3/5 ELIAN: PMBG 154 - Do I shoot or wait? Will reduce to 2.5

Status
Not open for further replies.
Susie and Elian

Susie and Elian

Member Since 2013
Am I doing something wrong that he could bounce so high and drop so low? Today I had to leave the house for 4.5 hrs. Came home to him dropping to 34!!! I just fed him FF for gravy lovers. Will test again shortly. The weird thing is that he acts no differently if he's at 571 or at 34. Is that 'normal'? Do I drop him to 2.5 units tonight because of the 34 or does he stay at 2.75 because of the 571?

yesterday's condo
 
Re: 3/5 ELIAN: HOLY SHNIT! Amps 571; 34 +6.5

Back on February 26 he may have earned a reduction because he went to 34. Please re-read the sticky post on the Tight Regulation protocol

That high level may be due to a 'bounce' caused either by a rapid drop, or a drop to unfamiliar levels. This provokes a compensatory response to bring the glucose back up.

Remember that with Lantus, once you're on it more than 5 days, you want to hold the same dose for 3 days and check the nadirs. You did that and didn't even make 3 days before he dropped way down, so I think he's earned a reduction of 0.25 units.
 
Re: 3/5 ELIAN: HOLY SHNIT! Amps 571; 34 +6.5; 60 +7

Susie --

It looks to me like you reduced from a fat 3.0 to a skinny 3.0 on 2/27. You did, in fact, take a reduction after the 34. You probably should have reduced to a fat 2.75u but to some degree, it's splitting hairs. For a cat that's so new to diabetes, I don't know that I would be micro-adjusting the dose. Typically, we fatten or skinny a dose when we're trying to zero in on a good dose. I don't think Elian is quite at that point yet.

For what it's worth, some cats are just bouncy. I'm not sure how you're feeding Elian. You may want to try to front load the cycle by breaking Elian's meals into 3 or 4 servings and feeding at pre-shot, +1, +2, and +3 if that will work for your schedule. The idea is to spread out the food so it slows down some of those fast drops. You may not see immediate results with changing feeding times. It taks a little while for some cats to adjust to a change in meal patterns. Gabby is one of those cats who's prone to fast, early drops in numbers. Spreading her food out at the front end of the cycle didn't eliminate the problem but it has helped.
 
Re: 3/5 ELIAN: HOLY SHNIT! Amps 571; 34 +6.5; 60 +7

I feed Elian and his brothers right after amps - 9:45 am; around 2:00ish, 6:30ish; and 9:45 pmps. I usually open another can in the middle of the night. I'd feel most comfortable if we're going back to 2.5 rather than guessing at the 2.75. Can I do that or should I keep him here we are? I'm also wondering- I try to be sure I get his shots into him although lately he's been trying to pull away. Is it possible that he was so high because maybe I didn't realize it but may have missed? I don't think so but is it possible that could cause a high reading?
 
Re: 3/5 ELIAN: HOLY SHNIT! Amps 571; 34 +6.5; 60 +7

You might try Making a reference gauge.

It helps to get some sort of magnifier too - there are free-standing, visor, and clip-on varieties available. I got ones that clipped on my glasses and they really helped. Check our shopping partner Amazon at the link at the page top.
 
Re: 3/5 ELIAN: HOLY SHNIT! Amps 571; 34 +6.5; 60 +7

My syringes have .5 markings so I go right in the middle. But I'd be much more comfortable if we could go to the 2.5u. Is the consensus that I can or should stay at 2.75?
 
Re: 3/5 ELIAN: HOLY SHNIT! Amps 571; 34 +6.5; 60 +7

With the drop to 34, you need to reduce Elian's dose. If he has bounced by PMPS, you can hold the 2.75u dose tonight and then reduce to 2.5u at AMPS tomorrow.

Please remember that for a newly diagnosed cat, a drop below 50 means that you should reduce the dose. A drop into the 30s is a clear message from Elian that he doesn't need that much insulin.

You may want to review the instructions on handling low numbers. Elian's numbers came up to a 60 after you fed some HC. However, as the HC wears off, numbers can drop again. You need to get some additional tests to make sure Elian is reliably in a safe BG range.

It sounds like you're feeding at PS, then at around +4 and +8. I would get rid of the +8 food and instead, give that meal before nadir. The food late in the cycle may be what's contributing to your high PS numbers. If you feed after nadir, the insulin curve is rising. If you add food, there's less insulin available to offset the effect of the food and you're causing numbers to be higher.
 
Re: 3/5 ELIAN: HOLY SHNIT! Amps 571; 34 +6.5; 60 +7; 78 +9

So if his nadir is around +6 should I feed at ps, +2 and +6 and then wait 6 hours til until pmps? And then feed again during the night?
 
Re: 3/5 ELIAN: HOLY SHNIT! Amps 571; 34 +6.5; 60 +7; 78 +9

Susie and Elian said:
So if his nadir is around +6 should I feed at ps, +2 and +6 and then wait 6 hours til until pmps? And then feed again during the night?
Click to expand...

No, you should feed him when you shoot and then give him a little food at +1,+2 and +3 if you can to keep him from that huge drop.. then again around +6. He starts going up after that. If you're going to give him a littel snack after nadir make sure it's not within 2 hours of PMPS
 
Re: 3/5 ELIAN: HOLY SHNIT! Amps 571; 34 +6.5; 60 +7; 78 +9

Susie --

Caryl is suggesting one strategy. Using food to manipulate the curve is a trial-and-error process. There isn't one "right" way other than what works for your cat. You can pick an approach -- what you suggested or what Caryl suggested -- and give it a couple of weeks to see how it's working. You can then try a different approach or, if you're satisfied with the results, stick with the feeding schedule you started with.
 
Re: 3/5 ELIAN: PMBG 154 - Do I shoot or wait? Will reduce to

I've followed what Caryl told me from the start - no feeding at least two hours prior. But other than that I feed when I think he's hungry which pretty much any time! But I was spreading out 4 meals throughout the day and then a can in the middle if the night. Will try holding off after nadir and see what happens.

Any advice on whether I should shoot or postpone? He usually goes up after pmps but he's been so unpredictable today I'm not sure what to do and this is his lowest PMBG to date.
 
Re: 3/5 ELIAN: PMBG 154 - Do I shoot or wait? Will reduce to

Just noticed he had a pmps of 128 on 2/18 and I shot so I will reduce and test thru the night.
 
Re: 3/5 ELIAN: PMBG 154 - Do I shoot or wait? Will reduce to

I think there's a good chance that Elian is going to bounce. I would shoot the reduced dose.
 
Re: 3/5 ELIAN: PMBG 154 - Do I shoot or wait? Will reduce to

That's what I thought too - he bounces every night so I gave him 2.5u.
 
Re: 3/5 ELIAN: PMBG 154 - Do I shoot or wait? Will reduce to

Susie

What a day! Good catch! Because he seems to like to dive, I want to urge you to get a +2 as many cycles as you possibly can. Yes..sometimes life takes precedence but that +2 will give you alot of info. If he's dropped quite a bit by +2, then you know it's going to be a very active cycle.

You can work towards slowing the drops with food as Sienne has suggested. It does work to frontload cycles but you have to be patient. For his +6 snack, you could just give him a little boiled chicken breast. That's what I do for Gracie so she doesn't have to wait so long to eat. It's a low carb snack and doesn't seem to overly slow the insulin.

Because syringes are so inaccurate and it's hard to measure those in between microdoses, many of us use Digital calipers to dose. It really helps dose consistently especially if you are micro dosing.
 
Re: 3/5 ELIAN: PMBG 154 - Do I shoot or wait? Will reduce to

Thanks Marji - I had actually slowed down on the +2's because he was always still high - seems like his 'action' takes place +4,5,6 ish. But I will go back to 2's now. It's gonna be a rough day tomorrow since I know I won't be getting much sleep tonight....watching him like a hawk. Lucky for me he sleeps right next to me with his head right on my pillow. At least I don't have to hunt him down for testing. Supplies are ready right next to my bed - just roll over, test, journal it and try to get an hour or two sleep til the next one! I'll check out the calipers but I'm also hoping we'll be sticking to real numbers on the syringes - no more f's and S's and in betweens!!!! Being a vegan I don't keep chicken in my house but if its what's best for my baby I will get him some. Caryl got us started on the Halo chicken and beef treats. He loves those as do his brothers. I caught Remy doing everything he could to try to get into the container earlier tonight. It really is kitty crack!
 
Re: 3/5 ELIAN: PMBG 154 - Do I shoot or wait? Will reduce to

Did you shoot? Your SS shows you did. Hopefully he will just give you a nice blue surf so you can get some rest.

I studied a bunch of syringes and they can vary as much as .5u from lot to lot of the same brand. From syringe to syringe, it can be by several tenths of a unit variation. So even if you are shooting 1u, I found that with one specific syringe brand, the 1u varied from 0.7u to 1.46u.
 
Re: 3/5 ELIAN: PMBG 154 - Do I shoot or wait? Will reduce to

Yes I did shoot. And he just ate a little bit at +1. Will test at +2 and decide when to test again when I see where he is. I had no idea the syringes could vary so much. Will definitely look into the caliper. Thank you.
 
Re: 3/5 ELIAN: HOLY SHNIT! Amps 571; 34 +6.5; 60 +7; 78 +9

Sienne and Gabby said:
Susie --

Caryl is suggesting one strategy. Using food to manipulate the curve is a trial-and-error process. There isn't one "right" way other than what works for your cat. You can pick an approach -- what you suggested or what Caryl suggested -- and give it a couple of weeks to see how it's working. You can then try a different approach or, if you're satisfied with the results, stick with the feeding schedule you started with.
Click to expand...

True I just suggested that because he seems to drop fairly early
 
Re: 3/5 ELIAN: PMBG 154 - Do I shoot or wait? Will reduce to

I'm trying your way Caryl. It makes sense. He already shot back up to 240+2. And is snoring away curled up next to me. Gonna try to catch a few zzzzz's before I have to test again. I'm a little bit worried because I have a pretty full day tomorrow - will be in and out all day. But will test when I can. Hope Alex is feeling better.... and mommy, too.
 
Status
Not open for further replies.
Back
Top