08/26 Fistuk, AMPS 272, +2.5 281, +6 216

Fistuk & Shelly

Member Since 2023
https://felinediabetes.com/FDMB/threads/08-25-fistuk-amps-380.280835/#post-3097653

GOOD MORNING! :)

Looks like we're clearing out of the bounce? :cat:

I'd like to test him today at +2.5 because it takes him about half an hour to finish bf, that'll give us 2 hours after food.

We both slept through the night which was wonderful! The heat is also clearing out here, had buckets of rain for the past two days.

Fistuk was playful this morning. Chased a tiny bit after a string. More encouraging signs.
 
Looks like he might clear the bounce this morning.

You don't have to test 2 hours after food. Food takes only around 20 mins to affect numbers. The reason we suggest +2 is because that's when most cats onset on Lantus.
 
Looks like he might clear the bounce this morning.

You don't have to test 2 hours after food. Food takes only around 20 mins to affect numbers. The reason we suggest +2 is because that's when most cats onset on Lantus.
Right! :)
I’ll give the +2.5 a try today bc I thought this is where I’m going to see more if for Fistuk it’s the onset (of where the BG is beginning to drop) does that make sense ?
 
Hi Shelly, the following is from the Basics stick.

It describes a active lantus cycle, and is the reasoning behind why we often ask for tests at certain times, we are looking for onset, and nadir for a given cat.

Not every cat onset at the same time and a given cat can change its onset from one cycle to another. Getting to know fistuks patterns is what its all about.

I'll use George as an example, once he started having active cycles his onset was around d +1 to+3
How did I recognise onset? A significant drop in bg from PS signalled onset.

Usually if he onset at +1, he would drop like a rock, so I knew I had to be vigilant
The later he onset the more gentle the cycle would be. With an early onset he usually nafired earlier. Nadirs can happen at any time too, George for instance nadired usually at +5/6 but he did nadir as early as +2 and as late as +12

Learning this gave me the opportunity to manage him more confidently.

Anyways here's the info from the basics sticky

Example of an ACTIVE, but NOT necessarily typical Lantus and glargine biosimilars cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus/Basaglar/Semglee cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir/Biosimilars: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

An active Levemir cycle will have an onset at approximately +4 and a nadir around +8 - +10. However, please keep in mind every cat is different (ECID). Data collection will offer you a better picture of YOUR cat's response to either of these insulins.

Initially, don't expect to see "active" cycles after every single shot whether you're using Lantus, Levemir or Biosimilars. Chances are, your kitty had diabetes for some time before diagnosis. It requires time for kitty's body to become used to dropping into lower numbers than their bodies have become accustomed. Don't expect immediate results! Regulation takes time and patience:

  • Also worth noting: "Many cats will occasionally react to an increased dose with increased BGs - within the first 2 to 3 days after an increase, usually lasting for less than 24 hours. Nobody really knows what the reason for this phenomenon is (perhaps a "panicky liver"?) - hold the dose and ignore the fluctuations." http://www.tillydiabetes.net/en_6_protocol2.htm. Here in the Lantus, Levemir, and Biosimilars Insulin Support Group (ISG), we've affectionately dubbed this unexplained phenomenon "New Dose Wonkiness" (NDW).
 
I got a phone call from an assistant two days ago asking me to send the vet the BG. So I sent a link to the SS. Got an email today - in total that's nearly a week since I called and asked to speak to a vet!

In her email she basically told me to f**k off, n a very Swiss way. She said:
Freedom Lite os not a valid meter for cats!
There's no research about it
They want me to buy the Alpha track
Insulin adjustment should me done every 5-7 days, a faster adjustment can lead to Somogyi effect.

So sorry, a lot of us have had similar experiences, my vet simply washed her hands of FD, she was happy for me to do my own thing but mostly because she had no idea, and it was easier for her to delegate that responsibility to me. I've si ce had other issues with her apathy when my pets get sick, so I no longer use her.
Pet meters are a fairly recent, in the scheme of things and earlier studies do reference human meter readings (romp rand study which then goes on to describe the TR Protocol with lantus, specifically references human meter readings, and stimulates the use of human meters to follow the protocol, it's not that we don't recognise that theirs a difference between human and pet meters, there is, but as a tool the human meter is as effective to monitor your cats BG, even if it's readings don't exactly match with a pet specific test, and more importantly in my opinion, if the romp rand TR Protocol was developed using human meters and we recognise theres a difference, I would argue that it is preferable to use a human meter when following that protocol.

Sorry she gave you a hard time.:kiss:
 
Good morning :cool:

Nice start today!
Good job on getting a PM+10 last night; I see it was pink however it did not convert the number on the US tab for some reason…

There is a third noteworthy marker to watch for after onset and nadir and that is duration- the length of time insulin continues to lower blood glucose.
 
Hi Shelly, the following is from the Basics stick.

It describes a active lantus cycle, and is the reasoning behind why we often ask for tests at certain times, we are looking for onset, and nadir for a given cat.

Not every cat onset at the same time and a given cat can change its onset from one cycle to another. Getting to know fistuks patterns is what its all about.

I'll use George as an example, once he started having active cycles his onset was around d +1 to+3
How did I recognise onset? A significant drop in bg from PS signalled onset.

Usually if he onset at +1, he would drop like a rock, so I knew I had to be vigilant
The later he onset the more gentle the cycle would be. With an early onset he usually nafired earlier. Nadirs can happen at any time too, George for instance nadired usually at +5/6 but he did nadir as early as +2 and as late as +12

Learning this gave me the opportunity to manage him more confidently.

Anyways here's the info from the basics sticky

Example of an ACTIVE, but NOT necessarily typical Lantus and glargine biosimilars cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus/Basaglar/Semglee cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir/Biosimilars: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

An active Levemir cycle will have an onset at approximately +4 and a nadir around +8 - +10. However, please keep in mind every cat is different (ECID). Data collection will offer you a better picture of YOUR cat's response to either of these insulins.

Initially, don't expect to see "active" cycles after every single shot whether you're using Lantus, Levemir or Biosimilars. Chances are, your kitty had diabetes for some time before diagnosis. It requires time for kitty's body to become used to dropping into lower numbers than their bodies have become accustomed. Don't expect immediate results! Regulation takes time and patience:

  • Also worth noting: "Many cats will occasionally react to an increased dose with increased BGs - within the first 2 to 3 days after an increase, usually lasting for less than 24 hours. Nobody really knows what the reason for this phenomenon is (perhaps a "panicky liver"?) - hold the dose and ignore the fluctuations." http://www.tillydiabetes.net/en_6_protocol2.htm. Here in the Lantus, Levemir, and Biosimilars Insulin Support Group (ISG), we've affectionately dubbed this unexplained phenomenon "New Dose Wonkiness" (NDW).
Thanks, Gill :) That's very helpful. I'm beginning the get the hang of it (I think) which is why I thought +2.5 and +6 will teach me something new about Fistuk's cycle. I do understand that it's easy days but I'm just acknowledging that I began to pick up on something. I'm very good at seeing patterns and have an intuitive analytical mind so i appreciate learning all that so I could help Fistuk better.

To apply the above I was thinking of taking the +6 and +9 today. And I'll take a +6 at the night cycle too. I really do have to refits the urge to keep poking his ear ;) Because I just want to know what's going on LoL. But I look at his energy and he's becoming more himself every day, especially in the past couple of days. That's a great indication.

So sorry, a lot of us have had similar experiences, my vet simply washed her hands of FD, she was happy for me to do my own thing but mostly because she had no idea, and it was easier for her to delegate that responsibility to me. I've si ce had other issues with her apathy when my pets get sick, so I no longer use her.
Pet meters are a fairly recent, in the scheme of things and earlier studies do reference human meter readings (romp rand study which then goes on to describe the TR Protocol with lantus, specifically references human meter readings, and stimulates the use of human meters to follow the protocol, it's not that we don't recognise that theirs a difference between human and pet meters, there is, but as a tool the human meter is as effective to monitor your cats BG, even if it's readings don't exactly match with a pet specific test, and more importantly in my opinion, if the romp rand TR Protocol was developed using human meters and we recognise theres a difference, I would argue that it is preferable to use a human meter when following that protocol.

Sorry she gave you a hard time.:kiss:

Sorry too to hear about your experience but am happy to hear about it bc it strengthens me, knowing I'm not alone! I will start making phone calls on Monday to see if I can find another vet. I do wonder if I turn up at the clinic and ask for more insulin if they'll refuse. But alas, I'm taking that as a sign we need to move on. We're moving house in a month and I'll need to find a new vet anyways. I'll be closer to Zurich city so hopefully Ill be able to find a more open-minded vet (good like to me ;)) :bighug:
 
Oh... I forgot to mention... Fistuk puked a bit this morning!

It was clear liquids, bit foamy, no food and he didn't have any problems enjoying a full BF or snacks. Anything to look out for?
 
Since the pm shot will be the 7th cycle of this dose I'd love to get your suggestions on what tests would be great to have during the pm cycle and if I shot the same dose the am cycle (I guess we'll need the +9 and PMPS to get a sense of that)
 
Since the pm shot will be the 7th cycle of this dose I'd love to get your suggestions on what tests would be great to have during the pm cycle and if I shot the same dose the am cycle (I guess we'll need the +9 and PMPS to get a sense of that)
See what his numbers are doing +9 and pmps before making that decision :)
 
Must be feeling good :)

Test once mote mid cycle.
I'd aim for a +9 or +10 (Even +11)so you can see where he is heading closer to amps.
Allows you to grab some better sleep too.
Gill, I was wondering if I needed to test more during the cycle since it looked like Fistuk was bouncing. All pm cycle is pink. What were your thinking behind it? this will help me learn. I guess it was also partly to learn what Fistuk's doing since he's/me quite new to this. xx
 
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