1/2 Ozy PMPS-54,+2-37,+3-66,+12-15,+13.5-88

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Re: 1/2 Ozy ,PMPS-54,+1.66-51,+2-37,+3-66

Ozy is sleeping unless I wake him. But he is fine when I do. It is normal for him to be asleep like this.

He purrs, wakes up, is alert.
 
Re: 1/2 Ozy ,PMPS-54,+1.66-51,+2-37,+3-66

Thank you for fixing the subject line.

Ok..before I go to bed...this is a carb number; he might come back down so I'd give him some LC food to help keep him up and surfing.

I hope you napped today. Sometimes, with non IAA cats, if they keep running low and the CG needs rest, we have them skip a shot to drain the depot. I'll run that by Sandy as I'm not sure who will be on in the morning for you.

You're doing great. Ozy rocks!!
 
Re: 1/2 Ozy ,PMPS-54,+1.66-51,+2-37,+3-66

Thanks, Marje.

ANd thanks Sandy for being there. Isn't this better than shoveling snow?

I was a little concerned when I didn't see much of a food spike at PMPS+1.... and he had a big meal. And here we are. I just made coffee. John has gone to bed and will take second shift if I need it.

I suspect we will be fine. I may be a little heavy handed with the carbs but those numbers in the thirties make me want him up fast.

I will just keep testing and feeding if need be. As long as I am vigilant, all should be fine, shouldn't it?

I have a nice Anthony Hopkins movie (the Efficiency Expert) which I started earlier.

Any pearls of wisdom? Are you concerned that I over fed him?
 
Re: 1/2 Ozy ,PMPS-54,+1.66-51,+2-37,+3-66

Let's get a +3.5 and see whats what.

Ozy is sleeping unless I wake him. But he is fine when I do. It is normal for him to be asleep like this.
He purrs, wakes up, is alert.
Great :cool:

You and John OK?
 
Re: 1/2 Ozy ,PMPS-54,+1.66-51,+2-37,+3-66

John and I are fine... we scrambled a little finding our sugar syringe ( he didn't like the food with the sugar added so I used the syringe for the 1/4 tsp. maple syrup. We couldn't find Ozy for a bit... he was sitting on the back of the settee looking out the window.

But we did fine. John has gone to bed but he will get up if and when I need him.
 
Re: 1/2 Ozy ,PMPS-54,+1.66-51,+2-37,+3-66

had to drop in to watch The Ozy Show tonight. you're doing a great job, donaleen!

Thanks Sandy, for all you do - you're awesome!

:YMHUG:
 
Re: 1/2 Ozy ,PMPS-54,+1.66-51,+2-37,+3-66,76@3.5

donaleen and Ozy said:
Are you concerned that I over fed him?

If you wouldn't mind, would you give me a run down of what you fed so far and the +times?

I'm putting together some thoughts on next (dosing) steps/strategy/options. :cool:
 
Re: 1/2 Ozy ,PMPS-54,+1.66-51,+2-37,+3-66,76@3.5

Hi Donaleen - yet another late nighter finding the Ozy show more exciting than plain old T.V. :cool:

I think the 76 is good - he's going to onset sometime soon, and that's still at the old dose. Paws crossed he just stays flat.
 
Re: 1/2 Ozy ,PMPS-54,+1.66-51,+2-37,+3-66,76@3.5

I will appreciate the guidance on feeding/dosing. Thanks!

I had a typo the first time... it should be 2.5 oz Wellness

Feeding.

He was quite hungry at PMPS and I fed him 2.5 ounces of his 5% Wellness. He would normally eat only 1.5 ounces but he was still hungry and so I gave him some more.

At +2 I fed him about a fat tsp of HC (22%) Fancy Feast. It didn't have that much gravy. It is Tuscany something.

At +2.5 he was only 42 so I gave him about a Tablespoon of medium carb 15% Fancy Feast (he didn't seem to like the high carb that much and I knew I had some medium carb he would eat). We also gave him 1/4 tsp of maple syrup, shot into his mouth.

Hi, Wendy. Lovely of you to come by.
 
Re: 1/2 Ozy ,PMPS-54,+1.66-51,+2-37,+3-66,3.5-76,4-75,4.5-79

Do I still need to test every half hour? Can I move to every hour?
 
Re: 1/2 Ozy ,PMPS-54,+1.66-51,+2-37,+3-66,3.5-76,4-75,4.5-79

We usually suggest once an hour at 80, so I'd call it close enough.
 
Re: 1/2 Ozy ,PMPS-54,+1.66-51,+2-37,+3-66,3.5-76,4-75

sorry for the delay - I'm a very slow typer.

You are doing great!
...and so is Ozy. :cool:

Now for my $0.02-
Ozy has built up quite a bit if momentum. Depending on how the rest of the cycle plays out, if he is still seeing action at AMPS, consider a reduced (token) dose or skipping the AM shot altogether. Doing so would serve to drain the depot a bit and reduce momentum. Just think of it as a partial or full fur shot. This would also allow you to get some much needed rest and give Ozys ears a break.

In terms of his reduction (new dose), right now I'm on the fence regarding how much to decrease - 0.25u or 0.5u. In general a 0.5u reduction would be appropriate for a kitty at 6.5u. For an IAA kitty - it's hard to say.

Others are sure to chime in.
Your thoughts?
 
Re: 1/2 Ozy ,PMPS-54,+1.66-51,+2-37,+3-66,3.5-76,4-75,4.5-79

Are you asking for my thoughts? I fear reducing too much and losing the good numbers but I will do what you say. I would be more in favor of a .25 reduction myself.
 
Re: 1/2 Ozy ,PMPS-54,+1.66-51,+2-37,+3-66,3.5-76,4-75,4.5-79

donaleen and Ozy said:
Are you asking for my thoughts? I fear reducing too much and losing the good numbers but I will do what you say. I would be more in favor of a .25 reduction myself.

yes, I was asking for your thoughts. I completely understand the fear of a failed reduction and of losing ground.
See what others think about how much to reduce - there is time for rumination.

Funny, when I was asked to help out with Ozy, I expected we would be working on learning to bring ugly numbers down with R.
Here we are, working on keeping numbers up and discussing a reduction :mrgreen:

eta - My suspicion all along has been that Ozy is not actively IAA. I don't believe we would be seeing him responding to insulin the way he has these last few days if he was.
 
Re: 1/2 Ozy PMPS-54,+1-67,+2-37,+3-66,4-75,+5-90

That is what I thought too... hard to be disappointed, though. :mrgreen:

I think Levemir is agreeing with him. He is more level than he was. I hope he doesn't bounce sky high. I would ask you (if you haven't already) to look at what happened in September when his numbers got pretty good and he kept earning reductions and then it all fell apart. That is what I fear... though of course, I don't want 30's either!
 
Re: 1/2 Ozy PMPS-54,+1-67,+2-37,+3-66,4-75,+5-90 ?Dosing

Looks like Ozy might be reacting to that low and giving you a chance to get a longer rest between tests.

Regarding dosing, a larger depot can easily get ahead of you. Sandy's suggestion of doing a one time reduced dose, then following on with your new dose, is a good idea. When Neko was coming down the dosing scale, we were coming down at .5U until we got below 4U. Then I needed to move to .25U. Nancy/Pepper (also IAA/acro) has done both .5U and .25U reductions and he is on a higher dose. However, those .25U reductions were often quickly followed by another. The size of the reduction partly being based on how low he got (40's vs. 30's or 20's) and how much HC was needed. I think you are going to have to see what works for Ozy. Both Neko and Pepper were/are much bouncier than Ozy seems to be now. A .25U reduction might be appropriate for Ozy.
 
Re: 1/2 Ozy PMPS-54,+1-67,+2-37,+3-66,4-75,+5-90

Well, I must say, I don't get this active IAA... what is the value of the IAA test if it doesn't show that? Not that I am wishing for IAA, just what does it mean? Does it mean it can rear up at any time? It is confusing.
 
Re: 1/2 Ozy PMPS-54,+1-67,+2-37,+3-66,4-75,+5-90

donaleen and Ozy said:
I would ask you (if you haven't already) to look at what happened in September when his numbers got pretty good and he kept earning reductions and then it all fell apart. That is what I fear... though of course, I don't want 30's either!
I'll have a look and see if anything jumps out at me.
On the topic of the past one thing I was taught back in the day was to focus on the patterns of the past 2 weeks. Further back is ancient history.

donaleen and Ozy said:
I don't get this active IAA... what is the value of the IAA test if it doesn't show that? Not that I am wishing for IAA, just what does it mean? Does it mean it can rear up at any time? It is confusing.
The little information that's out there on human IAA indicates the condition is self limiting lasting a few months to a year. I have not read anything about the possibility of it starting back up again. I think once the antibodies develop the test will be positive, regardless of whether they are binding up insulin or not. It is confounding.
The test was valuable to BK, he was clearly resistant. It was a year before he tasted HC and I never cracked open the karo. His R scales from 2008 make me shudder, yet his BGs would barely budge. By March of 2009 0.5u went a very long way - a complete turn around.

In my opinion, when sensitivity to insulin returns that's a clear indication the insulin binding is over.
 
Re: 1/2 Ozy PMPS-54,+1-67,+2-37,+3-66,4-75,+5-90

I see that 110. It will be interesting to see if he bounces very much.
If he does you can take the edge off with a little R

Keep an eye on the BG - Ozy is full of surprises!

I'm going to leave now - it's getting early :cool:
 
Re: 1/2 Ozy PMPS-54,+1-67,+2-37,+3-66,4-75,+5-90,+6-110,+8-9

Fantastic job last night ladies!!!

Sandy.....you are amazing. Of course, I have always thought so but we are all very appreciative of your help and knowledge.

donaleen....looks like Ozy is still hanging in there and perhaps dropping towards nadir again. I'd be sure you get that +10.
 
Re: 1/2 Ozy PMPS-54,+1-67,+2-37,+3-66,4-75,+5-90,+6-110,+8-9

Good Morning - Ozy was 69 @ +10 and 62 @ +10.5. I'll check again in 1/2 hour. Should be another interesting cycle coming up. Thanks for all the late night and early morning support. John
 
Re: 1/2 Ozy PMPS-54,+1-67,+2-37,+3-66,4-75,+5-90,+6-110,+8-9

Morning John! Hope you got some rest and donaleen is sleeping.

Have you decided how much you are going to reduce the dose?

And the bigger question....remember her Sandy said about possibly shooting a BCS or skipping today so you all can drain the depot a bit and get some rest. Thoughts?
 
Re: 1/2 Ozy PMPS-54,+1-67,+2-37,+3-66,4-75,+5-90,+6-110,+8-9

Good questions Marje. Last night we talked about .25u dose reduction. I just did a +11 test - he's now at 55 so maybe a one time reduced dose will be a good idea (is this what you call a BCS?) Thoughts - Thanks, John
 
Re: 1/2 Ozy PMPS-54,+1-67,+2-37,+3-66,4-75,+5-90,+6-110,+8-9

Yes...a one-time reduced dose is a BCS.

I'd like you to consider this.....his depot is pretty big at 6.5u. Shooting a reduced dose will help drain it but you might not see the effect of that....or a skipped shot...right away. In other words, you should be prepared today that this might still be an active cycle...at least early on.
 
Re: 1/2 Ozy PMPS-54,+1-67,+2-37,+3-66,4-75,+5-90,+6-110,+8-9

donaleen here (barely)... we have been thinking we would like to move his schedule forward two hours anyway... this seems like a good opportunity to do that.

that would also give us a little more time to think about what to do this morning, how much to reduce, whether to skip or give a reduced shot.

Any problem with doing that?

thanks
donaleen and john
 
Re: 1/2 Ozy PMPS-54,+1-67,+2-37,+3-66,4-75,+5-90,+6-110,+8-9

So you are thinking of delaying his shot by two hours? That is a possibility. You could see what he does and then decide what to shoot.

If you delay by two hours, you will need to shoot the full dose of his new dose, depending on whether you are reducing by 0.25u or 0.5u, since stalling is like a reduction.
 
Re: 1/2 Ozy PMPS-54,+1-67,+2-37,+3-66,4-75,+5-90,+6-110,+8-9

good morning john!

I'd encourage a more significantly reduced dose this morning. I know you did that in November and Donaleen didn't feel like it worked, but we are working with a different insulin now with a different situation.

If you think in terms of percentages, we reduce by 25% on kitties with 1u (typical) doses. or if a cat is getting 2u (another typical dose, a 0.25u reduction then is 12.5%.

On 6.5u, unless you want to be chasing low numbers all day, you're going to have to make a more significant reduction to allow the depot to drain some. When Punkin was coming down the dosing scale after his radiation treatment, I usually reduced by 1/2 or 1/3 to allow the depot to drain, then came back up under to a new slightly reduced dose on the subsequent shot. If you want to follow that model, this shot would be something like 4u, then tonight you would go to 6.0u. that's a reduction of slightly more than 30% this morning, and a "new" dose tonight that is about 10% less than the 6.5u.

Of course it's up to you guys, but i think the most significant factor to keep in mind is that the depot from the Lev corresponds to the size of the dose. previous doses can affect numbers for several cycles.
 
I think it is your and Johns decision. I'm sure Sandy is sleeping but I'd read back through the posts and weigh the pros and cons.

I know you don't want to slow the momentum....understandable. I'm not advocating either dose but if you do reduce by 0.5u and his BG goes up, you can always increase the dose. From what I read, it seems that Ozy might have busted through those antibodies.
 
That's because she hadn't read that you were stalling, you don't want to stall and shoot a reduced dose. Since you've stalled, I'd shoot the 6u dose you decided upon.
 
I don't think we have a single option for you - i think we've laid out the options and what we all will do is learn how Ozy's response is by whatever the option is that you choose today.

Have a great day, donaleen! woot!
 
right - i hadn't seen that option. hopefully the 2 hr stall + a 0.5u reduction is a combination that will keep up the momentum without getting him into the 30's today. :mrgreen:
 
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