? 1/1 Dexter AMPS 495

DexterTheCat

DexterTheCat

Member Since 2022
Happy New Year everyone from Canada!

I read in The Basics post that "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)."

Dose-related question: Given this wonkiness, how many days typically do you hold a dose? I read on here / the Web that typically a new dose is held between 8 to 10 consecutive cycles (4-5 days at 2 doses per day). My vet advised that it should be held for 14 consecutive cycles (7 days at 2 doses per day).

I am asking because I am seeing bouncing / increased BGs after increasing the dose, and so I am wondering what's going on and is it the case that I'm not holding the dose for long enough.

Dexter's spreadsheet for 2022 (setting up a new one for 2023).

Thanks so much for your guidance!
Irene
 
Keep in mind I'm not an Admin, but my Leo takes longer than expected to settle into a lowered dose, and the times I've increased .25, per protocol, he would end up going hypo so do the necessary higher carb food, testing, and so on to ensure he is safe.... including reducing the dose .25U. There we go again! Dose decrease ends up with too high BG, so back up. 25U again!

So @Bandit's Mom suggested using a MC, like 10%, at +1 to slow down the drop, when needed. This way he doesn't go hypo and earn yet another reduction. I'm still new at trying this method, and have to laugh at myself because of what I did this morning. I'm chalking up my 1st of 2023 mistake to staying up too late last night, plus it is Jan 1!

Curious, has Dexter BG ever gone < 2.8? Not understanding everything with Dexter, I would increase .25U at next shot, and using the 10% at +1. Keep in mind the 10% at +1 is only used if BG at AMPS or PMPS is at a certain level.... since I don't know the difference between your meter numbers and what I'm accustomed, I cannot fully explain this technique.

I hope you get some good info to use from a more seasoned person than me.

I'm sorry I can't answer your question adequately.
Happy 2023 for us!
 
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I’m not finding the US ss. With TR you hold the dose for 3-5 days. Looks like he’s bouncing from the blues so see what happens when it clears. Bounces can take 4-6 cycles to clear.
 
The NDW, if it happens, goes away by cycle 3. You see how Dexter hit the blues in cycle 3 of this dose, that meant no more NDW. The higher numbers after that were bouncing. NDW doesn't impact the Tight Regulation guidelines to hold doses with nadirs under 200 (note the plural) for 6-10 cycles. Your signature says TR. What your vet is quoting is more like the guidelines for the Start Low Go Slow method to dosing. If you hold doses too long, you risk glucose toxicity developing. Which basically means the cat's body gets used to higher numbers, and thinks of them as normal. And you have to increase further to get over it.
 
BTW, Dexter looks very familiar to one of our other kitties, Isaiah, aka BG, Big Gray, or GC, Gray Cat. We also have his brother from the same litter, Andy, aka BC, Black Cat, but like Leo, he is fluffy. Isaiah has a dense, smooth coat.I should change the profile pic to include all three kitties.

When my step-sis had to give up, Isaiah, due to her health and changing living conditions, I tried to find someone else to adopt jim since we already had two adopted kitties. Someone mentioned how special gray kitties are.... Anyway, we ended up with him as I didn't want her to stress about it. We've had him over four years now. Our daughter married and says she'll take him. Wellll, it will be hard on everyone at this point. He's always around us.... sitting next to us and even on us quite often. Who needs a heater? Grab Isaiah. ♡
 
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Just wondering; do you have a freestyle libre? Is there any way for you to get the data every hour that he has it on him? If it will only give you a graph you can give me the graph and I can convert it into hourly data with a program. I just see that the meter type on the spreadsheet says Libre. Might be helpful if you do have one.
 
Mom of 3 Fur Babies said:
Keep in mind I'm not an Admin, but my Leo takes longer than expected to settle into a lowered dose, and the times I've increased .25, per protocol, he would end up going hypo so do the necessary higher carb food, testing, and so on to ensure he is safe.... including reducing the dose .25U. There we go again! Dose decrease ends up with too high BG, so back up. 25U again!

So @Bandit's Mom suggested using a MC, like 10%, at +1 to slow down the drop, when needed. This way he doesn't go hypo and earn yet another reduction. I'm still new at trying this method, and have to laugh at myself because of what I did this morning. I'm chalking up my 1st of 2023 mistake to staying up too late last night, plus it is Jan 1!

Curious, has Dexter BG ever gone < 2.8? Not understanding everything with Dexter, I would increase .25U at next shot, and using the 10% at +1. Keep in mind the 10% at +1 is only used if BG at AMPS or PMPS is at a certain level.... since I don't know the difference between your meter numbers and what I'm accustomed, I cannot fully explain this technique.

I hope you get some good info to use from a more seasoned person than me.

I'm sorry I can't answer your question adequately.
Happy 2023 for us!
Click to expand...

Thanks so much for this tip!
 
Diane Tyler's Mom said:
Can you set up a US Tab on your SS, I can tag Bhooma
@Bandit's Mom to do it for you if you need help.
Click to expand...

To set up a US tab, do I just copy and paste from the template? I've done this before and it broke the formatting, so I'm wondering if there is a different way. And I assume you want to see numbers from the past few days (that is, including December 2022)?

Thank you!
 
Wendy&Neko said:
The NDW, if it happens, goes away by cycle 3. You see how Dexter hit the blues in cycle 3 of this dose, that meant no more NDW. The higher numbers after that were bouncing. NDW doesn't impact the Tight Regulation guidelines to hold doses with nadirs under 200 (note the plural) for 6-10 cycles. Your signature says TR. What your vet is quoting is more like the guidelines for the Start Low Go Slow method to dosing. If you hold doses too long, you risk glucose toxicity developing. Which basically means the cat's body gets used to higher numbers, and thinks of them as normal. And you have to increase further to get over it.
Click to expand...

Thank you for this information. I'm afraid of causing glucose toxicity as well, which is why in the past I've always held doses no longer than 6-10 cycles. Sigh.
 
tiffmaxee said:
I’m not finding the US ss. With TR you hold the dose for 3-5 days. Looks like he’s bouncing from the blues so see what happens when it clears. Bounces can take 4-6 cycles to clear.
Click to expand...

If bounces take 4-6 cycles to clear, and I'm holding a dose no longer than 6-10 cycles, then that means that I should wait for around 10-16 cycles before making another adjustment, right?

Just trying to wrap my head around this bouncing around..

Thanks so much!
Irene
 
chuckstables said:
Just wondering; do you have a freestyle libre? Is there any way for you to get the data every hour that he has it on him? If it will only give you a graph you can give me the graph and I can convert it into hourly data with a program. I just see that the meter type on the spreadsheet says Libre. Might be helpful if you do have one.
Click to expand...

Yes, I do use FreeStyle Libre! I will update the spreadsheet with as much data as possible. Thank you!
Irene
 
Mom of 3 Fur Babies said:
BTW, Dexter looks very familiar to one of our other kitties, Isaiah, aka BG, Big Gray, or GC, Gray Cat. We also have his brother from the same litter, Andy, aka BC, Black Cat, but like Leo, he is fluffy. Isaiah has a dense, smooth coat.I should change the profile pic to include all three kitties.

When my step-sis had to give up, Isaiah, due to her health and changing living conditions, I tried to find someone else to adopt jim since we already had two adopted kitties. Someone mentioned how special gray kitties are.... Anyway, we ended up with him as I didn't want her to stress about it. We've had him over four years now. Our daughter married and says she'll take him. Wellll, it will be hard on everyone at this point. He's always around us.... sitting next to us and even on us quite often. Who needs a heater? Grab Isaiah. ♡
Click to expand...

Gray kitties are the best! <3
 
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