Low numbers without shooting + Bruce’s Glucose Curve

Discussion in 'Prozinc / PZI' started by Cheeserball, Jul 14, 2019.

  1. Cheeserball

    Cheeserball Member

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    I guess I’ll post Bruce’s glucose curve first from 7/9. He’s been a bit testy lately and we were in a rush, so I didn’t test him before the vet.

    8:00-1.5 units
    8:50–374 (ReliOn 224)
    11:00-213 (ReliOn158)
    1:30-126
    3:30-149
    5:30-191
    7:00-206

    Bruce was given Gabapentin at the vet because he was MEAN! (We also got a rx for more for transport). Our vet said she’d like Bruce’s numbers down a bit, and to try 2 units. She also told me that I know Bruce best and to use my best judgement if I think 2 is too high.

    Since this attempt to bump to 2 units, I’ve missed more shots and glucose tests than ever! He’s definitely not acting himself. He’s hiding more often and just... off. Moving the location of his shots just a tad seemed to help—I was thinking maybe he was sore.

    Anyway, today he has been GRUMPY! Fed and shot this morning. Hid under a dresser for dinner. I didn’t want to drag him out and stress him, so I offered him food and decided we probably wouldn’t shoot today.

    He finally came out about 2 hours after normal dinner time. He had less than half of his food I’d say and was at 127. Yep, definitely thought right about not shooting. He ate the rest of his food, and two hours after that test, he was at 107.

    I’m pretty new to this stuff... could anybody give me some feedback about Bruce’s curve? And why would a cat’s sugar drop AFTER eating if he didn’t even have an insulin shot? Thanks!
     
  2. Harukyo

    Harukyo Member

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    Hey cheeserball! I think that drop might be Bruce's pancreas able to take care of the high blood sugar on his own there.

    Your spreadsheet is interesting because he dropped pretty hard on a 2.5u dose on 6/12 and then when the dose dropped to 1-1.5u all of a sudden it seemed like he bounced? I think those high numbers might have been because of a harsh reduction which made his levels spike temporarily. It seems like the 2u dose is finally starting to produce some good curves on his chart after his body has acclimated to the dose.
    If you ever need to reduce the dose in the future because hes dropping too low, reducing by .25-.50u seems to be the gentlest way to reduce without our cats bodies freaking out. And I know that most vets always recommend a whole unit reduction, mine certainly did!

    I found that consistency is key to getting the hang of diabetes, and unfortunately our furry friends don't always want to cooperate with us even though we know its for the best! If you can get that consistency for test/feed/shoot (either by really sitting down and figuring out the best 12-12 hour window that works for you and setting alarms, giving diabetic friendly treats every time before testing to start a positive association, etc.) then the numbers on your spreadsheet will start to make sense to you. Bruce's body is going from having the insulin and preforming well to having his pancreas take on all the workload after 12 hours and thats rough on his body, it might be why hes cranky!

    A normal curve you're looking for is high PS number, then a couple hours when Bruce hits nadir his levels will drop (look like he dips at +4, same with my kitty on ProZinc!) then in a couple hours it will rise again for next PS.
     
  3. Cheeserball

    Cheeserball Member

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    Thank you! We try to stick to 8 am and 8 pm for our test-feed-shoot. It usually works for us, but after our vet visit, he’s always thrown for a loop.

    He just tested at 212. I’m a bit nervous to give him 2 units because I’ll be at work in six hours. I’m also a bit nervous that he’d be at 212 this morning if he didn’t have a shot (but ate) last night.
     
  4. Harukyo

    Harukyo Member

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    You could try and reduce to 1.5u if you're worried he might drop into lime greens while you're at work, but then I'd try and stick to that dose for at least 3 cycles (12 hrs = 1 cycle). Try and get a test at +4 to see where he's at and if he's in blues at nadir you shouldn't have anything to worry about. If he's in greens, leave some low carb food out for him when you have to leave.
     
  5. Cheeserball

    Cheeserball Member

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    His +4 is 51 on a ReliOn. Keeping my eye on him and will test right before I go to work.
     
  6. Harukyo

    Harukyo Member

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    Do you have any high carb food on hand? (Fancy feast gravy lovers, regular cat treats etc.) 51 isn't terribly low, but we don't want him dropping lower than that, especially since you'll have to go to work soon.
     
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  7. Harukyo

    Harukyo Member

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    Also I know this may sound terrible, but if you can, test him again in another 30 minutes after feeding him some high carb food. We want to make sure he's not getting lower than 51. If you can't get in a test that soon, then feed more high carb food to make sure that he won't be getting lower. Always better to be too high than too low.

    What dose did you end up giving him? If he's getting this low, he might have earned a reduction.
     
  8. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    How long till you have to leave for work? You want to know Bruce is in safe numbers and able to hold a safe BG without needing constant steering when you leave. I'd definitely give him some higher carb food and retest 20 to 30 minutes later.
     
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  9. Cheeserball

    Cheeserball Member

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    +5.5ish (right before work) Bruce was at 89 (I think that’s what it was, definitely in the 80s). I gave him 2 units... I think I’m going to get some of the U100 syringes for a dose between 1.5 and 2. I definitely felt okay leaving him alone in the 80s at almost +6.
     
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  10. Harukyo

    Harukyo Member

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    Nice! Glad to hear that Bruce is just fine :) nice job!
     
  11. Cheeserball

    Cheeserball Member

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    I’m nervous about what he might be when I get home (it will be nom nom time for Bruce). I also don’t know what to shoot him at.
     
  12. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I'm sure Bruce will be just fine and may even be a bit higher than you expect from bouncing after that low earlier today. Tonight because he went that low, I'd reduce the dose to 1.75u. If you don't have half unit markings on your syringes, you can try to eyeball it or go with 1.5u but getting some U100 sryinges would definitely give you the ability to finesse the dose much more finely and consistently.
     
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  13. Cheeserball

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    He’s at 201 PMPS. Not sure what to do. He’s making things difficult! :-/
     
  14. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    You should be OK but if you are worried, don't feed Bruce and stall for 20 minutes and test again to see if he is rising on his own.
     
  15. Cheeserball

    Cheeserball Member

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    I gave him a 1.75ish unit dose this evening. I’m home for the rest of the night, so I can keep an eye on him. I am going to look into purchasing some u100 so we can fine tune that dose instead of eyeballing it. Honestly, he seemed to be doing better and more stable with1.5 units; I upped it after our vet suggested it after his curve last week.
     
  16. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Your vet had you go up by 0.5u. Maybe the 0.25u difference is what Bruce needs. It's amazing what a difference that 0.25u can make in some cases.
     
  17. Cheeserball

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    His +5 was 79 (or maybe 72... It’s late and I worked retail today, so numbers are a bit much right now ). There is currently a celebratory safe nadir cuddle puddle with him and his brother shoving their butts in my face in bed. I think I might stick with that 1.75ish dose until I get some U100s and can fine tune things.
     
  18. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    That is a nice nadir. Looks like 1.75u might be good for the moment.
     
  19. Cheeserball

    Cheeserball Member

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    So I didn’t feel comfortable shooting this am because of a 120 (I had work today). I just PMPS’d him, and he’s a 96. I’m really quite lost with this right now.
     
  20. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Well if you didn't shoot this morning and he's that low tonight, I think I'd be inclined to skip again and see what he does. Seems Bruce is on a mission right now. :joyful:

    Can I ask you to bring your spreadsheet up to date so anyone trying to help can see what's been happening in a consolidated manner? It's much harder scrolling through messages. :)
     
  21. Harukyo

    Harukyo Member

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    Those numbers are looking really good! Don't let not knowing how to approach the dosing discourage you! My kitty would run higher in the morning and lower at night just like Bruce is reading. You've gotten some good cycles when he's getting consistent insulin and his body is responding really well to it!
     
  22. Cheeserball

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    There, I think the spreadsheet is updated correctly. It’s not always easy to do it on my phone. I’ll be home for a good chunk of tomorrow—at least until +5 of his AM dose, then heading out for a few hours and will be back before his PM dose. I have a good idea of what I feel comfortable shooting at.

    I also used the control solution to make sure nothing funny was going on with the meter, and I’m within the range.

    This cat has never made anything easy on me. Ever! Two PU surgeries! Diabetes! 25% of my cats has caused 95% of my grey hair. I always tell him that he’s lucky he’s cute. I am grateful that he’s the most pleasant out of my crew—except when he hears/sees the cat carrier. But honestly, he has every right to hate vets. I don’t. Lame him.
     
  23. Cheeserball

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    Edit: My mistake. It was 156.


    He’s at 153 AMPS. Didn’t shoot him for two cycles. I’m stalling and checking in a bit.
     
    Last edited: Jul 16, 2019
    Reason for edit: Wrong BG
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  24. Cheeserball

    Cheeserball Member

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    The 20 minute stall produced a 152.
     
  25. Harukyo

    Harukyo Member

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    I'm not sure how much I would reduce, I'm not experienced enough for dosing advice, I'd wait for @MrWorfMen's Mom to chime in later. But I do think that skipping would be fine again since you've never given him a shot when he's this low (numbers are getting better day by day!) So skip the shot, feed him, and get in a test around +4 (if you can) to see if his levels are dropping on his own during that time.
     
  26. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    How long can you monitor today?
     
  27. Cheeserball

    Cheeserball Member

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    Until about +6 or so.
     
  28. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Ok since it appears Bruce hits nadir possibly around +5 or so, I'd suggest a very BCS shot of 0.5u today to see what he does. Test at +3 and see if he is up or down. If he is dropping anytime near when you have to leave, you can always give him higher carb food to boost him up.
     
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  29. Cheeserball

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    I was going to suggest .5u. I gave it to him while he’s finishing breakfast.
     
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  30. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Good choice! Since we don't know what Bruce is up to these days but evidently still needs a little help with his BG at times, better to be very conservative and monitor to see what he does.
     
  31. Cheeserball

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    +2 is 53... his pancreas is a little brat! It’s a bit warmer here than normal; maybe that’s impacting him? Every time he’s been low, he has acted fine.
     
  32. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Just seeing this now. Assuming you have retested since +2. If so what was that reading? If not retest again now please. That drop is substantial for that early in the cycle and you need to prop his BG up. Did you give him food at +2? What % carbs? high, medium or low?
     
    Last edited: Jul 16, 2019
  33. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Bruce hasn't been going lower than normal non diabetic cat's BG but don't rely only on observation because with the insulin we add, kitty can go from seeming just fine to having obvious symptoms quite quickly. When you get a reading like that 53, it's vital to give some food and retest in 20 to 30 minutes to ensure BG has risen. If it hasn't, then repeat the process. You want at least 2 readings of a higher safer BG without having to feed Bruce to keep him at a decent level before you let your guard down. I'd aim to keep get him around 90 and having him hold at roughly that level.

    While I am sure the weather can have some effect on BG at times, I'd expect excessive heat would be a stressor and raise BG not lower it. On the other hand, sometimes appetite isn't as good in hot weather and that could cause BG to be a bit lower. In any case, Bruce is obviously sending a message and right now what that message is, is a bit fuzzy. Obviously 0.5u was a bit too much this morning so next time you could try 0.25u or just skip the shot at that level AMPS/PMPS and I think the decision whether to shoot or not has to take into account whether you can monitor Bruce or not.
     
  34. Cheeserball

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    Thank you so much for your help.

    I gave him high carb food at +2. His +4 is 62.
     
  35. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    If you have to leave in an hour, then I would try to prop that BG up a bit more with some more high carb food and definitely leave some food out for Bruce when you do have to leave. :)
     
  36. Cheeserball

    Cheeserball Member

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    I left him at 86. :) Not only did I leave out some dry high carb food, I topped off the bowl, which in Bruce language means it’s buffet time

    Would you recommend I do two more cycles of the .5? Or go straight to .25? If his BG is high enough to handle a shot, that is.
     
  37. Cheeserball

    Cheeserball Member

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    +11 (well, more like 10.5) was 151. I’ll test right before dinner, but I’d feel more comfortable shooting a low dose if it was a shade higher.

    I work tomorrow morning, so I can keep good tabs on him until about his +5 or so tonight. After that, I’ll need to have some sleep. I won’t be able to watch him tomorrow during the day, but again, the evening I can keep a better eye. I’ll just see how he is right before shot time. I’m a bit frustrated because I felt like we were doing solid on 1.5 units. Then we had the vet glucose curve and the suggestion to bump up the dose to 2 and ever since then, it feels like chaos.
     
  38. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Since you had to steer him by +2, today I'd be wary of sticking with the 0.5u. How about trying 0.25u and see what he does. He may be higher tonight because of the 50s today not to mention the higher carb food, but if that +11 is any indication, he's not going to be THAT high.
     
  39. Cheeserball

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    Shot him with .25 and currently at Walmart to buy more test strips (and maybe different gauge lancets—I don’t like the new ones I got).
     
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  40. Cheeserball

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    PM +2 of 51. Eye roll. (that’s not towards Bruce; just this situation).

    In our defense, he didn’t clean his plate like normal for dinner. Feeding him now. He now comes over when I have the glucose meter because that means treat time. I will test in 30 minutes to see if there’s improvement.
     
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  41. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    What a little monkey Bruce is being! Doesn't seem to matter what you give him, he still drops low enough to need steering and he's dropping off quickly. His pattern right now almost looks like post prandial low BG. Did he eat well pre-shot this morning?

    ETA You haven't changed his diet recently have you.....to anything with less carbs than the FF?
    Thinking out loud .....wondering if Bruce might be one of those kitties who needs a bit more carb in his diet.
     
    Last edited: Jul 16, 2019
  42. Cheeserball

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    For the most part, yes. A few licks were left over, but he ate more this morning than this evening.

    After feeding him the rest of his dinner that he didn’t eat and waiting 30 minutes, he’s up to 65. Right direction, Bruce... just the wrong direction, too!
     
  43. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Interesting. He doesn't seem to be getting much if any food spike. Try to keep him surfing along with LC food if he needs more food to keep BG up. Of course when you need to got to bed, you can up the carbs so you can get some sleep.
     
  44. Cheeserball

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    Prior to mid May, Bruce’s diet was Royal Canin SO moderate calorie dry and Royal Canin SO wet, just a spoonful + water in an and pm. After diabetes diagnosis, he gets one whole can of FF + a FF can worth of water twice a day.

    Now that you say if diet changed, I did change something, but it was pre-diabetes diagnosis. I started using a Catit tree feeder in late April, I think. Because I have multiple cats and sometimes work long shifts between my two jobs, I leave Bruce’s prescription kibble out in the feeder. Bruce was the first one to figure it out. I think his diabetes hunger motivated him! Everyone has eaten significantly less dry food since then, especially Bruce. I still have it out, but I have a fraction of the food in it compared to pre-diabetes diagnosis.

    I checked out the SO diets, and they are so carb heavy. So he did go from a pretty carb heavy diet to much lower carbs (and wet food that he loves!).
     
  45. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Hmmmm! So if Bruce has been eating a wee bit of the dry SO food all along, is it possible he's had less of it on the days when his BG has been dropping to lower range? Rhetorical question because obviously unless you have cameras to monitor the feeder, you won't know who is eating how much when you are out and even then you'd only have time at the bowl vs real volume to judge by. What about trying Bruce on a slightly higher carb wet food? I'd have t check the food list but FF has some medium carb food and maybe a mix of LC and MC would give him just a tiny carb boost to keep him from dropping off so early and so much all at once. Something to think about.
     
  46. Cheeserball

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    Okay! +5 of 93. I feel alright with that. Bruce’s mom is going to sleep well tonight!

    The dry food theory could be true. However, I know there are days that if he’s with me at boyfriend’s, I won’t put out dry at all. I’ve never felt the need to do +2s there, but maybe I should just to see.

    Two of his siblings eat moderate carb (if moderate is 13/14ish) Friskies. Maybe I’ll experiment with a small spoonful of their food in Bruce’s breakfast. I still have two cans of his rx food which was 20% carbs. I also got two cans of FF gravy lovers tonight at the store. The problem is I won’t be home during the day to monitor him. I think shoot vs no shoot depends on his BG tomorrow morning
     
  47. Cheeserball

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    AMPS of 153... at least he’s consistent! :joyful:
     
  48. Cheeserball

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    I’m not shooting. I won’t have time today to run home and check on him at lunch. I will reassess tonight at PM dosing when I’ll be home and can check on him.

    Do you have any experience at giving cats a drop of insulin? I read about it on someone else’s thread.
     
  49. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Well at least he's being consistent. It will be interesting to see what he does without insulin today.
    Yes you can give a drop of insulin or even a tad more. It's very finicky but can be done.
    For a drop, you push the plunger of the syringe in as hard as you can and insert the needle into the vial while still tightly holding the plunger in. Once the needle is in the vial, you let go and withdraw the needle. There will be some insulin (a drop) in the needle shaft but you won't see anything. Might help to try this out with a used syringe and coloured water to practice.
     
  50. Cheeserball

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    +9 (since food, no shot today) is 180. Because I just got home from work it’s entirely possible that he ate before I came home.
     
  51. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Interesting. Those 47 points could potentially be a food bump. Let's see what his BG is at PMPS.
     
  52. Cheeserball

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    PMPS: 116. This child! I get it, Bruce—you don’t want a shot tonight.
     
  53. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    OMG! Bruce is being a real little monkey. I'd skip tonight. Feed him his usual meal and then test him again 3 hours post meal to see if his BG is down or not. If it is down, his pancreas is working better which is a good sign. The problem is he is still going higher than ideal part of the time. You'll get him sorted but right now he's holding his cards very close to his chest.:rolleyes:
     
  54. Cheeserball

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    This has been Bruce’s history with me! :cat: We dealt with a botched PU surgery for four years; we can deal with weird glucose counts now.

    I wasn’t even thinking of giving him even the smallest dose tonight after seeing that number. I feel like I have forgotten to add that he is in good spirits (we are all a bit lazy these past few days with the heat). He looks good and gained weight back (in a good way—when we went to the vet, you could feel his spine). His fur is softer than it ever has been. He’s currently wrestling with his brother. :) I also forgot to add that I did get control solution to test his glucose meter, and we are on a new container of strips. My biggest concern right now is the fact that he hasn’t had much insulin in a bit, and that the vet wants him back for another glucose curve in a few weeks. But hey oh, we’ll deal with that when we need to deal with that.
     
    Last edited: Jul 18, 2019
  55. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    When you are testing at home, there really isn't any good reason to take him to the vet for a curve. Too often, kitty's BG rises just from the stress of the vet visit (can rise 100 points or more) and this often leads to the vet prescribing more insulin than kitty needs. Have you considered doing the curve at home yourself and sending the results to the vet? OR taking this matter into your own hands as so many of us have done before you. Your vet is not with Bruce 24/7 but you are and you are handling him very well even though he is throwing you curve balls. ;)
     
  56. Cheeserball

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    Post dinner +3 of.... drumroll please... 83.

    I think my vet would be okay with me doing a curve at home if I was using an Alphatrak or some other pet meter. During the last curve, the difference in my meter and their meter was pointed out to me. I wish they would have used our meter for more than the first two times. Honestly, the cost of an Alphatrak is more or less the cost of a curve at the vet.

    When I say this little guy hates the vet, he hates the vet. As soon as he sees or hears the carrier, he runs. As soon as I grab him, he pees on me. EVERY TIME. :smuggrin: I know stress spiked his levels last week. If his first test was at 8:50 and 374 and his second was 11:00 am 213, and Gabapentin takes 2ish hours to kick in... my guess is they gave it to him around his first test and by the second one rolled around he was feeling relaxed. Now, I know his sugar would be dipping anyway, but I know numbers were elevated.

    Our vet told me she trusts my judgement, as I know B best. She was thoroughly impressed when I told her I was pH testing his pee. Since I’ve started taking our squad to her, she has never pressured or guilted me to make certain choices if it was not a financially sound decision for me. I appreciate that about her.

    Yeah, I think I just talked myself into a Alphatrak.
     
  57. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Doing a drumroll! Great BG! :joyful:

    It shouldn't be necessary to get an AT2 meter just to do curves for the vet but in the long run, you're right.......it would be cheaper over time than trips to the vet for curves. Even if Bruce is getting some sedation during his vet visit, it's not a normal environment for him and that could be skewing the readings taken at the vet. Never mind the stress you deal with from Bruce getting stressed out.

    The vet just needs to know what is considered "normal" BG range on a human meter and then look at the pattern of the curve readings rather than focusing on the actual numbers. I started out with the AT2 never knowing I could use a human meter. The first time I showed my vet a human meter spreadsheet she looked at me like I had horns growing out of my head. I had also done testing with the AT2 to show her and that was what she focused on. Fast forward and she had another client who insisted on using a human meter so my vet emailed me for information, knowing I had the reference numbers for human meters. While my vet still prefers the AT2, she is now open to the use of a human meter.
     
  58. Cheeserball

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    AT2 ordered. Same price as a curve + gas money to our vet. Less stress on him. Less pee on me. :p Far less stress on me, actually. I get really upset when I have to burrito him in a towel and see him not want to go in a carrier.

    It will be interesting to see his BG in about an hour (8 AM/8 PM are our feeding times). He usually avoids bed during the summer, but decided to pay me a visit around 6 AM. He usually does that when he’s hungry.
     
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  59. Cheeserball

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    AMPS: 176. Unfortunately, I can’t monitor him today even if I wanted to give him a small dose, so I’m nervous to even give him that .25 dose due to how quickly he dropped two days ago after .5 at 153. He also may have eaten some dry food. Thoughts?
     
  60. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I can understand your concern if you are not going to be able to monitor. I also would want to be cautious if you're not sure if he got into dry food or not. Hate to skip again but you've not had an opportunity yet to try a 0.10u or drop dose with him and he's been dropping right to the edge of safety. You can skip and see what he does. You'd probably be fine to give him a drop dose but again, with his recent history, I think it would be safer to do that when you can monitor.
     
  61. Cheeserball

    Cheeserball Member

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    I am going to skip. Depending on the number tonight, I’ll try the drop dose then. That way I can monitor his +2 and +4/before bed BG. I hate having him without insulin for 3 times in a row, but I also know how much and how quickly he dropped with .25 on 7/16 PM. I’m panicking that I’m doing something wrong with testing or insulin shot giving, but I’m doing the exact same thing as we were when we started with all of this.
     
  62. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    You're not doing anything wrong and Bruce is just being a cat....doing his own thing at his own time just to leave you scratching your head or worse! :rolleyes:
     
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  63. Cheeserball

    Cheeserball Member

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    For fun, I +9’d him (+9 from breakfast), and he was 143. Can’t wait to see what the little sugar booger has in store for me in 15 minutes!
     
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  64. Cheeserball

    Cheeserball Member

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    Jun 12, 2019
    PMPS: 113.
     
  65. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    OMG! I think you may have your answer re: the kibble! LOL! Let me guess........we're skipping again tonight unless you have your heart set on a potential PJ party! :facepalm:
    Love it! SO appropriate for your little enigma!
     
  66. Cheeserball

    Cheeserball Member

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    My casual plan (in my head at least) was a drop of insulin if it was around 150. 113 just seems way too low to chance that. You think it’s okay? I’ll test him before bed (approx +4) and see if he dropped.

    I jokingly told him last week after his curve that maybe he should get his pancreas working a bit better if he hates the vet so much. A man finally listened to me! I know things are still not where they need to be, but for today, I’m okay with this.
     
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  67. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    LOL! And a cat man to boot! Looks like he's trying his best to take you up on the suggestion!
    Given how much he dropped on the 0.25u dose, while he might be OK with a drop, I'm sure you don't want to be up all night steering him either and he is definitely all over the map lately so it's hard to predict what he might do. It's your call but last night he went down to 83 with no shot from 116 at PMPS!
     
  68. Cheeserball

    Cheeserball Member

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    +4 (with no shot) is 93... I guess technically it’s somewhere between +3 and +4, because he didn’t quite finish all of his dinner at 8 but finished the rest of it at 9 when I offered it to him.

    Mr. Sugar Booger will not eat food on the sides of his dish; he likes it scooped down into the center. What a diva!
     
  69. Cheeserball

    Cheeserball Member

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    Well, AMPS of 104. Someone is definitely not getting an insulin shot this morning.
     
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  70. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Looks like Bruce is on a mission and a very good one. All you can do is take this day by day at this point in time. The one thing none of us ever have with our kitties is a baseline of what their BG was like before diagnosis. While some non-diabetic cats can run as low as the 40s, you have no way of knowing what Bruce's BG used to average. He may have normally been in the upper range of normal. How are his other clinical signs these days? Less water intake, less peeing, a little more active/social? He's obviously not ravenous or he'd be finishing his food quickly. All of your observations of those factors are important too. Fingers crossed, this BG lowering trend continues. :D
     
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  71. Harukyo

    Harukyo Member

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    Jun 6, 2019
    Wow, I am so thrilled with the progress that Bruce is making wowowow!! Just sharing my experience with microdosing, I've been able to shoot a drop dose on Kyo at 88-107 readings and she responded really well to it. You can look at my spreadsheet for reference if you'd like, I feel like you're practically in the place we were in where I was very quickly reducing the dose and having to make sure I was available to test through the microdosing. But I think it really helped Kyo's numbers stick nice and low in the long run when I stopped giving her insulin. Every cat is different, and I'm glad you're making dosing decisions based on your best availability and health as well! I think those are very important to consider as I was so dead tired after Kyo threw me a couple PJ parties in one weeks time :coffee::coffee: but it ended up being so worth it to see all the hard work you've both put in to getting better reflected in the spreadsheet and the numbers you end up seeing. Keep up the great work and Bruce, stay out of the kibble! Lol :p
     
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  72. Cheeserball

    Cheeserball Member

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    He has no clinical signs, or at least no signs like he had before. Pre-insulin, he was drinking a lot (and subsequently, peeing a lot) and eating a lot. In fact, I made a vet appointment for him the day after he stole a cheeseburger from my hands! :rolleyes: He had gained a good amount of weight about two years ago, and earlier this year, lost weight. At the vet on May 14, he was down to 10 or 11 lbs., which the vet said should be normal to high for most cats, but way below weight for him. He filled out and his spine is not noticeable like it was. He's definitely social, not so much active, but we're also in a heat wave, so I'm taking that into consideration. And honestly, he's never been an active cat--even as a kitten.

    Years ago (circa summer 2012), when B started having problems, his first vet said his sugar was high. I had to take him back a few days later for a redo, and he was lower. Then his pee issues after that...

    I'm sickened and shocked at how carb heavy his moderate calorie dry SO and even the wet SO food was. I had no clue. And he was never really interested in the wet SO. He loves Fancy Feast, though!

    I am hopefully going to be getting the AT2 next week--I didn't want quick shipping because of how hot it is. I am going to take off work for a day and curve him myself when we get it. I work full time (plus a few hours a week second job and and pick up hours here and there with a third job), but my day job is very understanding and my supervisor is an animal lover. :)
     
  73. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    That is a great overall report. If your little one has had issues with higher BG long before his diagnosis, maybe he's just a high side of normal guy!

    Don't beat yourself up. None of us have a clue until we end up on the diabetic journey. While we may look for good quality food, no one thinks to check out the carb content. And very few vets it seems have a clue. My vet recommended a food for my girl who is in remission, that was 15% or more carbs. I had to correct the vet as to how she calculated carbs! If not for the diabetes, I wouldn't have even thought to check the carb %.

    Hopefully by the time you get the AT2, Bruce's BG will have dropped a little more. Even now, I think your vet would be impressed. :D
     
  74. Cheeserball

    Cheeserball Member

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    Jun 12, 2019
    Sugar Booger update:

    Decent Caturday! 117 and 151 yesterday. Chose not to shoot.

    This morning, he is 217. Considering a super small dose, as I will be home until +6 and then back at +10.25 (our times got changed up a bit because I worked 2+ hours after our normal feeding time last night, but my plan is to bump up to 11.5 hours between feedings to get us back to normal.
     
    Last edited: Jul 21, 2019
  75. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    It looks like he still needs a bit of support and a tiny dose when you can monitor would be a good place to start. Are you still using U40 syringes or did you get some U100's? If you don't have the U100s now might be a good time to consider them if you can obtain them easily (ie no Rx needed).
     
  76. Cheeserball

    Cheeserball Member

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    Jun 12, 2019
    +3.25ish is 87, so I’ll be keeping an eye on him.

    I am going to order the U100 right now. As I recall, the brand of U40 we use have a U100 version. I was playing around with the U40 syringes, and he got the equivalent of about two drops of insulin.

    Interestingly enough, this was a Facebook memory of mine today from seven years ago:

    “Urinalysis is back. Trace of blood was found, which means UTI (he already got an antibiotic shot yesterday)... but even more concerning is that there were noticeable amounts of sugar in his urine, which means diabetes. We are going back on Monday for blood tests.”

    That vet center was such a terrible place. :( so glad we don’t go there anymore!
     
  77. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Man he really swings a lot. Can you try to keep the spreadsheet updated? I know it's a PIA but the first thing many of us do is look at the SS for info.

    FYI sugar in the urine is not necessarily indicative of diabetes if that's what you are thinking. ;)
     
  78. Cheeserball

    Cheeserball Member

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    Jun 12, 2019
    No, I don’t think he’s had diabetes for the past seven years, but I do think that stress hits him heavier than our vet can imagine.

    +5ish is 125. There is the chance he may have grazed a bit on some dry while his siblings and I took a nap. He is living his best life by himself—he has always been my cat that gravitates to the hottest spots in the house. Thank goodness today is the last day of this. :facepalm:

    I work a short shift tonight, and then we’ll see where he is tonight. I doubt anywhere where I would expect him to be! :D He’s always been a finicky (but the sweetest!) little dude.
     
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  79. Cheeserball

    Cheeserball Member

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    PMPS of 220. Gave him a dose that was under .5 but more than a drop. I lined up the plunger right above the last line... I wish I knew how to explain it. Tomorrow I’ll see if I can attempt to measure. +3 of 103. Definitely eager for those U100s to come in. Glad he’s not doing his early drop into the 50s! Mama is going to get some sleep tonight!
     
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  80. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    If you are lining up the plunger with the first line on the barrel (Zero line) then I would call that dose 0.10u just for clarity sake. Can you please fill in the doses given on the spreadsheet when you have a minute? :)

    The other thing you can do, is hold in the plunger in as tightly as you can. Insert the needle into the vial while securely holding the plunger in. Then with the vial inverted just let go of the plunger. This sucks up a teensy bit of insulin in the needle that you can't see. We call that a drop dose. When you inject, push the plunger as far as you can and keep the needle in place for a second or so before withdrawing to allow any dregs on the needle tip to be released.

    You might want to take a used needle and practice these draws with coloured water. You can inject onto a tissue to ensure you are getting some insulin into the needle.
     
  81. Cheeserball

    Cheeserball Member

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    Jun 12, 2019
    I think everything is filled in now (or at least from recent times).

    191 this morning. I gave him that .1ish dose. He didn’t eat quite all of his food this morning, so he’s finishing the rest of the quarter or so of a can now. I’m home for most of the day, so I’m able to keep an eye on him.

    I was practicing the drop dose, and I feel like I’m not getting anywhere. I would assume I’d see a drop or no?
     
  82. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    You'd have to push the fluid out into a tissue to see it....you won't see anything in the syringe. You have to really push the plunger in hard and let go fast once in the vial to suck up a drop of two.
     
  83. Cheeserball

    Cheeserball Member

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    Jun 12, 2019
    +3.5 of 92.

    I will try letting go of the plunger fast. I’ve not been doing that part.

    Also, I discovered this Greenie cat proof container on the floor, complete with cat tooth marks, scratches, and lid ripped off. Bruce’s sister is checking out the damage, but his brother was the one found eating out of it. I would not be surprised if Bruce is somehow involved in this! He went many years without any treats at all, and now he gets one every time his mom pokes his ear. He has the life!

    25AA3F67-24A0-475D-8F30-91E63EEA703F.jpeg
     
  84. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Wonder if it's been sitting there for awhile and explains yesterday's readings too! Those higher carb treats and kibble tend to stay in the system longer than higher carb wet food.
     
  85. Cheeserball

    Cheeserball Member

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    PMPS 160. Gave him that .1ish again. Our U100s have been shipped!
     
  86. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Looks like the 0.10u is a pretty good dose for him but he's a bit lower tonight at PMPS so I'd make sure to get a +3 or before bed test tonight to ensure Bruce doesn't tread into dangerous waters. Fingers crossed he behaves himself! :)
     
  87. Cheeserball

    Cheeserball Member

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    That was my plan! He’s such a sugar booger.

    I accidentally fell asleep right around a +4 test, so it was +4.75 with a 59. I gave him some kibble and added a bit more food to the food tree.

    Because he keeps dropping so low before +6, would it be beneficial to maybe add a little smidge of moderate calorie food to his breakfast and lunch? I don’t mind keeping an eye on him this evening, but I won’t be able to do this tomorrow during the day due to work.
     
  88. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    You can try adjusting food times, carb levels and amount to see if you can slow down that drop a bit. That's actually a really nice number albeit a little disconcerting for you! Try to keep the majority if not all feeding in the first half of the cycle. Sometimes feeding pre-shot and then giving another snack at +1,2 or 3 will help slow down the drop. All you can do is experiment a bit and see what works for Bruce.
    I would try to keep the kibble out of the picture and use different carb levels of wet food if possible because the kibble lasts longer in the system and will wear off at an unknown time which could lead to higher pre-shots but then lower mid cycle tests.
     
  89. Cheeserball

    Cheeserball Member

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    He hates cleaning his plate all at once! Of course he does! He eats about three quarters of a can of fancy feast in a sitting. When he taps out, I grab the dish and put it in the fridge before anybody else eats it. I get ready for work, and then when I'm ready to head out the door, I give him the rest of his food and he eats it. I also need to push the pate to the middle of the dish because if it's on the sides, he won't eat it. He's such a diva and he knows it.
     
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  90. Cheeserball

    Cheeserball Member

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    Mr. Sugar Booger is at 153 AMPS. I’m going to attempt to give him that drop dose. I’ll also be home a good chunk of the day, so I’ll can keep an eye on him.
     
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  91. Cheeserball

    Cheeserball Member

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    +4.25 of 74. Maybe that baby dose is what he needs!
     
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  92. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Very nice cycle so far! Go Bruce! :joyful:
     
  93. Cheeserball

    Cheeserball Member

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    Sugar Booger!

    AMPS of 241. Where did that come from, Bruce?! I did hear him fighting with his sister before I got out of bed, so I passed it off as just some stress/adrenaline and gave him his drop dose.

    +3 of 76. Keeping an eye on him... may give him a spoonful of his normal FF for a snack and see if that balances him out a bit. I get nervous when he’s hitting that sort of number only 3 hours post shot.
     
  94. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Looks like Bruce is vying for the title of Best Dramatic Kitty! Hopefully that higher AMPS was just a product of some tiff or excessively rousing playtime.
     
  95. Cheeserball

    Cheeserball Member

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    He was 110 at +6.

    PMPS is 208. He seems to be a bit hungrier today and yesterday than normal.

    U100s came in today!
     
  96. Cheeserball

    Cheeserball Member

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    Never mind. I think I bought the wrong ones. :(
     
  97. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Oh NO! Oh well....Bruce is doing Ok with the drop from the U40 syringes.....don't think you need smaller just now.
     
  98. Cheeserball

    Cheeserball Member

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    :banghead:

    Things were going okay Friday until I unexpectedly had to work much later than anticipated. Fearing it would throw off our feeding schedule way too much, I skipped his shot (and my mistake of skipping BG). I still fed him his normal meal and figured he’d be a bit higher the next morning. Since then, he’s been in the mid 200s and he’s been in blues afterward (compared to his greens last week). And of course, now I’m clueless as to what is going on. And even more of course, my anxiety sends me to a bad place. Argh!

    Photo because he’s so darn cute. :kiss:
     

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  99. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Yes he is a cutie! I just want to give that chin some scritches! :kiss:

    I don't think the missed shot is still impacting Bruce's numbers. Sometimes dosing needs change for an unknown reason so when you can monitor Bruce and his pre-shot is high enough, you could try the 0.1u dose again to see if you can get him back into some green numbers.

    We've all missed shots or given fur shots at times so don't beat yourself up. BG is not static....it changes from time to time so the impact of missing a shot is usually not the reason behind a slight increase in BG.

    Try not to miss getting a test in before bed though. There can be clues in those numbers that help you understand what is going on.
     
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  100. Cheeserball

    Cheeserball Member

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    Jun 12, 2019
    Argh! Was hoping we were at least somewhat steady and then Bruce is like “LOL Hold my Fancy Feast and watch this!”

    Because he’s been steadily climbing and reaching numbers that scared me so I bumped him to .25. I feel like that may have been a mistake. :( Not sure why he’s not going any lower. He’s still not cleaning his plate at mealtimes but he finishes up about 30 to 60 minutes later when I set his dish in front of him again. I’m wondering if maybe his ProZinc lost efficiency or something? It looks okay to me but I’m not sure why he’s swinging so much. A few days ago he seemed hungrier than normal but besides that everything seems the same. I swear his numbers started fluctuating the day I got the AT2! (Still using the ReliOn for everything.)
     

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