6/15, Susie, Can Someone Please Explain To Me What Is Going On? Post #22

https://felinediabetes.com/FDMB/thr...ion-is-needed-see-post-8.248592/#post-2804084

Happy to see Susie get some blues. Not fun is the nighttime testing. I'm trying to determine just when her pm nadir is and when I should be testing at night. Of course, I will always get the +2 which is usually lower than the PMPS but what about the other times (depending on the +2 of course). Looks like her nadir last night was anywhere between +8 or +9. She was marching up at +11.2.

Last night there appeared to be no threat of her going too low with her numbers but that could change with this dose increase and any in the future. Is there a rule of thumb when testing at night like:

• Always get a +2
• Know when their nadir is and test one to two hours prior, during, and until they start to go back up.

Any suggestions would be appreciated. I might see some daytime blues today. Her AMPS wasn't too bad.

 

@Emily + Zen said yesterday "2) wonder if it might be worth it (if nothing else, for peace of mind) to get some fresh labs, just to be sure. We can make educated deductions, but data is always the best way for definitive answers."

I probably won't get another lab until July unless Susie shows signs that she is sick. She is acting well clinically now so I will keep an eye on her.

 

July isn't terribly far away-- I think that makes perfect sense.

Not sure about nighttime testing rules, per se, but we did exactly what you just described-- wake up and test 1-2 hours before nadir, then at nadir, then an hour after to watch him start to go back up. (That was if his numbers looked safe. If he was heading into the 60's two hours before nadir, that was an hourly affair. I don't think that's what you're asking, though.)

 

Totally agree with what you did and, yes, that was what I was asking. Test an hour or two a couple of hours before nadir just to see how low (or not) she looks then follow through with nadir testing and until you see an increase. Of course, if numbers are low I will need to watch and be prepared to feed. Thanks, Em.

 

Nice blues last night. It's always a good idea to get a before bed test. If that is your +2, you can decide on whether to get more tests from that number. If the +2 is the same or lower, that is a sign of an active cycle and you'll want to get at least one more test in. You'll have to figure out what works for your schedule. If you can't stay up and test, you can always leave MC or HC food out to carb her up.

 

The +2 is my before bed test. I'm just trying to figure out what her nighttime nadir time is. It seems to be much later than her daytime nadir but until I start testing more frequently I won't know. Wish she would get better daytime numbers like her nighttime numbers. Maybe we will see one blue at +3 this morning.

 

Arghh!!!! A 200 at +3. That might have been my best chance to see a blue this entire am cycle .

 

Happy to see the blues!

We do the same as you mentioned above, at least when it's predictable. Before bed (anywhere from +2 to +4 depending on the day), and depending on how big that drop is, about 1-2 hours before what we think will be nadir. He's been unpredictable as of late, so we just grab whatever tests we can while still trying to get some sleep. Im usually up a few times a night for whatever reason, so I just grab a test.

That said we've both missed alarms, and there's been nights where I've said forget it I am just too tired I think he's safe, he has food. Just this morning my husband said "I feel so guilty I missed the alarm" and I said "You didn't. I got up to test him, and told you to turn your alarm off and you did" haha

I've seen a few people come through that really can't test at night for whatever reason, health conditions, medication, etc. So they generally follow SLGS and let their cats run a little higher ...but there doesn't seem to be an in between for little Susie!

 

She's just messing with you now

You could always split tests up over a few nights. The first night, maybe a +4, +6, +8. The next night +5, +7, +9. Or even spread it out over 3 or 4 nights if every other hour is too much. It won't be perfect, but it'll give you an idea.

 

She is messing with me now. She followed that up with a 245 @+4.2. Why in the world is she shooting up so high so fast. I just don't understand this especially when her nighttime cycle was so different. Same insulin dose, every 12 hours, same food quantity (times are a little different). What gives, Susie? Every other hour is definitely too much, Melissa. I can't do that. Even the +4, +6, +8 then the +5, +7, +9 is too much to do every single night. Especially, when I have such a hard time getting back to sleep. Might have to opt for a little more food at +5 or +6 pm.

 

Hi Summer, good luck with the 2.5. Hope you are doing well. I totally understand how hard the night testing can be. Since my injury I rarely get past a +3. Hope you and Susie have a good day. Thinking of you both.

 

Oh no I didn't mean every night!

I just meant take the next 3 days or so of rough sleep to pinpoint nadir. From that you should know roughly when her nighttime nadir is, if it's consistent. After that, you should only have to get up once for a check.

The food is definitely an option. There's been nights where I need sleep so I just leave him extra food, or slightly higher low carb food just in case.

 

I am interested in Susie's liver values. But since it is a bit early for your 3 month follow up, I would keep increasing, per protocol, if and when needed.
As mentioned, you would test at different times during the night cycle. One night, add a +4, another night, check +5 or +6, and keep moving your test time until your SS shows a clearer picture of a whole night cycle. Melissa's way would work too; just throwing out another option to cover some bases that might allow you more sleep.
It seems lots of cats go lower at night. Tina was about the same, but earning reductions during the day, thankfully.

 

Yep that's what I meant! Either suffer for 2 nights, or stretch it out over a few more days to get a little more sleep

 

Thank you, Adrienne. I appreciate you stopping by.

 

Thanks, Jan. I think I am going to do a +8 and +10 tonight but I know I will be worrying so might get additional test. I probably won't sleep too well after midnight anyway. Susie's last lab was a mini lab in early May so a July test will only be two months.

 

Looking at her numbers last night do you think a +8 and +10 would be a good idea?

 

I think I would get another +7 and +8, or +8 and +9. It seems to me she started flattening out right about there.

 

Okay, thanks so much. I'll see how she looks at +2 and take it from there.

 

Hi Summer, I hope you and Susie have a good day ♥

 

Thanks, Diane. At this point in the day (5:15 pm EST) I am barely able to keep my eyes open after all the testing last night. Susie will get her PMPS test, food and shot in about 30 minutes then I may have to lie down. I will set the alarm for a +2 or +3 and also for a +7 and +9. If I can't drag myself out of bed that early in the morning I will leave some extra food. I don't know how I will survive, day in and day out, if she is a "low goer" in her pm cycle.

 

I need some answers. After three increases since June 6th, and not a bad night last night, why is Susie skyrocketing in her am cycle. She is getting the same insulin, 12 hours apart, the same quality and quantity of food. Why is she "off the charts" during the day and better at night. I'm afraid to keep increasing every three days. Can someone point out another cat who has had this same situation? I really need to know what is going on here.

 

Djoko is sometimes higher at +2 but still goes down (e.g. lower than ps) but remains in the healthy zone. I have noticed that Djoko seems to get just a bit higher at +5 (probably because hegtes most of his calories between ps and +5) and then goes a bit down (20-30 points or 1-1.5 in mmol) so there is no rule but the +2 does help a lot. I found that when Djoko was not regulated, the +2 would give a good indication whether he was going low too fast (so you feed the curve) or if he was going to stay high and flat (the bounces!).
today, Djoko has been at his lower point during his day cycle at +11 so...tough to see any patterns with these creatures.. good luck!

 

You are so right about it being tough to see any patterns. That is the frustration. Thank you, Marj. I appreciate your insight.