1/20 - Sami - PMPS 413;+2 461 -need advice tomorrow AM dose

Status
Not open for further replies.
Tina & Sammy

Tina & Sammy

Very Active Member
Yesterday's Condo - 1/19/10

Well, Sami did see some yellow last night, and I was so hoping we would still be there this morning, but nope she is back up in the mid 300's.

She slept on the bed for most of the night last night. Something she hasn't done in awhile, I guess she has felt more comfortable in her bed on the floor. Anyway, I am glad to see that she is returning to some of her usual habits.

I hope today will bring more yellow and possibly a blue. We have been on the 1.25 dose now for 4 doses now without much movement. It seems like Sami might need another increase in the next day or two, but I am somewhat nervous because of what happened the last time we jumped to 1.5. I know we took a stop in between this time and it might go a little smoother, but I am still concerned.

Anyway, I am hoping to have a good day with Sami at the office again. She has been getting very frisky in the afternoon, so today I am thinking about taking a few toys to give her something to do. Although at home I don't think she plays with toys a lot. I guess there is always the crumped piece of paper that she can chase around.

Hope everyone has a good day.
 
Re: 1/20 - Sami - AMPS 357

Hi Tina
I second what Ronnie says.
It takes time on a new dose to "fill the shed".
I know we expect quick results but for sure not always that easy.
Go have a look at my Max's spreadsheet and you will understand what patience means, lol.
You and Sami will get there, but in time.
Have a great day!
 
Re: 1/20 - Sami - AMPS 372; Lancet Tool Question +5 342; +7 307

Sami seems to be dropping nicely today. I hope to still see her fall below 300 by her PMPS.

I have a question about testing. Yesterday I asked if everyone alternates between ears, what I failed to ask is do you us the lancet tool or do you just do the prick without the tool. When I first started testing I tried to just do the prick by hand, but for whatever reason I could never get any blood. Now mind you, I wasn't totally sure where the sweet spot was, but nonetheless I had trouble, and Sami's ears got badly bruised. I have since been using the lancet tool to do the prick, and although it seems to hurt her less I am wondering if I should try again with doing the hand prick. It just seems like using the tool is quick where as if I do it by hand it isn't as quick and she usually flintches.
 
Re: 1/20 - Sami - AMPS 372; Lancet Tool Question +5 342; +7 307

Whichever works best for you - either using the lancet tool or freehand - is just fine. :smile: I've always done it freehand, others have always with the lancet device. ECID and EBID too (every bean is different).

Sending yellow and blue vines for later today and tonight!
 
Re: 1/20 - Sami - AMPS 372; Lancet Tool Question +5 342; +7 307

Cassandra and Sasha said:
ECID and EBID too (every bean is different).

Sending yellow and blue vines for later today and tonight!
Click to expand...

What does ECID and EBID mean?

Thanks for the Yellow and Blue vibes we need them. The vet just emailed me and told me to increase to 1.5 tomorrow morning if Sami is over 300 again. I am reluctant to do that just yet. I think I would like to give it another day or two. In the end I will probably increase her but I don't want to jump to quickly like last time. Plus she is saying to only dose once per day, and we see what that lead to last time. I probably wouldn't mind increasing the dose as long as I can monitor her and check often. As of tomorrow, my boss is out of town so I will be able to get more checks throughout the day if need be.

Does anyone thing I should go ahead and increase to 1.5 or should I stick with the 1.25 for at least another full day and possibly increase on Friday to 1.5? Any advice you can provide is greatly appreciated.
 
Re: 1/20 - Sami - AMPS 372; Lancet Tool Question +5 342; +7 307

ECID = Every Cat Is Different
EBID = Every Bean Is Different

Given Sami's numbers, I would increase to 1.5u on the PM cycle tomorrow unless you see some blue here in the next two cycles. That would be following the protocol's call for an increase, which this time actually coincides with your vet's recommendation too. ;-)
 
Re: 1/20 - Sami - AMPS 372; Someone Talk me DOWN +10 421

Help, someone talk me down, or give me the go ahead to increase. I am so discouraged. It seems like everytime I build myself up to see a lower number we get a higher one. Sami was doing so nicely at +7, but then she went into the RED at +10. She did eat at +8.75, is it possible that the little bit that she ate could cause her numbers to go up so much?

I am still hopeful that we will see a lower number for her PMPS in another hour or so, but why does this happen. It is so confusing.
 
Re: 1/20 - Sami - AMPS 372; Lancet Tool Question +5 342; +7 307

Cassandra and Sasha said:
Given Sami's numbers, I would increase to 1.5u on the PM cycle tomorrow unless you see some blue here in the next two cycles. That would be following the protocol's call for an increase, which this time actually coincides with your vet's recommendation too. ;-)
Click to expand...

Would it be so bad to increase in the AM cycle if she is still well over 300. I just feel more comfortable if I had all day to check her rather than to increase at night and only get two, maybe three, spot checks during the night. If she just over 300 I wouldn't mind waiting another day, but with a +10 at 421 I just don't know if I would really want to wait another 24 hours to increase. I guess I will have to wait to see where she is at her PMPS tonight. Hopefully she will come down some in the next hour or so.
 
Re: 1/20 - Sami - PMPS 413 - need advice about tomorrow AM dose

Well, at PMPS Sami was down a tiny bit from her +10. I did go ahead and stick with the 1.25 dose because no one was around to tell me if it was okay to increase for this shot.

I am discouraged though and am seriously considering bumping her up a bit more for her morning dose. Not quite to 1.5, but maybe another drop higher than what she is getting now. It would probably be considered a 1.5s. Then I will probably bump her up to a full 1.5 dose tomorrow night as long as things go well tomorrow during the day. I know this breaks protocol slightly, but watching her continue to rise is stressing me out.

I also tried the prick tonight without the lancet tool. Now that I am familar with the sweet spot I think it will be a little easier. I was just wondering if the clicking that goes with the tool is slightly stressing Sami out. I am probably just freaking out, but I just need to try something different I guess.
 
Re: 1/20 - Sami - PMPS 413 - need advice about tomorrow AM dose

Hi Tina
Glad you found the sweet spot and the lancet is easier to use.
I was taught by the vet tec to free hand with a needle they gave me.
I had to do my first curve that way and at one point I was lying on the kitchen floor
sobbing, and I mean hysterical, that I could not do it anymore.
I decided to uset the lancet and I am a pro. Sometimes I have to double prick but it works just fine

For the dosing, I understand what you are going through.
In my opinion, I would tell you to try and stick with the protocol. I know you want to do
the best for your sweet Sami but if you stay focused and consistent you will get there.
Look at me. I am at 5.25 with Max now, started at 1 in Nov. For sure I want to cry (and do) and hurry this along but look at his SS. Today was his lowest PMPS.
And you know from my posts how devoted I am to Max. Of course I want him better.
Hang in. We are here for you.
 
Re: 1/20 - Sami - PMPS 413 - need advice about tomorrow AM dose

I wouldn't suggest raising the dose any sooner than after 6 cycles (tomorrow PM). This could be NDW, or a high before the break, or it could be that Sami is bouncing from the yellow last night (sounds crazy but it's possible).
 
Re: 1/20 - Sami - PMPS 413 - need advice about tomorrow AM dose

Hi Tina and Sami - I understand your frustration and worry. I'm new so I don't have any personal advice. But, I wanted to paste a piece from Tilly for you:

However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU. Alternatively, if the cat is continuously producing moderately elevated BGs (nadir always >=200 mg/dl), increase the dose every 2-3 days by 0.25 IU ( if the cat is getting a low dose) or 0.5 IU (if the cat is getting a higher dose).

Hope you get some help.
 
Re: 1/20 - Sami - PMPS 413 - need advice about tomorrow AM dose

April and Felix said:
Hi Tina and Sami - I understand your frustration and worry. I'm new so I don't have any personal advice. But, I wanted to paste a piece from Tilly for you:

However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU. Alternatively, if the cat is continuously producing moderately elevated BGs (nadir always >=200 mg/dl), increase the dose every 2-3 days by 0.25 IU ( if the cat is getting a low dose) or 0.5 IU (if the cat is getting a higher dose).

Hope you get some help.
Click to expand...

So technically according to Tilly's protocol I can increase in as little as 2 days. I guess I will wait and see what Sami's numbers look like over night and tomorrow morning. Hopefully, they will be low enough that I will feel okay giving her the 1.25 tomorrow morning before increasing her to 1.5 units tomorrow night.

Tonight, I did notice that after I gave Sami her shot, there was still another drop of insulin in the syringe. I might be possible that I am not pushing all the insulin out and maybe she really isn't getting 1.25 units after all.
 
Sami is still rising at +2. She is currenlty at 461. I will spot check her at least one more time during the night. I just don't understand why she is rising so high after being under 400 for so many days. I understand the bounce on the 1/17 after the skipped shot in the PM of the 1/16, but I don't understand the rise today.
 
your cat, your decision, always. :smile: In Lantus Land, we follow the tight regulation protocol with some modifications. We wait at least 3 days (sometimes 5) before increasing the dose, unless there are extenuating circumstances (usually that means a cat with ketones or recent DKA, where we HAVE to ride the edge to get the numbers down fast). Three days gives time for the NDW and any rebound to clear, so we can get a fairly good idea of whether the dose needs to be increased, and by how much. That said, it is always up to the bean, and if you want to be more aggressive you can do so, as long as you are aware that being more aggressive requires a lot more testing and more comfort dealing with any low numbers that come.

If you increase the dose before giving the old dose enough time to kick in, and especially if you do that several times in a row, then you risk having the shed get so full that suddenly you will find Sami in very low numbers.

If you study the spreadsheets on the German forum, you will see people increasing sooner than 3 days. However, you will also notice that the Germans, in general, are MUCH more comfortable with very low numbers than we are (you'll also see them shooting in the 50's and even the 40's without a second thought, something I wouldn't recommend here).
 
I would urge you to follow a conservative approach to dosing. At this point, Sami has been on insulin for 6 days with 3 different doses and a skipped shot. Lantus works best with consistency. Being overly eager, especially with the amount of data that you currently have will not, IMHO, be in Sami's best interest. But, as Libby pointed out, it's your cat and your decision.
 
Status
Not open for further replies.
Back
Top