? 12/13, Sam, AMPS 332,+9 281, PMPS 287, +2 209, +4 151, +5 65, +8 104

chuckstables

chuckstables

Member Since 2022
Had given him food at 6am or so; he was begging me for it, also gave some an hour pre shot due to the begging. He might’ve bounced; i was too tired to test. At work all day
 
It is ok but wanted you to know that was likely factor in the high bg. Eating late in the cycle can cut duration as well.
 
Ah, so stop feeding in the last 2 hrs? I think he got too low last night again. He woke me up early demanding food, running around the apartment agitated. But at that time i’m exhausted and can barely get myself up to feed him.
 
When new it’s best to pick up food 2 hours before amps/pmps. Once you know how much of a food bump he gets you don’t have to follow that rule. I always did though some that if I had a low preshot I knew it wasn’t food influenced.
 
I’m almost happy he’s higher today; means i have less to worry about when i’m at work. Should i be testing for ketones as well? I feel like with us cutting his dose down to a third within 2 weeks that would be a concern.
 
+9 281, and he hasnt eaten in 9 hours. So i’m kinda tempted at this point to just change protocols. I’m testing him enough, and i have a better understanding of how he responds to the insulin.

Can anyone chime in with thoughts on this? I have 2 more months to regulate him before we cross the 6 month mark, i need to get him regulated and i don’t think i can do that if everytime he’s green i reduce his dose.

He’s off of dry food completely, only eats wet. I’m testing a lot, and i know he can survive low numbers.

I’ll read some more about TR tonight; if anyone else can chime in that’d be great.
 
I'm tempted to just put him back on 1.25, probably shouldn't have switched it so quickly, he took 2 dose reductions in one day because of how things turned out with the 2 90's before his next dose.
 
Depending on his PMPS readings I'm tempted to just raise him back up to 1.5 and switch over to TR. He's had over 400 ml's of water today, which is like 3-4x higher than normal. I'll do a PMPS test but if it's red I don't know. I don't want him reverting to what he was like before, and this is pretty much it.
 
+10 362, haven't fed him yet, after his test I just gave him 1 tsp of food. This is about the time last night when he started spiking as well. So I don't know; if he's above 400 at his PMPS test I'm going to be switching him to TR and increasing back to 1.5, as clearly 1 is not doing it for him (evidence; he drank 4x what he typically does today, urinated four times that I can count in the litter box, and has very high readings). I've read up on TR, I know that you need to hold for at least 6 cycles, I'll follow that to determine dosing changes from now on (assuming he's above 400 when I do PMPS). If I'm totally off base here please let me know.
 
chuckstables said:
Depending on his PMPS readings I'm tempted to just raise him back up to 1.5 and switch over to TR. He's had over 400 ml's of water today, which is like 3-4x higher than normal. I'll do a PMPS test but if it's red I don't know. I don't want him reverting to what he was like before, and this is pretty much it.
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Where is he at # wise right now?
 
chuckstables said:
+10 362, haven't fed him yet, after his test I just gave him 1 tsp of food. This is about the time last night when he started spiking as well. So I don't know; if he's above 400 at his PMPS test I'm going to be switching him to TR and increasing back to 1.5, as clearly 1 is not doing it for him (evidence; he drank 4x what he typically does today, urinated four times that I can count in the litter box, and has very high readings). I've read up on TR, I know that you need to hold for at least 6 cycles, I'll follow that to determine dosing changes from now on (assuming he's above 400 when I do PMPS). If I'm totally off base here please let me know.
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We cross posted Lol 362@+10. Is his spreadsheet updated?
 
Yeah the problem is; he shouldn't be bouncing FROM anything. He definitely wasn't hypo today; I had left out some food for him, he ate it, and he started the day pretty high. He's never bounced before in a way that resulted in his symptoms of diabetes returning. I'll see what his PMPS numbers are, but idk. I can't do this to him; I won't have him dying of DKA like so many other threads I've read following dose reductions.
 
chuckstables said:
+10 362, haven't fed him yet, after his test I just gave him 1 tsp of food. This is about the time last night when he started spiking as well. So I don't know; if he's above 400 at his PMPS test I'm going to be switching him to TR and increasing back to 1.5, as clearly 1 is not doing it for him (evidence; he drank 4x what he typically does today, urinated four times that I can count in the litter box, and has very high readings). I've read up on TR, I know that you need to hold for at least 6 cycles, I'll follow that to determine dosing changes from now on (assuming he's above 400 when I do PMPS). If I'm totally off base here please let me know.
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@Suzanne & Darcy @Bandit's Mom I think Sam is bouncing from the greens yesterday @chuckstables is worried that taking 2 reductions in one day was a mistake. Please advice him what to do? I think his water intake increasing is possibly just due the higher numbers ?
 
Chrispooky12 said:
@Suzanne & Darcy @Bandit's Mom I think Sam is bouncing from the greens yesterday @chuckstables is worried that taking 2 reductions in one day was a mistake. Please advice him what to do? I think his water intake increasing is possibly just due the higher numbers ?
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Thanks, I just find it difficult to believe that he would still be bouncing. He didn't even get that low. He's never bounced THIS hard before? And it's never lasted more than a cycle, 2 at most. And we're at the 2 cycle mark at this point pretty much.
 
chuckstables said:
Yeah the problem is; he shouldn't be bouncing FROM anything. He definitely wasn't hypo today; I had left out some food for him, he ate it, and he started the day pretty high. He's never bounced before in a way that resulted in his symptoms of diabetes returning. I'll see what his PMPS numbers are, but idk. I can't do this to him; I won't have him dying of DKA like so many other threads I've read following dose reductions.
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I think your safe from DKA since he has no history of it. I understand though my boys numbers are high right now but I'm supposed to keep at the dose he's at now for 10 cycles due to him being in the greens on 12-10.
 
Chrispooky12 said:
I think your safe from DKA since he has no history of it. I understand though my boys numbers are high right now but I'm supposed to keep at the dose he's at now for 10 cycles due to him being in the greens on 12-10.
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Yeah. I think part of the problem is that if I'm on SLGS I have to reduce it a quarter of unit immediately if he's below 90, so I'm definitely switching to TR at this point. I got 2 months to regulate him if he's gonna have a decent chance of remission, so I'd like to start sooner rather than later. If I'm following TR I should increase his dose back to his last dose (which was pretty much 1.5.

I have a lot more knowledge now. The vet did actually tell me he had ketones in his blood at diagnosis, but I didn't see that anywhere on his lab work. That's kind of why I'm worried about it. I'm not testing for them right now; I need to buy a blood meter to do that. The test strips I was using apparently suck, and now I'm out of them.
 
Ugh. I'm just gonna go for a walk and figure out what to do. Leaning towards just switching to TR, reverting the dose decrease, and going from there assuming he's still up for the rest of his next cycle. His longest bounce only really lasted one cycle, so kind of confused. Still got about 1.5 hours before his next dose.
 
chuckstables said:
Yeah. I think part of the problem is that if I'm on SLGS I have to reduce it a quarter of unit immediately if he's below 90, so I'm definitely switching to TR at this point. I got 2 months to regulate him if he's gonna have a decent chance of remission, so I'd like to start sooner rather than later.
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Remission doesn't happen for every cat. Your goal right now is regulation, my boy was pretty much regulated but on 12-2 he injested some advil & he's been all out of wack since than. My boy has been diabetic for almost 3yrs now. I found this site a year & a half ago,before than I was feeding dry food & blind dosing him 6 units. He may never go into remission but I hope he does. Some cats it takes a little longer to achieve remission. I saw one on here awhile back that it took 11yrs to get to remission, I hope that's not the case for either one of us because that's a long time! He can still achieve remission after 6mons, every cat is different. Don't give up, I know it's hard. I'm doing this by myself & I have a full-time job, I sleep when ever I get a chance, lot's of naps.
 
Chrispooky12 said:
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Remission doesn't happen for every cat. Your goal right now is regulation, my boy was pretty much regulated but on 12-2 he injested some advil & he's been all out of wack since than. My boy has been diabetic for almost 3yrs now. I found this site a year & a half ago,before than I was feeding dry food & blind dosing him 6 units. He may never go into remission but I hope he does. Some cats it takes a little longer to achieve remission. I saw one on here awhile back that it took 11yrs to get to remission, I hope that's not the case for either one of us because that's a long time! He can still achieve remission after 6mons, every cat is different. Don't give up, I know it's hard. I'm doing this by myself & I have a full-time job, I sleep when ever I get a chance, lot's of naps.
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Thanks! I definitely won't give up, but if he remains sustained high into his next cycle then his next dose is going to be 1.5 units, and I'm going on TR. I test him more than enough at this point; only difficulty is testing while I'm in the office. But he drops under 90 all the time; I can't keep on reducing his dose on SLGS (which I'm suspecting isn't designed for people testing as much as I am, but I may be wrong).
 
chuckstables said:
Thanks, I just find it difficult to believe that he would still be bouncing. He didn't even get that low. He's never bounced THIS hard before? And it's never lasted more than a cycle, 2 at most. And we're at the 2 cycle mark at this point pretty much.
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They can bounce for quite some time, I see it all the time o
chuckstables said:
Thanks! I definitely won't give up, but if he remains sustained high into his next cycle then his next dose is going to be 1.5 units, and I'm going on TR. I test him more than enough at this point; only difficulty is testing while I'm in the office. But he drops under 90 all the time; I can't keep on reducing his dose on SLGS (which I'm suspecting isn't designed for people testing as much as I am, but I may be wrong).
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You do test alot, I do as well & I'm following TR but I've been doing it for quite some time. I would wait & see if someone chimes in before you increase though.
 
chuckstables said:
Thanks, I just find it difficult to believe that he would still be bouncing. He didn't even get that low. He's never bounced THIS hard before? And it's never lasted more than a cycle, 2 at most. And we're at the 2 cycle mark at this point pretty much.
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They can bounce for quite some time, I see it all the time on other people's spreadsheets.
 
chuckstables said:
They can, he hasn't though. Plus his latest test scares the F out of me and confuses me.
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I completely understand I just got a 311@+4 PMPS for my boy. He rarely ever gets in the 300s. He normally stays in the blues & greens but he's just all out of wack because he was so low when he injested the advil that I had to skip a shot than the next day he was still low so I head to give him a token dose of 1.5 he was up to 2.75 before the advil, & I'm slowly increasing him back up.
 
So +10.5 and we're at.... 365. Lovely. Just absolutely fantastic. He was lower when I came home! He's barely eaten! smh. I don't get this.

EDIT: Nevermind I'm stupid and can't type. 365, not 395. I won't even post to the SS, will just post the +11.

Chrispooky12 said:
I completely understand I just got a 311@+4 PMPS for my boy. He rarely ever gets in the 300s. He normally stays in the blues & greens but he's just all out of wack because he was so low when he injested the advil that I had to skip a shot than the next day he was still low so I head to give him a token dose of 1.5 he was up to 2.75 before the advil, & I'm slowly increasing him back up.
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Oh crap; how is he doing now? I remember posting to that thread. He doing okay? Any blood in the stool? I remember following that thread intensely, was really worried, but I'm glad he's doing better. I remember looking up the LD50 for ibuprofen in cats. It's great that he's okay though.
 
chuckstables said:
So +10.5 and we're at.... 365. Lovely. Just absolutely fantastic. He was lower when I came home! He's barely eaten! smh. I don't get this.

EDIT: Nevermind I'm stupid and can't type. 365, not 395. I won't even post to the SS, will just post the +11.


Oh crap; how is he doing now? I remember posting to that thread. He doing okay? Any blood in the stool? I remember following that thread intensely, was really worried, but I'm glad he's doing better. I remember looking up the LD50 for ibuprofen in cats. It's great that he's okay though.
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He's doing okay, but like you I don't like the high numbers. He will come back down eventually though. I've been giving him slippery elm with bark every other day to help soothe his stomach because he's had spouts of puking up a small amount of liquid, but he's fine. I told him even if he has a headache he's not allowed to take advil :smuggrin:
 
Chrispooky12 said:
He's doing okay, but like you I don't like the high numbers. He will come back down eventually though. I've been giving him slippery elm with bark every other day to help soothe his stomach because he's had spouts of puking up a small amount of liquid, but he's fine. I told him even if he has a headache he's not allowed to take advil :smuggrin:
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Lmao, yeah no advil for him. Has the stomach upset been improving though? If so then he’ll be okay. Only reason i know so much about advil overdose is because i had to help someone who attempted suicide with advil one time. Talked her through it and she went to the hospital, we spoke about it quite a bit.
 
chuckstables said:
Lmao, yeah no advil for him. Has the stomach upset been improving though?
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Yeah he's eating fine & acting fine. He doesn't ever drink water neither does my other cat. It's there for them daily but they don't touch it. It worried me at first but It's normal. I put 3 tablespoon of water in every meal so thats how they get there water.
 
chuckstables said:
So +10.5 and we're at.... 365. Lovely. Just absolutely fantastic. He was lower when I came home! He's barely eaten! smh. I don't get this.

EDIT: Nevermind I'm stupid and can't type. 365, not 395. I won't even post to the SS, will just post the +11.
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Which dosing method have you decided on? I saw on an earlier post that he's off all dry food. Are you still doing SLGS as of today?
 
Chris & China (GA) said:
Which dosing method have you decided on? I saw on an earlier post that he's off all dry food. Are you still doing SLGS as of today?
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As of today i will be using TR. I’ve read a lot on it now, i can do a mid night cycle Nadir test always, but only for 9/14 days in a 2 week period can i get a mid day cycle NADIR. If my boss would let me merge by breaks i would have enough time to run home; he won’t allow it. I’m tempted to just put him back on 1.5 and monitor nadir at 3am, i shoot in 1 hr. He allegedly had ketones at DX, never seen them since. I just don’t want him dying.

So TLDR; my plan is to shoot at 7am from now on and 7pm (will adjust shoot time back 15 mins per day to reach this). I will test AMPS. This gives me enough to do a +2 currently. Then i test again at +6 if it’s a WFH day/ weekend. If not then i don’t. Then i test at PMPS, and then at 1am at nadir. Rinse, repeat. Follow TR protocol which i have read. Go off of both nadirs on days i can, go off of evening nadir otherwise.
 
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chuckstables said:
As of today i will be using TR. I’ve read a lot on it now, i can do a mid night cycle Nadir test always, but only for 9/14 days in a 2 week period can i get a mid day cycle NADIR. I’m tempted to just put him back on 1.5 and monitor nadir at 3am, i shoot in 1 hr
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OK...first, edit your Signature and add "TR" next to the insulin info and change it on your spreadsheet too. It's also helpful to put a line between yesterday's numbers and today's that makes it clear that you've switched. If you look at China's spreadsheet for 9/2018 you'll see some examples of what I mean.

You do not need to get a mid-cycle test on the PM cycle every night. If you can get 1 or two "before bed", that can tell you if you really need to set an alarm to get more tests later in the cycle or not. In a lot of cats, the +2 can almost predict what's going to happen later in the cycle (some cat's the +3 is a better predictor)

If the +2 is about the same as the PS, it's usually a pretty normal cycle, gradually down to nadir and gradually back up to the next PS.

If the +2 is higher than the PS, that usually indicates the beginning of a bounce and those cycles you can usually get away with getting some extra sleep instead of worrying about testing.

If the +2 is lower than the PS, that's your early warning that he might be planning on dropping a lot lower later in the cycle so those are the times you'll want to make sure you get more tests later, even if you have to set an alarm.

I would continue with the 1U dose for now. He was just in green yesterday morning so let's see what the 1U dose does. You'd only have to hold it for a max of 3 days (6 cycles) and if we don't see any green or low blue, you could go up to 1.25.

You've come this far...don't try to rush it or you could end up falling further behind.

Good luck!!!
 
Chris & China (GA) said:
OK...first, edit your Signature and add "TR" next to the insulin info and change it on your spreadsheet too. It's also helpful to put a line between yesterday's numbers and today's that makes it clear that you've switched. If you look at China's spreadsheet for 9/2018 you'll see some examples of what I mean.

You do not need to get a mid-cycle test on the PM cycle every night. If you can get 1 or two "before bed", that can tell you if you really need to set an alarm to get more tests later in the cycle or not. In a lot of cats, the +2 can almost predict what's going to happen later in the cycle (some cat's the +3 is a better predictor)

If the +2 is about the same as the PS, it's usually a pretty normal cycle, gradually down to nadir and gradually back up to the next PS.

If the +2 is higher than the PS, that usually indicates the beginning of a bounce and those cycles you can usually get away with getting some extra sleep instead of worrying about testing.

If the +2 is lower than the PS, that's your early warning that he might be planning on dropping a lot lower later in the cycle so those are the times you'll want to make sure you get more tests later, even if you have to set an alarm.

I would continue with the 1U dose for now. He was just in green yesterday morning so let's see what the 1U dose does. You'd only have to hold it for a max of 3 days (6 cycles) and if we don't see any green or low blue, you could go up to 1.25.

You've come this far...don't try to rush it or you could end up falling further behind.

Good luck!!!
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Okay. I'll follow that. I won't try to rush it. Thank you. If I detect ketones, what do I do? Because he had them when he was at similar levels at DX according to the vet (but the bloodwork didn't have them, not sure how he tested for it). You really think that even with those high numbers I should hold at 1? Not even 1.25? If that's your advice I'll stick to it, you have my word. I'm just a bit of an idiot sometimes and have a tendency to get headstrong and go "this is what I'm going to do, you can't tell me otherwise". I've really REALLY had to clip that urge over the last 2 weeks.
 
Chris & China (GA) said:
OK...first, edit your Signature and add "TR" next to the insulin info and change it on your spreadsheet too. It's also helpful to put a line between yesterday's numbers and today's that makes it clear that you've switched. If you look at China's spreadsheet for 9/2018 you'll see some examples of what I mean.

You do not need to get a mid-cycle test on the PM cycle every night. If you can get 1 or two "before bed", that can tell you if you really need to set an alarm to get more tests later in the cycle or not. In a lot of cats, the +2 can almost predict what's going to happen later in the cycle (some cat's the +3 is a better predictor)

If the +2 is about the same as the PS, it's usually a pretty normal cycle, gradually down to nadir and gradually back up to the next PS.

If the +2 is higher than the PS, that usually indicates the beginning of a bounce and those cycles you can usually get away with getting some extra sleep instead of worrying about testing.

If the +2 is lower than the PS, that's your early warning that he might be planning on dropping a lot lower later in the cycle so those are the times you'll want to make sure you get more tests later, even if you have to set an alarm.

I would continue with the 1U dose for now. He was just in green yesterday morning so let's see what the 1U dose does. You'd only have to hold it for a max of 3 days (6 cycles) and if we don't see any green or low blue, you could go up to 1.25.

You've come this far...don't try to rush it or you could end up falling further behind.

Good luck!!!
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Sorry for the 2nd post, but just to confirm. So my testing regimen goes like this:

AMPS (7 am), test
+2 (9am), test.
+6 (1pm), test if not working in the office (I'm in the office 5 days in a row per 2 weeks).
PMPS (7pm), test
+2, test
+3, test

If I see a big drop of AMPS to +2, then I should leave some food out? I work currently at 10:05 am, takes me 15 minutes to get to work. My shift times are switching to 9:00 am to 5pm in January though, so I might have to push everything back an hour when that starts.

And if it drops a lot PMPS, then I need to do some more tests during the evening. Am I understanding this correctly?
 
chuckstables said:
ou really think that even with those high numbers I should hold at 1?
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Yes for now. Since you just reduced from 1.25, you won't necessarily have to hold the 1U dose for the full 6 cycles...just long enough for us to know for sure he can't get into good numbers on the 1U.

When practicing TR you're looking to bring kitty's numbers down to that of a normal cat (50mg/dL to 80mg/dL) and under 100 overall. Therefore, when following TR you'll want to hold the reduced dose: (red highlights are mine)
  • until kitty falls below 50 mg/dL and earns another reduction, or
  • unless the reduction has failed (if you see BG numbers trending upwards after any bounce clears... you'll want to take the dose up,...no particular number of cycles...just once you're sure the bounce is over) or
  • for at least a week (stabilize the cat) if kitty's numbers maintain that of a normal cat (50mg/dL to 80mg/dL) and under 100 overall.
 
PMPS: 288. Those last two test strips I used were the last ones in the free 10 strip bottle that came with the bravo meter. Turns out they expired 2 weeks ago. Not sure if maybe that's why the results were so wildly different than the ones I got when I got home and the one I just did? In any case; 288. That's better. Should I remove the one that was stupidly high? Seems weird that he'd bounce up THAT MUCH, and then bounce down THAT much when I've fed him in the last few hours.
 
chuckstables said:
If I see a big drop of AMPS to +2, then I should leave some food out?
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Yes, if you're not going to be there to test. This "Is TR possible with a full time job" thread has some good idea's you might find helpful.

chuckstables said:
And if it drops a lot PMPS, then I need to do some more tests during the evening. Am I understanding this correctly?
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Any time you see a big drop at +2, you should plan on getting more tests in IF YOU CAN. If not, an auto-feeder can be your best friend because you can put higher carb food in it and program it to open every hour or 2 to make sure he stays safe. It's better that he runs too high for a day than too low for a minute.

chuckstables said:
My shift times are switching to 9:00 am to 5pm in January though, so I might have to push everything back an hour when that starts.
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Let us know about 2 weeks before. We all deal with time changes twice a year so we have it worked out on how to safely move back an hour or forward an hour.
 
Wait; I have one more expired bottle that just came with the 2nd meter I ordered (expired december 6th this time). Gonna retest and see if I get a different result.
 
So this one was 22.8 (about 410). Just tested him again (poor buddy) with the non expired ones and got 290, only 16.1, vs 16 that I tested before. So that'd probably be why. Why the hell would bravo send me test strips that were gonna expire in like 2 days (they're the free 10 test strip bottle that comes with the meter). I'm removing the stupidly high test from his spreadsheet, pretty sure the test strips are just effed after sitting around for 3 years.

TLDR: Don't be an idiot like me and use expired test strips. They're probably expired for a reason.
 
chuckstables said:
Why the hell would bravo send me test strips that were gonna expire in like 2 days (they're the free 10 test strip bottle that comes with the meter).
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They probably have a boatload of meters and don't sell enough of them to get rid of them all before the freebies are out of date. I'd call them and complain though...might get you a free or reduced bottle of new strips.
 
Chris & China (GA) said:
They probably have a boatload of meters and don't sell enough of them to get rid of them all before the freebies are out of date. I'd call them and complain though...might get you a free or reduced bottle of new strips.
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+2 207, maybe he is just bouncing?
 
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Bounces can take six cycles/three days to resolve. Patience is an important skill we all learn with Lantus. :p I'd get a test before bed, then see where he is in the morning. Actually, I'd probably give him another day on this dose, so you can see what 1.0 units can do by itself, before deciding if you want to increase again. Sam seems to be taking 3-5 cycles to resolve bounces now, tonight is cycle 3.
 
Wendy&Neko said:
Bounces can take six cycles/three days to resolve. Patience is an important skill we all learn with Lantus. :p I'd get a test before bed, then see where he is in the morning. Actually, I'd probably give him another day on this dose, so you can see what 1.0 units can do by itself, before deciding if you want to increase again. Sam seems to be taking 3-5 cycles to resolve bounces now, tonight is cycle 3.
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+3 151.

Thanks wendy for your input. Of course you guys are right and i’m looking like a trigger happy imbecile.

Can you guys pray to the patience gods and bless me with some? Lol; i need it.
 
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