Can someone review my SS (newly diagnosed)

Discussion in 'Prozinc / PZI' started by NoahFL, Jun 13, 2020.

  1. NoahFL

    NoahFL Member

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    Hello! Would someone mind reviewing my SS and see how we are doing? Had a scare this morning with a high BG. Max is newly diagnosed, so of course my nerves are getting the best of me.

    Original post

    Thank you!
     
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  2. JanetNJ

    JanetNJ Well-Known Member

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    It came down quite a bit from that high morning. Could he have gotten into some food?
     
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  3. NoahFL

    NoahFL Member

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    VERY possible. This morning we were still free feeding dry which I have taken up. No more dry. Going to try wet 3xs a day. I have 2 other cats too so going to try everyone on wet.
     
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  4. JanetNJ

    JanetNJ Well-Known Member

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    Ok then I wouldn’t worry too much about that black number. Most likely it was the dry. :).
     
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  5. JanetNJ

    JanetNJ Well-Known Member

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    I’d stay with the 2.5 a few more days keeping an eye On the numbers as the dry food is removed.
     
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  6. NoahFL

    NoahFL Member

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    @JanetNJ Will stick with 2.5U. He got 1/3 can (5.5oz can) at +5 after morning shot. Just now he was back at 542. I did give him 2.5U and then feed him 1/3 can. Will it take a few days for his BG adjusting to no dry food? Thank you
     
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  7. Deb & Wink

    Deb & Wink Well-Known Member

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    My understanding is that dry food can take a while to move through the digestive tract. Several days. While it's still clearing a cat's system, it's possible it will still be keeping the BG levels a bit higher.

    His body needs to adjust to the diet change too. So yes, it could take a few days for Max's BG levels to go lower.
     
  8. NoahFL

    NoahFL Member

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    Thank you. This is certainly an emotional roller coaster. I understand every cat is different now, but I was expecting similar results from him as my previous diabetic cat. Getting the insulin in his system, numbers would go down consistently and everything would be fine.

    May have to put a lid on my hedgehogs house tonight as he may try to sneak in and get some dry since his has been taken away.
     
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  9. Deb & Wink

    Deb & Wink Well-Known Member

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    Oh my gosh! The things we have to think of doing to keep our diabetic cats from getting into the dry food. For Max, sounds like it doesn't matter if it's the hedgies food, he just WANTS dry.

    I had to put one of those hook and eye hooks on my closets, so the cats could not open the bifold door to get to the food when I was not around.
     
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  10. NoahFL

    NoahFL Member

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    haha! If only they knew we were doing this to keep them healthy. His ears are so bruised and I feel awful. I wish he knew it was to keep him safe. My husband holds him when I lance his ear and he will actually purr, so I guess it doesn’t hurt that bad? Thanks so much for the replies. It really does help calm my nerves.
     
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  11. NoahFL

    NoahFL Member

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    So AMPS was 397. Not good, but better. The cats were acting like they were starving. Split 1 can between all 3. Izzy didn’t finish all her food, but of course Max did. This is definitely an adjustment for them all not getting dry food. @Deb & Wink or @JanetNJ , how long should I wait before determining to increase the dosage? Thank you.
     
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  12. JanetNJ

    JanetNJ Well-Known Member

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    Glad you are out of the black numbers. So the rule of thumb is about 20 calories per pound of ideal weight. So if you are feeding a 10 lb cat that would be about 200 calories per day. Diabetics with unregulated numbers sometimes will need more because they aren't utilizing the nutrients properly. Just something to keep in mind. Fingers crossed for some good numbers today.
     
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  13. JanetNJ

    JanetNJ Well-Known Member

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    ProZinc is usually at its lowest at 5-7 hours after shot. If you could get a +5 or 6 that would be helpful information.
     
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  14. NoahFL

    NoahFL Member

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    @JanetNJ We are in the blue at +6 at 131. Just gave him an afternoon meal of FF Classic. Going to try to use both FF Classic and Purina DM since I have a whole case of DM.
     
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  15. JanetNJ

    JanetNJ Well-Known Member

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    Excellent! So stick with 2.5 and let’s see how it goes. :). Yeah for blues!!!!
     
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  16. NoahFL

    NoahFL Member

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    Yay @JanetNJ ! We are getting there! 292 PMPS Lowest PMPS to date. Thank you @JanetNJ and @Deb & Wink. Baby steps right? Feeling much more positive since he was diagnosed.
     
    Last edited: Jun 14, 2020
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  17. Deb & Wink

    Deb & Wink Well-Known Member

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    Bruised ears you say? Do you hold pressure on the spot after the poke, and after you have gotten the blood on the test strip? Hold for 20-30 seconds and that helps to stop the blood from pooling, and that pooling of blood beneath the skin is what a bruise really is.

    Also, double check that you are aiming for the "sweet spot" at the edge of the ear, and not the marginal ear vein itself.
    Diagram and lots more in this link. Marje and Gracie's Testing and Shooting Tips
    • Be sure to poke in the "sweet spot" and not the major vein that runs along the length of the ear. Poking the vein will not only hurt, but will result in a lot of blood. The sweet spot is on the edge of the ear.
    [​IMG]


    p.s. Looking good there Max, BG wise. How do you feel buddy? 5 P's and appetite all good?
     
  18. JanetNJ

    JanetNJ Well-Known Member

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    That’s awesome!!!
     
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  19. NoahFL

    NoahFL Member

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    I do believe I’m hitting the sweet spot. In the beginning it didn’t seem like his ear would bleed much, now I have no problem getting a small drop. Vaseline has helped a lot. I was only holding for about 5 seconds. I will hold longer.

    His appetite is really good. I’m feeding the crew 3 times a day and sit with them to make sure everyone eats their own food. Still gauging on how much food to give him. Fortunately due to COVID I’m still teleworking, but when I go back I’ll have to develop a new routine. Right now it’s breakfast and AM shot between 8-830, 2pm lunch, then dinner and PM shot between 8-830.

    By Janet’s math, it should be just under 3 FF cans. He’s 14.5#. He is also using the litter box much less and consuming less water. I get to end the night in a positive way.

    Thanks again! This forum is amazing. Everyone is so friendly and knowledgeable.
     
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  20. NoahFL

    NoahFL Member

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    @Deb & Wink and @JanetNJ Max didn’t have a good day today. Numbers were up again today and diet was the same as yesterday. Thoughts?
     
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  21. Deb & Wink

    Deb & Wink Well-Known Member

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    Blacks = bouncing, almost every time.

    Are you testing for ketones, with those high BG readings? Good idea to do that, if you aren't already. Urine ketone test strips or a blood ketone meter are your 2 choices.

    Second thought for you? You need some night cycle tests, not just the PM pre-shot test. Many people get a "before bed" test every PM cycle.

    Cats are often more active at night, so they burn up more energy (glucose) and drop lower overnight. And then they bounce like crazy by the morning. How can you find that out for Max? Testing.
     
  22. JanetNJ

    JanetNJ Well-Known Member

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    I think he wasn’t used to that 131. Just keep going. The bounce usually clears in 1-3 days.
     
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  23. NoahFL

    NoahFL Member

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    I’ll pickup some ketone strips tomorrow. All I have are the DiaStix. I’ve went through a lot of BG strips this week. I have 3 strips left. Hope to get my shipment from Chewy tomorrow with more. Max generally sleeps with my daughter at night, but I can get some night readings once I get more strips. Thank you.
     
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  24. JanetNJ

    JanetNJ Well-Known Member

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    If it’s still high tomorrow you may consider 2.75
     
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  25. Deb & Wink

    Deb & Wink Well-Known Member

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    It's why so many of us use human meters, instead of the Alphatrak. Those test strips for the Alphatrak can't be purchased just anywhere. Plus they are expensive, $1-2 a piece. A Relion Prime meter and 100 test strips would be about 17 cents a strip. 1/4 the price of the Alphatrak test strips.
     
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  26. NoahFL

    NoahFL Member

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    Ugh, I know. I regret getting it now. If this is a long term thing, I’m going to switch.
     
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  27. Deb & Wink

    Deb & Wink Well-Known Member

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    You can always buy the human meter, and keep the Alphatrak as a backup. In case you drop the human meter into the cat's water dish, somehow :rolleyes:, or the meter slips out of your hand and goes "Kerplunk" from 4 feet up onto a hard tile floor. :(:(:( It's nice to have a backup meter. Trust me.
     
  28. NoahFL

    NoahFL Member

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    @Deb & Wink Sounds like you have some experience with meters in water dishes and tile floors??

    Max started out with a great number this morning, but terrible number tonight. This is so depressing. His strips should come in the mail tomorrow so I can get more samples throughout the day. I have one more strip for tomorrow morning, He seemed so spunky this morning, but tonight he doesn’t seem like he feels good. I had some Diastix Strips and took a urine sample and it was 1/2 which is lower than what it’s been. Feeling deflated again.
     
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  29. Deb & Wink

    Deb & Wink Well-Known Member

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    You think so? You're 100% correct.

    Less than 1 week since diagnosis and you are depressed about Max's progress? Please, give yourself a break. This is a marathon, not a sprint. Give it some time please. Patience little grasshopper. ECID Every Cat is Different and Max is different from your first diabetic cat.

    Those blacks mean he probably dropped really low sometime in the middle of the AM cycle, and because your test strip supply is so low, you could NOT do another test to catch that.

    Max looks like a really bouncy kitty right now. You'll see that when you get more test strips, and can do a test or two during the middle of the cycle, +5 to +7 would be good.
     
  30. NoahFL

    NoahFL Member

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    I did watch him like a hawk today for hypo, but he seemed fine. I am feeding him wet 3xs a day. As soon as the strips come in I’ll get more samples plus one before bed. Thank you, I do need to remember ECID. Love Max and want the best for him.

    If I was able to catch him too low in the late AM, how could I have prevented the high number tonight?

    Thank you for the support.
     
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  31. NoahFL

    NoahFL Member

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    @Deb & Wink Just read the last paragraph on Wink’s SS. In tears now....
     
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  32. JanetNJ

    JanetNJ Well-Known Member

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    You weren’t able to get any mid cycle readings today after that low preshot... it’s very possible he was down in blue numbers and bounced.
    If it makes you feel any better I didn’t even see a yellow preshot until her third month on insulin.
     
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  33. Deb & Wink

    Deb & Wink Well-Known Member

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    You probably can't prevent that bounce, but catching a low number in the middle of the 12 hour cycle let's you know that the high number at pre-shot is at least partially due to the low. Self protective mechanism kicks in and sends the BG levels shooting up high.

    p.s.
    Wink's profile is my tribute to him. Don't worry, reading it makes ME cry too. I tell people that Wink is why I'm here, helping others.
     
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  34. NoahFL

    NoahFL Member

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    Arg, FedEx failed me and my glucose strips didn’t arrive. What do I do? He’s due for insulin in an hour. @Deb & Wink
     
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  35. NoahFL

    NoahFL Member

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    Went to CVS because Walmart closes early and got a CVSHealth TrueMetrix meter. I may need help with interpreting the readings. Will they be much different?
     
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  36. Deb & Wink

    Deb & Wink Well-Known Member

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    A couple of options for you.
    Skip. As long as Max does not have ketones, this is the safest route.
    BCS. Big Chicken Shot aka a "token dose" of 10 to 25% of his normal dose, and watch him like a hawk. Not sure if you want to stay up all night to do that.

    Just saw you got a human meter. Test Max, and let me know what the BG is. You want it to be above 200, even with a human meter, since Max is so new to getting insulin.

    Other options if he is between 150-200. But first, please test and post.

    Thanks.

    p.s. All our dosing protocols are written with human meter numbers in mind. So the protocols do not expect the Alphatrak readings.
     
  37. NoahFL

    NoahFL Member

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    @Deb & Wink , Let me first say how much I appreciate you! My anxiety was pegged when the strips didn’t arrive. I didn’t want to skip any doses. On the human meter he’s at 273.
     
  38. Deb & Wink

    Deb & Wink Well-Known Member

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    He's over 200, so go ahead and shoot your normal dose, the 2.25U. If possible, get a +2 tonight, since that +2 often tells us what direction the BG is headed.

    Let me go get that info for you. BRB.
     
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  39. Deb & Wink

    Deb & Wink Well-Known Member

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    First part is specific to lantus, written by Chris & China. Second part is more specific to Prozinc, written by me.

    With lantus from Chris&China


    The +2 is like an "early warning" for most cats!
    If the +2 is about the same as the PS, it's usually a pretty normal cycle...dropping down to nadir and then rising back up again.
    If the +2 is higher than the PS, that usually signals a bounce, and those are the cycles when you can usually take a break from testing.
    If the +2 is lower than the PS, that's your "Early warning" that kitty might be going much lower later in the cycle so it's important to plan on getting another test or two (or 6) in.

    It doesn’t work every time or with every cat. But it does hold true most of the time, so keep this in mind for next time.

    With Prozinc by Deb & Wink

    More than a number range, think of the percentage of the drop at +2, that may tell you if your cat is going to drop much lower. Think of that +2 as being an indicator of what direction the BG levels may be headed.
    With Prozinc, if you see a 40%, 50% or greater drop, between the pre-shot and that +2, that's a serious heads up warning.
    If you see a 20-25%, 30% drop, not quite so worrisome. But still be cautious.

    Your cat drops 2 color ranges between pre-shot and the +2, pull out your hypo kit and plan on staying up to test.
    Your cat drops 2 color ranges between pre-shot and the nadir, that is to be expected. But you don't want the drop to be much more than 50% between pre-shot and nadir with Prozinc.
    Cats tend to bounce high if the drop is 50% or more from pre-shot to nadir.
    So you steer those mid-cycles with food, to slow down the steep drop and stop the bounces from being too high.

    It's a balancing act.

    The +2 is like an "early warning" for most cats!
    If the +2 is about the same as the PS, it's usually a pretty normal cycle...dropping down to nadir and then rising back up again. (About the same means taking meter variance, that 15% variance that hand held glucometers are allowed to have into account)
    If the +2 is higher than the PS, that usually signals a bounce, and those are the cycles when you can usually take a break from testing.
    If the +2 is lower than the PS, that's your "Early warning" that kitty might be going much lower later in the cycle so it's important to plan on getting another test or two (or 6) in.

    It doesn’t work every time or with every cat. But it does hold true most of the time, so keep this in mind for next time.

    It also kind of depends on what BG pre-shot your cat started out the cycle with. Lower than normal, keep a closer eye on the cycle. Lower than you are used to shooting, a number you may not have given insulin before, keep a closer eye on the cycle. Stalled and number rose some, but you did a reduced shot, maybe another test or 2 to see how much the number is rising.

    It makes a big difference if your cat starts the cycle in the pink 300-399 mg/dL range (16.6 - 22.16 mmol/L) then if they are in the blue 150 mg/dL range ( 8.3 mmol/L).

    p.s. Food notes in the Remarks column can be very useful. Helps to interpret what is happening in the cycle. Notes are done on AM and PM cycle basis and notations need to be with the + time format.
     
  40. NoahFL

    NoahFL Member

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    Thank you. I will check at +2 tonight. 273 is the lowest reading I’ve had at night, but it’s also with a different meter so I’m not sure how to compare.
     
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  41. JanetNJ

    JanetNJ Well-Known Member

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    The difference between the human vrs pet meters is less at lower numbers and greater higher numbers.
     
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  42. NoahFL

    NoahFL Member

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    351 (human meter, +2 PMPS, ate wet food after PM shot)
     
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  43. Deb & Wink

    Deb & Wink Well-Known Member

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    Higher at +2 than the pre-shot. Looks like it's safe for you to get some sleep.
     
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  44. NoahFL

    NoahFL Member

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    Max had a good night. I’m noticing less water consumption and urine output. It was 246 on the human meter this morning. Gave him 2.25U. I have to go into work for a few hours, but my husband is going to keep an eye on him. Chewy box is out for delivery thank goodness. I’d like to get another day using the AT2 and if numbers remain constant, possibly increase insulin a tad. Thoughts? Thanks again. Y’all have been SO helpful.
     
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  45. Deb & Wink

    Deb & Wink Well-Known Member

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    Yes, looks like Max could use a bit more insulin. We base dose changes on the mid-cycle nadirs.

    So if Max clears that bounce from today, and his mid-cycle nadir numbers are still >150 mg/dL, then it's time for a 0.25U increase with the Prozinc SLGS dosing protocol.

    Improving symptoms! You're on the right track with Max! Good job!
     
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  46. NoahFL

    NoahFL Member

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    Thank you. Tonight he was 415 and I jinxed myself and got a fur shot. I try to alternate between the shoulder blades and sides and I have such a difficulty on the side of his shoulder blade. Didn’t redo of course since I don’t know how much he got.
     
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  47. Deb & Wink

    Deb & Wink Well-Known Member

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    Fur shots happen. We've all done them. You NEVER want to give more insulin if you think you gave a fur shot. Simply note it on the SS.

    With a missed dose, that bounce will be a bit prolonged in all likelihood. :(
     
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  48. NoahFL

    NoahFL Member

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    @Deb & Wink Need you advice, again. So Max despite the fur shot had a BG of 195 this morning. I just gave him wet food, but no insulin. How much should I give him? How do you explain this? Surely it should have been much higher this morning. Thank you, and sorry to bother you!
     
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  49. Shelley & Jess

    Shelley & Jess Member

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    Hey Noah, the Prozinc Forum can be pretty quiet at times. I see @Panic is on. I recommend checking out the Prozinc Dosing Sticky found at the top of the Main Page for the Prozinc forum or posting over in Main Health if you're still not sure what to do.
     
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  50. NoahFL

    NoahFL Member

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    Thank you, Shelley. I checked his BG after he ate and it went up to 298 after 30 mins. Instead of the full 2.5U, I went with 2.
     
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  51. Panic

    Panic Well-Known Member

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    Looks like he still got some juice from last night. :) Remember meter variance; 195 isn't much different than 221 or 245. He probably could have had the full dose.
     
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  52. NoahFL

    NoahFL Member

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    Thanks @Panic, I got nervous and chickened out. So afraid of hypo.
     
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  53. Panic

    Panic Well-Known Member

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    Always do what you're comfortable with! Just noticed he's a brand new diabetic - do you have a no-shoot number? It's normally around 200 so you could have skipped for safety.
    Can you get a +2?
     
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  54. NoahFL

    NoahFL Member

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    @Panic Yes, he’s still adjusting. I will get a +2 for sure. Since he went up to 298 30 mins after eating, I felt a little more comfortable giving him some.
     
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  55. Panic

    Panic Well-Known Member

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    Part of that is just a food bump, the insulin hasn't kicked in yet. Let's see what happens. :)
     
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  56. NoahFL

    NoahFL Member

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    400 at +2 - looks like a bounce day.
     
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  57. Shelley & Jess

    Shelley & Jess Member

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    Rats! One point difference and he'd still be in the pink :(.

    (BTW - Hi Rebecca, just checked out your info tab :facepalm:)
     
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  58. NoahFL

    NoahFL Member

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    Hi Shelley! Nice to meet you. For Max, I’ll be happy to never see a black again! Those are the ones that scare me. This definitely tests my patience.
     
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  59. NoahFL

    NoahFL Member

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    @Deb & Wink , what is this cat doing?? His PMPS is 165. I fed him, but not sure about giving him insulin. Is it possible his pancreas is doing magical things?? He even seemed more active today
     
  60. Deb & Wink

    Deb & Wink Well-Known Member

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    Next time, stall without feeding for 20 minutes, to see if the BG levels are rising. Elizabeth is right, that 195 is close enough to 200 that you could have shot the full dose.

    Stall Please, no food, and retest in 20 minutes. Darn, I see you already fed him.
    How long ago did you feed him?

    Can you test him again right now? and let us know how long it's been?
     
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  61. NoahFL

    NoahFL Member

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    Sorry, I chickened out this morning. I am petrified about hypo. Had to run an errand tonight, so should I hold off on insulin tonight or shoot in an hour? Tomorrow, if he’s the same (under 200) stall 20 mins. If it’s not going up, what do I do? If it’s going up, then I feed and shoot reg dosage?
     
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  62. NoahFL

    NoahFL Member

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    Just stepped out. Won’t be home for 40 mins. :(
     
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  63. Deb & Wink

    Deb & Wink Well-Known Member

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    Shoot in 1 hour would be my suggestion for tonight. The BG levels SHOULD be high enough by then, but test first to make sure. Remember, there will be food influence in the BG number, even after 1 hour, so a little bit of caution would be a good idea. If he's too close to your decision point BG threshold, then a reduced dose is another option.

    See the Sticky PROZINC DOSING METHODS for answers.

    If it's not going up, then stall without feeding for another 20 minutes. With Prozinc, you can stall for up to 1 hour and still keep to your regular shot time for the next cycle.
     
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  64. NoahFL

    NoahFL Member

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    @Deb & Wink Seem to have some decent numbers the past couple of days. What do you think? Thanks!
     
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  65. NoahFL

    NoahFL Member

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    And now we’re bouncing.....
     
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  66. Deb & Wink

    Deb & Wink Well-Known Member

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    At least you are starting to recognize those bounces.
    Nice blue number for Max, that 154 at +5 on 6/21/20. Way to go Max! (and Rebecca!)
    Steroid induced diabetes often resolves quicker, and we can hope that Max is one of those situations.

    If you could start a new thread please, and link this one into the top for reference and history, that would be good.
    Threads that are longer than 50 posts get to be unwieldy and make the database behind the scenes run slower.

    Thanks.
     
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