3/9 Oren; AMPS-349;pmps-320;pm+5-348;

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Megan & Oren

Megan & Oren

Member Since 2015
Yesterday: http://www.felinediabetes.com/FDMB/threads/3-8-oren-amps-hi-6-479-pmps-457-5-299.134290/

Spring is making a showing! the snow is melted, the temps are glorious and Oren even dipped to a yellow last night for the first time in 3 days. Hope he's feeling even sunnier today. Slow easy climb only to pink this a.m.
6th shot since FS. Gave me a scare as at the last minute, he walked off! never does that, but after burying my face in his fur numerous times I'm pretty confident i got it.

at work, left him 1/4 can of FF split in two morning meals in the timed feeder. no testing till i get home.

Happy Monday to all (stupid DST notwithstanding...)
 
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Megan & Oren said:
Gave me a scare as at the last minute, he walked off! never does that, but after burying my face in his fur numerous times I'm pretty confident i got it.
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I can't count the times I've run my nose through Polly's nape fur scenting for insulin! Even when it turns out not to be a fur shot, I often still imagine the mediciny smell of Lantus. Arghhhh.

Oren, making progress. That's good.

Marilyn and Polly
 
damn i hate work days! A pink day at worst; his amps and pmps were only 29 pts. apart, 349 and 320! sure he must have dipped at least yellow today. so a pm+2 seems in our future?

he poo'd 2x today, maybe bc he didn't poo yesterday?

jeez, 2 more poos(4 total!) none were runny, all were firm, each time about 2-3 pieces. this is excessive though, should I be worried?
 
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He probably went down some in between the 2 shots - although you never know. i wouldn't worry about it too much. How is he feeling besides his blood sugar? We refer to the "5 P's": purring, preening, playing, pooping & peeing. Are those all good?

i must be the only person around that likes daylight saving time - i love having it sunny still in the evening.

Yesterday you mentioned switching to the TR protocol. If you do that, you can increase after 6 cycles. I don't think you've got any hidden low numbers in there - you've gotten quite a few tests in. Per the TR guidelines:
Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
If you're going by SLGS:

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours
Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
  • As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but do decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change). Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.
Lather, Rinse, and Repeat!​
 
Hi Julie; well did you see my notes about the pooping? he's done 4 today! 3 since i got home tonight (one this a.m after breakfast). That is excessive; but he didn't poo yesterday at all. I think he's pretty good otherwise, though he does seem a little low energy right now, dozy. I suppose i should do a +2 or +3 test?

Regarding the protocol guidelines:
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Also I would like clarification on the protocols, do all nadirs in the cycle count have to meet one of the conditions? or just a majority? obviously in the last 6 cycles, he's been over 300 all but once (though I don't have today to show for it). I would think he's due for a 0.5 U increase based on these numbers, but since the vet had initially suggested 2.5 from 2, and I only went 2.25, I'm wondering if I should only go to 2.5 now?

I'm so nervous to make these decisions. the 2 furshots since going to 2.25 really screwed things because i did have 7 cycles in at 2.25 starting 2/28-3/3 before a furshot. And he didn't get below 300 except once.

Short of it is I really feel like i need solid guidance/advice on what to do next re: an increase . Or should i call the vet?
 
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that's some serious pooping! hahahahaha he's been a busy guy. I wouldn't worry about the number unless it turns to diarrhea.

If he were mine, I'd just get one test before I went to bed, at the last possible minute.

even cats have low energy moments - hehehe actually, mine are mostly low energy. maybe they're tired from the switch to daylight saving time. ;)
 
Megan & Oren said:
Also I would like clarification on the protocols, do all nadirs in the cycle count have to meet one of the conditions? or just a majority? obviously in the last 6 cycles, he's been over 300 all but once (though I don't have today to show for it). I would think he's due for a 0.5 U increase based on these numbers, but since the vet had initially suggested 2.5 from 2, and I only went 2.25, I'm wondering if I should only go to 2.5 now?
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Think in terms of how low Oren has gone on the dose. The other higher nadirs are probably bounces so can be ignored. He's been getting into the yellows, so a .25U increase is what is called for.
 
thank you! I think I might wait to do the increase till Wed, because I will be home for the day teleworking. I am nervous to increase tomorrow when I won't be around. I guess I could just leave food but does it seem prudent to wait till Wed?
 
i missed your edited question - probably posted while you were editing.

I agree with Wendy - you don't need all nadirs to fit in the category. She's got a good explanation.

it's ok to wait until Wednesday for your next increase.
 
foo, pink all day, at least per tests. maybe there was yellow while i was gone. but now to bed.
and it all starts over tomorrow...night all
 
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