11/26 Henry PMPS 101 +1 138 + 2 108 +2.5 107 +3 83 + 3.5 77 +4 88 + 4.5 99 +5 101 + 6 110 + 11 334

AMPS 345 +5.5 247 +11 113 +12 95 PMPS 101 +1 138 + 2 108 +2.5 107 +3 83 + 3.5 77 + 4 88 + 4.5 99




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Happy Thanksgiving Robert!

 

Thank You

You Also

 

Happy Thanksgiving! Great to see the yellow today. I suspect he might be clearing a bounce so you might want to get a +10 and not be surprised by a lower number at PMPS.

Remember that if you aren’t comfortable shooting a lower PMPS under 150, try stalling without feeding for 20-30 minutes. Retest and shoot if the BG has headed up. If it’s not high enough to shoot yet, repeat the process. Once you get to stalling for two hours, if the BG is still not up, it’s best to just skip at that point.

Usually, I’m not a fan of stalling and skipping unless the BG is below what we would shoot per the specific method we are using and/or the CG is not available and able to test. The reason is because stalling and skipping BGs that are safe to shoot are (1) generally for the CG and not the cat and (2) will often result in the same BGs during most of the cycle due to the depot.

However, since it is a holiday and I won’t be around most of the rest of this day and evening to help, I am not going to suggest you shoot a lower normal than usual (but above 90) unless someone is here to help you and stay up to guide you through dealing with lower numbers.

I hope you have a quiet, uneventful day and Henry doesn’t decide to use a holiday to make a statement.

 

OK, Marje what does CG mean?

I can get a + 11 now too late for + 10

You also have a Happy Thanksgiving

Thanks for getting back to me it REALLY MEANS A LOT

AMPS + 11 (113)

Take Care

 

CG = caregiver.

Beautiful +11. Henry likes this dose. Now we'll know by PMPS whether he's on his way up or still going down.

 

AMPS was given at 6:00am EST today

 

Wendy his PMPS BG reading is (95)

 

Hi Robert,
Remember what Marje said:

How about stalling and retesting without food in 20-30 minutes, then we can see where Henry is at?

I see you are doing SLGS, so we are pretty close to that 90 right now.

 

Will do next BG reading @ 6:30pm EST - 20 minutes from now and will post

 

Okay, I'll check back with you then. I'm also on EST.

 

Thanks Lyla! I'm hopping on a zoom meeting shortly.

 

So great to see Henry in these nice numbers! I worry that this stall may bring him below the 90, but we'll see. Your signature says you are doing SLGS but your spreadsheet doesn't really look that way? I know how hard you've been working with Marje to get Henry's numbers down, so I'd hate for you to lose the momentum.
Shooting when they are green (90 or above in your case) is a wonderful opportunity.

 

OK If I shoot Henry under TR will it be the full amount 4.75 units

 

As per Marje, you could shoot as long as he is above 90:

I am not going to suggest you shoot a lower normal than usual (but above 90) unless someone is here to help you and stay up to guide you through dealing with lower numbers.

I wouldn't go against what Marje says. However, I am here to help you navigate low numbers if you can shoot Henry at or above 90. And you would shoot the full amount. As she pointed out, the depot is going to be in play anyhow. So shooting a "big chicken shot" ie a lower dose wouldn't affect his numbers in the evening cycle.

 

Just performed BG reading on Henry (101) at 6:30 pm EST

Shoot full amount 4.75 units?

 

Yay! I will urge you to do so (full amount) if you are comfortable, and therefore I will stay with you and guide you in case he goes lower.
Do you have enough test strips and MC and HC food, and karo if you require it? It looks like Henry may be on the rise, but we can't say for sure. But the 101 is a really nice number to shoot.

 

I have about (75) AT2 strips

I do have Karo, Temptations kibble, Fancy feast ocean white fish and tuna in gravy, and Earthborn harbor harvest

 

Great! Did you shoot?

 

No need to break out anything HC just yet. I asked just to make sure that you have something just in case. Assuming that you did shoot, I'd feed Henry his usual PMPS food and then get a test at +1. Sound good?

 

I shot henry full amount (4.75) at 6:45pm EST

Next BG reading (PMPS +1) at 7:45pm Correct

 

Correct! Great job shooting. Can you please also note in here what you are feeding him so I can keep track. What did he eat at PMPS?

 

We feed Henry (4) times daily 80 Calories each feeding - Times are as follows: (6:00am, 11:30am, 6:00pm, and 11:30pm)

Of the 80 Calories - 50 calories is wet food (Earthborn Montery Medley) with 10% carb and 30 Calories of Dr. Elsey's kibble high protein with 5% carbs - Combined calories 80

Henry is 22 inches long (Very Large Cat) Vet says ideal weight is 16Lbs

Henry was 24.75Lbs at his diagnosis Feb 2020 so we have him on 320 Calories daily for ~= 16Lbs diet

He's 20.5 Lbs now maybe little less

 

Oh he is really coming along! Thanks for the info on the food. He is adorable.
With feeding him the dry food that's probably why you're doing SLGS and why Marje is helping you with fast tracking his dose. TR doesn't allow the feeding of dry food.

Tonight you stalled without feeding, and then fed him at 645pm when you shot, correct?

 

Correct feeding at 6:45pm EST

 

Okay. And I will meet you back here at 745pm EST to see what his +1 is and figure out our next move, so please be sure to post it.

 

I need to tell this too

The 6:00pm BG reading fed Henry (3) kibbles ~= 3 Calories
The 6:30pm BG reading fed Henry (3) kibbles ~= 3 Calories total of (6) calories they were rewards for getting pricked in the ear

 

I can't tell from your spreadsheet if you have ever delayed before and then needed to move your shot times earlier. You can move the shooting time earlier in increments of 15 minutes per shot, OR 30 minutes at one time in a 24 hour period. So if you normally shoot at 6am/6pm, then you could do the following:

11/26 PM shot at 645pm
11/27 AM shoot at 630am
11/27 PM shoot at 615pm
11/28 AM shoot at 6am

OR

11/26 PM shot at 645pm
11/27 AM shoot at 615am
11/27 PM shoot at 615pm
11/28 AM shoot at 6am.

 

Only one delay two days ago 11/24/2020 PMPS was given at 8:00pm two hours later

 

Okay, my understanding is you're not supposed to move the shot time back more than 30 minutes per 24 hours or 15 minutes per shot....unless Marje gives you special instructions. THat's different.

 

You are correct with the protocol of moving back the times.

Marje said since Henry's numbers were HIGH she waived (this time only) the protocol for moving back time

 

Just performed BG reading (PMPS + 1) on Henry (138) @ 7:45pm EST

 

In your title, change the "+12.5" to PMPS so everyone can see you shot Henry. The 101 is your PMPS even though you got it 15 minutes before shooting.

 

Okay, so maybe he is on the rise and going to bounce, OR maybe this is a food bump. Get another test at +2 and let's see what that says. At +2 the latest dose will likely kick in, and the food may start to wear off. Sound good?

 

Yes will do a BG reading at 8:45pm EST

 

Great. I'll be back at 8:45pm EST.

 

Just performed BG reading (PMPS + 2) on Henry (108) @ 8:45pm EST

 

Okay, so we have a drop from +1 and a similar number to PMPS and it is early in the cycle. Normally when your PMPS and your +2 are similar, or your +2 is lower, it means it could be an active cycle. It wouldn't surprise me if he goes below 90 tonight. Let's try to keep him surfing around or just above 90 for as long as we can.

How about try feeding him a couple tsp of 10% and check again in 30 minutes? You don't have much data, so this is a good opportunity to get some. We can see whether 10% carb food is enough to influence his numbers at this point.

 

How is his appetite? Is he a good eater?
And just so you know, numbers above 50 are nice and safe on a human meter. 68 and above on an alphatrak. But if he goes below 90 that earns a reduction (unless Marje says otherwise as a special one time thing just for Henry and for no other cat).

 

Knock on wood but YES Henry is eating the tsp of 10% like he's not ate in days

Henry so far has been eating well this entire time (forever)

If we let Henry have his way on eating he would be right back up 25Lbs

Will do BG reading at 9:15pm EST

 

Lol. Butters is also a longstanding member of the clean plate club. Great. a 9:15pm test it is, and then we can go from there.

 

Henry's BG reading @ PMPS +2.5 (107) @ 9:15pm EST

 

Nice and steady number. The 10% didn't seem to influence things, but it might've prevented him from going lower. How is he doing with the testing? I suggest no more food right now, and check him again in another 30 minutes. How does that sound?

Testing in another 30 gives us a better idea of how quickly (or not) he might continue to slide down. Once we see that number, which will be a +3, I think we will know better if he is going to continue to surf at these numbers, or possibly go lower.

 

I stand to be corrected I just fed (1) tsp not (2)

Does this change anything?

 

Nope. Test at 9:45.

 

How is he doing with the testing?

He's getting tired (sleepy) long day but Henry does not fight or squirm during the test

 

That's good to know. Because Henry is just starting to get into lower numbers, it is such a good opportunity for you to gather some data. But it is hard to do that when a cat fights the testing.

 

Henry's PMPS +3 reading (83) @ 9:45pm EST

 

Okay so reduction earned. Still a good number. Feed him 2 tsp of the 10% and check again in 30 minutes. If we can hold him around here that would be nice.

 

OK Henry just consumed (2) tsp of wet 10% carb

Next BG reading at 10:15pm EST

 

Okay. I'm not clear if you have MC wet food. Do you? That may be our next move here. I'm trying to balance Henry's surfing in greens for as long as possible but also recognize it is early in the cycle and we want to keep him hungry.

 

Yes,
Fancy Feast Gravy Lovers 16% carbs

But will Henry pull an act I've not tried this hmmmm do I want to eat this

Now the Temptations kibble is 35% carb this might be a good alternative if need be

 

Henry's BG Reading @ PMPS + 3.5 (77) @ 10:15pm EST

 

Time to open up the 16% . I'd say because he is bigger, give him 2 tsp. And test again in 30 minutes.
You're using an alphatrak, so we want to stay above 68.

 

It's the moment of truth...will he eat it or won't he?

 

Henry just consumed (2) Wet Fancy Feast Gravy 16% carbs - done

 

He did in fact consume the (2) tsp of wet 16% carbs

It's has been 10 months since he has had the Temptations Kibble 35% carbs boy was he addicted to this stuff

 

Kudos to you for getting him off it. That could not have been easy.

 

The Temptations Kibble (35% Carbs) is only for the HYPO kit

 

What would be the REDUCTION for tomorrow morning AMPS 0.5 units???

 

Henry's BG reading PMPS + 4 (88) @ 10:45pm EST

 

Good, so he has come up a bit. So don't feed him anything right now and check again in 30 minutes. We want to see if he is still going up.

 

Now his next structured feeding is 11:30pm EST (Everyday at this time) - 80 Calories

 

Are you flexible on that? He has been getting extra food over the past few hours, so he wouldn't be starving come 1130pm, would he? Let's see what his BG number is at 1115pm EST.

 

No I do not think he would be STARVING but he might consume some and walk away but I'm flexible no problem if need to be (2) tsp at a time, YOUR CALL

My wife knows him better than me she says it's almost a certain he'll eat all 80 calories (I'm little shocked I did not think so)

 

Ok sounds good. Lets see where he is at come 1115pm. We don't want to feed him too much right now in case his numbers drop more. We also want to be able to see when his numbers start to hold on their own without needing to be propped up with food.

 

I can stack the numbers in the cells in your spreadsheet for you, if you want. It's hard to read right now.

 

How do I proceed to allow you (Sharing File) to modify spreadsheet?

 

I sent you instructions in a Private Message.

 

Henry's BG reading @ PMPS 4.5 (99) 11:15pm EST

 

How is the 1115pm test?

 

11:15pm EST BG reading is (99)

 

We cross posted there. Okay that's great. He may be slowly rising but it is still a bit too soon to know for sure whether it is because of the food. Withhold food and get another test in 30 minutes.

He has a really great surf going on today. You're doing a good job steering his numbers.

 

Robert, you and Layla are a great team. Henry's looking great.

0.25 unit reduction. Good luck with the reduction.

 

OK 0.25 reduction AMPS tomorrow @ 6:30am EST

Thank You Wendy

 

Robert, you can delete all of your AM Cycle numbers from your thread title...to make it easier to read and give you space to type in the evening ones. First number of your title could be PMPS.

 

Henry's PMPS + 5 (101) @ 11:45pm EST

 

Would you be willing to withhold food for an hour and test him (+6), and then feed him his meal? This will really tell us if henry is going to keep surfing it out at these numbers without food influence, which would be amazing.

 

I'd also like to officially declare this a PJ party.

 

It's a lovely cycle numbers-wise tonight, Robert.

 

Yes I willing to perform BG Reading @ PMPS + 6 @12:45AM EST and NO FOOD

 

Great. No food until we see the +6. What I'm hoping is that he is going to be on the rise, and that you might be able to feed him and we can call it a night. I'm not sure that will happen. But we'll see.
See you at 12:45AM EST.

 

Please buy some more strips tomorrow if you can. I always have at least 100 extra strips on hand. Those are strips that I keep in butters’ hypo toolkit.

 

Let me give you an inventory of strips on hand:

1) 150 of Nova Max Plus (Human Meter have not use on Henry Yet) - 300 more strips of this brand is on it's way for delivery at my home for a total of 450 strips
2) 60 strips of the PETSURE Brand (Code = 22) that is designed for the AlphaTrak 2 Meter (Have not use these yet on Henry)
3) 70 plus of the AlphaTrak 2 strips - Which is what I've been using thru out this entire process which are populated on the spreadsheet
40 I will transition to the Nova Max Plus at some point, I thought once we had Henry's ideal units of insulin established I would start using the Nova Max Plus meter

 

This is music to my ears. When I saw that you only had 75 AT strips, it occurred to me that’s great for tonight but what about tomorrow and the next day.

 

Every time that I purchased (50) AlphaTrak 2 strips thru CHEWY I always purchased the Kit form (50 strips plus meter plus lancet needles included)

So I think I have (4) AlphaTrak 2 meters, why did I does this because it was only $5.00 more versus strips only

 

When you say tomorrow?? I'm supposed to check as frequent as we did tonight???

 

What do you do with four Alphatrak meters?

 

No, i just meant like if he goes low again.

 

Still in their pouches put up on the Shelf

 

I’m getting punchy and maybe nonsensical. My bedtime was three hours ago.

 

How often should I check Henry's BG tomorrow with the 0.25 reduction????

 

Could have fooled me ==> not obvious

 

Will depend on his numbers! But remember the reduction does not kick in right away. The depot may still be full.
I’m kinda waiting for henry to bounce. He probably will at some point.

 

Just performed BG reading on Henry PMPS + 6 (110) @ 12:45am EST

 

Explain bounce?? what are the factors that would create a BOUNCE

 

There is a detailed explanation that I’m too tired for, but basically when a cat has lower numbers that they aren’t used to, often they will go into higher numbers after they have the lower numbers. Henry did it on 11/24

 

OK I get that so being Henry dropped to new lows the Bounce could factor in next 24 to 48 hours?

 

see if this helps:
9/24 Great explanation of bouncing that helped Gussie& I | Feline Diabetes Message Board - FDMB