More steady numbers for Nico— good? what’s next?

Discussion in 'Prozinc / PZI' started by Emily Tuomey, Nov 27, 2020.

  1. Emily Tuomey

    Emily Tuomey Member

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    Okay, so. Since we bumped Nico up to 4.0u he seems to be holding fairly steady (in the minimal data I have because we just changed it..) in the 300s (PURPLE!!). I’m assuming it’s good to see less huge jumps throughout the day, while also hoping to get him down a little further— maybe steady in the 150-250 range?— does that sound correct? Can someone talk to me about what I should or could expect to see now as we get closer to having a more correct dose? Just curious. I feel like right now I’m so thankful for 300s, but also have zero idea what to expect next, or what to hope for. Hoping someone knows the answer(s)!

    Nico’s previous thread here: https://www.felinediabetes.com/FDMB/threads/le-sigh-nico-the-rollercoaster-cat.238924/#post-2688240
     
  2. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    @JanetNJ Helped you in the previous thread . Tagging her for you
     
  3. Emily Tuomey

    Emily Tuomey Member

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    Thank you.
     
  4. JanetNJ

    JanetNJ Well-Known Member

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    Yes we definitely want to get down into the blues, but I want to see what this dose does tomorrow.
     
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  5. Emily Tuomey

    Emily Tuomey Member

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    Great. Thank you for this. Would you like more frequent testing for him tomorrow? I always do AMPS, mid (+5 or +6), and PMPS. Usually a +3 or +4 after his evening dose as well, just depending on our sleep schedule. I’ll look for your response.
     
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  6. JanetNJ

    JanetNJ Well-Known Member

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    No what you're doing is fine. If you want to test out of curiosity you could.
     
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  7. Shelley & Jess

    Shelley & Jess Member

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    Oh my! Did I just read that right??
    AMPS 293!!! :)
     
  8. Emily Tuomey

    Emily Tuomey Member

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    YOU DID, YOU DID!!!!! 293, HIS VERY FIRST YELLOW PRESHOT!!!!!!

    upload_2020-11-28_7-51-29.png
     
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  9. Shelley & Jess

    Shelley & Jess Member

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    AWESOME!!!
     
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  10. Emily Tuomey

    Emily Tuomey Member

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    Couldn’t be a more welcome sight. Thrilled!
     
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  11. JanetNJ

    JanetNJ Well-Known Member

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    upload_2020-11-28_11-20-22.png
     
  12. JanetNJ

    JanetNJ Well-Known Member

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    See, I thought we were going to see movement in the numbers today! Did I call it or what?! Lol
     
    Last edited: Nov 28, 2020
  13. Emily Tuomey

    Emily Tuomey Member

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    Nailed it.
    upload_2020-11-28_10-13-0.png
     
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  14. JanetNJ

    JanetNJ Well-Known Member

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  15. Emily Tuomey

    Emily Tuomey Member

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    Wishful thinking that he’d stay in the 200s :( +4 313. Bummed.

    I’ll grab a +6 later too.
     
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  16. Emily Tuomey

    Emily Tuomey Member

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    YOU GUYS, IT’S NOT BLUE BUT IT’S D**N CLOSE!!!
    +6: 203!!!!!!! upload_2020-11-28_14-9-44.png
     
  17. Emily Tuomey

    Emily Tuomey Member

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    My gut says hang tight at 4.0u for a bit longer and see where his body goes with it?

    I’m on the rollercoaster today, folks!
     
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  18. Shelley & Jess

    Shelley & Jess Member

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    With meter variance I'm seeing blue!!!:confused:;):p
     
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  19. Emily Tuomey

    Emily Tuomey Member

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    HAPPY HAPPY HAPPY!!!! upload_2020-11-28_16-6-50.jpeg
     

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  20. JanetNJ

    JanetNJ Well-Known Member

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    Yes I'd keep it another day.
     
  21. Emily Tuomey

    Emily Tuomey Member

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    Will do. I’ll let you know how he does!
     
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  22. Emily Tuomey

    Emily Tuomey Member

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    So.... ROUGH BLIP.... PMPS 600+HI. :arghh: +2 455. :nailbiting: Nearly +4 276. :confused: Is he possibly bouncing from the 203 mid this afternoon? Will see what the morning brings.

    (Not sure I’ll ever get used to seeing the 600+HI to be honest...)
     
    Last edited: Nov 29, 2020
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  23. SashaV

    SashaV Member

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    When a cat isn't used to be 'down there' in the good numbers, their bodies sometimes shoot them right back up. So yes, the first many good numbers often follows with a bounce. Annoying as ****, but hopefully it will get better :bighug:
     
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  24. JanetNJ

    JanetNJ Well-Known Member

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    Yes I'm sure it was a bounce
     
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  25. Emily Tuomey

    Emily Tuomey Member

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    Some pretty significant movement in the last 12-16 hours. We shot back up to 600+HI at our AMPS this morning. Can you advise on BG testing today? My gut says to monitor a little more closely with such drastic jumps, but I’m far from having any idea really (maybe it’s more for my peace of mind than for his actual health??)... scary stuff. How does one handle bounces like these? Just patience and holding the dose at 4.0u until he evens out a bit more? He’s acting totally, 100% fine— really, really energetic, has a great appetite, his water intake and urine output seem to have decreased (YAY!!) in the past two days. Honestly, I was surprised he read so high this morning, I thought he was gonna read much, much lower just based on his demeanor & energy alone. :cat: I’m hopeful these large jumps will pass soon. I’ll update as soon as there is new news. :blackeye:
     
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  26. Emily Tuomey

    Emily Tuomey Member

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    Not yet. But I’m trying to remain patient and hopeful. We shot back up to 600+HI this morning.. :blackeye:
     
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  27. JanetNJ

    JanetNJ Well-Known Member

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    You can test whenever you want. Let's see what happens today.
     
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  28. Emily Tuomey

    Emily Tuomey Member

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    We’re headed straight for the 600+HI reading tonight... kicking myself for not testing nearer to his mid today. Tomorrow I’ll pay closer attention.
    +7 441. :(
     
    Last edited: Nov 29, 2020
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  29. Emily Tuomey

    Emily Tuomey Member

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    I should add his personality and demeanor are nearly back to normal and we are completely enjoying that aside from our current (high) blood sugar readings. That is enough for us, for now— eye on the prize.
     
  30. JanetNJ

    JanetNJ Well-Known Member

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    do you think 4.5 tomorrow?
     
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  31. Deb & Wink

    Deb & Wink Well-Known Member

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    Seconding Janet's recommendation for a dose increase.
     
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  32. Emily Tuomey

    Emily Tuomey Member

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    I think probably smart, as long as it’s something you’d recommend. Unless you want me to dose him 4.5u tonight? I can test him at +3 or +4 tonight too? And/or +9 when I put up his food for AMPS?
     
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  33. Emily Tuomey

    Emily Tuomey Member

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    Tomorrow morning start 4.5u or tonight? We just started our 2 hour fast before PMPS, so plenty of time to decide...
     
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  34. Deb & Wink

    Deb & Wink Well-Known Member

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    Hey, Em. If you can test a bit more this PM cycle, no reason to wait until tomorrow to bump up the dose.
     
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  35. Emily Tuomey

    Emily Tuomey Member

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    So he read identical numbers at his (am cycle) +7 and his PMPS: 441. I shot 4.0u because I wasn’t sure if him staying out of the upper red & all black brackets would change anything. Please let me know.
     
    Last edited: Nov 29, 2020
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  36. Emily Tuomey

    Emily Tuomey Member

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    4.5u after AMPS. Can’t kick the 400s. Seems flat for some reason— (pm)+3 421. Any thoughts on why he hasn’t budged? I’ll update in the morning. Thanks.
     
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  37. JanetNJ

    JanetNJ Well-Known Member

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    Sometimes it only starts kicking in at hour 3.
     
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  38. Emily Tuomey

    Emily Tuomey Member

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    AMPS 438. 4.5u shot. Will monitor closer today to see how he does. Fingers crossed!
     
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  39. Emily Tuomey

    Emily Tuomey Member

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    +6 334. Not as low as I expected it to be after a dose increase.. possible his nadir is closer to +5? Will continue to watch him. What do you think?
     
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  40. Emily Tuomey

    Emily Tuomey Member

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    Not saying it’s necessarily bad, just not what I expected...
     
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  41. JanetNJ

    JanetNJ Well-Known Member

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    could be,... or could be he won't hit nadir until 7 or 8. guess we will see. Good luck!
     
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  42. Emily Tuomey

    Emily Tuomey Member

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    +8 305.
     
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  43. Deb & Wink

    Deb & Wink Well-Known Member

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    No, Nico staying out of those upper red and black BG ranges would not change anything. You would have been fine to shoot the dose increase to 4.5U.

    Hey, hey, hey! Nico dropped over 130 basis points, from the AMPS to that +8! Not too shabby! That's a good 30% drop for Nico. You don't want to see too much of a drop, no more than 50% if you get there. Hard to control the drop percentage, but "the bigger the drop, the greater the bounce" so you try to moderate those steep drops. I don't think you need to worry about "feeding the curve" at this point, to prop up the BG numbers. Lets' wait until Nico gets into some better BG ranges before you try that.

    Yes he could have dropped more earlier in the cycle, but you can't test every hour. You'll get a better picture of what is going on if you vary the testing a bit from cycle to cycle, to fill in the blank spots on the SS. Plus, you are not likely to see a lot of difference if you tested every hour. No need to do that much testing.
     
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  44. Emily Tuomey

    Emily Tuomey Member

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    PMPS 416. Still nothing from his vet about his curve last week. I’ve left a bazillion messages.. if I can’t get her tomorrow then she’s gone until Friday. UGHHHH
     
  45. Emily Tuomey

    Emily Tuomey Member

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    Couldn’t sleep and was up at +5 so decided to give a random test and mighty glad I did too... (pm) +5 66. :eek: Scrambled to see at what level to give high carb treats (<50?) and fed some anyway. What’s next? I think at AMPS if he’s under 200 no insulin, right? But read he might also test super high.. PLEASE ADVISE.
     

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  46. JanetNJ

    JanetNJ Well-Known Member

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    Wo
    wow good catch! You didn't by any chance test twice to make sure it was correct, did you? Either way is an amazing number. BUT we have finally found his breakthrough dose!!! You have several hours before the amps, so I would bet it will go back up.
     
    Last edited: Dec 1, 2020
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  47. JanetNJ

    JanetNJ Well-Known Member

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    If it's under 200, stall for up to an hour and see if it goes up. He's definitly not used to these low numbers so don't be surprised at a big bounce.
     
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  48. Emily Tuomey

    Emily Tuomey Member

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    No, he definitely is not. AMPS 460.
     
  49. Emily Tuomey

    Emily Tuomey Member

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    +5 156, but I think I may have only shot 4.0u this morning.. I can’t be sure. I think I may have been on autopilot because it was so early and I didn’t get much sleep. Right after I shot I thought, “oh my god, did I just shoot 4.0u or 4.5u??!” “Now, I don’t know and there’s no way to check..” Has this ever happened to you guys? Should I just assume it was 4.0u? 4.5u?
     
  50. Emily Tuomey

    Emily Tuomey Member

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    Talk to me about this^^ What does that mean??
     
  51. JanetNJ

    JanetNJ Well-Known Member

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    hahaha cut the difference. 4.25. LOL I'm so so happy you are seeing blues!
     
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  52. JanetNJ

    JanetNJ Well-Known Member

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    sometimes when they are in glucose toxicity like your cat was (where a the insulin wasn't doing as much as you'd expect and they are stuck in high numbers), once you find the "breakthrough dose" it comes down. For my cat in the beginning it was 3 units. Before that she didn't have a number under 300... suddenly I started seeing fast progress. For you it was 4.5. Don't be surprised if we need to lower the dose soon. :)
     
  53. Emily Tuomey

    Emily Tuomey Member

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    +8 216.
     
  54. Emily Tuomey

    Emily Tuomey Member

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    Hahahaha I’ll make sure to pay extra attention tonight LOL ;):joyful:
     
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  55. Deb & Wink

    Deb & Wink Well-Known Member

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    Nico is doing SO MUCH better, since you found that "breakthrough" dose. You broke through the HI (black) BG numbers, and overcame (or broke through) some insulin resistance.

    A BG of 66 last night?!?!? That probably caused the bounce up to the red BG range for the pre-shot this morning.
     
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  56. Emily Tuomey

    Emily Tuomey Member

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    PMPS 600+HI :( Sigh. I’ll test again in a few hours to make sure we are moving.. these bounces are discouraging.
     
  57. JanetNJ

    JanetNJ Well-Known Member

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    The average am preshot the past 7 days was 428.
    The average for the 7 days prior was 546.

    The average pmps the past 7 days is 503. Prior it was 560.

    You can't let a single reading drive you crazy. Look at the big picture. He's making progress.
     
  58. SashaV

    SashaV Member

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    It's a marathon, not a sprint.
    That sentence helped me a lot, when it seemed like nothing was happening.
    :bighug::bighug:
     
  59. Emily Tuomey

    Emily Tuomey Member

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    Thank you both. Sometimes it’s hard, I’m sure you’ve both been there. I feel better this morning. AMPS 383. :rolleyes:
     
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  60. Emily Tuomey

    Emily Tuomey Member

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    +6 99. <<happy dance!!>>
     
  61. JanetNJ

    JanetNJ Well-Known Member

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    Whoohoooo
     
  62. Deb & Wink

    Deb & Wink Well-Known Member

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    Whoa Nico, slow that drop please!

    That 99 is awesome!
     
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  63. Emily Tuomey

    Emily Tuomey Member

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    HELP. PMPS 113. No insulin, correct?? What do I do??
     
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  64. JanetNJ

    JanetNJ Well-Known Member

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    Wow. Yeah stall for an hour
     
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  65. JanetNJ

    JanetNJ Well-Known Member

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    If it's low like low 200's I would reduce tonight. I think like 2 units. I think overall your dose has to come down. Id say go back to 4u because we are seeing a steep drop now.


    Let's see what others think.
     
    Last edited: Dec 2, 2020
  66. Emily Tuomey

    Emily Tuomey Member

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    Great! I’ll keep you posted, and vice versa!!
     
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  67. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Emily contacted me privately so I'm updating here

    I suggested she test again in 30 minutes (and NOT feed). If he's still too low, stall for another 30 for a total of 1 hour.

    She also asked about the AM dose....I told her to test at the normal time and if he was high enough, she could go ahead and shoot at the normal time but if not, she'd need to stall and work her way back by 15 minutes per cycle or 30 minutes per day
     
  68. JanetNJ

    JanetNJ Well-Known Member

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    Do you feel her regular dose needs to come down a bit in the am? I'm thinking of like to see what happens now at 4u or 4.25.
     
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  69. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    This
     
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  70. Emily Tuomey

    Emily Tuomey Member

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    Thank you! Going to test momentarily.
     
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  71. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Yes...I think I'd try 4.25 myself as long as she's able to test
     
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  72. Emily Tuomey

    Emily Tuomey Member

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    Recap: Last night after three sets of testing he finally rose to 262 at approx. +13, and was given 3.0u. Retested at +3 and was 291, so left him alone for the rest of the night.

    **Ran AMPS at 6:45a and he is 88, so we are holding until 7:15a then retesting. If above 250 then giving 4.25u— as discussed last night with Chris and Janet— if not, we hold again. I’ll be back after that. But, I believe the plan is on try 3 if he’s above 250 shoot 4.25u, if lower than 250 (but still rising) shoot 3.0u as we did last night. If still under 200 and not really rising, skip the shot entirely? Or give 1.0u? Or, 2.0u?
     
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  73. JanetNJ

    JanetNJ Well-Known Member

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    ok we have to rethink this. Don't give 4.25. Clearly that pancreas had woken up. I think even 3 might have been too much last night. Let me think.
     
  74. Emily Tuomey

    Emily Tuomey Member

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    Will retest and post here. (Will hold insulin until we come to a consensus on this morning’s dosing needs) Be right back.

    UPDATE: retested at +12.5, 100. Will continue to wait 30mins more and retest.
     
    Last edited: Dec 3, 2020
  75. JanetNJ

    JanetNJ Well-Known Member

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    Ok I'm thinking 190-250 do 1.5, and over 250 do 2 over 300 do 2.5
     
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  76. Emily Tuomey

    Emily Tuomey Member

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    :cat: Retest in 5mins. Sounds like a plan. I’ll check back in before I shoot with his current number.
     
  77. Emily Tuomey

    Emily Tuomey Member

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    121 @+13. Will wait for advisement.
     
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  78. JanetNJ

    JanetNJ Well-Known Member

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    Id do 0.5 and check in a couple hours. If you totally skip he may wind up back in black. He may wind up high later but it's safer than dropping too low.
     
  79. Emily Tuomey

    Emily Tuomey Member

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    I will let him eat a bit then shoot 0.5u. Will retest at +3 and let y’all know where we are at. Advisement for this evening, should it occur again?
     
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  80. JanetNJ

    JanetNJ Well-Known Member

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    omg i have no idea. His numbers are so wacky and unpredictable right now. hahahaha Ill take this over 400+ though!!!! I think I'd go with 190-250 do 2, and over 250 do 2.5 over 300 do 3 @Chris & China (GA) What would you suggest.
     
    Last edited: Dec 3, 2020
  81. Shelley & Jess

    Shelley & Jess Member

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    Me too! These recent numbers are a good problem! o_O You're doing awesome Em :)
     
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  82. Emily Tuomey

    Emily Tuomey Member

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    Just shot 0.5u. He’s eating well! I’ll check back in a couple hours, and let you know how he’s doing— this is CRAZY :D
     
  83. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    That we wait until a lot closer to PMPS to see what's going on.

    Obviously something is happening with Nico's pancreas so it's in charge!
     
  84. Emily Tuomey

    Emily Tuomey Member

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    Hopefully it’s a good thing...! When would you suggest I test today, Chris??
     
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  85. Emily Tuomey

    Emily Tuomey Member

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    +3 385. CRAP.
     
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  86. Emily Tuomey

    Emily Tuomey Member

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    Thought I updated this, but I guess I didn’t. His +6 was 409, so I’m full on prepared for a 600+HI reading as we near PMPS. Anticipating shooting 3.0u if above 300, yes @JanetNJ & @Chris & China (GA)??
     
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  87. Emily Tuomey

    Emily Tuomey Member

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    Just a quick update: PMPS 600+HI, as anticipated. Shot 3.0u after dinner. Will get a +3, then update here after his AMPS. Here’s hoping..!
     
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  88. Emily Tuomey

    Emily Tuomey Member

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    (Pm) +4 394. AMPS 257. 2.5u given. Question though. He’s had really stinky poops over the past two days, this morning it is looser than usual. Is this common? Does this have to do with reaching a breakthrough dose? Or his pancreas now being a little more alert? He hasn’t had any diet changes or issues eating or drinking. I’ll keep my eye on it. Poor guy, can’t catch a break!
     
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  89. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    no, has nothing to do with the insulin
     
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  90. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Probably be a good idea to start a new thread at some point too. This one's getting pretty long. Just include the link to this thread in the message part of a new one.

    How long until PMPS? Might want to get a +11 or +11.5 if you can so we know if he's going up or still dropping.
     
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  91. Emily Tuomey

    Emily Tuomey Member

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    @JanetNJ @Chris & China (GA)
    Nico’s +8 was 134, so I anticipate his PMPS will be above 190 but on the off chance it’s not I wanted to grab advice before it gets to be too late. Assuming I’ll still do 2.0u if he’s 190-250, 2.5u if he’s 250-300, and 3.0u if he’s 300+?? Let me know. :)
     
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  92. Emily Tuomey

    Emily Tuomey Member

    Joined:
    Oct 1, 2020
    2.25hrs to PMPS.
     
  93. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    Sounds like a good plan to me!
     
    Emily Tuomey likes this.
  94. Emily Tuomey

    Emily Tuomey Member

    Joined:
    Oct 1, 2020
    Thank you!! (I’ll work on that new thread too ;))
     
  95. Emily Tuomey

    Emily Tuomey Member

    Joined:
    Oct 1, 2020
    +11 334.
     
    Chris & China (GA) likes this.
  96. Emily Tuomey

    Emily Tuomey Member

    Joined:
    Oct 1, 2020
    Last edited: Dec 4, 2020

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