's hard to know when Markies' nadir is, but most cats on Lev nadir late in the cycle. @Wendy&Neko or @Marje and Gracie would have a better idea of when you might expect to see his lowest numbers and be able to help you figure out when it's best to test. I know Wendy's at an event today, but hopefully one of them could stop by later to help you.

SLGS is Start Low, Go Slow - it's a modified protocol for people that can't test a lot and/or can't get their cat off of dry food.
 
I don't have experience with Lev, but in general, I think it's helpful to think of your spreadsheet like a jigsaw puzzle. If you have a puzzle with a sprinkling of pieces all over, you can see what the picture is pretty clearly. On the other hand, if you have just the edge pieces, or a stripe down the middle, there could be an elephant hiding in one side and you might not even know it.

The edge pieces and stripes down the middle are like when people only get a preshot test or always just get a +6. To me, that makes it much harder to see what's going on than if they sprinkle their tests around. If you have a giant white area in the spreadsheet, get a test there sometime. That doesn't mean testing every hour of every day. Usually I got about 5 tests a day with punkin - always the preshots and about 3-4 midcycle tests, depending on what his blood sugar was doing.

Looking back a couple of weeks on Markie's spreadsheet, it looks like his nadir is at least sometimes around +6-+8. Of course, bounces override the normal cycle entirely. I always liked to get a test before the nadir so if punkin was headed into low numbers, I had notice so I could intervene if needed. If I were you, I'd always get preshots, and I'd try to get a test around the nadir in the day cycle (if you could) to help you with dosing and to intervene if needed. Then I'd try to get a variety of other tests in here and there, as you can, to fill in some of the white spaces in Markie's spreadsheet.

When you have conflicts with his shot time, just keep in mind that most of the time, it's going to be safer to have a cycle be longer than 12 hours than it is to make it shorter than 12 hours. There are times when you could shoot early, but until you know more about how he responds to his insulin, I'd probably avoid early shots unless someone with experience helps you look at things and see that it's ok at that time.
 
I can’t tell you definitely when Markie’s nadir is with the data you have. But with all you’ve had going on, it’s ok. You can start building some data now.

I don’t always test Gracie at +2. It depends on whether she is headed up or down at preshot. If she is flat from +10 or down, I test at +2. If she is headed up from +10, I test at +3 or +4.

I recommend you try and get some spot checks on Markie at different times. A couple cycles, you might want to get a +2 or +3 and then another cycle get a +4. But I’d focus more on tests after +4 so we can figure out where his nadir is. With good duration, Gracie will sometimes nadir at +15 which means she gets carryover from the previous shot and overlap of two shots. Data is your friend if you can get it. Once you can put together some data and see some patterns, then you can potentially back off and test around onset and nadir.
 
Tricia & Cinco said:
Hi Silvi.

I'm glad things are getting more calm at your house and you will be able to test more. It's hard to say whether a +2 or a +3 is better. It really depends on the cat. Some cats have a BG "spike" (their numbers go up) shortly after feeding, so the +2 is often higher than the PS, then they come back down. Other kitties don't. I would suggest you try a +2 one cycle and a +3 another cycle, and decide based on what kind of numbers you get. The lower the numbers you get, the more you probably want to test. If you aren't sure when to test next, post and (hopefully) someone will be able to help you. The time difference makes it a little complicated, but there are usually people on the Board at just about all hours.

Since you haven't been able to test consistently for a while, it's hard to know when Markies' nadir is, but most cats on Lev nadir late in the cycle. @Wendy&Neko or @Marje and Gracie would have a better idea of when you might expect to see his lowest numbers and be able to help you figure out when it's best to test. I know Wendy's at an event today, but hopefully one of them could stop by later to help you.

SLGS is Start Low, Go Slow - it's a modified protocol for people that can't test a lot and/or can't get their cat off of dry food.
Click to expand...
julie & punkin (ga) said:
I don't have experience with Lev, but in general, I think it's helpful to think of your spreadsheet like a jigsaw puzzle. If you have a puzzle with a sprinkling of pieces all over, you can see what the picture is pretty clearly. On the other hand, if you have just the edge pieces, or a stripe down the middle, there could be an elephant hiding in one side and you might not even know it.

The edge pieces and stripes down the middle are like when people only get a preshot test or always just get a +6. To me, that makes it much harder to see what's going on than if they sprinkle their tests around. If you have a giant white area in the spreadsheet, get a test there sometime. That doesn't mean testing every hour of every day. Usually I got about 5 tests a day with punkin - always the preshots and about 3-4 midcycle tests, depending on what his blood sugar was doing.

Looking back a couple of weeks on Markie's spreadsheet, it looks like his nadir is at least sometimes around +6-+8. Of course, bounces override the normal cycle entirely. I always liked to get a test before the nadir so if punkin was headed into low numbers, I had notice so I could intervene if needed. If I were you, I'd always get preshots, and I'd try to get a test around the nadir in the day cycle (if you could) to help you with dosing and to intervene if needed. Then I'd try to get a variety of other tests in here and there, as you can, to fill in some of the white spaces in Markie's spreadsheet.

When you have conflicts with his shot time, just keep in mind that most of the time, it's going to be safer to have a cycle be longer than 12 hours than it is to make it shorter than 12 hours. There are times when you could shoot early, but until you know more about how he responds to his insulin, I'd probably avoid early shots unless someone with experience helps you look at things and see that it's ok at that time.
Click to expand...

Thank Marje. We are using Levemir since May aprox. Markies nadir is at +8 aprox.
Yesterday he had very beautiful numbers but Im kind of scared. I will update his log now.
 
julie & punkin (ga) said:
I don't have experience with Lev, but in general, I think it's helpful to think of your spreadsheet like a jigsaw puzzle. If you have a puzzle with a sprinkling of pieces all over, you can see what the picture is pretty clearly. On the other hand, if you have just the edge pieces, or a stripe down the middle, there could be an elephant hiding in one side and you might not even know it.

The edge pieces and stripes down the middle are like when people only get a preshot test or always just get a +6. To me, that makes it much harder to see what's going on than if they sprinkle their tests around. If you have a giant white area in the spreadsheet, get a test there sometime. That doesn't mean testing every hour of every day. Usually I got about 5 tests a day with punkin - always the preshots and about 3-4 midcycle tests, depending on what his blood sugar was doing.

Looking back a couple of weeks on Markie's spreadsheet, it looks like his nadir is at least sometimes around +6-+8. Of course, bounces override the normal cycle entirely. I always liked to get a test before the nadir so if punkin was headed into low numbers, I had notice so I could intervene if needed. If I were you, I'd always get preshots, and I'd try to get a test around the nadir in the day cycle (if you could) to help you with dosing and to intervene if needed. Then I'd try to get a variety of other tests in here and there, as you can, to fill in some of the white spaces in Markie's spreadsheet.

When you have conflicts with his shot time, just keep in mind that most of the time, it's going to be safer to have a cycle be longer than 12 hours than it is to make it shorter than 12 hours. There are times when you could shoot early, but until you know more about how he responds to his insulin, I'd probably avoid early shots unless someone with experience helps you look at things and see that it's ok at that time.
Click to expand...

Thank you Julie!! I wish I can copy Markies previous spread sheet in this forum one so you can see his behavior on Lev. But what you say is what I have been doing. I know there are cycles like when I go to bed that I don´t test on that cycle but I usually test at preshot and nadir. I like that idea of prenadir testing to prepare for possible low numbers. Actually Markies numbers are lowering now and I will try to do that consistently.
 
Hello all!

Let´s see. Yesterday Markies threw nice numbers but very scarry! We started shot time with 327, +3 264, +7 57 (gave canned whiskas), +8 78, shot time was at +14 (385). Came home late. No testings during the night. Im trying to take him again to shots at 1AM / 1PM so I tested at +11.5 and his GC is 186. Im very scared since this is a low number to start the cyle with 2 units of levemir.

Any idea? What should I do if his numbers go down and we start with a nince number at shot time? For the one that don´t know, we had a hypo episode in October the 5th and after that his GC went up. Now I see GC is coming down again.

Im edditing this post. As I have no clue of what to do (and I have to run to visit my mom) and considering that I also need to take Markies shot time to 1AM / 1PM instead of 4 AM / 4PM I will wait to dose tonight, Im not dosing now.

I will dose at +21, in the meantime you can read this post and tell me what to do. Im very scared to have a hypo episode again. When we had the hypo episode we started at shot time with BG 253, then +5 (bg 25), +7 (LO). After that we decreased the dose but then increased again since he had a spike until now, that he shows nice numbers.

My concern is that when he had his hypo episode we started the cycle with BG 253 with 2 units of Levemir. Now at +11.5 (almost shot time) his GC is 186, and the dose is the same, 2 units of Levemir. I know that he will drop a lot and Im very concerned that he has hypo.

Help!
 
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When you shoot low, the cycles are often much flatter. By the way, I shot 6.0 units of Lev into 184 this morning, so pretty close to your PMPS. The size of the dose doesn't make any difference in what the cycle will look like. The cat needs the amount of insulin they need.

If you are at all able to get any tests tonight, I would encourage you to shoot, so you can see what happens when you shoot a blue number.
 
On this forum, as long as he is above 150, we say it's fine to shoot. Below that, you can post and ask for advice before shooting. Experienced people will shoot anything above a 50 on a human meter, but you might want to gradually work your way down to that.

Shooting now sounds good. Waiting for 2.5 hours today tells you that if you do shoot lower, he'll likely go up for a while before onset. I find it easier to shoot lower on Levemir because of that later onset.
 
I agree with Wendy. People think that if 2u brought a cat from 400 to 200, then shooting it at 200 will kill the cat. But shooting lower actually works better, because Lantus and Lev are both very good at holding blood sugar flat. It'll help if you look at some of the other cat's subject lines and look for people who've shot lower numbers.

Punkin got up to 15.5u. You still have to shoot even when your cat needs a large dose of insulin. But as long as you worked up to that dose carefully and methodically, following the dosing guidelines, you can feel confident that your cat isn't overdosed. The amount of insulin a cat needs fluctuates and we just follow the cat's blood sugar and let that guide what the dose should be.

Go ahead and start a new thread when you start a new day - this one's getting a bit long and they can become hard to find the current information when they get too long.

Hang in there, Silvina, things get easier. I hope you and your mom are both feeling better.:bighug:
 
By skipping, you can shoot tonight when you want to, so if you were pretty far off your "chosen" schedule, skipping earlier will let you get back on schedule tonight

Hope all the health problems are behind you and things settle down for you, your mom and Markies!!
 
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