1/22/15 Oz - Wondering if it's time to increase the dose

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Ian & Oz

Ian & Oz

Member Since 2014
Hello,
Well after a few days of watching his numbers stay higher than they have been, hoping to see an end to a bounce, Oz still hasn't come down yet. There were a few better blue numbers but whether it was from a fur shot or just multiple bounces, he's staying in the higher yellows now. Today he may have received a fur shot, hard to say with his numbers lately. A few days ago I posted & we discussed possibly raising his dose again. When I did that recently I didn't know he was coming down from a bounce & the extra dose really tried to take him down low very aggressively. I'm thinking raising the dose will help but how do I avoid catching him coming down again & having to fight the dose for the whole cycle?

Thank You.
 
Ian,

I'd look to the guidelines for TR for failed reductions. When you went down from 2.75u, his numbers immediately trended upwards. I'd go back to 2.75u.

If an attempted reduction fails, go right back up to the last good dose as soon as you see kitty's numbers trending upwards. You don't have to hold the reduced dose for a certain number of cycles before taking the dose right back up. The guidelines listed under the topic "Increasing the dose" do not apply to a failed reduction.​
 
Hi Julie, my concern is giving his increased dose if he's still bouncing & maybe coming down, like what happened the other day. I'm wanting to give his shot hopefully at a more stable time if that's even possible to know. You & Marje were able to tell that he was bouncing & that he was coming down, just wondering if you see anything that tells you where he may be as far as the bouncing goes.
 
yes, true. he is in a bounce with those flat yellows. in between bounces on this 2.5 he's getting into blues. So one option would be to wait until he's back in blue again and increase with the next shot, if you want. that would put his increase at the start of a bounce cycle and avoid increasing on the tail end of a bounce, which may be where he is now. Good thinking.
 
Hi Ian,

I hope all is well with you, Erin, and Oz. I've missed you the past few times you've posted.

I'm so sorry to see that Oz didn't hold the last reduction. I have no doubt you'll get him back into those better numbers soon, though.

You raised a great question about increasing when a bounce is breaking. That was an issue I always struggled with, too. I could tell when Jersey was bouncing, but I was never sure when it was going to break. Thank goodness for all of the expertise we have on the board; they were all a godsend for us. And Julie is an absolute angel. I'm glad she could help you figure out when the best time to increase might be.

Good luck with the increase when you decide to go for it!
Shelly
 
Thank you Shelly, I'm concerned because I raised his dose recently having no idea that he was coming down & had a rough night trying to bring him back up since the dose was trying to take him very low. I want to increase the dose & may just have to be prepared for another long night when I do.
 
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The "don't increase on a bounce" advice is mostly for newer folks who don't have a good sense of their cat's patterns yet. I've increased on a bounce and not had a problem. However, Marje was absolutely right that sometimes the momentum you get when the bounce is clearing + a little extra insulin from an increased dose can cause the result you had the other night. I think you had the perfect storm of ingredients that made it difficult. You won't necessarily have that same experience again, but it's certainly ok to wait and increase right after you've seen a bounce clear.
 
Thanks Julie,
I'm just not knowledgeable enough yet to know when the bounce has cleared. At the moment, at least to me, Oz seems to be on a perpetual bounce, he seems to bounce easily.
 
One thing you can look for is a high before a break. Look at 1/17. He was bouncing in blue....popped up a bit to 203.. And then down he came. He was fairly flat yellow today but I wonder if the 273 signals he might come down.

I definitely agree he needs more insulin and Julie has a good suggestion for increasing the dose at a time that will minimize the chance of another night like the other one. Of course, he's a cat and so he might fool us all. I usually try to do dose increases on an a.m. Cycle to avoid those crazy nights. But since one of us is around during the day, we have more flexibility. You may need to increase at night if that is when he starts the bounce.

Good luck with the increase!
 
Thank you Marje,
So giving a dose increase during a bounce is ok, but not so good if he's clearing a bounce.? I have to admit, it still looks like very random numbers without any pattern or reasoning to me, I've got to find a way to confidently know what I'm seeing on his chart. If I give a raised dose & have the same reaction as the other night, do I just stick with the dose & will he or should he even out fairly soon? I still don't understand why he was doing so great for six days & then everything changed, I guess that falls under every cat is different.
Thank you both for your replies & help.
 
i completely sympathize, Ian. I found it really hard to identify bounces for a long time. While you're struggling with it, just keep on asking. and yes:

ian said:
So giving a dose increase during a bounce is ok, but not so good if he's clearing a bounce.?
Click to expand...

that's the idea.

I think raising the dose when he's not clearing the bounce won't cause the same issue that you had before. No guarantees, of course, but i *think* that'd be true.
 
Hey Ian,

Marje and Julie, along with many others, helped me tremendously when it came to figuring out Jersey's numbers. I struggled, too, when it came to recognizing a bounce, the bounce breaking, not enough insulin versus a bounce, etc. I wish I could help you recognize the patterns more; I'll leave that to the more experienced users.

I did just want to comment on one of the things you said:

ian said:
I still don't understand why he was doing so great for six days & then everything changed, I guess that falls under every cat is different.
Click to expand...

I just posted our story in Mary (& Mikey's post) this evening. With Jersey, we started on just .10 unit, upped it to .25 unit, and ended up with a bg reading of 33. Obviously, we reduced her dose back to .10 unit. Somehow, in just a matter of days, though, Jersey changed. The .10 unit was no longer enough. The .25, .50, and .75 units ended up not being enough either. For us, our breakthrough dose ended up being 1.0 unit. That's when everything fell into place for us - and stayed in place.

I don't have any concrete answers for you. I just wanted you to know that you're not alone. Lots of cats, even those who go into remission, bounce around in dose. It's frustrating, but it's also normal. Try not to look at what he needed in the past. Just try to focus on what he needs now. (I know, easier said than done!) :bighug:
 
Thank you Julie & Shelly, it truly is confusing but I'll keep at it until I understand. Ultimately I just want to help him. I appreciate every ones input, I hate asking the same questions but want to know the right things to do.
 
Ian

I have raised the dose when the bounce is clearing and had cycles like you had. For Gracie, I know she can get really active on a bounce clearing cycle so I don't decrease her dose unless she goes into the 30s. On a bounce clearing cycle, If I have to work hard to keep her up but I can keep her out of the 30s, then I hold the dose. She also can be very active and dip low on a new dose, even if she's not clearing a bounce, and so I tend to hold the dose, again, as long as I can keep her out of the 30s. Again, this is Gracie and it might not be the best approach for another cat.

These see things we learn over time about our kitty and it might be different for Oz. I will say that it is not unusual for a kitty to suddenly stop doing well on a dose they were doing very well on. There are so many external things that can affect BG...including barometric pressure, weather, season, absorption, etc.

My best advice is to not get attached to a dose. Sometimes they will have a little hiccup on a dose and if you give them a cycle or two, they get right back to business. But sometimes they don't and then you just take the dose up. Sometimes they only need that increase for a short time to kickstart them and then they do fine on the dose they just fizzled out on. We've been going up and down around the same dose for quite a while.

It does take time to see patterns and be able to distinguish between a bounce and high numbers. What I look for is if he's coming down at all during a cycle and how far down is he coming? How long have his bounces taken to clear in the past several cycles? You will figure it out:):) and we are always here to help you.:)
 
Thank you Marje,
I learn something each time I ask questions so that's good. I haven't raised his dose yet but this morning he started off at 156, it has been around the mid 200's, so something changed, it just took awhile. If he doesn't show much improvement I'll raise his dose.
 
So the 273 last night was, in fact, the high before the break. Yay for my crystal ball!:)

You have the info, you know where to find us, and you know Oz so just let us know if you have any questions. We are always happy to help.
 
I hope to be able to make sense of it like you do, someday Marje. I raised his dose back up this morning since he was stalling in the 200's last night, hopefully this will get things back in order.
 
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