Hi all, Here's a link to my previous thread: Gizmo - dosing difficulty I've been trying to get better about dosing her at lower AMPS/PMPS BG levels to keep her level. I once freaked out when I had dosed below 200 and then read the thread to never dose below 200 (as a newcomer). I took that 200 to heart, and have a hard time not freaking out when I do dose below 200. However, Gizmo's been diabetic 5 months, and well monitored for 3, so I am trying to read the numbers and do more <relatively> low BG dosing. A couple of questions: We still seem to be chasing the dose. (i.e. this morning 3/31, she was 170 normal AMPS and 164 after waiting a 1/2 hour with no food and no shot). I couldn't see giving her a full dose (1.25) with that, so gave her 0.8. Is it better to settle on a regular dose (maybe 1 Fat?), and not try to watch so closely, or is it better to look at each individual day and follow that? Is it safe to give Gizmo a full dose at an increasing BG from 167 to 175 (i.e. 3/20)? How important is it to monitor ketones? I have read (and re-read) Prozinc Dosing Methods, and I see where ketones are discussed several times, but I don't see it a lot in the active posts. And what do you think of the urine vs blood monitoring of ketones? I can't imagine trying to catch the urine while my cat is going, but I also couldn't imagine sticking my poor cat's ears multiple times a day. Overall, how am I doing? Is there something I should be doing differently? Thanks, P.S. - Now to see if I can get the How Low Can You Go Limbo song out of my head. P.P.S. Tagging a few people: @Marje and Gracie, @JanetNJ , @Deb & Wink
Don't overthink this. There's a lot to think about but you need to keep your sanity to take care of Gizmo. I've been there, even coughed up four mortgage payments for an MRI that went nowhere. It will all come to you with time. And remember N2C. No two cats are ever the same.
sometimes all we can do is take our best guess. You try something, if it works, great. If not next time you try something else. You are doing great and your cat is super lucky to have you. The spreadsheet looks good! Looks like the .8 worked. you could maybe bump that up to 1 when its' around that same number, but looks good.
The key word in that sentence is "newcomer". As you gain experience and get more comfortable with testing, you learn how low Gizmo goes, how reactive he is to LC, MC, HC food, and when you need to test more. After 5 months, I would not consider you a newcomer. Nervous still shooting low, heck yes. I can see that and understand that from the number of tests you are getting today in the AM cycle and on some of the other days where Gizmo has been low. "Shoot low to stay low." You should be able to slowly lower that pre-shot of 200 for your decision point number gradually over time. Try shooting a 180 or a 190. Don't be locked in to the 200 BG number. Yes, it's hard to shoot lower. But if you don't learn to do that, you keep Gizmo in high BG numbers too much of the time. Just make sure you have plenty of test strips on hand, have your hypo toolkit fully stocked with a variety of foods, and be able to be test when you shoot lower than normal. You've shot lower than 200 before, much lower. You just need to gain the confidence that you will be able to handle any low number situation and you have in the past. Remember that any number within 15% is the same number, within meter variance. So for example, a 170 and everything down to 144 are the same. A 170 and everything up to 195 are the same. I know it's hard, but do please try to get at least 1 more test in every PM cycle, after the pre-shot test.
@Deb & Wink , @JanetNJ , & @Noah & me (GA) , I took your advice to heart, and tried to relax a little, and to learn to shoot a little bit lower. Now 4 months later, I'm just checking in to see if I have learned to be a bit too comfortable shooting at low numbers. Unfortunately I can't often catch a mid-cycle (near nadir) glucose number, but have included some when I can grab them. I've never seen a number below 64, and have never seen her acting hypoglycemic, so I think I've kept her from the dreaded hypo events. In May I got a feeder that allowed her a very little amount of Dr. Elsey's dry protein kibble(I thought) at a couple of intervals during the day. My hope was that she would not like the food very much and she would only eat it if she was approaching hypoglycemia. Well, that didn't work out. She learned when the feeder was going to feed her, and she would be right there to gobble it up. Only once did I find that she didn't eat all of it immediately. Unfortunately she also gained weight. So I think my idea of trying to have something around for her should a hypo event happen while I'm not around is doomed to failure, and I quit giving her dry food at the beginning of July. Could you please take a look and see if you have any recommendations? Thanks! Angela
You are playing around with the dose a lot. Is try sticking to 1 unit. If you can't get a mid cycle test during the day, can you get one every evening before bed, and then get lots of n mid cycle numbers on weekends /days off. You can leave wet food in the auto feeder. If it's warm in your house and your are worried about freshness leave an icecube in it or freeze it.
Janet is right, try and be consistent with your dosing. Both of my boys got a lower PM dose but that may have been specific to them. Some members get up at 2AM every night, that was something I just couldn't do.
I am sticking to the 1 unit for a few days and I will see how that goes. I didn't realize that having different morning/evening shot quantities was ever advisable, but it sounds like it worked for you? How different were the AM and PM values? She was high this morning (273), but I stuck with one.
Not meaning to sound condescending. There's a good reason you see "do not copy dosing" on most members spreadsheets. I reduced Noah's PM dose to 2/3 of what I would have given him in the AM. He was getting old, his metabolism had slowed way down and he was anything but nocturnal. So again with the N2C rule, no two cats are ever the same.
