1/21 Buzz AMPS 259

[Sarah and Buzz]

Yelllllllloooooooowwwwwww!

Here is yesterday's condo: posting.php?mode=quote&f=9&p=32289

Her PMPS last night was 360, and +3 was 355. I didn't hold out much hope but this morning, yay! Last night was to be the last cycle at 1.25u, with an increase to 1.75u planned for this morning. I did not increase this morning but stayed with 1.25. I wanted to see what you guys thought, but I bet that depends on how the cycle does this morning.

Sorry about the SS; hopefully our Internet is back up soon. Thank goodness for my phone!

Oh, WCR: Buzz is fine as usual. She didn't seem quite as hungry this morning but is still finishing off Eve's food as we speak.

 

[Cassandra and Sasha]

Does depend on the cycle this AM - can you get a +2 or +3 to see where she is headed?

Yellow!!!! :mrgreen:

 

[Helene & Tizon]

Re: 1/21 Buzz AMPS 259 dose ?

Hi Sarah,
Doses are typically only increased by 0.25 units at the time - per the protocol.
If you want dosing tips, I suggest that you add the word 'dose??" on the 1st subject line.
AMPS is definitely better than last PMPS.
Enjoy your day.

 

[Sarah and Buzz]

Cassandra- Yes, I will get a +2 in about 45 minutes.

Helene- Decision to increase by 0.5u was based on this from Cassandra on 1/20 (maybe 1/19?): The 0.5u increase would be because her nadirs have not been below 300:

Most cats need to have their dose increased. Do it in 0.25 IU or 0.5 IU steps (0.25 IU if the cat is getting a low dose and/or relatively low BGs, 0.5 IU if the cat is getting a higher dose and/or relatively high BGs). Hold each dose for 5-7 days. 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). From this point onward test for ketones once per week, or more often if the nadirs are still >=200 mg/dl.

You can take the dose up in the AM to 1.75u if you would like. We usually hold for 3 days here in LL, but the protocol does allow for 2 days and sometimes people are more aggressive with high numbers like this. You do need to monitor very closely if you dosecrease early, though, especially with a 0.5u increase. It really just depends on how aggressive you want to be and how much monitoring you are able to do.

Now that her numbers are lower, assuming they stay that way and depending on what you guys think, IF we need to increase, I would only increase by 0.25. Yes, no? Again, I know it depends on this cycle, so we will wait and see.

Thanks to both of you for the input.

 

[Cassandra and Sasha]

Re: 1/21 Buzz AMPS 259 dose ?

Doses are typically only increased by 0.25 units at the time - per the protocol.

The dosecrease of 0.5u was recommended because Buzz was over 300 consistently. Now that she has shown yellow (yay Buzz!!!), the recommendation goes to 0.25u.

Very interested in seeing how Buzz does today. Probably still will need an increase, but you never know. Kitties can go green easily from that starting point. :smile:

 

[Sarah and Buzz]

+2: 413

I have typically seen that Buzz's food spike lasts well into the +2 hour, so I believe that we are seeing a good bit of that as well as the insulin wearing off before this AM shot kicked in.

I will get another check in at +4 and +6 to get a better picture.

Oh, I did want to ask about food. When Buzz was on PZI, I was feeding them twice a day (at AMPS and PMPS) so that food would not interfere with the readings (per some advice I got on the PZI board). When she went OTJ, I started feeding 4 small meals a day to help the pancreas. We are now feeding 3 meals a day: AMPS, AM +6, and PMPS. Would it be better to feed 4 smaller meals again? If so, should I do AMPS, AM +4, AM +8, and PMPS?

 

[Cassandra and Sasha]

She's going to bounce from yellow right now too, so there is a bit of that in the mix as well.

Smaller meals more frequently often help flatten cycles out, especially is Buzz is one to hang onto food spikes. I would normally recommend trying as many small meals as you can, and 4 is a good starting point. Once Buzz gets into normal numbers again, you may have to play around with the times depending on how you see her cycles going. Sometimes a +2 or +3 meal is good if a kitty has a propensity to drop early, and sometimes it isn't. Just play it by ear for now. :smile:

I would still take her up to 1.5u tonight, unless she ends up turning around quite a bit before then (like showing blue).

ETA: Not sure if this has been discussed yet, but we try to not feed for 2 hours prior to preshot tests in order to get a non-food influenced number. Spot checks don't matter food wise, just the preshots.

 

[Sarah and Buzz]

She's going to bounce from yellow right now too, so there is a bit of that in the mix as well.

Smaller meals more frequently often help flatten cycles out, especially is Buzz is one to hang onto food spikes. I would normally recommend trying as many small meals as you can, and 4 is a good starting point. Once Buzz gets into normal numbers again, you may have to play around with the times depending on how you see her cycles going. Sometimes a +2 or +3 meal is good if a kitty has a propensity to drop early, and sometimes it isn't. Just play it by ear for now. :smile:

I would still take her up to 1.5u tonight, unless she ends up turning around quite a bit before then (like showing blue).

ETA: Not sure if this has been discussed yet, but we try to not feed for 2 hours prior to preshot tests in order to get a non-food influenced number. Spot checks don't matter food wise, just the preshots.

+2: 413
+4: 414

Bummer! Ah well, the dance is intricate, right? So noted about the meals, although I will leave as-is for the weekend while I am gone. If I am not home to get a +6 in a couple hours, DHW will do so. Also, good to know about spot checks not really mattering in terms of food. How do you know if you are seeing a true number vs. a food spike, particularly if you are checking at (what you believe to be) nadir? Or even if you KNOW that it's a food spike, how do you get useful information out of that test?

Speaking of DHW, I have instructed him that if he needs to ask anything while I am gone, he should sign in here as me. I will show him the basic ropes, but if he doesn't do the condo quite right, please forgive him. He will only sign in if it's a true emergency, I figure, otherwise he will probably call me and have me ask you guys.

We will increase to 1.5u tonight in the absence of anything blue and I will post here with updates for the late-night crowd.

 

[paige]

Hi Sarah, I am so glad you and Buzz seen to doing well today. Good luck with the dosecrease when you start!! :mrgreen:

 

[Cassandra and Sasha]

How do you know if you are seeing a true number vs. a food spike, particularly if you are checking at (what you believe to be) nadir? Or even if you KNOW that it's a food spike, how do you get useful information out of that test?

Speaking of DHW, I have instructed him that if he needs to ask anything while I am gone, he should sign in here as me. I will show him the basic ropes, but if he doesn't do the condo quite right, please forgive him. He will only sign in if it's a true emergency, I figure, otherwise he will probably call me and have me ask you guys.

During the cycle, all of them are true numbers, food influenced or not. You want to be able to see trends based on the 'normal' workings of the day - food, meds, poop, etc. The reason we don't want a food influenced preshot number is mostly because with Lantus and Lev you can shoot low, but if you are stalling because your preshot was 40 and you feed and then get a 70, then that preshot is most likely food influenced and not the true rise you are waiting for. While you may be comfortable shooting a 70, it is really then just a 40 wrapped up in a bow, kwim? If you had a true 70 that was not influenced by food, then shooting it would be a different scenario. If you get to a point where you will pretty much shoot anything (within reason) and aren't going to stall, then the food rule isn't quite as necessary.

Do let DHW know that we are always here if he needs help. We won't bite, I promise. ;-)