? 1/20 Silver PMPS 432 +4=329 switching meters, a little worried...

[Juliet]

http://www.felinediabetes.com/FDMB/...lower-this-time-in-cycle.189844/#post-2114753

Well there’s a surprise AMPS. I shot anyway as I was too half asleep to think about it although my finger was slightly damp after the shot so maybe a drop short of a full dose. Glad it’s a curve day. Testing again in a couple hrs. As @Jill & Alex (GA) says, I’m not shooting the low blue but where he’ll be at onset which is usually higher.

Our first blue of the year

 

[Alicia & Maggie (GA)]

Good job shooting low! Hopefully this will be the beginning of many more blues and greens.

 

[Stacy & Asia]

Yes, Silver! Knew you could do it!

A pressie for your curve day, Juliet!

 

[Sandy and Black Kitty]

Yes, with Lantus, being that it is slow acting, you are not shooting at the PS number, you are shooting at a number 2 or 3 or so hours down the road, when onset occurs.

It can be a difficult concept to wrap ones mind around because, frankly, who the heck can read the future?
So we determine onset by gathering data from the +2 and +3 tests. It’s becoming ‘data ready’ - an important part of ‘knowing thy cat’ .

 

[Juliet]

Yes, with Lantus, being that it is slow acting, you are not shooting at the PS number, you are shooting at a number 2 or 3 or so hours down the road, when onset occurs.

It can be a difficult concept to wrap ones mind around because, frankly, who the heck can read the future?
So we determine onset by gathering data from the +2 and +3 tests. It’s becoming ‘data ready’ - an important part of ‘knowing thy cat’ .

Well as usual, he spikes with food - but such a high spike - 288! Is that common to spike so high?

 

[Juliet]

Yes, Silver! Knew you could do it!

A pressie for your curve day, Juliet!

A lovely present until I saw his +2

 

[Stacy & Asia]

Silver, I thought we discussed this no bouncing on curve day business?

 

[Juliet]

Silver, I thought we discussed this no bouncing on curve day business?

Is this a bounce? He always food spikes at +2

 

[Stacy & Asia]

Is this a bounce? He always food spikes at +2

That’s my guess, 167 point jump for a food spike would be pretty remarkable for LC food not eating a whole cake or something. All of his other +2 data suggests the number would much lower if this were a food spike.

 

[Sandy and Black Kitty]

Well as usual, he spikes with food - but such a high spike - 288! Is that common to spike so high?

The bigger question - is it just a food spike? Could it be Silver is visiting some lower than accustomed to numbers during the bottom half of the PM cycle and what you are seeing is a bounce in progress? Sure, that AMPS is down from the PM +4, but could it be up from some lower number?

 

[Juliet]

That’s my guess, 167 point jump for a food spike would be pretty remarkable for LC food not eating a whole cake or something. All of his other +2 data suggests the number would much lower if this were a food spike.

So why are all his +2’s really high food spikes? Look at last night from PMPS to +4 - that’s from a high food spike at +2. Unless he is bouncing every day?

 

[Juliet]

The bigger question - is it just a food spike? Could it be Silver is visiting some lower than accustomed to numbers during the bottom half of the PM cycle and what you are seeing is a bounce in progress? Sure, that AMPS is down from the PM +4, but could it be up from some lower number?

Not per the curves I’ve been getting and the evening tests. He never goes low past +6 and doesn’t do sudden drops. I almost always get a +4. I know he’s not dropping low in the following two hours.

 

[carfurby (GA)]

I hope Silver will come back down for you today, but regardless at least you saw some blue. That is progress.

 

[Stacy & Asia]

Not per the curves I’ve been getting and the evening tests. He never goes low past +6 and doesn’t do sudden drops. I almost always get a +4. I know he’s not dropping low in the following two hours.

Unfortunately, you can’t possibly know that he never goes low past +6 in the pm cycle because you don’t have the data to back that up. Even if it’s there in the am, it’s a different story at night for most cats. Many go lower at night. Asia’s am & pm cycles are quite different. There are many hours between that +4 and AMPS, it wouldn’t need to be a sudden drop for him to hit a lower number than your AMPS and then come back up a bit. He could also be a sudden drop at night kind of cat. He could go lower, come back up and get a double dip. Yet another possibility is he could just have gone lower and lower and lower until AMPS, I find Asia does that when clearing a bounce. So many possibilities, assuming isn’t always a safe bet even with tons of data.

It’s been said over and over on this board...never trust a cat!

 

[Juliet]

Unfortunately, you can’t possible know that he never goes low past +6 in the pm cycle because you don’t have the data to back that up. Even if it’s there in the am, it’s a different story at night for most cats. Many go lower at night. Asia’s am & pm cycles are quite different. There are many hours between that +4 and AMPS, it wouldn’t need to be a sudden drop for him to hit a lower number than your AMPS and then come back up a bit. He could also be a sudden drop at night kind of cat. He could go lower, come back up and get a double dip. Yet another possibility is he could just have gone lower and lower and lower until AMPS, I find Asia does that when clearing a bounce. So many possibilities, assuming isn’t always a safe bet even with tons of data.

It’s been said over and over on this board...never trust a cat!

Ok guess you're right. Nothing I can do about the nighttime tests though so will just have to go with what we've got. I do sometimes get a +5 or even 6 at night on the weekends and still high though. Why is his PMPS always so much higher than his AMPS then if the nighttime cycle is supposed to be lower?

I do think he got a bit of a fur shot today which may play into this as well.

 

[Juliet]

I hope Silver will come back down for you today, but regardless at least you saw some blue. That is progress.

Yes. I am pleased. I just hope he doesn't bounce on this.

 

[Stacy & Asia]

Ok guess you're right. Nothing I can do about the nighttime tests though so will just have to go with what we've got. I do sometimes get a +5 or even 6 at night on the weekends and still high though. Why is his PMPS always so much higher than his AMPS then if the nighttime cycle is supposed to be lower?

I do think he got a bit of a fur shot today which may play into this as well.

You can only do what you can do, but it’s good to know what the possibilities are so you can plan accordingly. I hope he didn’t get a furshot, they are always ill timed it seems.

As far as AMPS and PMPS, that would depend on when/if he is bouncing, how long it takes to clear them, etc. in addition to so many other variables like when and what he eats during the day vs at night, how active or inactive he is at various times. For example, if he went lower last night and if he is bouncing today, it might take him the good bit of this cycle and even in to the next (or longer) to settle down, and then he goes lower at night and it starts all over again. It’s hard to say, but it’s a possibility. If he keeps getting these blues, it might be easier, visually, for you to see the bouncing and get a feel for how long it it takes for him to clear it. I know you can’t get more tests in, but what that translates to is it will take a bit longer to work out some of these patterns, just as it’s made it take a bit longer to do increases.

Many people have trouble getting a lower AMPS, so I would put that in the plus column!

 

[Sandy and Black Kitty]

He never goes low past +6 and doesn’t do sudden drops.

l see no data whatsoever to support even an educated guess as to what his BG does between PM+5 and AMPS. I see one quarter of the picture missing.

Try sprinkling a few tests in those hours ...a PM+7 one night, a PM + 10 another etc.; just enough to break up the wide open space that has developed in your ss. You may be surprised.

 

[Juliet]

l see no data whatsoever to support even an educated guess as to what his BG does between PM+5 and AMPS. I see one quarter of the picture missing.

Try sprinkling a few tests in those hours ...a PM+7 one night, a PM + 10 another etc.; just enough to break up the wide open space that has developed in your ss. You may be surprised.

Its not at all possible to ever get those tests in. I guess you're new to seeing Silver's condo. But I need my sleep, I work or commute 12 hours a day and do not keep good health. I test at 6:30am and 6:30pm and for me to get a +7 means staying up until 1:30am and getting up at 5:30am. Never never going to happen.

 

[Juliet]

You can only do what you can do, but it’s good to know what the possibilities are so you can plan accordingly. I hope he didn’t get a furshot, they are always ill timed it seems.

As far as AMPS and PMPS, that would depend on when/if he is bouncing, how long it takes to clear them, etc. in addition to so many other variables like when and what he eats during the day vs at night, how active or inactive he is at various times. For example, if he went lower last night and if he is bouncing today, it might take him the good bit of this cycle and even in to the next (or longer) to settle down, and then he goes lower at night and it starts all over again. It’s hard to say, but it’s a possibility. If he keeps getting these blues, it might be easier, visually, for you to see the bouncing and get a feel for how long it it takes for him to clear it. I know you can’t get more tests in, but what that translates to is it will take a bit longer to work out some of these patterns, just as it’s made it take a bit longer to do increases.

Many people have trouble getting a lower AMPS, so I would put that in the plus column!

I think he is either bouncing or a furshot - his +4 is terrible. I am so annoyed. I was half asleep at shot time but I thought some went in and only a drop on my finger.

 

[Sean & Rufus]

I think he is either bouncing or a furshot - his +4 is terrible. I am so annoyed. I was half asleep at shot time but I thought some went in and only a drop on my finger.

Sorry to hear this

 

[Juliet]

Sorry to hear this

It happens....stinks tho

 

[Juliet]

Oh well, the day did get off to a good start. Bummed by this curve.

 

[Juliet]

On his way back down. Let's hope this is just a little bounce.

 

[Juliet]

Should I increase tonight? I think he may have had a bit of a fur shot and he may be bouncing off this am’s low. I would normally be increasing after 7 days but should I hold?

 

[Jill & Alex (GA)]

Should I increase tonight? I think he may have had a bit of a fur shot and he may be bouncing off this am’s low. I would normally be increasing after 7 days but should I hold?

From the SLGS sticky:

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

Where did the 121 @ AMPS this morning come from? Was Silver on the way up or down?

If Silver didn't drop lower before you caught that 121... the 121 on it's own would put Silver in the hold the dose category according to the guidelines above.

If Silver DID drop lower than 90 last night and was on his way up at AMPS, it might mean a reduction was earned if he dropped lower than 90.


Unfortunately, I don't know the answer to these questions...

 

[Juliet]

From the SLGS sticky:

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

Where did the 121 @ AMPS this morning come from? Was Silver on the way up or down?

If Silver didn't drop lower before you caught that 121... the 121 on it's own would put Silver in the hold the dose category according to the guidelines above.

If Silver DID drop lower than 90 last night and was on his way up at AMPS, it might mean a reduction was earned if he dropped lower than 90.


Unfortunately, I don't know the answer to these questions...

I don’t know either as I was sleeping. So should I hold because I don’t know? I have read and understand the sticky and have that info saved to my phone - but the fur shot/bouncing is going on as well.

 

[Jill & Alex (GA)]

I don’t know either as I was sleeping. So should I hold because I don’t know? I have read and understand the sticky and have that info saved to my phone - but the fur shot/bouncing is going on as well.

If this were Alex, I definitely would not increase the dose until I knew how low it was dropping her. Truth be told, right now, we don't even know if Silver earned a dose reduction. I would also do whatever I could possibly do to find how low the dose was dropping her... then I would adjust the dose accordingly.

 

[Juliet]

If this were Alex, I definitely would not increase the dose until I knew how low it was dropping her. Truth be told, right now, we don't even know if Silver earned a dose reduction. I would also do whatever I could possibly do to find how low the dose was dropping her... then I would adjust the dose accordingly.

Thanks. I’ll hold. I wish I could get overnight tests but my health does not allow it. I am recovering from brain surgery.

 

[Jill & Alex (GA)]

Thanks. I’ll hold. I wish I could get overnight tests but my health does not allow it. I am recovering from brain surgery.

Yes, I know. I'm sorry. I'm sure it makes things harder for you.

 

[Juliet]

I hope we are not going to see red at PMPS....a multi colored curve today Silver.

 

[Tracey&Jones (GA)]

Love the blue, not sure about those bounce numbers though!

I hope he comes back down quickly for you. I agree with the hold the dose decision and not increasing. You are seeing action on this dose.

 

[carfurby (GA)]

Sorry about the bouncing to pink, but at least you know he can get to blue on this dose. I think holding the dose is a good idea.

 

[Juliet]

Sorry about the bouncing to pink, but at least you know he can get to blue on this dose. I think holding the dose is a good idea.

Its now a bounce to red....grrr

Switching to Freestyle Lite tomorrow so I know this will affect the numbers a bit. Am going to save 20 Accu Check strips as a just in case I want to double check a low AMPS as I know Freestyle runs low. I may be too chicken to shoot a low blue or green but if the Accu Check is slightly higher I may be able to shoot anyways.

 

[Tracey&Jones (GA)]

Yep he really doesn't like blues...he runs to red each time.

 

[Juliet]

Yep he really doesn't like blues...he runs to red each time.

Well I think it was also partly fur shot. So what do I do about his aversion to blues? I’m holding dose for now as he did get that low blue.

 

[Juliet]

I'm going to see the numbers drastically drop tomorrow as I switch to the Freestyle meter. Tonight I did a test with the Accu-check that I am stopping and the Freestyle. 329 on Accu-check and 203 on Freestyle and I know this is okay as if I calculate Accu-check minus 20% I get 263 and add 20% to the Freestyle I get 243 which is reasonably close. I believe the lower the number the closer the two of them get and there is not such a wide variance. I am worried about the suddenly lower numbers I'm going to face and concerned over their accuracy.

It is trends that is important though right - not just the numbers?

For those wondering why the switch - I was given a Freestyle meter and 100 strips from DCIN cap programme and so when I ran out of the Accu-check strips I was going to use the Freestyle ones and then switch back but I was advised on here to pick a meter and stick to it - so I guess the Freestyle is going to win out so I don't have to switch and switch again.

Hey, maybe I will see green tomorrow as I will be 40% less than Accu-check measures. A little scary.

 

[Jill & Alex (GA)]

It is trends that is important though right - not just the numbers?

Exactly.
No doubt you'll see differences, but deal with the numbers as you see them. In other words, don't get hung up on worrying about "accuracy". If the Freestyle is your new meter, treat the Freestyle numbers the same way you have the Accu-check numbers.