2/13 Akane AMPS 388 - PMPS 340

Yesterday

Good morning and Good evening to everyone in the other side of the ocean..

He went up to 388 and I kept the dose again. Reason. Because if I raise the dose to .5, I may not be able to shoot to, like lower 200's and may not be able to hold it consistently for 6 cycles, in Akane's case. I speculate that Akane could drop below 40 easily if I dose him to 200's. Then I will need to reduce the dose again without holding it for 6 cycles. So I stayed 0.4s for consistency..

Re-educate me pleeese if I am wrong.

I hate to see him in above 350 range and I want him to stay lower level as soon as possible of course but I do not want to make a mistake to confuse him again..

Re: 2/13 Akane AMPS 388 -education please

dosgatos said:

Yesterday

Good morning and Good evening to everyone in the other side of the ocean..

He went up to 388 and I kept the dose again. Reason. Because if I raise the dose to .5, I may not be able to shoot to, like lower 200's and may not be able to hold it consistently for 6 cycles, in Akane's case. I speculate that Akane could drop below 40 easily if I dose him to 200's. Then I will need to reduce the dose again without holding it for 6 cycles. So I stayed 0.4s for consistency..

Re-educate me pleeese if I am wrong.

I hate to see him in above 350 range and I want him to stay lower level as soon as possible of course but I do not want to make a mistake to confuse him again..

Click to expand...

Hi Mami

Yup, you're wrong, although with all the insulin-wizards here on Lantus boards, and I am not one of them, I can't be the one to educate you. Besides, you pretty much know how I view this from my previous postings..

I could see holding the dose if there were some real evidence of harm that would occur.... but you've actually had fairly consistent numbers with Akane. So I don't really see how the risk that you "may" not be able to hold the dose for six cycles -- or whatever -- is as great as the reality of the red numbers, that are fact right now and that cannot be good for Akane. Besides, by raising, you will be pushing ahead to where you will be going anyway. IMHO.

Let's see what others think.

Re: 2/13 Akane AMPS 388 -education please

Hi, I am not familiar with your situation.. but I know you don't want Akane to get used to higher #s & it appears there are a lot of high ones..
I am bumping your condo so expert eyes can advise..

Re: 2/13 Akane AMPS 388 -education please

Thank you, Ilkka. But if he dropped to like 30, I have to reduce the dose again. You are saying that is all right compared to keeping him in reds ? Then what will happen to "consistency" ? Ocean tanker..?

Have I had fairly consistent numbers with him..? Sorry please be patient with me, I am stuck.. why can't I see it as you do! :?

Thank you, Nicole. You posted while I am confused and writing..Appreciated.

Re: 2/13 Akane AMPS 388 -education please

i too, am not one of the wise ones, so will just say hello!...and bump your post up for better eyes...

celi & binks

Re: 2/13 Akane AMPS 388 -education please!

Hi Celi! Thank you!

I held the dose for one more reason. I looked at his past numbers and he came down to 200's +12 from similar numbers above 350 on 1/4, 1/8, and 2/4. So I hoped he might come down today with the same dose again.. but I need further education. Will test him in 30 mins. He could have dropped to lower than 132 last night as the curve towards +6 was a bit steep.

ETA
If his PM response is similar to his AM, I will definitely raise the dose now.

Re: 2/13 Akane AMPS 388 -education please

the way the Lantus and Levemir protocol was explained to me is that the treatment consists of a series of steps UP in dose, followed by a series of steps DOWN in dose.

In other words, most cats need a series of methodical dose increases until they reach a dose that causes a breakthrough. Once they get to that breakthrough, most cats will then start needing a series of fast dose reductions until they settle on a dose where they can stay a while in decent numbers. That will be a dose that you passed on the way up and it didn't work then, but on the way down it might be the perfect dose. It's hard to explain until you have seen it happen in your own cat.

Most of our cats build a little bit of insulin resistance just by virtue of the fact that they are spending a lot of time in high numbers. To break through the resistance, they need for you to build the amount of insulin. Once the resistance is broken, though, then often they will quickly have to go back down to a lower dose. You can look at my cat Lucy's spreadsheet to see how that worked for her - she had to build all the way up to 4.25 units, but once she hit that dose she had a great breakthrough and then started earning dose reductions.

The tight regulation protocol gives great guidance as to how to increase and decrease. The main difference is that while most of us increase and decrease in increments of 0.25 units, it looks like Akane has a tendency to be sensitive to smaller changes. For Akane, I would follow the timing parts of the protocol (holding doses usually 6-8 cycles unless he goes too low), but instead of making changes by 0.25 units at a time just change by 0.1 units (or less) at a time. Have you read the Tight Regulation Protocol sticky in this forum?

Again, I am being very wordy but what I am saying is that in my opinion, you have done a great job of collecting data and you have room for an increase. I would add just a drop to his dose. I would do it in a cycle when you can monitor, just in case he likes the new dose a lot. ;-)

Re: 2/13 Akane AMPS 388, +3 338

Thank you so much for taking your time, Libby!

OK.. I may need to see it myself to get it and digest it well, as you said.. Big sigh. I am frustrating with myself! :sad: I was cautious because he often drops to low easily (even now with the current dose in PM but has not gone down to below 50 maybe..) and his rebound will seem to be severe so I thought it would be better to wait until his liver get used to lower numbers and will not react too badly and settle.. I thought his high numbers in AMs are from rebound..not resistance.. I thought resistance was broken when he went down in PM a few days ago..

And I had an idea that it is better to get it flat and get it lower. Now he seems to making a valley shape curve in PMs and flat in AMs. I did not know how to think..

I will wait until morning to raise it. I want to sleep tonight..

Thank you very much again!

PS Yes, I have read the sticky! :smile:

Re: 2/13 Akane AMPS 388, +3 338

Just remember, you can use food to steer Akane's numbers. Seeing low numbers is nothing to be nervous about. As long as you are testing and have high carb food, you are in control of the numbers.

Re: 2/13 Akane AMPS 388, +3 338, +7.5 258

Hi Sienne!
OK! I am not really worried about him going to low but about a rebound afterwards.. but will go ahead to raise it tomorrow! Thank you! :smile: