1/15 TOM amps 395 +2 331 +5 305 +8 322 pmps 339 .75

viewtopic.php?f=9&t=34391

woke up early to get the +10...knew it would be ugly and i don't want to sit around for an hour while it gets yet worse...but i have to, i know.
he seems purrfectly fine. not even begging for breakfast. are you all still still i'm doing the right thing? one hour after breakfast amps 395 (food drop) .75u.

Re: 1/15 +11 580 :-(

Lori, Rome wasn't built in a day, and Lev does not work overnight. You need to have patience and dose consistently for a period of time in order to see how the insulin/dose will work for Tom. You need to allow the shed to fill and the dose to settle. I know it's hard to wait, but you need to look at longer term trends with the Ls...you can't look at each cycle as a separate entity anymore like with PZI....they are interrelated, and the patterns are much longer than one cycle....they are measured in days. It's a whole different approach, and it takes time to adjust your thinking.

Yes, I'm sure you need to stay with the dose, hang in there. Take a look at Tinkles' SS when we switched to Lantus. It took 3 days for the shed to fill and see a significant response, and then I needed to increase to get to a dose that gave him a good response...it took a week to get anywhere. Tinkles was on a good dose of PZ at the time, and I started very close to the dose he needed of Lantus, but even so, it took some time to get him back into good numbers....and his switch was relatively easy. You won't see a seamless transition because you don't know what dose he needs, and you weren't getting a consistent response on the PZ. It's hard to know whether some of the high numbers are due to infection issues along with the insulin change. I'm not sure if anyone warned you about the higher numbers being expected, but that is part of the switch. None of us like high numbers, I feel your pain....but it will get better. You just can't rush it, it takes time.

Re: 1/15 +11 580 :-( anps 395 food DROP, normal.

tom dropped 200 points in 1 hour with no insulin on board just becuase i fed him----which is what he ALWAYS does, which is why i kept trying to tell everyone TOM IS DIFFERENT that the insulin did NOT take him down 300+ points that the FOOD did. PLEASE NOW HEAR ME. his amps are 395 and he got .75
sorry if i sound Loud but i kept tryin to splain it!!!!

Re: 1/15 +11 580 :-(

Good morning, Lori & Tom Tom!! GRReat news.. you shot 12/12 & .75.. you are doing awesome, listening to everyone! With this consistent dose & shots.. I have a feelin Tom is going to be doing furbaby fabulous in no time! Happy Caturday! I hope your evening at worship was enjoyable too!

Re: 1/15 +11 580 :-(

I hear you Lori. So you feed before AMPS? How long before? Do you do the same thing before PMPS? Please tell us how you are feeding Tom, how much and when in relation to his shots.

A few housekeeping notes....can you add Tom's name into your header please? Also, many of us will look at the SS before responding (I always do!), so it's important to try to keep the data up to date....can you update Tom's SS please?

Re: 1/15 +11 580 :-(

1 hour before his shot I fed his a few mouthfuls of ff.
he dropped 200 point in said 1 hour.
this is routine. in another hour without insulin he likely would have dropped another 100 points.
this is routine. he always does this. i don't always wait. this morning i fed first only because i had to WAIT an hour to shoot...a few mouthfuls
and no, i don't do it pmps becuase i just don't. by that time he's eatten 4-6 meals a day.

Re: 1/15 +11 580 :-(

MAN...tom definitely takes the road less traveled, doesnt he?

he's an individualist. hope this gets easier for you guys quickly!

celi

Re: 1/15 +11 580 :-(

Lori, most of us do not feed within the two hours prior to shot time. It will create either a food spike...or like with Tom (whose pancreas is functioning on some level ) a drop in numbers.

Most of us will test first to get that true pre-shot number. Feed and then shoot.

What is appearing unique is your strategy and why you would feed before a test? Either way it is what it is and it is wonderful to see Tom has some level of a functioning pancreas.

I am more apt to believe that 580 is a closer pre-shot fasting value. The fact his pancreas kicks in just after he eats or even thinks about food, means who should need less insulin over time as the levemir builds up in his system. It will take several days for that to occur.

Here is a technical video on how levemir actually works...maybe it will help...maybe not:
http://www.novonordisk.com/images/diabe ... movie.html

I believe part of the problem here is you're not understanding the action of the insulin. The video, while pretty technical, explains the big differences and maybe why some of us are not as overly concerned with Tom unique nature as you are. And that is understandable on your part, because you would have to be very highly aware using PZI. Please watch the video if you have time.

Blue & Atlas

Re: 1/15 +11 580 :-(

I would try to not read anything into why he is dropping 200 points after eating right now.Right now is a time to just observe, hold the dose, gather the data, then start to look for patterns LATER.

Does he have food available overnight? I am starting to wonder with Jeddie if getting less food overnight is causing his inconsistent PS values. Talking about patterns that emerge over days - his are over about 6 days, near as I can tell, so take a look at his SS as well for patterns that are more than several cycles in the making.

Anyway, write down what his food availability is during the day versus the night. And, yes, stay with the .75u!

Re: 1/15 +11 580 :-(

ummmm, blue, i do not always or usually feed before the ps. i usually test feed shoot ok.
since i'm on this strict 12/12 i tested upon wakening got his +11 and out of habit becuase to eats when i wake up----he HAS TOO or he freaks out, but i did get as close to a pmps with that +11. he likely would have been 600+ without the food

anyway none of this is the point!

INSULIN DID NOT DROP MY CAT TOO FAST....AS I KEPT SAYING. HE ALWAYS DROPS WITH FOOD. i'm tired of saying this and i'm tired of explaining my cat. i need a break. i love you guys i really do but these q and a's are NOT THE POINT

Re: 1/15 +11 580 :-(

lori and tom said:

INSULIN DID NOT DROP MY CAT TOO FAST....AS I KEPT SAYING. HE ALWAYS DROPS WITH FOOD. i'm tired of saying this and i'm tired of explaining my cat. i need a break. i love you guys i really do but these q and a's are NOT THE POINT

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DARLING ALL THAT MEANS IS HE HAS A FUNCTIONING PANCREAS!

THAT ALONE IS A DARN GOOD REASON TO START LOW AND GO SLOW.

AND YES I AM YELLING!

I'M TIRED OF YOU YELLING AT EVERYONE WHO IS TRYING TO UNDERSTAND AND HELP YOU GET STARTED ON A NEW INSULIN, THAT FOR SOME REASON YOU REFUSE TO LEARN ABOUT. The action of the insulin isn't going to change, they way the insulin works isn't going to change...you and Tom need too.

Your post said you fed Tom and then came on this board with the see I told you so attitude. As my post to you clearly indicates all that tells us is he has a functioning pancreas on some level.

Re: 1/15 +11 580 :-(

Since we're advocating for consistency, and Tom is responding to food, how about a compromise. Beth is correct -- we discourage feeding 2 hours prior to shot time. Can you set a feeder so Tom has food at +8 or +9? If you get one of the feeders with rotating slots, you can set the timer to rotate to an empty bin at +10 so you know Tom won't have access to food. I would suggest doing this for both the AM and PM cycle. Alternatively, if you don't want to do the feeder thing, don't feed 2 hours prior to shot time either cycle.

Lori & Tom said:

this is routine. he always does this. i don't always wait. this morning i fed first only because i had to WAIT an hour to shoot...a few mouthfuls and no, i don't do it pmps becuase i just don't. by that time he's eatten 4-6 meals a day.

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When you've noted big differences between AMPS and PMPS, it would appear that how you are feeding is what is effecting the numbers and you are not being consistent with respect to how you feed in the AM vs. PM. Without consistency, the data you are getting is very hard to interpret.

Re: 1/15 +11 580 :-(

i'm so sorry guys, really. i thought it was relevant that his morning drop was not due to the insulin so we should'nt assume it was too much insulin and that the 1u was good.

let me say why i think he is always high is the am.
tom is an active fellow. he is busy most of the day what with staring at grass, chasing mices, butterfly's, lizards...he wanders in and out of the house with occassional naps and food begging.
he gets on 8 ounces of food a day but i break it into as many meals as possible.
i believe the activity and the continual eatting prevents his #'s from going to high at pmps.

on the other hand, at night he sleeps a solid 9-10 hours without barely moving, he snores, he drools, he' out of it. i never see evidence that he's even used the restroom during the night.
i tried 2 am feedings (had it on the ready when i woke up to go to br) and had to nudge him awake to eat...of course when he saw food he jumped to attention, ate and went back to sleep right next to me.

theory: no movement or exercise and no food = high #'s
activity and frequent snacks = low #'s

and again, this thing for some reason has had me more upset than i've been in a long while. i have'nt had to explain my cat to anyone for awhile and it's hard thinking you know something about your cat that might be helpful and it is'nt.

my fondest hope is that you all are right and i will soon say " I stand corrected dear tireless friends and you have been saints for tolerating me" until then i will make it a point to be more tolerable.
lori

Re: 1/15 TOM amps 395 +2 331

I can't believe I missed that you've switched Tom to Lev! ohmygod_smile Welcome to LL, Lori. I hope the .75 works well for Tom and you start seeing some good numbers soon.

Re: 1/15 TOM amps 395 +2 331

good luck with the new dose! I hope it flattens Tom out a little bit. That will give us something nice to work from.

Re: 1/15 TOM amps 395 +2 331 +5 305

flat smooth day after high start.
i forgot to add tom's many responsibilities on top of just being a busy guy having fun.
every day he goes out after breakfast to slowly and carefully examine the full scope of the property and come home in about 20 minutes to let me know it's safe to go outside.
next, he must keep the throw rugs from getting too full of themselves by beating the crap out of them 1-3 times per day..or as needed.
also he must run to catch me enter the bathroom and use it lest i should do it wrong without his presence. actually we both feel kind of bummed if we miss each other pee. he for the obvious reason that i'll most likely make a mistake without him. and me because i have to get real close to his private parts with a longish white stick then gaze at it intently while counting to 10 (yay! no ketones) then 20 more counts and then (boo! marinating urine sugar)
and as if all that were'nt enough tom is also in charge of keeping mice, lizards and other critters from entering his domain when not in his mouth. as well as keep spider and insect patrol
is it any wonder that he sleeps like a log after a day like that?

i think tomorow morning i would like to get up 45 minutes or so early to test feed and test again before shooting.
my reasoning is yes i do agree the first number is the actual true number but i also don't want peeps mistakenly thinking the lev is what nosedives him. make sense? to prove that he just goes high at night. as opposed to lev giving him a steep drop in the am.
i hope this makes sense to you.
he does go high at night
he does not nose dive in the am due to too much lev.
perhaps if his #'s don't improve it will not be assumed it is too much insulin but perhaps too little. and i mean this is a completly non confrontational non attitude innocent way.
Lori
loving the flatline day

Lori, he may be higher in the am because he is getting too much insulin (has been for a while now. I am talking PZI as well as lev) so rebound reaction sets in at night when there is no food to offset the extra insulin. He eats and his body says "I can relax now that there is food coming in". That's another scenario to keep in mind.

And, yes, he does lead a busy life. Makes all of mine look like lazy-bum-cats, which is what they are.

lori and tom said:

i think tomorow morning i would like to get up 45 minutes or so early to test feed and test again before shooting.
my reasoning is yes i do agree the first number is the actual true number but i also don't want peeps mistakenly thinking the lev is what nosedives him. make sense? to prove that he just goes high at night. as opposed to lev giving him a steep drop in the am.
i hope this makes sense to you.
he does go high at night
he does not nose dive in the am due to too much lev.
perhaps if his #'s don't improve it will not be assumed it is too much insulin but perhaps too little. and i mean this is a completly non confrontational non attitude innocent way.
Lori
loving the flatline day

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Actually Lori, I think we get that. Why you would feel you need to repeat what you did today ...I don't understand? Especially after several explanations by several folks otherwise. I guess in some way too, our concern of starting so low with Tom, is those drops. I guess that is why we are being conservative with your dose advice too. We're looking to stabilize him out...that flatline as much as possible, before upping the dose. We're looking to avoid that prolonged hypo due to too much insulin.

As you settle into the lev. the dosing will need to be adjusted and will account for his pancreas functioning on some level. His functioning pancreas becomes part of the nadir. The BG and the pancreas and the insulin all have to work together, stop trying to separate them you're making yourself bonkers unnecessarily. Tom's drops at meal times are part of the whole picture, that is why lev. should be a good insulin for Tom, but I am sorry you need to let go of this idea he is "special situation" because of it. Lev. used properly is going to make that go away, if you let it.

Lantus Land and Levemir are full of cats with partially functioning pancreases. It's why they go into remission. WE GET IT , do you?

Lev works on the whole system in unison. Please reread the stickies and watch that video I posted in your condo. The way Lev works is not going to change. You are loving the flatline? That's the lev starting to fill the shed and being allowed to work.

I think this looks good for now. The easiest scenario to work with for Lev kitties is when they will give us nice flat cycles like this. Then all we have to do is work (slowly) toward lowering the nice flat numbers into the nice flat range we want them to be in. If he drops at PS time? That's ok too. It just helps give the next cycle a better place to start the surf. That's a good thing!

A lot of kitties are bouncers and it takes longer for them to work their way into flat Lev cycles. On the other hand, some cats "get it" much more easily. We're just now getting to the point where we can start to get some meaningful data from Tom, so the next few cycles will tell us a lot.

Blue is right, we do have a lot of functioning or sputtering pancreases in LL (and all over FDMB). That is one reason why you will see some of the people who have been here a while experimenting with when they feed their cat meals and snacks. If Tom can drop himself that much with food (or even without it), then we can hopefully use that information to his advantage eventually. Especially in the past 6 months, we have been gathering a lot of new ideas about how we can use food to make the insulin work even better for our cats. For the moment, though, your focus should be on gathering the data.

You know how when you are putting together a puzzle, at first all you have is a bunch of random puzzle pieces scattered around on the table? You can't see the picture and nothing makes sense. As you gradually start to add more and more puzzle pieces, then the picture becomes much more clear. Just collect the pieces, don't try too hard to put them together just yet. It will be much easier soon.

Ok?

Have a good Sunday! And relax. :mrgreen: Remember that each Lev dose has an influence on at least the next 2-3 cycles, so changes have to be made gradually and given some time to work. This is better, though. :smile: