? 03/05 Chico 124@AMPS; 90@4 - another increase?

Marina & Chico

Marina & Chico

Member Since 2021
We increased Chico's dose but apparently it is not enough, it is his 7th cycle on 0.75 and we think we might have to go to 1U. 1U was the last dose he saw green preshots on, we hope it might be enough to bring them back and bring back the flatness of the cycle as well :) We will wait for a couple more cycles just to make sure the 61 he registered yesterday was just an exception that can easily be controlled with a little honey.

Thanks in advance for any opinions, ideas about our plan :)

Wishing everyone a great day :bighug:

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Ok, I am just musing... but looking at your spreadsheet you have not had consistent green preshot at any dose.... maybe at 1.75U? Is this really an important goal? Chico is having great cycles, and his nadir values do not really indicate the need for more insulin... just my two cents.... but perhaps the AMPS will come down with time?
 
Hercule's mum said:
Ok, I am just musing... but looking at your spreadsheet you have not had consistent green preshot at any dose.... maybe at 1.75U? Is this really an important goal? Chico is having great cycles, and his nadir values do not really indicate the need for more insulin... just my two cents.... but perhaps the AMPS will come down with time?
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He started having green preshots at 1U as well, they start with PM cycle and after a while the AM cycle should start having them as well. In my opinion if we managed to keep him at 1U for longer he would have started having the AM preshots green as well. Yes, having green preshots is important because by getting those means that his pancreas is working on its own, not only relying on insulin - therefore a remission is more realistic. Chico's nadirs are low (if we don't honey him up) but the low values lasts for half an hour and then he goes immediately up and overall his values go gradually higher. Maybe it's not visible "to the naked eye" but since we are in his SS every day all day we notice the trend.

I think this is what happens to Hercules as well and the reason for better and more stable values in February was a higher dose. Hercules dives, and goes up very quickly, i think (again - only my opinion) is that if you would manage to stop his steep dives he would stabilize and gradually increase his overall values but become flatter. When this happens i think you can increase insulin dose and do the same exercise again until he becomes more stable on his own. Honestly i don't know if this will work as planned with Chico but up until now, nobody could give me a way to "stop" him from diving again, i know that at a higher insulin dose he was much flatter.
 
I see what you are saying, and I have wondered whether I should up Hercules dose and carb him up through the tricky spots.
The question I have then, is what is the evidence that staying on green 24 hours leads to more remissions than, say 18 hours a day? I understand that intuitively that makes sense, but in practice, a number of cats I have seen going into otj cycles had blue PS? I am not trying to convince you one way or the other... just wondering if there is good evidence for one approach or another?

From my limited research, most studies are really small and not helpful :( At which point is all about your own call...
 
Hercule's mum said:
The question I have then, is what is the evidence that staying on green 24 hours leads to more remissions than, say 18 hours a day? I understand that intuitively that makes sense, but in practice, a number of cats I have seen going into otj cycles had blue PS?
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I've seen many cats go OTJ with blue preshot numbers and have been tempted to do the same when I think about how much I want my life back again, how much I'd like to hang out with friends rather than be home at 7 PM every night to give a shot to a cat. But you know, I don't really want to do this again. If Ruby goes OTJ, I want it to be FOREVER. I don't think she will have green numbers 24 hours a day, but I have worked very hard to get it there as close as possible. I also think Ruby feels better in green numbers--she's more active, playful, kitten-like. Each time I've poked Ruby's civvie sister, I always get numbers below 90 even after a meal. That is representative of a cat with a fully working pancreas.

I think Chico can do this, he just needs more insulin and time to flatten out his cycles. When you can bring him up from a low number with just a little LC, you will know he is heading in the right direction.
 
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Hercule's mum said:
I see what you are saying, and I have wondered whether I should up Hercules dose and carb him up through the tricky spots.
The question I have then, is what is the evidence that staying on green 24 hours leads to more remissions than, say 18 hours a day? I understand that intuitively that makes sense, but in practice, a number of cats I have seen going into otj cycles had blue PS? I am not trying to convince you one way or the other... just wondering if there is good evidence for one approach or another?

From my limited research, most studies are really small and not helpful :( At which point is all about your own call...
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I didn’t find any research on this topic, i lead myself based on Chico’s best period on insulin: it was flat cycles and gradually started with the green preshots. Additionally it is not only the preshots that make us think he needs more insulin, on the 0.5 he started seeing gradually blue +1 and then +1.5, overall he stopped seeing lower values. We think 0.75 is better for him than 0.5 nonetheless it is still not where we want him to be.
 
PerfumedCatMom said:
I've seen many cats go OTJ with blue preshot numbers and have been tempted to do the same when I think about how much I want my life back again, how much I'd like to hang out with friends rather than be home at 7 PM every night to give a shot to a cat. But you know, I don't really want to do this again. If Ruby goes OTJ, I want it to be FOREVER. I don't think she will have green numbers 24 hours a day, but I have worked very hard to get it there as close as possible. I also think Ruby feels better in green numbers--she's more active, playful, kitten-like. Each time I've taken the time to poke Ruby's civvie sister, I always get numbers below 90 even after a meal. That is representative of a cat with a fully working pancreas.

I think Chico can do this, he just needs more insulin and time to flatten out his cycles. When you can bring him up from a low number with just a little LC, you will know he is heading in the right direction.
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For now it is obvious he is not going in the right direction and thank you for the support, we hope too that can get there :) it is exhausting and difficult not to be able to travel anywhere or as a matter of fact leave the house for longer than 6 hours but if it is going to work, the chances are higher the sooner we try so we will try our best

The experiment with the civvie is very nice :) gives some insight

you have a good eye for this, do you think it is safe to increase or should we wait a bit longer?
 
Have you ever looked at Tyler's spreadsheet in 2020? He was down to 0.1 units, and pretty good numbers, but the odd blue. Seems it wasn't quite enough insulin support for the beta cells to fully recover. Of course he had been diabetic longer than Chico. Diane kept on increasing, until he finally snapped to green at 2.75 units, and went OTJ this year. This is probably an extreme example, but as long as you can monitor Chico closely, you could increase. For some cats they just need the one increase to get back on track again.
 
Wendy&Neko said:
Have you ever looked at Tyler's spreadsheet in 2020? He was down to 0.1 units, and pretty good numbers, but the odd blue. Seems it wasn't quite enough insulin support for the beta cells to fully recover. Of course he had been diabetic longer than Chico. Diane kept on increasing, until he finally snapped to green at 2.75 units, and went OTJ this year. This is probably an extreme example, but as long as you can monitor Chico closely, you could increase. For some cats they just need the one increase to get back on track again.
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Thank you very much for Tyles's SS, it was very interesting to see. We hope that increase to 1U will be enough but it is reassuring to see that even after such a big increase it is possible to achieve remission :)
 
Marina, best of luck to you and Chico. I haven't seen anyone analyse and interpret their kitty's numbers as well as you (and of course you even took a look at Minnie's way back when, I am so appreciative!)
Marina & Chico said:
if you would manage to stop his steep dives he would stabilize and gradually increase his overall values but become flatter. When this happens i think you can increase insulin dose and do the same exercise again until he becomes more stable on his own. Honestly i don't know if this will work as planned with Chico but up until now, nobody could give me a way to "stop" him from diving again, i know that at a higher insulin dose he was much flatter.
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I can't relate to these tiny dose discussions (not yet, anyway!) but definitely relating to the discussion about stopping/slowing the diving. I was very stressed with Minnie's last reduction - BG up, ketones up - and now it looks like the 5u is kicking back in, I am quite determined to work on feeding the curve and hopefully flattening more before we need to reduce again.

I am hopeful for you that you get Chico into remission but will be so sorry to lose your keen eye from here!!:bighug: I hope you all get a decent night's numbers AND sleep tonight.
 
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