1/12 Sam AMPS 394

[KristenP&Sam]

Well, I've gone up to .7 (from .6) since yesterday was so flat and his number this morning is creeping back up. Little bit bummed as I thought we were doing so well. Maybe he'll balance out after a few days. I hope.

 

[Sue and Oliver (GA)]

Patience. Who knows what he will do; he's always full of surprises. :lol:

 

[Charliemeow]

I hope Sam has a more colorful day today than he did yesterday. Just when you think you can start to get comfortable. They sure like to keep us on our toes.

 

[KristenP&Sam]

Well, his +4 is 188 so that makes me happy. He, on the other hand, gave me fits when I gave him his sub-q fluids today. He was not interested one bit in sitting still for that. I really need to get him into the vet to get his kidney levels redone so we can possibly stop those, but I was hoping to have his BG numbers more stable. Guess it really doesn't matter, he should get checked up one way or the other.

 

[judy and squamee(GA)]

Have you ever tried the clothespin trick? It was the only was I was ever able to give subQs to Squamee.http://www.felinecrf.org/giving_sub-qs_ ... _peg_trick

 

[KristenP&Sam]

He's normally pretty good, but today I couldn't get the needle in for anything and he got cranky with all the sticking, I think.

 

[KristenP&Sam]

+6 - 153

So today is kinda flat again, albeit with better numbers. I really don't know what to make of this. Anyone?

 

[Sue and Oliver (GA)]

You are a fine tuning stage, Kirsten. And he is so sensitive that .1 increase makes a difference. Wait to see what others say. I think you have two choices - give it another day at .7 or try a fat .7 I think I would give it another day. He does always surprise us! :lol:

 

[KristenP&Sam]

+8 - 191 So definitely better numbers than yesterday, but still flat. This is really weird. I have no idea what to do as far as dosing, but I'll probably stick with the .7 for tonight if he's in the 300 range ps.

 

[Sue and Oliver (GA)]

It is hard to see any patterns on his spreadsheet. Like the other Sam, he doesn't always do what we think he might. On 1/8, he was flat - 180, 150 range. The next day he was down in the 40s. I say stick with your dose. Maybe a high flat day before a lower day is a pattern?

Don't lose sight of the good news. You are giving less than one unit and he is in good numbers.

 

[KristenP&Sam]

You're right, I do need to focus on the positive. I guess I'm fearful he's going to creep back up, you know?

 

[Gator & H (GA)]

See the PZI Sticky links for microdosing increments:

• Micro-dose increments how to: link 1, link 2, link 3
• Getting the bubbles out

Hedging between two doses might be able to give you more courage to try higher doses if needed again.

 

[KristenP&Sam]

I feel pretty good about microdosing, I just don't want to give him more insulin, I want to give him less! I'm impatient for remission and this feels like a step back. Trying to remember that whole marathon thing. :mrgreen:

 

[Gator & H (GA)]

Another idea for you. It seems there might be days that he has larger deltas than other days [days where he is more flat than others]. On the day that you do not feel the dose accounts or accounts fully for the deep or shallow curve, take a note of anything that you notice different in his routine. The potential objective would be to find ways to make the more shallow curves repeatable. I'm a fan of shallow curves if one can have shallow curves and sill bring down the numbers.

 

[KristenP&Sam]

Sam's PMPS is 394, exactly the same as his AMPS. I stuck with the .7 and hope to see a good number in the morning.

 

[Joanna & Bix (GA)]

My guess is that the 1/10 AM cycle, 1st dose on 0.6u, was so good because you were coming off of a 0.8 dose and had a lower PS that you shot into. I'd call it overlap. :mrgreen: So the 0.6 had a little extra oomph to it following a 0.8 shot, and then combined with the lower PS, you got a good nadir. Generally speaking when you lower the dose, you may tend to see a lessening of the effect over the 1st 3 or 4 cycles, just as when you raise the dose you can see some improvement over the 1st 3-4 cycles, before it's clear what the full effect of the dose is. So often if you lower the dose and get good results on cycle 1, you can be disappointed soon enough. That's why personally I am a fan of holding a dose for a few cycles on a dose increase, but not necessarily on a decrease (unless the #s continue to be low and you want a continued lessening effect). If the #s drift higher in the 1st couple cycles on a lower dose, I wouldn't expect it to improve from there.

Of course, Sam has his own ideas and his habit, as others have pointed out, of being flattish one day and then all green #s the next, wonkifies everything up and keeps us on our toes! So with him, I have a little less confidence that my interpretation is right, compared to a cat who tends to be more consistent from cycle to cycle. Not sure what to make of that with Sam, except that it's nice to see the great nadirs when he gets them!!!

Hopefully 0.7 will be the ticket. Because he's gone on the low side before on 0.8 and it looks like the #s are improving on 0.7 (YAY!), I would probably hold this dose a few more cycles if the #s keep improving. If they look stagnant by tomorrow night or so, I might try a skinny 0.8 or something...?