Cadmium BG cont., AMPS: 387, +4.5: 135, +6: 201, PMPS: 487

Previous thread: https://www.felinediabetes.com/FDMB...-5-328-pmps-483-2-300-4-5-162-5-5-155.271406/

12/14/2022
AMPS: 358, 1F unit, whole can
+4: 206
+5.5: 194
+6: 188, dasuquin
[play session shortly before PMPS]
PMPS: 481, 1F unit, whole can
+3: 322, shortly after finishing eating the rest of his meal from dinner and playing some more.
+6: 244 (partner got this reading for me!)

12/15/2022
AMPS: 343, 1F unit, whole can
+3: 193, ketones- negative
[doctors appointment, out of house]
+7: 383. I suspect he went lower while I was gone, and this is a bounce.
PMPS: 489
+1: ketones- negative
+1.5: 410
+3: 328, he has eaten only half of his can at this point, going to try and get him to eat more. I wonder if his previous heightened appetite + ketone development was being influenced by steroid exposure?

12/16/2022
AMPS: 331, 1F unit, whole can. Incredibly zoomy and running around!
+7: 197 (partner took this reading and I forgot to add it to this post!)
PMPS: 321, 1F unit, whole can
+3: 139, playful
+3.5: half can
+5: 119
+7: 231
note: he did not finish half can

12/17/2022
AMPS: 426, 1F unit, whole can
+4: 257
+6: 247
PMPS: 477, 1F unit, whole can.
Will not offer half can tonight as he could not finish it and his sugars got rather out of wack today, which I think the extra portion contributed to as thats the main variable that changed.
+2.5: 250
+4: 150
+5: 148

12/18/2022
AMPS: 450, 1F unit, whole can
+3: 330
+6: 265
PMPS: 318, 1F unit, whole can
+2: 270
+5: 163

12/19/2022
AMPS: 234, 1S unit, whole can. Going to stay with him pretty closely just in case. Even with his AMPS being much lower than he is used to as of late, he is very playful and having zoomies!
+2: 298, taken shortly after he finished his breakfast
+4: 292
+6: 296. Hrmm. I wonder if 1S was too little and the additional energy from his breakfast hasn't been dissipated yet. Might consider giving him 1 unit flat for his PM cycle.
PMPS: 362, 1U, whole can
+1.5: 332
+3: 224, ketones- negative
+6.5: 106!!

12/20/2022
AMPS: 438, 1U, whole can
+6: 263
+8: snack of churu
PMPS: 509, guess snack past nadir made him go through his insulin too soon. Wont repeat in the future unless he used up far too much energy and started getting low, he just looked sad when the others got food 1U, whole can
+2: 279
+4: 174
made sure he finished his dinner
+5: 188
+7.5: 385

12/21/2022
AMPS: 471, 1F unit, whole can, ketones- negative. He may have gotten his insulin while his stomach didn't have quite enough food in it (as he was in the process of eating) because he threw up a small amount. Learning that insulin can make him nauseous if his stomach is empty or close to empty! Update: finished breakfast without issue, and is very playful.
+3.5: 221
+5.5: 106!!
PMPS: 372, 1F, whole can
+2: 330, this reading was incredibly hard to get. His ears were cleaned and it kept making the blood not pool correctly. I suppose now we know for future reference?
+3.5: 202
+5.5: 150
+6: 174

12/22/2022
AMPS: 212, stalled and retested: 217. Gave 1U with vets advice, whole can.
+2: 175
+4: 113
+5: 124
PMPS: 430, 1U, whole can
+2: 310
+3: zoomies!!
+4: 164

12/23/2022
AMPS: 380, 1U, whole can, ketones negative
+4: 200, taken sometime after he finished breakfast
+6: 199, woken up from a nap
PMPS: 466, 1U, whole can, ketones- negative. I wonder if his blood sugar is higher due to the cold, as his room is rather chilly and blood sugar does have a tendency to rise when it's colder.
+1: zoomies!
+2: 294, was able to fix the radiators
+3: 182
+6: 141

12/24/2022
AMPS: 394, 1U, whole can
+4: 143!
+6: 156
PMPS: 456, 1U, whole can, dasuquin
+3: 151
+4: 117
+5: 153
+6: 224

12/25/2022
AMPS: 454, 1U, whole can. Wish he wasn't so bouncy!!
+3.5: 203
+5: 130
+7.5: 195
PMPS: 395, 1U, whole can
+3: 234
+5.5: 189

12/26/2022
AMPS: 458, 1U, whole can
+1: zoomies
+3.5: 314, he might have found some kitty contraband (kibbles that hes no longer allowed to eat) thanks to one of the other cats being a very messy eater. Further investigation confirmed that his insulin is fine, and there were kibbles around J'zargo's food bowl still left over. I believe that it was Cadmium getting into food he shouldn't have!
PMPS: 408, 1U, whole can
+3: 197, so the insulin is definitely working!
+4: snack, freeze dried chicken treat
+6: 184

12/27/2022
AMPS: 456, 1F unit, whole can. Returning to fattened dose to try to break the cycle of red pre-shots.
+1: EXTREME zoomies, he just biffed it twice in short succession but is still running around!
+4: 204
[running errands]
PMPS: 458, 1F unit, whole can
+2: 380
+6: 173
+11: 203

12/28/2022
AMPS: 294, stalling for now. Edit: vet requested that I maintain current dose of 1F so they could best assess the curve and offer advice from there! So he will get 1F and whole can as normal.
+2: 208
+4: 97!! Still active and playful
[play session and treat of freeze dried chicken]
+5: 121
+6: 175
+8: 350. Boing.
+10: 372
PMPS: 453, 1F unit, whole can.
+2.5: 337
+6: 219

12/29/2022
AMPS: 419, 1F unit, whole can
+6.5: 191
PMPS: 441, 1F unit, whole can
+4: 218

12/30/2022
AMPS: 420, 1F unit, whole can
+6: 210
PMPS: 429, 1U, whole can. I gave 1 unit because his pre-shots have been getting worse and I noticed hes been having a bit of a wobbly gait with his early nadirs
+4: 283, playful, finished his food before his reading
+9: 225

12/31/2022
AMPS: 387, 1U, whole can. Vet requested I keep him on 1 unit to see how he responds.
+4.5: 135!!
+6: 201
PMPS: 487, 1U, whole can
+0.5: ketones- negative. zoomies!!

 

Have also figured out that the combo of 33 gauge universal CVS lancets coupled with the Microlet Next lancing device works great for getting a reliable sample with ease from his ear! This lancet device primes by pulling back the white end until it clicks and then pressing the button on the side, but is WAY quieter than the AccuChek device. Plus, it accepts universal lancets while the AccuChek doesn't. That way, I don't need to hold his ears, try to massage some blood out of a wound, get repeated E4 errors from too small samples thus needing to try again, and its a much smaller puncture compared to the 26 or even 30 gauge lancets I've been using in the past! I have been setting the lancing device fairly low at setting 2 or 3.

 

Double checking vet calories calculator and it says that individual animals can vary up to 50% of estimated values? Interesting. Either way, his vet did say he could lose a tiny bit of weight but nothing too drastic, so it seems two cans would work. Will offer more food if ketones pop up again in the future.
EDIT: yeah it seems from looking up the body condition chart, Cadmium is slightly overweight. He should be around 10 pounds, currently somewhere around 11 but has been having more activity lately! And he has been excited for food and maintains food/treat motivation, it just seems like his stomach isn't as much of a bottomless pit as it was.

 

I always just free-handed the lancing with 30 gauge ultra thin lancets (from Walmart.). I never used a lancing device, but I am happy that you have found a quieter device that is working better.

 

Great update! Now hopefully he'll just stop bouncing so high...

 

That's what I used to do, but lancets have gone through his ear a few too many times! Or he dodges and I manage to get my thumb instead.... Little man knows a few tricks and most of them involve not wanting to stay still!

Yeaaaahhhhh...... It at least seems that the bounces are able to resolve relatively quickly into his dose? But every time I see a 400+ number I want to have words with his endocrine system lmao

 

It’s good to see the blue nadirs (at night when he likes to drop a bit lower.). I hope he will get more used to blue and not bounce as much.

 

I see that yellow preshot this morning. It was reasonable to try a reduced dose. You will get to see how it goes today. What did you shoot last night? The units cell on your spreadsheet is blank.

 

Whoops I guess it didn't save! I gave him a 1F dose, along with his whole can. At around +5 he got extremely active and was running around the house, so maybe thats part of the reason why his pre-shot today was in the yellows!

 

I guess you had a Boing from the 106 last night! Sorry about the bounce but the 106 is phenomenal! I hope all is well this evening.

 

That's my thoughts too! I'm thinking it's possible he may have been in the greens at some point in the night, as the 106 was a bit later than his nadirs have been lately! He's currently warm and cozy, which is good because we have a blizzard coming soon

 

Stay home and snuggle with Cadmium during the blizzard! Hopefully you have lots of food and supplies at home … and test strips and cat food, etc.!

 

We have acceptable amounts of food for the next few days for the humans, but we refreshed his food stock just yesterday and got loads of testing supplies! I was able to buy a bunch of short-dated strips on clearance (they were guaranteed to have at minimum 2 months before expiring) and I'm very glad I did. Also got more needles for his insulin while I was at it

 

Always good to be prepared!

 

Whoa!! He reached 106 during his AM cycle! That hasn't happened in a long time!

 

Nadir is pretty much perfect, good dose!

 

Awesome! so does that mean I should maintain this dose for now? PMPS is 372. He does drop lower at night is my only concern

 

Yes, if nadirs are between 75 (per your vet) and about 130 I'd hold the dose. Our SLGS guidelines say 90-150 you hold, so the top end is more your call since you're doing custom dosing. Regardless, below 75 is a reduction. I don't quite think he's going that low, even at night.

 

AMPS for 12/22 was 212, would it be wise to reduce the dose to 1 unit? Currently stalling to see what's up. Update: stalled and hes at 217.

 

Called vet and she looked over his sheet, she said reducing from 1F to either 1 or 1S would be acceptable with his breakfast! This means his dose will be 1 hour later than normal, so I will need to shift everything over, oy.

 

Any tests since the 212?

 

About to go get one, will edit this comment with what the result is. +2 is 175

 

A couple of blue tests today… not too bad. I hope PMPS won’t be pink!

 

Unfortunately, its red at 430. Dang it! Realized I also forgot to record one of his tests (AM+5 was 124) so he actually had 3 blues today! Progress!

 

I think what I'm going to do is have the goal of maintaining 90-150, if he goes below 90 thats a "soft" boundary suggesting I may need to prepare for a reduction soon and I'll need to keep a close eye on him. Then if he goes below 75, that's a "hard" boundary and he will definitely need a reduction. How does that sound?

 

Sounds good! Id just note it somewhere to avoid any confusion or repeated questions. Merry Christmas if you celebrate!

 

Thank you! Merry Christmas and Happy Hanukkah!
Added to my spreadsheet "reductions considered below 90, reductions enacted if below 75" as that was the most concise way I could figure out how to word it, lol.

 

If you want to modify the hard reduction point for SLGS to 75 that sounds okay. I think it’s a good idea. You monitor him really well, so I am comfortable with that.

 

It would be good if you added your reduction points to your signature. I hope you are weathering the storms and keeping warm.

 

Just modified my signature, and it is on my spreadsheet in the dosing method cell. It seems that it has calmed down for now, we are finally in the positive degrees again! Hope things are going well for you too!

 

We’ve been super cold, but not as cold as a lot of people! Can’t wait for this to pass.

 

Same here.... At its most severe where I'm at, it was almost -50 degrees from the windchill. I think that may have been part of the reason why his glucose started getting higher again, that was during the height of the storms. I think we got about a foot of snowfall in a single day during that, too! People's cars also started getting buried in the snowdrifts out on the highways, which is part of the reason why I-90 got completely shut down

 

Accidentally pricked myself with Cadmium's insulin needle before giving him his dose and didn't realize it until after I used it on him I am starting a new sensor, my glucose is currently 110 because I had some soup a bit ago, but it feels like I ammmmmm going to need to eat some more. Blegh.

Update: even with the soup in my system before this all happened, I ate half of an apple pie and that tiny pinprick STILL brought me down to 86!! And at some point later right on the edge at 71. Jeez. I am stabilized now though and safe, have alarms set for my sensor just in case, but what the heck! Hypoglycemia is so annoying!

 

I'm glad you are on top of it! Maybe I need an excuse to eat half of an apple pie... I have pumpkin pie here (half) but I'm going to have to share that with my family because they love it. I'm glad you're okay!

 

Get a second pie and say its for emergency sugar boosting, lol!

Adding this to my main post here shortly, but Cadmium's +11 was 203. The little man is such a mystery to me sometimes. But I am very glad his glucose is in decent numbers for almost pre-shot!!

 

Nah... it's a homemade one.... and I'm not up for any more cooking right now! But I'll settle for a slice with home made whipped cream later today.

I'm wondering what your preshot number will be for today.

 

Same here.... Was thinking it might be beneficial to perform a curve today. Contacted his vets about it too in order to see what they think about it.

And fair enough with the baking! I'm going to grab some sugar cookies here shortly that my grandma made and sent to me for Christmas. I'm considering baking something later that is from an old old recipe book my other grandma sent me... The book calls it marble squares, and it's a dense cake that is soooo good. Made some for partners birthday, and I want some more lol.

 

Update: his AMPS is 294!

 

Personal update: I'm not taking as many readings for Cadmium today as my glucose is acting out of wack, according to my Libre 2 sensor I dipped down to 53 earlier I pulled out of it thanks to eating a bunch and came back up to around 110, buuuut it keeps trying to dip down. I am thinking of preparing some sugar water for myself because this is getting OLD.

 

I'm getting concerned that I might actually be overdosing Cadmium, as with the fattened doses his pre-shots have been getting worse, not better.
@FrostD @Suzanne & Darcy what do you think?

 

Remember that the effects of a bounce can last up to 6 cycles, so it could be that he hasn't fully shaken that yet.

The other possible explanation is that he has an earlier nadir that you aren't quite catching...it's possible he's going a bit lower around +4 but I don't think it's low enough to be a reduction.

The goal of midcycle testing isn't always to catch nadir, it's just a spot check. If we catch nadir, great. But over time you get to see his patterns and then can draw some inferences.

 

I did slightly reduce it to 1 for his PM dose to play it safe, as I have noticed hes been a bit more wobbly around his mid cycles, right around when that +4 would be. If it turns out to not suit his glucose needs, then I'll put it back to 1F. Does that sound fair? He does have a tendency to drop rapidly so I felt like it's possible that he went below that 97 from his curve....
Trying to manage his glucose and my glucose at the same time has been rough