FrostD
Member Since 2020
I am not sure he came back down. The slightly lower AMPS on 7/1 tells me he may have come down more overnight; or it could be a meter variance thing. Often they come down only to go right back up.
New here. Dosing advice needed
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FrostD
Member Since 2020
Can you explain what you mean by carryover?
Julie Sue & Oscar too
Member Since 2022
His evening dose seemed to affect his morning and I lowered that, helped to get some movement, then his morning seemed to influence the evening and he'd bounce by morning. He's behaving as though 1.75 lasts a full 12 hours. I could be misreading the data, but it's what I suspected.
Julie Sue & Oscar too
Member Since 2022
Or more than 12 hours really.
Julie Sue & Oscar too
Member Since 2022
He's 252 at pmps now. !! Fat dose still?
FrostD
Member Since 2020
So picking a couple of dates that I think you may be referring to, they're all very characteristic of a bounce break. They tend to have later nadirs, and tend to get slightly longer duration. 6/11 into 6/12, 6/14 into 6/15. It seems the 1.75U did a better job of bringing the bounces back down.
They both influence each other essentially. The AM numbers started trending up shortly after you started the different dosing; the smaller PM dose wasn't enough to hold him down. The larger AM dose was able to bring him down decently, and tended to cause bounces that the PM dose couldn't quite cut through.
The important thing is you want his nadir down closer to 90-120. We can work around duration changes, late nadirs, etc.
@Lee Renfro 's Spike is a perfect example.of a very late bounce -break nadir, hopefully he'll get a chance to comment and I can show you on his spreadsheet. Lee also has schedule and monitoring limitations, so we've got a bit of a sliding scale. It doesn't result in perfect numbers, but it's the best we can do given constraints while still keeping Spike safe
We also have another cat who nadirs at like +17 or something, I'll have to dig for that sheet another day. It's just a bit of trial and error figuring out what works best for you and Oscar.
They both influence each other essentially. The AM numbers started trending up shortly after you started the different dosing; the smaller PM dose wasn't enough to hold him down. The larger AM dose was able to bring him down decently, and tended to cause bounces that the PM dose couldn't quite cut through.
The important thing is you want his nadir down closer to 90-120. We can work around duration changes, late nadirs, etc.
@Lee Renfro 's Spike is a perfect example.of a very late bounce -break nadir, hopefully he'll get a chance to comment and I can show you on his spreadsheet. Lee also has schedule and monitoring limitations, so we've got a bit of a sliding scale. It doesn't result in perfect numbers, but it's the best we can do given constraints while still keeping Spike safe
We also have another cat who nadirs at like +17 or something, I'll have to dig for that sheet another day. It's just a bit of trial and error figuring out what works best for you and Oscar.
FrostD
Member Since 2020
Form where I sit, perfect opportunity to try to keep low numbers low. Also possible he may bounce up on you, so a full dose helps tamp that down. So if it were me I would shoot 1.5U - but if you do, you for sure want about a +2/3 to start.
Again, what you're comfortable with. You could also try something like 0.5U to be more cautious.
Julie Sue & Oscar too
Member Since 2022
He's less likely to bounce if I give him 1.5 but more likely to hypo? Am I understanding? I think I've been conservative on dosage. We had a traumatic hypo night early on.
FrostD
Member Since 2020
It's a gamble. You can stall without feeding and retest in 20 mins, how big that rise is may give you a clue. He will still bounce, but the full dose will help hold it down. If you already fed, you can still retest in 20-30 mins but then it's a little less clear if you're seeing food bump or possible bounce.
If you're uncomfortable, ease your way into it
Retest in 20 mins, if he's higher than about 325 (whether or not he ate) that's pretty solid bounce indicator and I would give full dose. If not much rise, do something more conservative that you're more comfortable with, like 0.5U.
Julie Sue & Oscar too
Member Since 2022
He's 242 15 minutes later. What about 1 unit?It's a gamble. You can stall without feeding and retest in 20 mins, how big that rise is may give you a clue. He will still bounce, but the full dose will help hold it down. If you already fed, you can still retest in 20-30 mins but then it's a little less clear if you're seeing food bump or possible bounce.
If you're uncomfortable, ease your way into it
Julie Sue & Oscar too
Member Since 2022
It's a gamble. You can stall without feeding and retest in 20 mins, how big that rise is may give you a clue. He will still bounce, but the full dose will help hold it down. If you already fed, you can still retest in 20-30 mins but then it's a little less clear if you're seeing food bump or possible bounce.
If you're uncomfortable, ease your way into it
He hasn't eaten
FrostD
Member Since 2020
If you're comfortable and can start with a +2, sure. He may still bounce higher later, but let's hope he doesn't and he sees blue!
Julie Sue & Oscar too
Member Since 2022
Ok. 1 unit. I'll check him in two hours.
Julie Sue & Oscar too
Member Since 2022
242 again at +2. I think he'll bounce up by morning but he's not dropping.
Julie Sue & Oscar too
Member Since 2022
That would be great! Fat 1.5 in the am? I feel like the day turned out ok after all.
Lee Renfro
Member Since 2022
Hi, I'm Lee. Spikes Daddy. Yes, y'all can check out Spikes Spreadsheet and see how his dosing is pretty customized for his bouncy self. In Spikes case, just when I get him trending down into the mid-blues for a couple of days, he'll get low at nadir and/or have a late nadir making him too low to shoot at Pre-Shot Time, then bounce into the red for a day or so. It feels like it's a never ending cycle with him. Melissa is fantastic though, at figuring out how to work him.
Julie Sue & Oscar too
Member Since 2022
Boy oh boy! So bouncy. I like how he's really not on a lot of insulin lately.. seems like a good thing.
At this point I think I'm doing well but still just can't get a handle on it. I should be looking for ways to respond to his numbers and try less to find a dose that works. From looking at Oscar over the past few days.. what would you do?
Julie Sue & Oscar too
Member Since 2022
Spike is gorgeous, btw
Lee Renfro
Member Since 2022
Spike thanks you!♡! And your Oscar is a good looking boy also! There is a tab on my SS that is the current dosing guide that Melissa worked out for Spike based on his PS numbers, but it's the nadir number that is the real focus. I can't have him dropping into a hypo or near-hypo situation because I'm always either at work or dead, stone cold asleep at his nadir time usually. A high bounce into the red or high purple usually means that he got very low (for my comfort level anyway) mid-cycle. It's a nearly never ending thing with him.
I'm totally not qualified to give advise. But I personally don't panic over a high PS number (although I HATE seeing them), it's the number at the shots nadir time that I'm hoping is 90-140ish. Melissa is expert at either seeing or guessing the nadir and seeing what the curve is doing in the 12 hour cycle. If all the numbers are trending too high she'll probably want it increased by .25 unit. That's why those +4, +7 tests are a huge help to her.
Your Oscar stays in the red a lot, but he's had some good days too. It appears to take some cats longer to level out. I often wonder is Spike ever will. I ALWAYS err on the side of caution though.
Julie Sue & Oscar too
Member Since 2022
Thanks!
Yes, I meant more attitude and approach than dosing. I think I need to learn how to ride this ride rather than tame it. I worry on tampering things down too much and being at work or asleep during those most sensitive times and have been cautious too.
Oscar seems to have one good day and three bad. I know I can find a better handle on it somehow, I'm just having a hard time making it work well. Glad to know there's others in a similar boat. I will take a look at your dosing guide. I'm interested to see how other kitties behave and how their people handle it. Thank you
Hendrick Cuddleclaw
Member Since 2022
The bouncing is very frustrating and in the case of my kitty Hendrick, he took months to settle down and quit with the trampoline action!
Takes some cats longer than others, of course. It's a marathon not a sprint and you've only just begun so give yourself a break and a deep breath, maybe a hug. It was very frustrating for me that I could not speed up Hendrick's insulin therapy, there were times it seemed like the dose wasn't doing much at all and his numbers were not improving at all but I just needed to take a step back and have some patience. Easier said than done!
Check out Hendrick's AMPS and PMPS numbers, you can really see the bouncing in this graphical representation of the data, and when he finally stopped
Takes some cats longer than others, of course. It's a marathon not a sprint and you've only just begun so give yourself a break and a deep breath, maybe a hug. It was very frustrating for me that I could not speed up Hendrick's insulin therapy, there were times it seemed like the dose wasn't doing much at all and his numbers were not improving at all but I just needed to take a step back and have some patience. Easier said than done!
Check out Hendrick's AMPS and PMPS numbers, you can really see the bouncing in this graphical representation of the data, and when he finally stopped
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Lee Renfro
Member Since 2022
Yes, just ride the ride for the long haul. Kyle said it best about it being a marathon rather than a sprint.
I always (sometimes daily) have to repeat silently "better high for a day than too low for even a minute." That saying gets me through a lot of days with Spike. I can't take the worrying during the day if he's going to drop too low and me not be there to give him carbs, etc., so thats why I'm a little too conservative on his dosing. Spike doesn't like having to stay indoors during the day either, so that I have peace of mind that he's got access to food if he gets low. He is an eating machine, so no worries there...lol. in Spikes case, we hit a point where 1.25u was driving him too low and he would bounce way high, so we reduced to 1.0u. That didn't seem to get thee job done, so we went back up to 1.25u and it was too high and he went down to like 67...so back to a max dose of 1.0u it is...
The biggest help on it is that when I have to get out of bed in the middle of the night or have a day off, is that i can get a +4, +6 or +7 test in. Those can really tell the tale of why he is so high at PS time or even if he has earned a reduction in dose. So danged hard for me to do though.
Just hang in there and keep fighting the good fight. Hendrick is totally "off the juice" now, so it IS possible for Oscar and maybe even ol' Spike.
Julie Sue & Oscar too
Member Since 2022
That's crazy that you were able to get him otj.
How old is Hendrick?
At the beginning of this whole thing I thought, maybe I'll get another year with him. So I have a sense of urgency that doesn't go well with being super patient. Oscar's about 16 already and we've been at it with the insulin 5 months already. Truthfully he only looks better and better as we go but is remission really possible at his age?
I would be happy if I could just keep him under 300 all day. Those green numbers are frightening! Haha. I can't monitor him all day everyday. I'm already exhausted. Your bravery has paid off though. I see the benefit of being less conservative with my dosing. IDK if I'm brave enough.
Hendrick Cuddleclaw
Member Since 2022
Hendrick is 10 years old and you're right, Oscar being 16 may make for a more challenging management of his FD and maybe in his future is only regulation, not remission. But regulation is great, cats can have a fantastic quality of life when well-regulated.
There is a 16.5 year-old kitty here at the FDMB just days away from being considered in remission though, so it's not impossible. All depends on the cat imo.
And yes, I followed the Tight Regulation dosing method which is aggressive and required a lot of testing, sleepless nights, and shooting doses of insulin at low BG numbers. Lowest I ever shot was a 63 but TR says shoot anything 50 or higher (human meter numbers that is). It takes some courage no doubt about it.
There is a 16.5 year-old kitty here at the FDMB just days away from being considered in remission though, so it's not impossible. All depends on the cat imo.
And yes, I followed the Tight Regulation dosing method which is aggressive and required a lot of testing, sleepless nights, and shooting doses of insulin at low BG numbers. Lowest I ever shot was a 63 but TR says shoot anything 50 or higher (human meter numbers that is). It takes some courage no doubt about it.
Julie Sue & Oscar too
Member Since 2022
We had a terrifying hypo situation months ago as the vet had him up to 4 units and I wasn't monitoring him properly. Bad advice.
Tight regulation is not for me. I worry way too much and don't have the time or energy. I just want my old man to live out whatever he's got left comfortably. Making the right choices when ecid and the professionals know very little has been one of the biggest challenges of my life... And my family is definitely concerned about me. Balance and bravery. We're working on it.
Julie Sue & Oscar too
Member Since 2022
Unfortunately we didn't see yellow this morning. So now I've tried .5, 1 and 1.5 on a low ps. As far as I can tell, none of which prevented a big rise in the am. Next time I will try a whole dose. Also I'm thinking we will need to go up to 1.75 here soon. A few more days on the fat dose.. just don't think it'll help to change the dose again quite yet.. but I'm seeing what you're saying.
My Dad has been in town and thinks I'm absolutely nuts for giving this old cat so much of my energy... Let's not dive in deeper today. But I will give him a full dose tonight if he's in the 200s again.
FrostD
Member Since 2020
Just remember you're not going to stop a bounce. About the only way to stop a bounce is to feed the curve in a way that prevents fast, hard drops. Strategically feeding food to help "ride the brakes" as it were. But (1) in my opinion that just isn't worth the time/effort at the moment, partly because (2) his bounces tend to be caused by lower numbers than he's used to, not necessarily fast drops.
Our goal is just to help tamp it down a bit, as it's a little easier to recover from say 300s vs 400s and probably feels a little better. But as I said last night, sometimes it's a risk because you don't always know if they're going to bounce. Full dose can help tamp it down, but could also result in some lower numbers and extra testing if he doesn't bounce.
I think to people outside looking in, it does seem crazy. But a lot of us here are of the mindset that we took these cats in, with the responsibility and accountability to give them the best life we can - and that looks a little different for everyone. It just becomes part of the routine, part of the day. It's quick once you've got the hang of it. Diabetes, if left untreated or poorly treated, is honestly like long-term torture. They slowly waste away, it wears away on everything. So I'd much rather take the total 30 minutes out of my day to give insulin and test. I'm actually more annoyed by his current meds schedule than I was with shots and testing
(current meds require gloves when medicating, handling any bodily fluids/things that have touched bodily fluids, thorough cleaning, etc).
Our goal is just to help tamp it down a bit, as it's a little easier to recover from say 300s vs 400s and probably feels a little better. But as I said last night, sometimes it's a risk because you don't always know if they're going to bounce. Full dose can help tamp it down, but could also result in some lower numbers and extra testing if he doesn't bounce.
I think to people outside looking in, it does seem crazy. But a lot of us here are of the mindset that we took these cats in, with the responsibility and accountability to give them the best life we can - and that looks a little different for everyone. It just becomes part of the routine, part of the day. It's quick once you've got the hang of it. Diabetes, if left untreated or poorly treated, is honestly like long-term torture. They slowly waste away, it wears away on everything. So I'd much rather take the total 30 minutes out of my day to give insulin and test. I'm actually more annoyed by his current meds schedule than I was with shots and testing
(current meds require gloves when medicating, handling any bodily fluids/things that have touched bodily fluids, thorough cleaning, etc).
Julie Sue & Oscar too
Member Since 2022
Just remember you're not going to stop a bounce. About the only way to stop a bounce is to feed the curve in a way that prevents fast, hard drops. Strategically feeding food to help "ride the brakes" as it were. But (1) in my opinion that just isn't worth the time/effort at the moment, partly because (2) his bounces tend to be caused by lower numbers than he's used to, not necessarily fast drops.
Our goal is just to help tamp it down a bit, as it's a little easier to recover from say 300s vs 400s and probably feels a little better. But as I said last night, sometimes it's a risk because you don't always know if they're going to bounce. Full dose can help tamp it down, but could also result in some lower numbers and extra testing if he doesn't bounce.
I think to people outside looking in, it does seem crazy. But a lot of us here are of the mindset that we took these cats in, with the responsibility and accountability to give them the best life we can - and that looks a little different for everyone. It just becomes part of the routine, part of the day. It's quick once you've got the hang of it. Diabetes, if left untreated or poorly treated, is honestly like long-term torture. They slowly waste away, it wears away on everything. So I'd much rather take the total 30 minutes out of my day to give insulin and test. I'm actually more annoyed by his current meds schedule than I was with shots and testing
Absolutely. He's my responsibility and I want to do my best to give him a happy retirement.
He dropped pretty fast today.. 200 points in 3 hours. I don't know if that's good or bad but the fat dose does seem to be bringing those numbers down. Faster today than yesterday.
Hendrick Cuddleclaw
Member Since 2022
I wasn't trying to push it, sorry if it came off that way. It is definitely not for everyone, the other method, SLGS (start low go slow) is also very effective and a lot of people find it fits their situations and lives better than TR. Another thing to note is Hendrick was on Lantus/Basaglar not ProZinc.
Julie Sue & Oscar too
Member Since 2022
No no, just saying, different strokes. I'd be a nervous wreck all the time.
I'm learning how different insulins work differently. I'm glad he has options. It's all very interesting and confusing and frustrating. Ha
Lee Renfro
Member Since 2022
Yes, it is frustrating at times. If Spike doesn't get off his Rollercoaster soon, I'm looking into Lantus. I think there are some scary downsides with a depot insulin too. I feel the same way about my lil buddy as you do about Oscar. It's my job to give him the best life possible because they are family.
@Julie Sue & Oscar too - when you have a chance, can you start a new thread? This one is getting rather long.
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