10/4 Newman AMPS 260 shot 1.25, PMPS 379 shot 1.25

Discussion in 'Prozinc / PZI' started by Linda and Newman, Sep 28, 2022.

  1. Linda and Newman

    Linda and Newman Member

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    Previous thread: https://felinediabetes.com/FDMB/threads/9-26-newman-amps-162-stall-171-stall-199-reduce-dose.268877/


    I will skip AM dose based on low BG and the fact that we are experiencing disruption to normal household routines as we deal with the impact of the hurricane on our area. Waking up this morning with increased storm effects.

    The pets, Newman, Ozzie and the dog, Minnie are spooked by the storm and the sounds associated with it. I would not expect the emergency vet to be available and it is not safe to be on the road for the next 24 hours or so.
     
    Last edited: Sep 28, 2022
  2. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Good morning, Linda! How is it there right now? I saw that there have been a lot of tornado warnings and that there’s been rain. What have the winds been like? Do y’all have all of the hatches battened down for the storm? Did your son put up the hurricane shutters, etc? My family, who are very close to you, eventually got permanent some permanent shutters and impact glass. We have loads of evacuated Floridians here right now. I feel sorry for them. At least you aren’t getting a direct hit on the Atlantic side. Keep us posted so we know you are okay. Sorry the kitties and Minnie are frightened.
     
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  3. Linda and Newman

    Linda and Newman Member

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    For the record, I was just able to get a test. He is at 288 after grazing on his usual (1) can of FF, over 3 hour period. Is it too late to give a token dose?

    @FrostD @Suzanne & Darcy
     
  4. FrostD

    FrostD Well-Known Member

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    Depends if you can be off schedule for a little while...

    Hope everything turns out ok with hurricane!
     
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  5. Linda and Newman

    Linda and Newman Member

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    Hi Suzanne, good to see you. Woke up this morning and it has turned out to be a bit more of a storm than when I went to bed last night! But that is the nature of hurricanes and tropical storms. There was a lot of wind overnight and a confirmed tornado in the area. Our shutters are colonial shutters, so they remain in place, hinged so it is simple as folding them closed. That is not necessary for this one. The boys removed any items in the yard, chairs, birdbaths and hanging plants and so forth. Cars are in the garages. There are long periods of relative calm between the bands that precede the eye. We are on the edge of the hurricane, so we will get increasing tropical storm winds as the storm moves north, after coming ashore on the west coast. Being on the east coast, we will not get hurricane force winds. Our sustained winds should only be 30-40 mph with gusts to 60-70. We've been through worse. Thanks for asking.
     
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  6. Linda and Newman

    Linda and Newman Member

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    Thanks, Melissa. I don't want to get this far off schedule, looking at the evening dose at 10 PM or later. Speaking of which, do I just pick up the schedule this evening at the usual time?
     
  7. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Funny, I was just sitting here thinking about you all. I was thinking that I wish you had given at least a small dose to help keep him on a more even keel. It would put you off schedule a lot though. You may want to just shoot for tonight?
     
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  8. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    You can shoot this evening at the usual time, yes.
     
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  9. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Oh, the colonial shutters are my favorites... of course, it really depends upon the style of your house as to which ones look best (but I'm from Virginia... so you know I'm fond of colonial architecture!) :) Yes, I know you've been through worse (even in recent years). We have too. I'm actually hoping to get some rain out of this storm, but hopefully nothing too bad.
     
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  10. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    How are you, Linda? I see the normal dose brought Newman into blue so that is good.
     
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  11. Linda and Newman

    Linda and Newman Member

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    Good morning! I was also glad to see that blue number last night. Even this morning, I would not have been surprised to see a higher fasting BG. Hopefully the interruption didn't do too much damage in his process

    Lots of debris from the trees and palm fronds down, still feeling tropical storm wind gusts, but no other concerns for us. The wind today will help to dry out all the stuff that wasn't supposed to get wet!

    I trust that your family down here is well.
     
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  12. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Yep. Everybody is well (including new baby we just had added to the family) :) It's pretty windy here today in Georgia, but I honestly don't think we are going to see a drop of rain since the whole thing is moving east. Hope everything is dried out soon!
     
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  13. Linda and Newman

    Linda and Newman Member

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    Wow, this is the lowest fasting BG (108) since he was dx.

    I will stall for 30 minutes, but if he is under 200, I'm not sure what to give for a dose. Back to my notes. Help!

    @FrostD
    @Suzanne & Darcy
     
  14. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Good morning, Linda. Let's take a look at his SS and see what history will tell us... but that is quite low for him. Did you test that number only once? If not that's fine, just do what you already have planned and retest in 30 minutes.
     
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  15. Linda and Newman

    Linda and Newman Member

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    After 30 minutes he tested at 122. Guidelines tell me if below 150, skip. It seems like I should give some kind of dose, say 1.0 units or less. Looking back on his SS, in early August, 8/12 he had 138 and I skipped. He got pink later in the day, but the next day he had blue, so it didn't last long.

    What do you see, Suzanne?
     
  16. Linda and Newman

    Linda and Newman Member

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    I am going to feed, hopefully he will not vomit and complicate the situation.
     
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  17. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    This low of a number is really unprecedented for him. You can skip, but we know what will happen and he will go too high. I was thinking of maybe a 1 unit dose, too.
     
  18. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Well yes, why don't you feed him and wait a little to make sure it's not a vomit day. Can you feed him just a little at first? Small amounts doled out?
     
  19. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I noticed this same day because it was one of the lowest. I don't think the skip was a great idea because within 6 hours he was in the pink, but as you say, he got back on track with the next cycle. I just think if you can give some insulin it will help keep those pinks at bay.
     
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  20. Linda and Newman

    Linda and Newman Member

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    Naturally, he went under the bed after eating, so it is impossible for me to be 100% sure that he is keeping his food down. I did feed a small amount, less than 1/3 can FF, but that is what I normally do so that he comes back for treat and shoot after breakfast.

    I will coax him out and test again, for my peace of mind, and then give him 1 unit. At least it is the AM cycle so I have the best chance of tracking his numbers. Normally, he will be grazing most of the morning, so he should be covered by food.

    I see that he moved to the porch when I wasn't looking. It is a nice cool morning here.

    I appreciate your input and guidance, as usual.
     
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  21. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Well.... just let me know how he does and what you decided to do. You've got this, Linda. Whatever you decide ... it will all be okay. :)
     
  22. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Okay... we cross posted. I'm glad he moved to the porch. I think he will be safe with 1 unit.
     
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  23. Linda and Newman

    Linda and Newman Member

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    Gave 1 unit.
     
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  24. FrostD

    FrostD Well-Known Member

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    Glad that worked out!

    Any ideas about the low number? Did he eat like usual last night?

    Normally I'd say that's reduction worthy as a precaution, but I also don't really want to reduce...
     
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  25. Linda and Newman

    Linda and Newman Member

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    I can't think of anything unusual to cause the low number. He actually ate more yesterday, his full allotment rather than leave any at the end of the day. I was planning to ask generally, why he may be getting more response to the insulin in the overnight cycles, compared to daytime? He does seem to sleep most of the day and comes alive at dinner time and into the night when I am going to bed.

    If I do get up during the night, I always find him sleeping somewhere and he responds to me when I talk to him. Then as I wake in the morning his is laying on me!

    I have not fed any food today other than his usual LC Fancy Feast Pate. So he seems to be holding his own if we look at the numbers today. Yellow, but on the low end. A bit surprising that 1 unit is effective today.

    I wish I could get a test during the night to get a better idea. I have tried and it's just isn't happening. Can you make a good guess as to how low he must be going to produce the lower AMPS values?
     
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  26. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    You started a new vial of insulin a day or two ago.
     
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  27. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Also, many cats do drop lower at night. It’s a common phenomenon.
     
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  28. Linda and Newman

    Linda and Newman Member

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    You're right, I hadn/t thought of that. I started a new vial with the AM dose on the 27th. The old one was 10 days short of 3 months old, so not that old and I would say properly handled. But you never know.

    Is this something you see?
     
  29. Linda and Newman

    Linda and Newman Member

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    I'm curious, is there an explanation or theory as to why this happens?
     
  30. Linda and Newman

    Linda and Newman Member

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    Well, it wasn't too hard to make the decision on the evening dose.

    I hope it was the right one!
     
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  31. FrostD

    FrostD Well-Known Member

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    He was relatively flat to +3 last night, so (and this is obviously me throwing a dart at the dartboard) my guess is around 60-70. So technically still safe numbers, but definitely something to think about in your situation.

    I suspect he's just "more nocturnal" than most, and drops lower at night. Most cats do, but some more dramatically than others.
     
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  32. FrostD

    FrostD Well-Known Member

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    Theory has to do with circadian rhythm, be sure they're nocturnal and more active at night. I can't say it's ever been proven though! Just something we've noticed with a lot of cats. Mr Kitty is pretty darn nocturnal - he's up roaming and playing basically all night - and he did always run lower at night (once we hit a breakthrough dose anyway).
     
  33. Linda and Newman

    Linda and Newman Member

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  34. Linda and Newman

    Linda and Newman Member

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    I have to ask, would you have shot the fat 2 this evening?
     
  35. FrostD

    FrostD Well-Known Member

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    Seeing as this was more of a fluke, no I wouldn't do a different dose just yet. We try to keep consistent dosing whenever possible as that seems to work best for most cats.

    Yes I'd have done the 2f...now we just hope he doesn't dive like he did 2 nights ago...
     
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  36. Linda and Newman

    Linda and Newman Member

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    Yikes!
    What to do next. I will stall, but I think it will take a while to come up to a number, safe to shoot. Left on my own, I would skip but I definitely need and want advice on this one.

    ETA: got 68 repeated immediately to check strip/meter and got 69

    @Suzanne & Darcy
    @FrostD
     
    Last edited: Oct 1, 2022
  37. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    What? I just saw this... never got a notification but was just checking up after yesterday. You got a 68/69! Reduction is necessary.
     
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  38. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Isn't it a little early this morning to be doing that test? I thought you shot at 8:15 p.m. last night. And you tested around what... 7:15 a.m.?
     
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  39. Linda and Newman

    Linda and Newman Member

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    Correct. I was aiming to move the schedule back closer to the 7:00 - 8:00 hour. The 81 was at 7:30 this morning.
    Should I test again at 7:45? That would be within the 30 minute allowable fluctuation if I am correct?
     
  40. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    81? But your spreadsheet says 68. I am confused. But to answer the other part of your post, you are correct that you can test again at 7:45 and use that as your PMPS if you don't want to stall any further. He's definitely going to bounce from this.
     
  41. Linda and Newman

    Linda and Newman Member

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    Sorry, I added the 81 to the thread title and did not add to SS.
    He is having no parts of any more testing, waiting at the feeding area for breakfast. I will assume that he won't be too much changed in the 15 minutes since the 81, so I will feed and decide on a reduced, token dose. I need to give the amount of that dose some thought. I'm not a quick thinker with this stuff. What do you think would be a reasonable dose?

    Minnie and Ozzie are getting annoyed at the delay! LOL
     
  42. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I'm thinking .25 unit or skip. What do you think? However, yesterday you fed, and he went up to 181 (according to the notes on your SS) before you shot the 1 unit. So if that's happening again today you may want to repeat that (if you're shooting after the food bump/natural rise as the insulin wears off.)
     
  43. Shelley & Jess

    Shelley & Jess Member

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    I'm thinking the same thing :)
    He's on his way up - it's the exact same amount of a rise in the 30 minute stall as yesterday, just starting a little lower today.
     
  44. Linda and Newman

    Linda and Newman Member

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    He is up to 102 after a full tbsp of food. I shot .5 U.
     
  45. Linda and Newman

    Linda and Newman Member

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    Hi Shelly, Thanks for your input. I greatly appreciate the guidance.
     
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  46. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Okay. Good luck today. He's probably going to bounce, so don't be too distressed if you see it, he's not been staying in bounce mode too long lately.
     
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  47. FrostD

    FrostD Well-Known Member

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    Well he sure answered that reduction question in dramatic fashion :eek:

    I'm suspecting he has late nadir when he breaks the bounces, I just don't know how late. But as Suzanne said, a reduction is in order. At least a 0.25U reduction...0.5U might be better in your situation+ we're not really sure just how low he went the last few times.
     
  48. Linda and Newman

    Linda and Newman Member

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    His numbers have been pretty good today on the 0.5 units this morning. He may be eating a little bit less than usual. Still very interested in the Dr Elsey's chicken kibble for testing treats.

    I will reduce to 1.5 units this evening assuming his PMPS is 250-ish.
     
  49. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    How’s Newman?
     
  50. Linda and Newman

    Linda and Newman Member

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    He had a nice day with a string of blue numbers. I had hoped to get a few more tests in, but as often happens on the weekend, we had company so schedule was interrupted. Then as expected he bounced and his PMPS was 465. I shot the 1.5 as planned.
     
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  51. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Ouch! 465. But hopefully it won’t last long.
     
  52. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    It looks like he may be coming down from his bounce today I hope you will get your hands on him soon for a test :cat: Enjoy your Sunday.
     
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  53. Linda and Newman

    Linda and Newman Member

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    I hope he is getting over the bounce.

    He is 264 @ +4 Thanks for checking on us.
     
  54. Linda and Newman

    Linda and Newman Member

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    Good morning! Fasting BG 106, stalled 30 minutes and got 106 so I immediately rechecked to test strips/meter and got 114.

    I am going to feed him, wait for a few to be sure he keeps his food down and at the moment thinking a fat 1 unit. What do you think?

    @Suzanne & Darcy, @FrostD, @Shelly & Jess
     
  55. Shelley & Jess

    Shelley & Jess Member

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    If you're going to shoot right away and not wait for the food bump, my first thoughts are 0.75u.

    This new bottle of Prozinc seems to be agreeing with him!
     
  56. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    He’s doing it again!
     
  57. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    You had a similar number on 9/30 and shot one unit.
     
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  58. Shelley & Jess

    Shelley & Jess Member

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    I'm looking at he might not bounce as hard. That 9/30 was after 2.0F and waiting until 181 food bump to shoot.
     
  59. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Right. I am simply making an observation. Don’t know how long she’s waiting to shoot. Your plan if she’s not waiting for a food bump is a good one. :). Linda? What’s up with Newman now? Or is he being elusive? ;)
     
  60. Linda and Newman

    Linda and Newman Member

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    Sorry, having slow computer issues this morning!!
     
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  61. Linda and Newman

    Linda and Newman Member

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    I gave him a heaping tbsp. of food. I am trying to get him to come back for a quick check.
     
  62. Linda and Newman

    Linda and Newman Member

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    I have to be prepared to test and shoot because once he comes back there is no guarantee that he will sit still while I draw up insulin to shoot. I will draw 1 unit and then finely adjust down if best.
     
  63. Linda and Newman

    Linda and Newman Member

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    Okay, he just tested 128 after food about 30 minutes ago. I'm shy to shoot even .75 I'm awful at making these decisions.

    In the meantime, he jumped down, so another delay until I get him back.

    ETA: I guess as long as he is on the rise, the .75 is a good dose.
     
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  64. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I would shoot .75 if I could not retest him. If I retested and he is clearly on his way up I would shoot 1 unit. Sorry you are having such a challenging morning.
     
  65. Linda and Newman

    Linda and Newman Member

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    Shot .75

    Thanks for your patience and input.
     
  66. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Okay good. Hope he will come by to see you today!
     
  67. Linda and Newman

    Linda and Newman Member

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    Trying to get out of the hole in the schedule that we dug this morning. He ate part of his dinner and I started the hold at 6:00 PM. I would like to test and shoot about 8:15, that will be 30 minutes off of the 8:45 that I shot his morning dose.

    For me, 7:00 - 8:00 AM would be the most desired goal in the long run.

    What dose do I shoot this evening? Last night's dose was 1.5 and apparently he had late nadir and arrived at the 106 this morning. Do I want to stay with the plan to shoot full dose if he tests around 250 and shoot 1.5 tonight, ignoring the .75 that I shot this morning?

    Does my question sound as confusing as I think it might?

    @Suzanne & Darcy, @FrostD, @Shelley & Jess
     
    Last edited: Oct 3, 2022
  68. FrostD

    FrostD Well-Known Member

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    If he's high enough I would shoot at your normal time (looks like he will be above 300, so no problem doing that).

    I am not sure if his nadir was so late last night...it might be wise to reduce to 1.25U as a precaution, but up to you.

    As for what to shoot with these lower preshots, it's a tough call because you always run the risk that he doesn't start to bounce, and instead goes down. The 0.75U seems to work pretty well...
     
  69. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    I think last night/this morning he was breaking a bounce.
     
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  70. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Agreed. If you don’t want to stall too long in order to keep on schedule then you won’t know for sure if he’s really going up. So you can adjust downward as you did this morning.
     
  71. Linda and Newman

    Linda and Newman Member

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    It will get better when I feel more confident in adjusting the dose on my own. My indecision is the brunt of the delay.
     
    Last edited: Oct 3, 2022
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  72. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    You do very well
     
  73. Shelley & Jess

    Shelley & Jess Member

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    AGREED!!
     
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  74. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Paws crossed for Newman to do well on the 1.25 today.
     
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