Discussion in 'Prozinc / PZI' started by LindsayF, May 23, 2019.
And I gave her 2 chunks of chicken after I tested her
You did great, Lindsay! You got her up to a good number without stuffing her, just what we want in case you need to prop her up with a little more food for a bit longer.
She literally had the gravy food 2 minutes before I tested
So she got out of the limes just on normal, low-carb food? (It usually takes at about 20 minutes to start seeing the impact.)
That's great! Hopefully, that means that your +30 minutes test (or 20 ) will be good, too, since the gravy will be kicking in about that time. If it is, hold off on the food to see if she can stay up on her own.
Here's the "hypo clock" I read about (I think from Chris and China?):
From the lime:
+30 minutes: re-test. Keep doing this until she gets above the lime (you've already done this!)
+ 30 minutes from the safe number: retest
a) if still in good numbers, retest in 60
b) if back in the limes, feed and restart your clock and test in 30 minutes
(The point is you have a two hour clock from the low test.)
One caveat: since she hit the lime so early in the cycle, if it were me, I'd run the clock for a little longer this time . . .
109 at +3
Okay -- I'm going to give a second caveat to the hypo clock! Since you gave her the gravy right before the *last* test, re-test in 30 minutes, and use *that* test to see if you go the +60 minutes route or the +30 minutes/restart the clock route.
(And the collateral benefit to this is that it gets you another 30 minutes deeper into the cycle -- win/win!)
I think she's going to be good! (Hear that, Zoe? You be good!)
She was NOT happy with me last test. Do you think her pancreas is kicking in? where do we go from here? So tomorrow morning drop to .25?
Yep. It's been observed that they get Very Crabby when they're feeling a little woozy!
And yes, I think her pancreas decided to work this evening but forgot to let anyone else know.
She's definitely earned a reduction after tonight's shenanigans! Let's see how things go for another bit tonight, and we can talk about tomorrow . . .
@LindsayF any updates?
Hi sorry- 109 at +4. I wasn’t able to get her for the 30 minute test as she was being a PIA lol
She’s currently eating more
Her regular snack, yes? I think she’s going to coast along here, but if you can get one more test in an hour, that would be great. Then I’m sure it will be fine, and you can both get some rest.
As for tomorrow, I think you shoot at 5:00 central (Chicago) time? She’s definitely earned a reduction, but I wondered she will bounce up again from tonight’s lime. Even so, I would definitely reduce, and my only thought is that if she is *not* bounced up, then it gets tricky. I think that a cat getting insulin should get insulin, but I would be nervous if she’s low’ish given how she seems to be running down the dosing scale. (Remember last week when you were giving 1.5? ). What is your schedule tomorrow? I assume you have to go off to work?
Yes I do shoot at 6am EST. And yes I work 8:30-500
And yes regular snack, no gravy
If she's bounced up, that's easy: .25. If she's not, then I would post for opinions. I think that @JanetNJ and @Rachel are often up at that time and could maybe weight in.
Do you happen to have food timers you could leave for her? If not, can you leave food out for her, or does she scarf-and-barf? Do you have other cats who would eat any food you left out for her?
172 at +5
I can run home at lunch to make sure she has food. I have 3 other cats. I usually make sure there is food before I leave and there is almost always a little left when I get home.
Then I’d be very surprised if she weren’t high tomorrow!
It would be great to get a midday tomorrow if you can both for peace of mind and to get a sense of where she might be heading for tomorrow’s PMPS.
Good job tonight!
Thank you for your help!!
458 at amps so I’ll do .25. I’ll check her at +2 before I leave
380 at +2
119 at +6.5
That's a nice curve she has started. It will be interesting to see if she flattens out for PMPS, staying around where she is now (which may indicate that she's clearing the bounce), or is she finishes off the curve and comes back up.
Will check in with you about shot time!
Ugh! And I have to say, I'm surprised! I thought she was going to surf it along there and flatten out . . .
Still do .25?
@Jenna Josie ?
She's a bouncer like my cat.
I went with .25
Sorry! We got distracted battening down for the looming thunderstorms ... Yes, that’s what I would have done despite the high PS because 1) it was just last night that she went so low so fast (yes, on a much lower BG, but still ... ) and 2) I think she could stand a little consistency right now so that we can see where she might settle — she’s literally had seven different doses in seven days, the little trickster!
My guess is that despite last night’s dive, the .25 just didn’t last long enough for her, which is how she got so high between today’s +6 and the PMPS.
338 at +3
Hmm. Well, at least you should have a relaxing night, which I’m sure you both could use after last night’s adventures.
She’s high, but that’s still quite a big drop for +3 when considered as a percentage ... about 40%, I think?
Yes that’s what i Thought too!
427 at +2
Darn — doesn’t look like her pancreas decided to work today.
What syringes do you have, btw? U40 or U100? Full or half markings?
U-40 full markings
@Jenna Josie 165 at PmPs not sure what to do?!
Went with .25 still I have an appt from +.50 to +2 I’ll check her when I get back home
416 at +2
I'm sorry our schedules don't sync up very well! I think that you did the right thing to hold the dose at the 165, and I don't know why she's bounced up so high at +2! She's had some really big food spikes today. Nothing's changed in her diet, though, right?
But overall, since her adventurous night 48 hours ago, even though she's bouncy, her pre-shots are coming down: from black (ugh!) last night to yellow this am to blue this evening. Maybe she's settling into the dose?
I asked about syringes earlier because she may be a cat who needs tiny adjustments, and switching to U100s -- the ones with the half markings -- allow for that. You have to be careful, but there's a conversion chart, and it's actually very easy. It may be worth thinking about. U100s are available at pharmacies, and a lot of order them online from adwdiabetes.com.
No changes in diet!
Oh Zoe. Lindsay, you're doing great. Hang in there. It's not easy when you get a bouncy cat. I'd leave her at 0.25 tomorrow (Friday), and then this weekend if she's still running high, you can try bringing the dose back up.
I agree with Jenna that the u100's might be needed here. It's so hard to be accurate with the u40 whole unit syringes, and for bouncy cats, being precise in the dose can matter. A lot. Do you happen to have a WalMart near you? They sell the u100's for about $13/box so it's not too much of an investment to give them a try.
Hi ladies! Thanks for the advice! She was 190 at Amps.
I don’t want to jinx it lmao
Ugh well 391 at amps and then at +6 she was 64
At least you know you don't need to consider raising the dose . . .
Did you get some U100s, btw? I'm thinking that being able to shoot .2 and .4 (and be confident that it is indeed those measurements because there are lines to draw to) may be very helpful. When you're drawing such tiny doses, even being a teeny smidge off makes a big difference.
I didn’t get them yet but plan on it tonight or tomorrow do I need to get them at the pharmacy counter?
Also she’s 147 and I’m not going to be home until 9:00 or so. Do I shoot ? @Jenna Josie @Djamila
Can you stall 20-30 minutes *withiut* feeding and retest to see if she’s coming up?
I already fed her as I’m running out the door in a few
Okay. Were you able to get a test anyway?
Yes she was 177 after she ate
I ended up shooting. I’ll be home in +2 to check
I’ll check in on you at +2.
Oh, Zoe She sure is a bouncy one, isn’t she?
Once you get the U100s, if it were mr, I’d smidge her down to .2 and hold there unless she throws you another lime.
Ok! Do you know if I need to get them from the pharmacist or if they are just on a shelf?
You'll have to ask the pharmacist for them. They keep them behind the counter.
My Walmart didn’t have the syringes. Can I order online? I looked but there were different CC numbers 1/2 or 1 and i was confused.
We order from adwdiabetes.com. Here’s a photo of the kind we use, which I like bc it has short needles. (May not be best for longer-haired cats?).
Just be sure you order the kind with half unit markings since that’s really the whole point!
We didn’t the first time ...
I wound up with some from Walmart -- they were the correct .3cc, BUT no half unit markings, and the markings that were there were not what we need for small doses, they were useful, IMHO, only if you needed to shoot entire units of U-100 insulin -- crummy for using with U-40
Ordered the ones you have @Jenna Josie. I’ll be honest the past few times I’ve shot below what I was considering .25. Wondering if what i was actually doing was more like .40. Holding my breath but it seems to be better for her.
Our PMPs numbers have been good!!!! My syringes shipped so hopefully I have them soon!!!! I did under .25 tonight
Yes, they have been good! I wonder if her higher AMPS are from going low over night? (Many cats run lower at night.).
I’m glad the syringes are on their way. Hopefully that will make life easier
I’ve been wondering that! Is there a reason why cats tend to be lower at night?
I'm not really sure why they run lower at night...it could be because they aren't running around as much or eating as much at night. It's something we see with most cats, but we only have theories as to why.
After her crazy pmps number her morning #
Ok ladies my syringes arrived! Am I still doing .25 on a u-100 syringe?
That’s not really a choice for the conversion on U100s. The great thing about U100s is that that you can make tiny dose increments and, because there are so many lines, you can be confident that you’re always drawing a consistent dose.
Some of us draw odd-numbered doses (e.g., 0.3, 0.5, etc) by framing the plunger right between the lines, so you’ll need to go either .2 or .3.
Still haven’t started with the new syringes finishing up my other ones but her Numbers have been
Her PS numbers are quite pretty! (I admit I'm a little jealous ) Looks like she finally decided to settle into the dose for you. Do you have an idea of how low she may be going during the cycle? Not too low, or I'd expect to see some bounce-numbers PS, but I'm sure curious . . .
I’m gonna get one tonight but my thought was she wasn’t getting too low or she’d bounce
115 at +3.75
So this morning she was 100 at AMPs I stalled to 107 and then fed her I can’t stall much in mornings with work. I went with a fat 0 on the insulin. She’s like a completely different cat anymore. Her coat is shiny and soft her dry skin is gone and she’s playing and doing things she did years ago.
She’s looking so good, Lindsay!!
I’ll write more later but wanted to post this before I forgot .... Djamila wrote this about how to draw the dose FDMB calls a “drop” of insulin: “you push the plunger in as hard as you can. Then insert the needle into the vial, invert, and release the pressure from the plunger. It will suck in one drop of insulin. Then you inject that. It will feel like you injected absolutely nothing ...”
104 at PMPS!
So I think it's time to break out those new syringes, if you haven't already!
She's looking really great, and I'm hoping for very good things for you both! I don't have much experience observing this stage of things, but from what I recall reading, etc., you want to keep supporting her with insulin until -- hopefully!! -- she can handle things on her own again.
IIRC, you want to give 0.2, 0.1, and then "drop" until she's good on her own. (A 0.1, on the U100s, will be with the plunger essentially "centered" on the first, left-hand line [that's the first 1/2 mark line, which is 0.2 for us using the conversion].)
So two questions:
1) what did you end up shooting (if anything) this evening? 0.1? "drop"? nothing?
2) would it be possible to get some +4-+7 tests in? I am really curious to see how much time she is spending in the "normal" range, which is 40-60 on a human meter? (I know you use AT; that range would be a little higher, but I'm not sure what . . . I'm sure it's in the stickies somewhere! )
We usually say that normal for a non-diabetic cat is 50-120, with most numbers in the 50-80 range (human meter), and 68-150 on the AT2 with most numbers in the 68-low hundreds. I'm not sure that if that is in our stickies or not. It's probably in the stickies over in Lantus though. They get all the good ones
Zoe is looking pretty good these days . It doesn't look like she's ready to go it on her own just yet though. I'd like to see more green before you try taking away the insulin. Jenna has given you good suggestions about how to walk the dose down, and she's right that you want to keep going with the insulin as long as she needs. Hopefully this weekend if you can get some of those mid-cycle tests in, we can get a better idea of how she's doing.
Still on the u40’s switching this weekend not going to lie can you send me a pic of where the plunger should be so I know exactly? (I’m a visual learner haha) this is where I typically put the plunger for her I’m calling this .25 but let’s be honest i have no idea ? When I say F0 I actually go under this line so it’s more on the first line. It’s basically no liquid but still something so could be more like .10? That’s why the u-100’s will be great.
This is 0.2 on U100s. It’s the first half-unit line, so the first on on the *left* side.
This is a 0.1, where the plunger is centered on that first half-unit line (on the *left* side). Essentially, that line is bisecting the plunger, so that half the plunger is above the line and half is below the line. Or, if you prefer, you are centering the plunger between the zero line (the very top line; it’s thick and dark) and the first line on the *right* side.
Edit: this picture unfortunately isn’t taken exactly straight on, so the plunger looks a little higher bc of the angle, but hopefully the descriptions clarify.
106 at pmps and 107 at +5
Well, that’s what I’d call “flat”! (She hasn’t been hanging on with my cat, has she? )
Safe, though! And safe is always good.
140 at amps and 69 at +4
Hi Lindsay. You use an alpha track, right? She’s still fine, but I would get another test in here to see if she’s going to flatten out or dip into the limes.
Do you usually feed her a bit about this time in the cycle? It might not be a bad idea to give her a little bit of her regular low carb food.
Alpha yes! She did eat earlier after I tested her she always eats lol it’s +5.5 and she’s 101
85 at pmps. Clearly no insulin? Or do I stall?
Well, always stall, but I’m thinking no insulin, or possibly “drop.” Lemme check your SS while you stall ...
Given that she's still under three months since diagnosis, and she was just barely above a lime green today, I think I might suggest skipping. A drop could be okay, but you'd need to get some tests tonight to be sure, and I tend to error on the side of a good night's sleep.
Let's see what Jenna thinks....
You can stall but I doubt it's going to bring her up much. Oh I see others are sharing my opinion. She's a little close to the lime green margin and like Djamila, I tend not to create pyjama parties....they're bad enough when they are spontaneous. I'd skip. Besides you've never shot a pre-shot that low with any dose.
Which i didn’t expect a jump that much?
That could just be hunger agitation. I still vote skip!