Nico, finally some (short-lived, I’m sure..) decent numbers

Discussion in 'Prozinc / PZI' started by Emily Tuomey, Mar 1, 2021.

  1. Emily Tuomey

    Emily Tuomey Member

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    Last edited: Mar 2, 2021
  2. Emily Tuomey

    Emily Tuomey Member

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    Still stuck. AMPS, 326.

    (@Deb & Wink @Shelley & Jess, Inquiring minds would like to know) Do a string of flat numbers reflect a kitty who is still bouncing, or a cleared bounce??
     
    Last edited: Mar 2, 2021
  3. JanetNJ

    JanetNJ Well-Known Member

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    bummer
     
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  4. Emily Tuomey

    Emily Tuomey Member

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    I know, right? I was hoping for a lower number overnight, but not yet it seems. His pancreas likes to surprise us when we least expect it. <fingers crossed it’s soon>

    How are you????
     
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  5. SashaV

    SashaV Well-Known Member

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    I believe a flat cycle is a warning of an following active cycle. Or that's what I'm told in the LBL forum, and after what I'm seeing Nico fits into that description :oops:
     
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  6. Emily Tuomey

    Emily Tuomey Member

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    That’s my understanding (and previous experience) too. The question would be “when?” Nico’s body, unfortunately, likes the element of surprise— and his lows happen when you least expect them. :nailbiting:
     
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  7. SashaV

    SashaV Well-Known Member

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    I know the type!
    Mine did the same on prozinc. And it's terrifying :nailbiting:
     
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  8. Emily Tuomey

    Emily Tuomey Member

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    Especially in the middle of the night (which, over here, is more often than not)! What made you decide to change insulin, just out of curiosity?
     
  9. Deb & Wink

    Deb & Wink Well-Known Member

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    A string of flat numbers can be a kitty getting READY to clear a bounce. Bounce might not clear until the next cycle or 2.
    Hope you are doing better now.

    I kept trying to convince Sasha she needed to change the insulin, but it took some real "nudging" to get her to try the Levemir again.
     
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  10. SashaV

    SashaV Well-Known Member

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    Exactly my experience too. Always at night.

    Well, Deb and I agreed that I've been trying long enough without any results. She kept bouncing, going low at night, I couldn't predict where a cycle was headed.
    And..... the reason it took me so loooooong, besides every time we talked about it, Mauer showed good numbers!! But I didn't want to leave Deb... :oops:
    The LBL forum is totally different from this!

    Except the fact that I'm up every night, also more than once, I'm actually extremely happy about the switch. She was on Caninsulin, Levemir, prozinc and then back to levemir. I'm not constantly afraid she's going hypo on me. Lev lasts so much longer that she won't crash as before. I have a bad feeling today, and I can't sleep.... so I'm watching her! But lower numbers feel more safe now. And that's a relief!
     
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  11. Emily Tuomey

    Emily Tuomey Member

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    .... still pink [“you're killing me, Smalls”], PMPS 334.

    Crap. (pm) +3, 394. :arghh:
     
    Last edited: Mar 3, 2021
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  12. Emily Tuomey

    Emily Tuomey Member

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    And still... AMPS, 305.
     
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  13. SashaV

    SashaV Well-Known Member

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    Wanna switch?:eek:
    First hypo ever on Lev today....
     
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  14. Emily Tuomey

    Emily Tuomey Member

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    Oh gosh, no thank you!! Hoping you’re in the clear now. We have broken the pinks for some nice greens ourselves today :Dhappy dance:D

    +6, 72. @Deb & Wink @Shelley & Jess
     
  15. Deb & Wink

    Deb & Wink Well-Known Member

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    Since Nico doesn't seem to hold those dose reductions, you might want to keep the dose the same for now.

    Saying hello to Mr. Green is very nice for Nico.:D:D:D
     
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  16. Emily Tuomey

    Emily Tuomey Member

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    We are still falling, but if he’s at 100+ for PMPS I’m gonna hold him to 1.5u and test like crazy overnight— he doesn’t take reductions well, you hit the nail on the head!

    +6, 72
    +7, 66
    +8, 60
    +9, 58
     
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  17. Deb & Wink

    Deb & Wink Well-Known Member

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    Keeping paws crossed for you and Nico tonight.
     
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  18. Emily Tuomey

    Emily Tuomey Member

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    Thank you!
    +11, 102. PMPS, 123. We’re good :D
     
  19. Logan & Sandy

    Logan & Sandy Member

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    Green is your favorite color huh Emily??!!!!
     
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  20. Emily Tuomey

    Emily Tuomey Member

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    Abso-friggin-lutely!!!
     
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  21. SashaV

    SashaV Well-Known Member

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    Great numbers!! :D:p
     
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  22. Emily Tuomey

    Emily Tuomey Member

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    I’m glad I held. Nothing even close to a hypo, nada. For his pm cycle I shot at 123, so I guess our new “good to go” number is 120. :cool:

    +3, 131
    +6, 97
    +8, 127
     
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  23. Emily Tuomey

    Emily Tuomey Member

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    Good overnight too! (Even though mama didn’t sleep too soundly.. <yawn>) I expect his bounce will start with the am cycle; hopefully not long-lived since I didn’t reduce his dose! <fingers crossed>
     
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  24. SashaV

    SashaV Well-Known Member

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    Sleep is a privilege we don't often have :Do_O
    I was up 3 times :eek:
    Hopefully he won't bounce!
     
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  25. Emily Tuomey

    Emily Tuomey Member

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    The beginning of the bounce has come, Nico’s AMPS was 269. I’m just praying that because we didn’t do a knee-jerk, panic dose reduction that it won’t be long or severe; he tends high, so is never in the greens very long, and never within hypo territory— which I guess is a good thing.. we shall see what today brings. Hoping Mauer does well today too!!
     
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  26. SashaV

    SashaV Well-Known Member

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    269 is a lot better than the pinks you've been seeing!
    But he was green yesterday and last night, that's progress!
    Mauer is high today. High being hanging out in the blues :p
    I guess it's a bounce. But a tiny one!
     
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  27. Emily Tuomey

    Emily Tuomey Member

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    I feel like I should be jealous of all these kitties with low(er) numbers, but I also know that comes with its own set of unique challenges.. apples and oranges. Just hoping my sweet boy stays out of those pinks for at least a cycle or two. He’s totally blissed out in his box at the moment (and yes, the Christmas tree is still up :joyful:), sleeping with a smile: upload_2021-3-4_9-22-48.jpeg
     
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  28. SashaV

    SashaV Well-Known Member

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    Exactly... having a cat in the lower numbers isn't a walk in the park either. But it has to be done no matter what.
    Aaaaw he looks cute!! Box kitty!
    I sang a Christmas song yesterday, in a bit it'll be Christmas again! :D:D:D
     
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  29. Deb & Wink

    Deb & Wink Well-Known Member

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    Em, you are still doing very well managing Nico's dosing cycles.
    While it's very hard to do, keeping the dose as is and monitoring can help you make some real progress.
    One of many sayings we have here, "Shoot low, to stay low."
    Of course, you have to have enough test data and supplies in order to do that.

    Em. We're proud of you, very proud of you.
     
  30. Emily Tuomey

    Emily Tuomey Member

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    The bounce has begun... PMPS 439 :oops:
     
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  31. Emily Tuomey

    Emily Tuomey Member

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    I figure the lights make me happy, especially at night, and really not many people are coming by due to COVID, so I might as well leave it. I’m a Christmas Eve baby, so Christmas always seemed like my holiday. I just love it.
     
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  32. Emily Tuomey

    Emily Tuomey Member

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    Awe. Such words, completely unexpected. <heart swell> It’s all just part of the job, but I am thankful to all of you for teaching (and continuing to be patient with) me the ropes! Feline Diabetes sucks, but it’s nice to have people in our corner. :smuggrin:
     
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  33. Emily Tuomey

    Emily Tuomey Member

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    Anyone wanna wage a bet on which way Nico goes tonight with a (low-ish) yellow pre-shot?? Historically he goes green, but he likes his surprises, so he very well could tip the other way and go pink... :cool: PMPS 236.
     
  34. SashaV

    SashaV Well-Known Member

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    HA! Green! Way to go Nico! :D:stop:
     
  35. Shelley & Jess

    Shelley & Jess Member

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    ...my money was on green (but didn't want to *jinx* it :p)

    WooHoo!!!:)
     
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  36. Emily Tuomey

    Emily Tuomey Member

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    SO GOOD (and thank you for not jinxing it, Chell!). It was nice to have a bunch of green, but no near hypo/full hypo scares. We were back in the pink this morning, so we shall see where he goes from there..
     

    Attached Files:

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  37. SashaV

    SashaV Well-Known Member

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    Em, are you doing anything special every other week?
    Seems he has two high weeks, one great, then back.
     
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  38. Emily Tuomey

    Emily Tuomey Member

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    Interesting. It looks like it might be more like ten days, but nothing special that I can think of.. we’ve had some weird food things (tried out Kitten Friskies, then removed), a new vial of insulin opened, etc that were all since the beginning of the year but not sure they were all 10-14 days apart, and if so totally coincidental. Could it be that his pancreas has a timer..? A fit bit? Ha! “Too many steps.” “Cheat day!” :joyful:
     
  39. Emily Tuomey

    Emily Tuomey Member

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    @SashaV we're gonna have a black tonight for PMPS, guaranteed. At +8 he was already 490. :arghh:
     
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  40. Deb & Wink

    Deb & Wink Well-Known Member

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    Maybe @SashaV could talk you into trying one of the L insulins, either lantus or levemir. Her Mauer has done better being on one of those longer lasting insulins. They can sometimes, but not always, help to give a more smile shaped curve without the wild bounces.
     
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  41. SashaV

    SashaV Well-Known Member

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    He is a great candidate! I didn't have all these colors in Mauers SS, so I think it would be a better choice.
    You could make a post in the forum asking advice on switching, to what insulin and so on.
     
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  42. SashaV

    SashaV Well-Known Member

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    And Mauer doesn't bounce in the same way anymore. Now a bounce is blue!
    But I think you have a lot to gain, Em.
    You're still relatively new, within the 6 months.. give lantus or levemir a real chance now.
     
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  43. Deb & Wink

    Deb & Wink Well-Known Member

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    Order from Canada, Marks Marine Pharmacy if you decide to go with Lantus or Levemir.
     
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  44. Emily Tuomey

    Emily Tuomey Member

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    I may need to pop over there tomorrow and take a peek around. To be fair, Nico’s vet did recommend Lantus to begin with but as both Lantus and Prozinc have similar statistical results (at least within my vet’s clinic) I opted to try the cheaper one first— Prozinc.
    Nico has a follow up appointment with the vet, and will be out of insulin in early April, so that may be a good time to discuss changing it up for him then.
    Thank you! The cost is certainly a factor, especially since I’m only working part time until COVID is a little more well-managed through the vaccines and people used to personal precautions and social distancing.
     
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  45. Emily Tuomey

    Emily Tuomey Member

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  46. Emily Tuomey

    Emily Tuomey Member

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    A nice, “healthy” (in Nico’s world) pink for his +3. 361. Not too shabby considering his day! And, most importantly, SLEEP. G’night! upload_2021-3-6_22-47-54.png
     
  47. SashaV

    SashaV Well-Known Member

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    Em, I wouldn't wait.
    Research says the sooner a cat is treated with long lasting insulins and TR, the better chance to go OTJ. It's 84% within the first 3-6 months. Long-term diabetics is 34%
    So I'd do it sooner rather than later!
    You could look in the supply closet forum :D
     
  48. Emily Tuomey

    Emily Tuomey Member

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    I really appreciate all the help and suggestions, but I’m extremely overwhelmed right as of the moment — a lot of life stuff needing more emergent attention, unfortunately— so, I’m gonna need to shelf this idea for a bit. I’ll go look in the supply closet, but otherwise I just really can’t. I may try a tighter food regulation for a few cycles and see if he has a high food influence or not, but that’s the best I can do. I’m really sorry. :oops:
     
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  49. SashaV

    SashaV Well-Known Member

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    There's no pressure and no need to be sorry! :bighug:
    We just wants what's best for you and Nico. If you're ready to give it a shot in two months, then he'll be ready in two months. You need to be and feel ready too :bighug:
    I waited a long time to feel ready, and that's just how I work. You can't take care of Nico, if you don't take care of yourself first! :bighug:
     
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  50. Emily Tuomey

    Emily Tuomey Member

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    Still riding the yellow train, hard to predict his overnight, but I’m personally hopeful for some decent sleep! A couple of updates: I decided to try fasting Nico from 3am/pm to 7am/pm (instead of 5am/pm to 7am/pm) to see what his food influence is and exactly how it effects his numbers. Though I’m nervous about his weight, so will have to monitor it closely and revert back to his normal schedule is there is any weight loss— he is a grazer, always has been. So, we started that today and I plan on a few cycles with that change, then reassess. The other update is that I was able to get my hands on one pen of Lantus through the Supply Closet, but is that enough to trial him on it before seeing the vet? I’m not sure how soon it will arrive either. Any advice welcome! :confused:
     
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  51. Emily Tuomey

    Emily Tuomey Member

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    Looking over his spreadsheet I think we are tracing a similar trajectory to 2/28 with a huge high(s) the previous day then yellow then longgggg recurrent string in Pinkalicious Prison.. like 5 cycles worth possibly.. :nailbiting::nailbiting::nailbiting::nailbiting:
     
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  52. SashaV

    SashaV Well-Known Member

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    There's 300 doses in my Lev pen, it must be the same for Lantus, and Nico is on a tiny dose and would probably start even lower. I always draw way too much up, and therefore a lot of waste, so mine lasted a bit more than a month. But Mauer is double Nico in dose, so one pen will last you a nice 3-4 months?
    I'm terrible at math, and it's 4 in the morning so I'm probably wrong... I usually is :oops::D:D:D:D
    But nice with the pen! Good catch :bighug:
     
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  53. Deb & Wink

    Deb & Wink Well-Known Member

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    Confirming that there are 300 units in a Lantus pen.
    You still use the insulin needles to withdraw the insulin from the pen, just like you would with a vial. There is a little rubber stopper at the end of the pen.

    BUT you need to use different insulin syringes.

    Lantus is a U100 insulin, and it's dangerous/difficult to use U40 syringes with the U100 insulins. Because it's so difficult to measure those really tiny doses to begin with, and the wrong size syringes make it even harder to measure accurately.

    So the recommendation is to use the U100 syringes with a U100 concentration insulin.

    Nico, please get out of those pinks. Pink is really not your best color.

    If you could record your feeding times in the + hour format, that would make more sense to us. We live in all different time zones, and 3 pm my time is likely to be really different from 3 pm your time. We also give our cats insulin at all different times during the day. So one person may dose at 5 am/5 pm and someone else might dose at 9 am/9 pm. So the + hour time format is what we have come up with to, so the times make sense to everyone.

    Em, I hope things are going better for you these days.
     
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  54. Emily Tuomey

    Emily Tuomey Member

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    @Deb & Wink @Shelley & Jess @SashaV Sorry I’ve been a bit MIA this week (and last week), or sporadic to say the least. Dealing with some new life challenges and some crazy awful side effects to a new medicine I was started on. Anyway, I’ll try to at least pop on once a day to catch everyone up if I can. Nico has been a bit all over the place lately, which could be my own stress transferring onto him or a missed low nadirs or two, or really anything (or nothing!) at all. I did want to ask one question for the next time you guys have a spare moment: we have been doing a 4 hour pre-test fast, both cycles, to see if food alone would alter his numbers at all. It’s been almost 8 cycles now, and I’ve come to the conclusion, “I don’t think so.” That is probably long enough to know one way or the other, right? I sorta promised him this would be the last one— plus the extra, uninterrupted sleep would be nice, I’m not gonna lie. :) Thoughts? Experiences? Patterns you see that maybe I don’t?

    Happy Wednesday from a very relaxed and “blissed out” Nico. :cat:
    upload_2021-3-10_18-12-57.jpeg
     
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  55. Deb & Wink

    Deb & Wink Well-Known Member

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    No worries. Life gets busy and throws us curve balls all the time, so we have to make adjustments to what we are doing.
    Sure do hope you are doing a bit better these days.
    Please, take good care of yourself and catch up on your sleep.
    We'll all be shorted on sleep this weekend, as the clocks change ahead this weekend.

    Yes, that should be plenty of time to see if your "Experiment" was having an impact.

    Food and insulin work hand in hand, to manage the BG levels. They are not in lockstep though, and show their impacts at different times during the cycle. So you might see a "food bump" in the BG cycle anywhere in the first hour or two. Prozinc onsets or starts to work about 2 hours after the injection. So it's more normal to see the BG levels start to come down around +3 to +4. Food is digested over a period of time, not all at once. Think of how slow your own digestive system is.

    Although it's good to not feed your cat much at all in the last half of the cycle, you might not see a big impact on the BG numbers from withholding the food. The reason is that the INSULIN is normally used up by that time, and what you are seeing is the natural rise later in the cycle because there is no more insulin to counteract any glucose that is in the bloodstream, as the food continues to be digested.

    No more insulin to counteract the food, the BG levels go up.

    There aren't many tests in that +8 to +11 time frame, so very difficult to say if the lack of food during that time is having any impact.
    Remember, it's the intersection of the food being digested and hitting the bloodstream in conjunction with the insulin working that makes the difference.
     
  56. Deb & Wink

    Deb & Wink Well-Known Member

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    @Emily Tuomey

    Too many low BG’s lately. You need to reduce the dose more for Nico.

    A bit worried with all those under 50 BG numbers you are getting.

    Please lower the dose Em. Please, no more than 1U for Nico. Those neon green BG’s are the danger zone. Past time to lower the dose, even using the MPM dosing protocol.
     
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  57. Logan & Sandy

    Logan & Sandy Member

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  58. Emily Tuomey

    Emily Tuomey Member

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    YES. He is going down to 1.0u in just a few minutes. I have a watchful eye on him; he’s been full of *surprises* lately.. I don’t know where all the neon green is coming from all of a sudden. Thank you for looking out for him/us! upload_2021-5-17_18-28-34.jpeg
    I’ll be back with a pmps shortly ;)
     
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  59. Emily Tuomey

    Emily Tuomey Member

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    @Deb & Wink PMPS 66. 1.0S given with 1tbsp mc food (along with his normal dinner). Another test in an hour.
     
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  60. SashaV

    SashaV Well-Known Member

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    When shooting low like that, please get a +1 and +2 :oops:
    Even when you're shooting yellow or pink, get some more mid cycle tests in..
     
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  61. Emily Tuomey

    Emily Tuomey Member

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    Overnight his gravy food did it’s job (but mama got no sleep..): 48 +4, 72 +5 —with gravy food influence, 80 +9 — with gravy food influence, 116 AMPS. 1.0u given. :)
     
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  62. Logan & Sandy

    Logan & Sandy Member

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    Hopefully tonite Nico will let you sleep!
     
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  63. Deb & Wink

    Deb & Wink Well-Known Member

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    Nico may need an even smaller dose than 1U. Please be very cautious with the dose.
     
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  64. Emily Tuomey

    Emily Tuomey Member

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    He has been in the 50s the majority of the day (+6 50, +8 58), so I’m planning on a 0.75u dose this evening. He’s already had 0.90u, so it’s the next step, Hopefully he stays a little higher with that reduction. :confused: I do have a question though: Nico is still within his “healthy” weight range set by his vet, but he’s nearing the heaviest end and I fear with all this gravy/carb-laden food he will go above where he should be. How can I keep him healthy for both his blood glucose levels and his weight?? Anyone feel free to weigh in here...
     
  65. Deb & Wink

    Deb & Wink Well-Known Member

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    No pun intended!?!

    Fewer treats?
     
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  66. Emily Tuomey

    Emily Tuomey Member

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    :joyful: Pun totally intended!! He doesn’t get treats except when he’s poked, but yes I reduced him to minimal after I weighed him. I’ll just see how it goes. I’m sure he will be fine, he’s never been an overweight or obese cat so odds are it’ll even out. Happy to see him under 1.0u!! :D:D:D
     
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