5/13 Newman AMPS 257 shot 2.25 then he regurgitates his morning food

This thread continued from New Again and Struggling need help thread https://felinediabetes.com/FDMB/thr...g-need-help-with-dosing.262900/?_params=Array

 

Hi! I found you!

 

I see he’s cruising in yellow right now.

 

Yes, I figured I would test at +4 because he was right in front of me.

He ate some more of his food, about 15-20 minutes ago.

I didn't answer a question raised this morning. Our routine is to test first thing and then based on that number, I trust that it will only get higher with food, so I feed (all 3 critters) and then he takes a few minutes to groom and then he comes back to the treatment area on my desk and I shoot, so from test to shoot is probably 30-40 minutes. I am logging that as AMPS even though there is a lag. If not, I would have to test, feed, test and shoot. I thought the fasting number was the one I was looking for.

 

I am thinking that this is probably okay, but some cats do have a late nadir where it may be the lowest point just before shot time. Right now, if he’s yellow, it probably doesn’t matter.

 

Posted 120 @ +9. It's dinner time in their world.

 

Hooray for dinner. I like that blue. Is he eating now then? There's plenty of time before 8:15 shot time.

 

So, the rule is don't give food for the two hours before shot time, but this is totally contrary to what he has known for his 13 years. Does anyone continue with established schedule and work testing and insulin around ? It is 6:20 now. He can't have food again until after 8:15 insulin.

 

I thought you fed him at 5:30 ish?

 

So, Newman is a grazer? Is that the problem? Here I was thinking that his regular dinner time would be perfect because he could eat dinner at 5:30 or 6:00 and get his insulin at 8:00 or 8:15. Is he freaking out about food? What is his regular dinner time? I know you said it takes a while to get them all fed.

 

Yes, both of the cats are grazers. They are usually waiting to be fed around 5:00 PM and then come and go all evening up until probably 9:00.

 

Wow. That’s kind of a problem - at least for the beginning of Newman’s insulin journey. I am trying to come up with ideas. I’m still pondering this. Maybe you should put food down earlier and let them graze earlier so that they won’t get so upset about not having food for the two hours before shot time? I can see how this might be difficult on certain days when you have therapy though - or if you are out of the house for another reason. Where’s Minnie during this whole process? Where is she when they typically have been grazing up until 9-ish at night?

 

I converted an unused coffee table to use for feeding the cats. It is easier for me to reach. Each cat has their own bowl which is covered by a colored lid. Newman is blue and Ozzie is red. Ozzie has to be monitored as his food is measured when I started dieting him. That has been a success.

Minnie eats at the same time, but she instantly eats all of her food, twice a day. Because the cat bowls are on that coffee table she can't reach them. Also if the cat bowls are uncovered, I am there to monitor.

I can and I am striving to get on a tighter schedule, but I don't think I can change it as quickly as we may want it to be.

 

Yes. There have been a lot of changes for you and the cats lately. And cats don’t usually like change

 

You will wonder why the delay. First AM test 295 @ 8 AM, fed him and intended to shoot. He decided to be inaccessible until my son could help. It was 8:45 so I retested. He was 303 and I shot 2.5 units, the planned .25 unit increase.

 

Oh, that Newman! What did he do, eat and run? He thought he was going to escape you this morning. Interesting how there was no real difference between the 8 am and the 845 am test. I hope you didn’t have to wake up your son.

 

I think we have noted before, that he doesn't get much of a bump from his food. Probably because he grazes. He just finished the can of FF that I opened for him at 8 AM and it is 11:00 now. I didn't have to wake Mike, I was trying to avoid setting up a chase. And of course, Newman is one of those cats who sit and think about what you want them to do before they act. LOL Ozzie acts on impulse. I only have to open the cabinet door to get a can of cat food and he is there!

 

Hi. I’m just checking in to see Newman’s spreadsheet and see if you got any more tests today. I am kind of excited/ worried (worried is not exactly the correct word but I cannot think of another right now) after today’s increase and his lower end blue yesterday.

 

Sorry, I should have checked in sooner, I didn't mean to leave you hanging. He has been fine so far, based on behavior and activity. I was getting caught up on some household chores and he spent the day on the screened porch. I just poked him and charted 148 @ +7. Next at 5:00 (+8) will be regular feeding time. Maybe I will feed him and check again at +9 or 10. What do you think?

 

So you got a 146 and a 141 an hour later? But he hasn’t eaten yet? It’s about quarter to five now. So he will eat at 5. It will be good to see where he is at +9 or 10 yes.

 

I posted 139 @ +10. He is still grazing on his Fancy Feast but nearly finished with his one can. Sometimes if he is still looking for food later, he will eat up to 1/2 can more.

Of course, I am going to have a hard time deciding what his evening dose of insulin should be. That will be 2 hours from now at 8:45.

 

You could shave that a bit and shoot at 8:30. I bet he will be higher. Are you going to pick up his food?

 

So shorten the time back by 15 minutes? Yes, I can hold anymore food at this point since he has finished the usual can. If he is looking for more at bedtime, I can give it then. Would you stay with the new dose of 2.5 based on what you saw today?

 

He’s really been in lovely flat blues this afternoon. Let’s see where he is in a few minutes. Yes. I thought you might like to shave 15 minutes off since he was a little late this morning. And then tomorrow morning if it works out, shave another 15 minutes. Will that get you back to regular shot time? Or will you still need another 15 more minutes? Anyway, you can work your way back to a preferred shot time - if Newman cooperates.

 

Okay, I posted PMPS 245 and I'm thinking of shooting a skinny 2.5 units. What do you think?

 

You can try it. If that’s a fasting number it should be okay to shoot the full dose, but you would need to be able to monitor

 

Will you be able to get a +2 at about 10:30

 

I probably can check him at +2 but I never know for sure. Presently I am home alone. Since today was the first increase, I would rather not risk it and give it more time. I can shoot a safer dose tonight and go back up to the 2.5 tomorrow. What would be a safer dose?

 

. Well if you are really not comfortable then go back to 2.25. You do have to gain confidence and that takes time.

 

Thanks for your support and understanding.

 

It’s all good. We need to take a lot of factors into consideration.

 

It looks like Newman is having a little bounce from his string of blues today. And you have had a night of rest

 

How is Newman this morning?

 

Just about to post. At 8 AM his fasting BG was 243. He then ate 1/2 can FF. At 8:45 I retested, because of the time lapse. He was 297 and I shot 2.5 units.

How to post the 297 because that is after food. I can't test, feed and shoot in less than 30 minutes, so there is always that discrepancy in time/test and it doesn't make sense to have to test twice every morning.

 

I am not sure. It would have been good if you could have just given insulin at 8. But that would have been a little early. If he likes to eat at 8 then you could make that his test and shot time.

For the spreadsheet I guess the 243 really belongs on the pm cycle for last night. Like +11. something (however many minutes). And the 297 would really be the AMPS. You could note in the comments that the 297 was 45 minutes after eating 1/2 can FF.

 

I know my particular schedule is complicating. I would say that test and feed, ideally would be 8 AM. hopefully shooting on or before 8:30. It is my indecision on dosing in the evening that throws that off.

 

Things will get more regular as you go along. I’ll check in on y’all later to see how he is doing. I hope you have a good Sunday.

 

Thank you. I hope that you have a good day as well.

 

Look at Newman go! Similar to yesterday.

 

He was getting a bit "growl-ie" about testing, so I decided to just observe him and while it is normal for him to sleep, he was stretched out on the bed, not choosing seclusion and his gait is normal. I know the numbers are very helpful in figuring out dosage, but I have to maintain his willingness to be available and cooperative. At 5:00 he started his dinner routine. I will aim to withhold food after 6:30 and test and shoot at 8:15 - 8:30.

Thanks for checking in on us.

 

Are you giving him low carb treats like pure bites when you test? I do hope he won’t become difficult about testing!

 

I have Pure Bites Chicken and Wellness Kittles Chicken & Cranberries, all natural ingredients and grain free. I don't know the carb content, but each treat is under 2 calories.

 

I was just hoping the treats would keep him happy

 

I have therapy treatment tomorrow so I will be out from about 12:30 thru 3:30 which will be +4 thru +7. That period seems to be where the lower numbers are cooking. I have been here, available to offer him his food when he looks for it but since I won't be, I want to consider shooting 2.25 if his AMPS is similar to today. I would rather lose a little ground, than risk him unattended and sinking too low.

Also, last night I shot 2.25. I assume his numbers were in the blue overnight, since his fasting number was 243 this morning and after food AMPS 297.

 

Maybe you should just drop him back to 2.25 until the therapy is finished? Unless he starts seeing really high numbers. I don’t like to risk glucose toxicity where his body gets comfortable in higher numbers because it’s harder to break through that later on, but if you finish up by the end of this week then we can consider good back up the 2.5 units.

 

Also - regarding last night - it looks more likely that he bounced a little into the red and then drifted down to yellow by morning. But we can’t know for sure.
Either way, the blue numbers that he has been getting on the 2.5 dose are very safe numbers for him to be in.

 

Therapy this week Monday and Thursday. I assume and hope that will complete it although it remains to be seen. My leg looks pretty good.

I ended up having to chase him this evening for his shot and he always wins. Funny how they know to stay just out of reach! I finally gave up and waited for him to come for food. I got him and shot him at 8:30.

I will plan on the 2.25 tomorrow. I did not know about glucose toxicity.

I must say those blue numbers looked real good to me and I feel encouraged that we will get there. Thank you!

 

Yes. The blues are very encouraging. I got really excited about them! I am actually hoping we will see more of them this week - even if you shoot 2.25.

 

He must be feeling well if he’s that spunky! At least that’s a good thing!

 

I am so afraid of doing the wrong thing. This morning, fasting BG 224 at 7:45 AM. In hindsight, I made the mistake of going ahead with feeding him when I guess I should have stalled. So after he has eaten, I retest. He is 217 at 8:15. So close to 200. Referring to the guidelines, I suppose I should wait a couple of hours, test again and make a decision on dosing at that time. Or do a give a reduced dose and by how much. I already made one mistake. Consequently, I am doing nothing for the moment.

I have to go out to physical therapy appointment at noon, so he will be home alone.

Edit Update: Shot skinny 2.25 with test result 288.

 

Next time, stall and don't feed for 30 minutes to se if his BG is rising on its own. Thanks for the update. I don't like the waiting two hours thing because it really messes up the whole schedule.

 

I would give him a snack before leaving at noon. Hopefully, you already did that -- if he's available.

 

And don't beat yourself up about it. In the beginning, I forgot about the stall and don't feed a whole bunch of times before I remembered it. My boy was frantic for food a lot of the time, so I always wanted to keep him happy and I fed him.

 

Okay, it is 12:30 and he ate some FF then for peace of mind, I snatched him up and tested. He is 215. I will trust that he will be okay until I get back.

 

Purrfect. I think he's fine. He has a long way to go before he'd be in any danger and I don't think he's going to dive.

 

See, you did everything right. You gave him food, you tested him (he seems pretty flat right now).

 

I'm back and just tested him. He is 116 @ +7.

A thunder storm is starting so he is a bit spooked. He was on the top spot on the cat tree when I came in so I assume all was well in my absence. lol

 

Yes. I had a feeling that he was going to go blue today -- that's why I suggested going back to 2.25 and holding it for at least the rest of this week. He is doing very well on 2.25

 

Let's see if he will be true to form and be back in the yellow at PMPS.

 

Hi Linda. What time will you be testing and feeding and shooting tonight? I just want to check in on you. Have you gotten any more tests this afternoon?

 

No tests after returning from my appointment. I fed him and withheld any food after 6:15. He seemed to be feeling pretty good. He even found a toy that he likes and chased it around!

I tested him at 8:15, he was 473 and I shot 2.25. He was hungry again so I let him have more of his food.

The 473 was a bit surprising, like you I expected a yellow number. I guess that would be too easy. lol

 

B

. Well I think he’s bouncing from his green today. He probably was in green for a few hours. You are doing great, Linda. I really appreciate you!

 

Thank you, that goes both ways. We are doing so much better with your help. I finally feel like there is light at the end of the tunnel.

 

There is!

 

Be sure to get a before bed test, okay?

 

I have been trying for over an hour to get a hold of him and he is not having it. I think he played himself out, literally. He responds when I talk to him, but he is comfortable in his sleeping place, tired with a full belly. I have let him smell every treat I have to offer to no avail. I wish I could have tested.

I was falling asleep in front of my computer this afternoon. LOL I'm going to bed.

 

Me too

 

I see you got a yellow pre-shot and already gave the insulin. Very good.

No therapy today so I am hoping Newman will cooperate and you can figure out how low he is going on this dose. You may actually have to keep him a little hungry and feed smaller amounts (good for diabetics anyway) to keep him coming. It seems like he's gotten wise to your testing and isn't happy about it. I'm not worried about him going too low on this dose, but we will need to see how it's going so you will know if an increase will be required or not.

 

I know they like to graze. It's just that if Newman has access to food all day (or most of the day) he may evade you. Sorry, I'm not trying to change his whole world... I'm just wondering if you will be able to grab him and test ... maybe while he's grazing.. if you are around near the food coffee table (which, by the way was a great idea... making it easier for you and also keeping Minnie from getting the food. I'd LOVE to see a photo of Minnie, by the way, as well as your other kitty.

 

Yes, I was thinking the same. Looking at the spreadsheet, I think I will aim to get a spot check around +5.

 

I control access the food, so technically not grazing unless I remove the cover from his bowl. I have grabbed him at those times. I don't want to do it so often that he associates the two.

As to adding a photo to a thread? That will take some study. LOL

 

Sometimes the easiest way for me is to drag a photo onto my "desktop" and then drag and drop it into a message. That's when I'm using either my laptop or my desktop computer.

 

Good job. You caught that blue. I expected that. So hold that dose - of course, we already planned to hold it for the week at least.

 

And I see this thread has 71 replies to it - and we’ve been requested to not exceed 50 - so when you get a chance, you can start a new thread.

 

Starting a new thread. 5/17 Newman BG 135