09/12 Eddie AMPS 398 +3 432 PMPS 391 +3 418

Jodey&Eddie&Blue said:
Yes, I see he was starting down because PMPS was 227; but then he doubled that by PM +3, which I then read as on his way up again.

So, that's what I don't understand about Levemir. This morning we're back up high again so I have increased...I hope I did the right thing.
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Yesterday's tests were AMPS 339 +3 313 PMPS 227 +4 407. The way I read it, he onset around +3 and started going down. The rest of the day he kept going down, nadired at some point, then started back up and was 227 at PMPS. Or maybe he nadired around PMPS? It could happen on Lev. Then he bounced based on however low he got during the day, so was higher at PM+3. We dose based on how low the dose takes the cat, which means trying to, when you can, get some tests closer to the nadir time. We don't have enough data yet to say when that is with Eddie, but a typical Lev nadir is around +8. He tended to nadir earlier on Lantus than "typical", so maybe he does the same with Levemir? Anyway, when you have the time, like a weekend or day off, and you see a +3 dropping from a AMPS, it's be worth getting a few more tests in the back half of the cycle.

He did need the increase, regardless.
 
Wendy&Neko said:
Yesterday's tests were AMPS 339 +3 313 PMPS 227 +4 407. The way I read it, he onset around +3 and started going down. The rest of the day he kept going down, nadired at some point, then started back up and was 227 at PMPS. Or maybe he nadired around PMPS? It could happen on Lev. Then he bounced based on however low he got during the day, so was higher at PM+3. We dose based on how low the dose takes the cat, which means trying to, when you can, get some tests closer to the nadir time. We don't have enough data yet to say when that is with Eddie, but a typical Lev nadir is around +8. He tended to nadir earlier on Lantus than "typical", so maybe he does the same with Levemir? Anyway, when you have the time, like a weekend or day off, and you see a +3 dropping from a AMPS, it's be worth getting a few more tests in the back half of the cycle.

He did need the increase, regardless.
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It appears with AM +3 he's done the same thing, that is, go up from PS to 432. So, with this pattern in mind, the +3 is not necessarily going to tell the nadir story? I will have to work towards figuring out when he nadirs and I have yet to do that because I'm looking at it through Lantus lens, which seems opposite to the way Levemir works. I've been doing a +3 based on previous discussions regarding later onset...but Eddie just goes to prove the ECID rule...
 
It does take some thinking at a different angle with Lev. As a first approximation, think of everything being delayed a couple hours from when it was on Lantus. +3 can be an indicator of how the cycle will go, but not going to tell you how low he's going on the dose. Next time, during the day when you can monitor, and you see a drop from PS to +3, try getting some tests every couple hours to narrow down when he might be nadiring.

It might help to take a look at spreadsheets from other cats on Lev that onset early. As one example, here is Max today:
9/12 Max AMPS 298 +3 218 +5 89 +6 73 +7 75 +8 74 He is also a post SRT kitty.
 
Wendy&Neko said:
It does take some thinking at a different angle with Lev. As a first approximation, think of everything being delayed a couple hours from when it was on Lantus. +3 can be an indicator of how the cycle will go, but not going to tell you how low he's going on the dose. Next time, during the day when you can monitor, and you see a drop from PS to +3, try getting some tests every couple hours to narrow down when he might be nadiring.

It might help to take a look at spreadsheets from other cats on Lev that onset early. As one example, here is Max today:
9/12 Max AMPS 298 +3 218 +5 89 +6 73 +7 75 +8 74 He is also a post SRT kitty.
Click to expand...
Wow, look at that +3 to +5 range! That is so interesting...
 
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