02/8 Quincy AMPS 343 +4197 +6 139 +8 191

April & Quincy

April & Quincy

Member Since 2019
https://www.felinediabetes.com/FDMB...s-he-no-longer-regulated.242653/#post-2734627

Above is my previous post. So I did a curve on Quincy yesterday and was quite disappointed at all the high numbers. He even had a number in the 300s at +6, something I haven't seen in months! Could this be a bounce from the previous day's 148? Or is he literally just all over the place? I am wondering if I should increase to 1 unit. I'm nervous to do so but this curve seems to be pointing me to do it. I'm going to try to tag a few members that helped me in my last post.

@LindyNova
@Gill & George
 
In a week’s time, you’ve had three nadirs under 150. That’s great that you’ve been getting that data as it’s helpful in combination with the curve. Often, members using SLGS don’t get those midcycle tests every day so great job.

It’s good you see that yesterday was a bounce. This is one of the shortfalls of SLGS in that any cat could have been having frequent nadirs below 150 during the week that the CG might not have seen but the curve would indicate an increase.

IMHO, I’d increase to 1u. Good luck with the increase if you feel comfortable doing it.
 
Marje and Gracie said:
In a week’s time, you’ve had three nadirs under 150. That’s great that you’ve been getting that data as it’s helpful in combination with the curve. Often, members using SLGS don’t get those midcycle tests every day so great job.

It’s good you see that yesterday was a bounce. This is one of the shortfalls of SLGS in that any cat could have been having frequent nadirs below 150 during the week that the CG might not have seen but the curve would indicate an increase.

IMHO, I’d increase to 1u. Good luck with the increase if you feel comfortable doing it.
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Okay so even though that was a bounce, you think increase? Thank you for your advice!
 
April & Quincy said:
Okay so even though that was a bounce, you think increase? Thank you for your advice!
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Yes. There’s no reason to not increase just because he’s bouncing. Just be sure that when you do increase, he’s not clearing a bounce. If you aren’t sure, just ask for help using the “?” Prefix and after the day’s BGs, put “dose help” or something like that. You can also tag me.

You’re welcome!
 
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Marje and Gracie said:
Yes. There’s no reason to not increase just because she’s bouncing. Just be sure that when you do increase, she’s not clearing a bounce. If you aren’t sure, just ask for help using the “?” Prefix and after the day’s BGs, put “dose help” or something like that. You can also tag me.

You’re welcome!
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So is he not clearing a bounce right now? How long does it take to clear a bounce?
 
I agree with Marje. An increase is in order. Bounces are SO common, and some just don't stop! (ahem, Nova!) It can take up to 3 cycles to clear a bounce (from what I remember) and sometimes when clearing said bounce they go lower than previous nadirs. So keep an eye out! You are doing great! The curves really help.
 
LindyNova said:
I agree with Marje. An increase is in order. Bounces are SO common, and some just don't stop! (ahem, Nova!) It can take up to 3 cycles to clear a bounce (from what I remember) and sometimes when clearing said bounce they go lower than previous nadirs. So keep an eye out! You are doing great! The curves really help.
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It's been soooooo long since he's been on 1 unit. It makes me so nervous. I just checked him - 197. So looks like he's clearing the bounce.
 
April & Quincy said:
It's been soooooo long since he's been on 1 unit. It makes me so nervous. I just checked him - 197. So looks like he's clearing the bounce.
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He’s....looks like he is. It will be interesting to see if he continues to drop towards PMPS. That would be normal. If you give him some LC food during the cycle, that might slow it down so he’s no longer dropping at PMPS.
 
Marje and Gracie said:
He’s....looks like he is. It will be interesting to see if he continues to drop towards PMPS. That would be normal. If you give him some LC food during the cycle, that might slow it down so he’s no longer dropping at PMPS.
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Yes, he's scheduled for his lunch shortly so he'll get some LC food. We'll see what happens with that. Can you explain what you meant when you said, "Just be sure that when you do increase, she’s not clearing a bounce." What does that mean? And why not?
 
April & Quincy said:
Yes, he's scheduled for his lunch shortly so he'll get some LC food. We'll see what happens with that. Can you explain what you meant when you said, "Just be sure that when you do increase, she’s not clearing a bounce." What does that mean? And why not?
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Sorry to ask but if you could update his subject line with the +4 of 197, that would be appreciated.

Bounce clearing cycles are often more active cycles than a typical Lantus cycle. The BG starts dropping from one preshot to the next and it can drop rapidly. If you throw extra insulin into the mix, the BG can real fall fast and perhaps drop below the reduction point when it really wasn’t the increase that caused them to drop below the reduction BG but the bounce clearing + increase.

If you know the kitty needs more insulin but is clearing a bounce, it is safer and less difficult for you (i.e. you aren’t struggling with lower numbers) to wait and see where the BG ends up before increasing.

Conversely, if you know the kitty needs an increase and a bounce is starting, it’s fine to raise the dose.

Make sense?
 
Marje and Gracie said:
Sorry to ask but if you could update his subject line with the +4 of 197, that would be appreciated.

Bounce clearing cycles are often more active cycles than a typical Lantus cycle. The BG starts dropping from one preshot to the next and it can drop rapidly. If you throw extra insulin into the mix, the BG can real fall fast and perhaps drop below the reduction point when it really wasn’t the increase that caused them to drop below the reduction BG but the bounce clearing + increase.

If you know the kitty needs more insulin but is clearing a bounce, it is safer and less difficult for you (i.e. you aren’t struggling with lower numbers) to wait and see where the BG ends up before increasing.

Conversely, if you know the kitty needs an increase and a bounce is starting, it’s fine to raise the dose.

Make sense?
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I think so. But I am still confused because it seems like Quincy is clearing a bounce right now so shouldn't I wait to increase? Or are you saying that since he already needs more insulin, it's okay to do it?
 
April & Quincy said:
He just had a +139 but I fed him his lunch after so he'll probably go up now.
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Possibly, but when they clear a bounce they can continue to slide down all the way into the PS.
do you think you could get a +6 or a +7/

April & Quincy said:
I think so. But I am still confused because it seems like Quincy is clearing a bounce right now so shouldn't I wait to increase?
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You will need to wait and see if he goes lower in this cycle, that might indicate that you hold on to the dose.
 
April & Quincy said:
I think so. But I am still confused because it seems like Quincy is clearing a bounce right now so shouldn't I wait to increase? Or are you saying that since he already needs more insulin, it's okay to do it?
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After all this time, this still confuses me, too. But honestly, if I were in your shoes, I would still increase. From the looks of your spreadsheet, Quincy most likely will not drop into an area where I would be hesitant to increase. Sometimes when a bounce clears (for me anyway) they bounce right up again from the low they haven't seen in awhile. SO frustrating, but they eventually get used to the lower numbers you are seeing now. I would want to see those beautiful green numbers. It's your call.
 
April & Quincy said:
I think so. But I am still confused because it seems like Quincy is clearing a bounce right now so shouldn't I wait to increase? Or are you saying that since he already needs more insulin, it's okay to do it?
Click to expand...
If you know the kitty needs more insulin but is clearing a bounce, it is safer and less difficult for you (i.e. you aren’t struggling with lower numbers) to wait and see where the BG ends up before increasing.
Click to expand...

He looks like he needs more insulin but we have to be sure he’s done clearing the bounce before we raise the dose.
 
Gill & George said:
Possibly, but when they clear a bounce they can continue to slide down all the way into the PS.
do you think you could get a +6 or a +7/


You will need to wait and see if he goes lower in this cycle, that might indicate that you hold on to the dose.
Click to expand...

That 139 was +6 but I'm gonna try to get a +8. No guarantees though... Might have a work mtg.

I'll see if he goes lower to know if I should hold the dose.
 
LindyNova said:
After all this time, this still confuses me, too. But honestly, if I were in your shoes, I would still increase. From the looks of your spreadsheet, Quincy most likely will not drop into an area where I would be hesitant to increase. Sometimes when a bounce clears (for me anyway) they bounce right up again from the low they haven't seen in awhile. SO frustrating, but they eventually get used to the lower numbers you are seeing now. I would want to see those beautiful green numbers. It's your call.
Click to expand...

That's what I'm nervous about too... That he'll bounce again and just keep bouncing.
 
April & Quincy said:
What if he just keeps bouncing?
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We ignore the bouncing, over time as he spends more time in good numbers, (when he clears the bounce) he will probably stop bouncing.
The important number here is the low number, the nadir, that is what governs our dosing decisions, not the fact that he bounces or how high but how low the dose is getting him.
Post #17 discusses increasing dose and bounces, it pertains to TR, but the theory is the same for slgs.
https://www.felinediabetes.com/FDMB/threads/tight-regulation-slgs-myths-debunked.111088/
It's an excellent post by Libby covers other issues.

April & Quincy said:
+8 191
Click to expand...
On his way up.
 
Gill & George said:
We ignore the bouncing, over time as he spends more time in good numbers, (when he clears the bounce) he will probably stop bouncing.
The important number here is the low number, the nadir, that is what governs our dosing decisions, not the fact that he bounces or how high but how low the dose is getting him.
Post #17 discusses increasing dose and bounces, it pertains to TR, but the theory is the same for slgs.
https://www.felinediabetes.com/FDMB/threads/tight-regulation-slgs-myths-debunked.111088/
It's an excellent post by Libby covers other issues.


On his way up.
Click to expand...

It seems like he has been bouncing quite a bit, based on his SS but I could be wrong. I'm no expert!!

I'll check out that link, thanks!

Yes, on his way up! I've learned enough about him to know he goes up in the afternoons so I know he'll just keep going up.
 
April & Quincy said:
It seems like he has been bouncing quite a bit, based on his SS but I could be wrong. I'm no expert!!

I'll check out that link, thanks!

Yes, on his way up! I've learned enough about him to know he goes up in the afternoons so I know he'll just keep going up.
Click to expand...
I would increase his dose now that we’ve seen what he does when he clears the bounce. Again, your choice on tonight or tomorrow but if nights are tough for you, you might want to do it in the morning.

Good job today!
 
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