Afternoon nadir is 64... time for an insulin reduction?

Yes, a +4 test sounds good. It will help fill in the blanks and guide you as to next steps.

Every cat is different, and a lot of this is about figuring out Lewie. Sometimes there are multiple ways to arrive at the same end point, so if it appears that a few of us disagree at bit ... well, that's the beauty of this board. Different experiences, different analyses, different nuances, but it's always about the cat. Hopefully those minor differences of opinion don't confuse you.

It seems that Lewie handles food pretty well without spiking his BG. That's great. Just keep that in mind in case you need to steer his BG up from a low number.

To clarify ... my comment about low-carb food potentially dropping the BG rather than raising it was situational and nuanced, but a "bottom line" version of what I've seen happen. Yes it involves the pancreas attempting to help out. No, it is not what is "typical." In Lewie's case, my point was that on a dose that I suspected was too high (2.5-3 u), and the possibility that the pancreas was sputtering (which others had also theorized), I wanted to make sure Kathy had the info she needed to successfully raise BG in the middle of the night if no one was around. And that might have involved higher carb food rather than lower carb due to my above point. It's probably not worth any more space, and perhaps I'm inadequately explaining it, so I'll leave it at that. At this point I think Lewie is at a much better dose so it's probably less relevant now anyway.

To Rachel, Djamila, Kris, and the others who are the workhorses of this forum ... kudos for the help you provide.

 

I agree that it's always about the kitty cat!
With such a complex biological creature, there are so many variables so I truly appreciate ALL of the opinions, thoughts and brainstorming!

I just tested Lewie at +4 and he's at 99. Yikes. I gave him a snack and will test again in a couple of hours when it's time for his dinner.
On Sept 29 he leveled out on his own, but I hadn't shot early that day.

 

This is where I personally like to put on my "data collection" hat and test hourly until the BG begins to rise again so as to see exactly what happens and where it "bottoms out." It might not be necessary, I'm just a data-driven person. Your call. But it seems that you're getting really good data and are getting close to identifying Lewie's ideal dose. That's really great progress from just a couple of weeks ago.

 

Excellent! I’ll test hourly until I see his BG rise. Thank you!

 

Tested at +5=80

 

Tested at +6:15=58.
He is angry and cold to the touch.
Feeding carb food.

 

This low number could be a one off after a dose increase so you could keep on with that dose. Another option is to try a "fat" 1.0 u. Draw up insulin to a level that's a little more than 1 u and release a tiny bit so you're *almost* at 1 u but slightly over. These minor dose adjustments are sometimes very effective. I use them a lot.

 

Very good. I'll test again in 1 hour. I like the idea of the "fat" 1.0 u. I'll do that tonight for sure!

 

I would test in 1/2 hour just to make sure he's not going lower and that the food is nudging him up.

We can re-visit the idea of using u-100 syringes later (they let you fine-tune doses easier than the u-40s). But like I said, that's for later.

 

So sorry for the delay... I had to leave the house for an hour... what a stressful hour! I wish I could have tested at the 1/2 hour.
After the test at +6:13=58 when he was not a happy camper, cold and angry, I fed Royal Canin Babycat Instinctive 11g carbs.
I tested at +7.29=82
Tested at +8=103, gave pills and food.
Whew!

I may need this information sooner rather than later!

 

I'm at +12 and barely within shootable range at 210.
Should I still give a "fat" 1.0 u ?
I'm tired and would like to go to sleep.

 

If I needed sleep, I'd probably shoot 1u tonight, even if he's slightly higher in the AM, then start the fat 1u tomorrow.

 

Awesome. Thank you. I will do this. Goodnight zzzzz

 

We can give you info on u-100s whenever you feel ready! They're really not HARD to use..no math or anything. When you buy them, you want to be sure to get the ones with 1/2 unit markings. Then you use this Conversion Chart. All you have to do is determine how much you would be giving in u-40s and match that line to the amount in the u-100 needles. It allows you to change by 0.2 units so you can make those smaller changes that some kitties need. It also really helps you fine tune dosing when you have a kitty who seems to need small increases like Lewie.

 

I agree that the U100 syringes are very easy to use and open up a big range of dose fractions. As we always say, put the U40s away somewhere so you don't accidentally grab one of those once you make the switch!

 

Would this be a good time to start a new thread? I would like to buy the U100 for smaller dosing AND also start adjusting his schedule to get away from these midnight shots.
Or continue this thread to get Lewie to his perfect dose, and start another thread about adjusting the schedule.

 

At +9 Lewie was at 201 so this might be an opportunity to bring his shot schedule up a little. Last night I gave his shot of 1u at 12:15am Central time.
Yesterday 1.25 units was too much for him WITH the combination of shooting 45 minutes early. (I didn't gain any time by shooting early since the 1.25 was too much and I had to stall).
Today I would like to shoot 45 minutes early and I'm thinking 1u again today so I don't have any overlap.
Is my thinking correct? Thoughts?

UPDATE: He was 258 at +12 so I gave him 1 unit.

 

Sorry no one answered your question earlier. I didn't see your post until after you shot.

He's looking pretty good today so far. I'd try for a +6 to see if he's still dropping, but that's your call.

There are multiple places to get U-100 syringes. Walmart carries the Relion brand; a box of 100 is around $12.57. Others buy online. I used ReliOn 3/10cc 31 gauge with 5/16" needles and 1/2 unit markings due to the affordability and ease of availability.

As others have said, Walmart employees often don't know the syringes have 1/2 unit markings and may say they don't carry them. Typically they do.

If you like the u-40 syringes, by all means continue to use them. I've used both and prefer the u-100, primarily because it's easier to fine-tune dosing. And to reiterate what's already been mentioned, DO remember to lock away the u-40s if you switch. More than one member has grabbed the wrong syringe and, well, let's just not go there!

 

Than you for your encouragement to test at +6. I wasn't going to, but data is our friend and I know you like data. Me, too! His BG number stayed even. He's been hungry today so I've been giving him a snack of his 3g carb food each time I test so maybe that's keeping him even?

At +10 he was 196 so it looks like he will be in shooting range by +12. I gave him his pills (in pill pocket) and fed him another dinner at +10 so I may not know the true number if I shoot early. I would like to shoot a little early and get away from these midnight shots.
UPDATE: He was 252 at +11.50 so I gave him 1u (I gave his shot 20 minutes early, yay!).

Thank you for the information about the syringes and I will definitely look into this tomorrow. I'm scared of making mistakes because I am so sleep deprived with work and Lewie (and all the other critters) so I will definitely lock the u-40 syringes away! Thank you everyone so much for this wise advice.

 

Shooting 20 minutes early last night didn't have any effect on his BG value, in fact he is high this morning at 380 so I could have given him a "fat" 1 u. I have 2.5 hours to go before his shot so I hope he doesn't get too high. He did so good yesterday on 1u so I was surprised at his high number this morning. Do you think it's because he went without food for so long overnight?
UPDATE: AMPS=351, which is a drop in 30 points from last night's +9 of 380 so I gave 1u 15 minutes early to try to bump schedule up earlier: goal is 9:30 Central time (1u instead of a fat 1u in case there is any overlap)
+5=87 Glad I only gave 1u.
QUESTION: Is shooting 15 minutes early each cycle moving his schedule too fast?

 

You can certainly move his schedule by 15 minutes with no problem.

 

This is good news... I'll work on his moving his schedule up.

His +6 reading is 69. Isn't that a big swing from AMPS of 351?

 

Yes it is. It's not too low but it's a big drop so he might bounce high for PMPS.

 

I looked in the dictionaries and I don't see "bounce"... do you know why he is bouncing?

 

You know, I've been wondering about that. He seems to thrive on multiple small meals. It's hard to say but you could try leaving food out for him to snack on overnight or get a timed feeder that automatically opens at a certain time. A lot of people use them.

Not at all, as Kris already said.

 

Kris explained bouncing really well in RRaptor’s thread called “Dosing Advice.” It’s just a bit down the ProZinc forum list. I remembered reading it but couldn’t find it and so used the search field at the top right. I put “bouncing” in the search field and her user name in the “Posted by Member” field, and it popped right up! (That search function is really good, btw. I am always using it to find things when I can’t remember where I read about them.)

 

Great! Thank you for this tip and about RRaptor's thread... I'll go read it!

 

I'll leave food out tonight. I have a very fat cat that eats everything so I'll leave a lot out!

 

The other thing I wanted to mention is that I think it's important to remind ourselves that this is an art as well as a science. Every cat is different, and sometimes every cat is different every day. We're looking for the big picture and overall trends while at the same time trying to keep them in a good (and safe) zone. Try not to get too hung up on any single number.

I tend to tinker and experiment to try to improve things with my own crew ... there's a lot of finesse to this game and much of it involves learning how your particular cat responds.

I don't know that Lewie has been particularly bounce prone lately so hopefully you won't have to worry too much about it BUT it's important information to understand and keep in mind. And that's a really good post to read.

 

Yes, sometimes different everyday!
I just tested at +12 and he is at 94.
So this means either a couple of hours of stalling... or putting out a bunch a food and going to bed. I'm gonna say... bed.
What do you make of his numbers today? Since I'm going to skip (it ya'll agree) can I just give a shot at anytime in the morning? And how much should I give in the morning? 1u again?

 

Well that's interesting.

Yes, if you skip you can give the shot any time in the morning (as long as it's a shootable number, of course). You can get back to your preferred schedule that way. Or closer at least.

You might want to post in the morning for dosing opinions. I wouldn't go over 1u for now given his proclivity for big drops, but let's see what you get for AMPS. Depending on his BG, I might even be tempted to go with a smidgen less.

 

Excellent! I'll leave out food overnight and I'll test in the morning and post. And I'll stick with 1u or a smidgen less.
Thank you!

 

I tested this morning at 7:10am Central and Lewie's BG number is 240... this is with skipping his PM shot and leaving food out all night.
Please look at his spreadsheet... 10/2 was a good day with 1u, however, 10/3 he got rather low on 1u.
Should I try 0.5 or 0.75? I'm thinking a smidge under 1u might be too much now.
Tested at 7:10am Central = 240
Tested at 8:30am Central = 264
UPDATE: I gave 0.75 u at 9:30am Central

 

Sorry no one responded earlier.
I think you made a good call on the 0.75u. Now we just need to see where that takes him. Are you able to grab some mid-cycle tests today?

Edited to add: never mind, I see from the ss that you're planning to get a +6.

 

I always appreciate the encouragement to test.
I took a break, he's awake, so I grabbed a test at +5 and he is 113.

 

I just tested Lewie at +12 and he is 204... this is his safe to shoot number but just barely.
I'm not sure if I should shoot now or stall.
Thoughts on dosage?

 

If it were me, I'd probably shoot 0.5 or 0.75u...depending on what happened next.

I'd retest soon and if he's still hanging in the lower 200's, I'd probably shoot 0.5u and go to bed. He might end up higher in the AM but who knows. I don't like to push the envelope for the PM cycle when no one is awake.

If he's in the mid to upper 200's or higher, I'd consider going with 0.75u (but might also catch a mid-cycle test just because we know he can drop sharply, or leave down extra food, or both).

What do your instincts say? (You're doing really well at this, btw)

 

Is there a door #3?
I tested at +13 and he has dropped to 180. He is anxiously awaiting his before bed dinner.
Thoughts? 0.25u?

 

When's the last time he ate?

I say follow your instincts. I'm not inclined to skip entirely but 0.25u sounds like a dose where you can go to bed and not worry. There's something to be said for that! He'd probably be fine at 0.5u but, hey, no need to push it.

I might leave food out again tonight... You know, continue the experiment and all...

 

He last ate at +9.
When I tested him at +13, I went ahead and gave him his pills wrapped in 1/2 pill pocket.
Now, at +14.5 he is at 264.
I feel more comfortable now about giving 0.5... but here we are pushed out to 11:30pm Central.
Thoughts?

UPDATE: I gave him a skinny 0.5u at midnight. Will leave food out tonight.

 

Sounds good. (Sorry, was tied up briefly so couldn't post)

 

No worries. Do you agree with my skinny 0.5? It’s ok if you don’t, it’s a learning opportunity. It seems like not enough, but then I had to stall from this morning’s 0.75.

 

I do agree.
It seems he tends to go up rapidly after a stall and I think a skinny 0.5 is a reasonable and measured decision. He seems to want to come down the dosing scale ... so as fretful as it can be to stall and guess what's going to happen next and to try to walk that line between dosing too much and too little, this is actually all a really good thing!

 

Oh good! I’m glad the stalls are a good thing! I imagine that doing this dance with him... helps him heal faster.
Goodnight!