1/24 Lucian AMPS HI,+10/HI - Shot +9/573

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nckitties3

nckitties3

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Seems he needs a higher dose. But because last night certainly wasn't the norm, I'm going to give it another cycle.


Since I'll be testing all day and there isn't room in the subject line, I'll add the numbers here:

AMPS HI
+2/324
+4.5/245
+6/308
+8/320
+9.5/470
+10 HI Shot
+2/543
+4/296
+6/307
+8/377
+9/573 - Shot
 
Re: 1/24 Lucian AMPS HI

Our protocol is about 3 cycles, then adjust.

Since its an in and out kind of insulin, maybe track the tail end of the cycle to see when it is wearing off.
 
Re: 1/24 Lucian AMPS HI

Good morning Debbie and Lucian,

Not a bad first cycle. He did go down for nadir which was good to see. The 444/373 was interesting. I know it's within the 20% variance, but still interesting.

Yes, I would give it one more cycle. Sometimes the shorter cycle is because the insulin didn't last long enough; sometimes it's because the dose was low. Another cycle should give you a better idea.

If he isn't getting a lower drop and longer duration by tonight, you can increase by .25 or .5. Or tomorrow am, if you'd like to sleep tonight. :mrgreen:
 
Re: 1/24 Lucian AMPS HI

Setting the clock every 2 hrs sux, but it's not the first time and daresay it won't be the last.

Because he started out under the influence of the R, I feel like it isn't a true example of what the 1U of PZI could do. I don't think it's enough, but want to wait until tonight to decide.

Going back to bed, see ya in 2.
 
Re: 1/24 Lucian AMPS HI,+2/324

That's a good drop. It is so fascinating to watch how a kitty adapts to a new insulin. They all have their unique responses.

Check out Eddie's ss today. Jen was frustrated with the the higher flatter cycles and then, today, amps of 157 = all on the same dose.
 
Re: 1/24 Lucian AMPS HI,+2/324

Glad to see some pink. Keepin' my fingers crossed for Lucian!
 
Re: 1/24 Lucian AMPS HI,+2/324,+4.5/245

Back in the sunshine! :thumbup

Surprised me, I didn't expect him to come down to 200's from HI on 1 unit. My only goal is for him to STAY below renal threshold, I don't care about remission, just that he's healthy and happy for the time he has left.

Lucian has spent a lot of time in the Black Hole. I'm afraid this will start a roller coaster ride, since that is quite a drop from 600+.

I'll try to hide the trampoline............. ;-)
 
Re: 1/24 Lucian AMPS HI,+2/324,+4.5/245

That's a nice mid-point number! Keeping an eye on his SS :smile:
 
Re: 1/24 Lucian AMPS HI,+2/324,+4.5/245

@Jen Only problem with that is, if that's a mid-way point, then it's a 9 hr cycle. Which would not surprise me. :roll:
I know Lucian and he's always been known to spike in the last couple hours. The idea that even Lantus and Lev didn't last long enough for him, has been bounced around quite a bit. He did much better on Lev, until recently, which is what led us to PZI. I would be more comfortable shooting every 8-9-10 hrs with an in & out insulin, than a depot insulin like the L's.

Only time will tell at this point.

Poor boy, gonna be tested every 2 hrs for 24 hrs. I did miss the last one by 30 min ohmygod_smile , but after the +2, felt comfortable enough to sleep without the alarm clock. Setting the clock all night is crazy, but whatever it takes. ~O) ~O)
 
Re: 1/24 Lucian AMPS HI,+2/324,+4.5/245

Got a ?? For you experienced with PZI.

You know I'm testing every 2 hrs at present. Let's say that Lucian is climbing towards the end of the cycle. If it was YOUR cat and he was at 4-500 at +10, would you go ahead and shoot early and change his cycle? Rather than allow him to go into the 'Black Hole'?

I have seen him spike 2-300 pts in 2 hrs or less at the end of a cycle, more than once. The reason for my question, can we avoid this?
 
Re: 1/24 Lucian AMPS HI,+2/324,+4.5/245

nckitties3 said:
@Jen Only problem with that is, if that's a mid-way point, then it's a 9 hr cycle. Which would not surprise me. :roll:
Click to expand...

Sorry :smile: I didn't mean necessarily nadir or half-way through the cycle when I said "mid-point." Just meant that it looks good so far! Hopefully, he'll hang in the yellow numbers for a few hours before starting to come back up.

I'll let some more experienced folks chime in on whether to shoot early.
 
Re: 1/24 Lucian AMPS HI,+2/324,+4.5/245

That's ok Jen. :-D

Lucian is NOT the norm and has a tendency to give a 'check mark' instead of a 'smile' on his SS. I'd love to see him hang in the sun for a bit. Getting ready for his +6 test, keep fingers crossed.
 
Re: 1/24 Lucian AMPS HI,+2/324,+4.5/245

Yes, you can. Just be sure you are past his nadir and he is climbing. I would not shoot before +8. Shooting early consistently makes it hard because you wouldn't have a set schedule and would need to keep track of where you are in terms of numbers and hours from the last shot.

Hope this doesn't become an option because he stays lower, longer.
 
Re: 1/24 Lucian AMPS HI,+2/324,+6/308

I can't see letting him hit 600+ at preshots. Should I try an increase first to see it that will last a bit longer? You know I'm still pretty confused with the PZI dosing thing. ohmygod_smile

I didn't plan to do anything today, I want to go with a full 12 hr cycle and see what happens.

If he's over 500 at pmps, I think we need to consider something, an increase, earlier shot time, something..........
 
Re: 1/24 Lucian AMPS HI,+2/324,+6/308

There is something else ya'll need to consider, Lucian's diet.

Lucian eat low carb, under 9, FF and Friskee's pate. He eats very little, 1/3 of FF, 1/4 of friskees , leaving some, at every meal.

Here's the kicker, he eats every 2-3 hrs, 24 hrs a day and will NOT eat anything left out. It has to be fresh and I have to get up TWICE for every time he is fed during the night. Once to feed him and again, when he's done, to put him back on the bed. He isn't able to get on the bed because of his arthritis, but he expects to sleep there. :lol:

His +6 was 1.5 hrs after eating, usually his tests are always 2 hrs or more after eating, but I was late on his +4.
 
Re: 1/24 Lucian AMPS HI,+2/324,+6/308

Have you ever gotten a feel for how food impacts his numbers? Just might be nice to know if a number was likely to be food related.

I understand that you'd like to get him in good ranges fast. I just don't know whether the best results would be an increase (i do think that would be my first choice) or TID(I would definitely wait on that). I'd give an increase a chance partly because TID is so hard and because, it just might work. He got a good drop but clearly is headed up. A short cycle is often because an increase is needed. Of course, not always. Sometimes it's that the insulin just doesn't last long enough for that cat. Like with the Ls and even more so, data is your friend and the key to this dance.
 
Re: 1/24 Lucian AMPS HI,+2/324,+6/308

Usually his food only brings him up a little, less than 50 pts, which is a little in Lucian's case. :lol: Now short term, like controlling hypo, when I feed 1-2 tsp every 30 mins, maybe 5-10 points. But he is responsive to that and I don't usually have to go to med or hi carb. Haven't had to deal with a low number since Nov, when he dropped to 38. That was turning point with him, until then, he was doing beautifully on Lev. Since then, no control.

I would try a dose increase before considering a shorter cycle, but I hope you know, I am willing to do whatever it takes to get him regulated. Hell, I'm already up most of the night! :lol: It just doesn't take much to put some food on a plate, you need to be reasonably coherent to test. :shock: :lol:
 
Re: 1/24 Lucian AMPS HI,+2/324,+6/308

Here's the kicker, he eats every 2-3 hrs, 24 hrs a day and will NOT eat anything left out.
Click to expand...

I'm not sure how that affects a Lantus/Lev kitty, as their cycles (when the dose is "right") tend to be flatter. And I think you saw that on Lev, the onset and nadir can tend to come later in the cycle than with Lantus? Lucian doesn't seem big on doing the "typical thing" though. :lol:

With PZI, "typical" is the smiley shaped curve where the effect of the insulin wanes over the last half of the cycle. That said, food after nadir is likely to make the "climb after nadir" more pronounced, to give you that "checkmark" curve shape. In which case, shooting early when you see that big climb makes sense. If you can tell by the first part of the cycle that there doesn't seem to be a number that would have caused a bounce, then you could more safely assume that the rapid climb is more due to food, and to the insulin dose wearing off.

This cycle is looking like he gets a good response from 1u - his BG dropped by more than 50% in five hours - but that also assumes that the Lev depot is "gone" and no longer playing into it too.

I think this evening, you could shoot early to try to avoid the high red/black PMPS. I think I'd do that before trying a dose increase this early in the "game".
 
Re: 1/24 Lucian AMPS HI,+2/324,+6/308

At least you didn't tell me not to feed him! :lol: The only way that happens, is if I'm not home and that's rare.

When he wants to eat, he meows at me, repeatedly! If that doesn't work, off to the closet door where he proceeds to try to scratch his way to China! There is NO avoiding feeding him, it can't be done. The best I can do is make him wait 15/20 mins for test time, by giving a little tuna or freeze dried liver treats, that are carb free, but that doesn't last long.

I know there are some people that feel they should only feed twice a day, never after nadir, etc, but they don't have Lucian. If their cats are good with that, bless them! Lucian ain't having it! :o

Since there is no option with him, he will continue to eat when he wants to. Since he grazed for 14 yrs on dry, on demand, that's just the way it is. He doesn't understand WHY he can't eat whenever he feels like it, like he always has and I can't seem to explain it to him. @-)

I'll be testing all day again, next time in 30 mins.

You think an earlier shot is a better option than an increase, why is that? Because it's actually his first cycle without influence from other insulin? Or maybe because he responded TOO well and may spike later? Knowing how well he bounces, I'd be leaning towards that. Just curious, you know I'm at a loss with PZI. :sad:

As for his depot, 1 missed shot will send him sky high, I have doubts as to how much 'depot' he has ever had. Maybe he's just different. The 'check mark' cycles were on Lantus. It did not work well for him from day 1, no matter the dose. Lev did well for a few months, then in Nov, he dropped to 38 and after that, no control. No clue what caused that. But it led us here.
 
Re: 1/24 Lucian AMPS HI,+2/324,+6/308

You think an earlier shot is a better option than an increase, why is that? Because it's actually his first cycle without influence from other insulin? Or maybe because he responded TOO well and may spike later? Knowing how well he bounces, I'd be leaning towards that. Just curious, you know I'm at a loss with PZI.
Click to expand...
My concern would be that a higher dose might drop him low enough to cause a bounce, not necessarily like into greens, but low enough in relation to his preshot to trigger the bounce. He might not do that from today's 300 point drop, but a bigger drop could make it happen.
If you can shoot at pink numbers instead of reds or blacks, you might be able to maintain lower numbers overall.
 
Re: 1/24 Lucian AMPS HI,+2/324,+8/320

For now, he's rising, but not spiking, as of yet. Keeping fingers crossed it will stay that way, but then, we're are talking about Lucian here. :roll: :lol:

I was shocked to see him in 200's from 600+, no way of knowing just how high he was, which I hate, but can't afford a pet meter. That drop is more than enough for Lucian to bounce. He's got bouncing down pat! Does it very well! Unfortunately. :roll:

Guess I'll just see what happens in the next couple hours, testing again @+10. I feel if he is 400+, I should shoot, rather than allowing him those crazy numbers. If he's still pink, I'll wait an hour and test again. I want to catch him before he gets too high, but I hate having to keep poking the poor guy. I know, it's necessary with a new insulin and especially with a cat crazy as my Lucian. :lol:

Thanks to all for the info, opinions, etc. I surely need and appreciate them. :YMHUG:
 
Re: 1/24 Lucian AMPS HI,+2/324,+9.5/470

Hate to say I expected it. :sad:

Lucian got up a few minutes ago, wanting to eat, although he ate less than 1.5 hrs ago. I gave him some liver treat to try to hold him off, but he seemed to be starving, so I tested. No wonder. :o He always eats more when he's running high.

I've decided to shoot at +10, I feel it is the only way to prevent another HI at preshot.

Any advice or opinions are welcomed.

Thanks to you all! :YMHUG:
 
Re: 1/24 Lucian AMPS HI,+2/324,+9.5/470,+10/HI - Shot

So much for trying to keep him off 600+. :cry:

Guess I'll stick with a 10 hr cycle, or less if need be, until something changes. Looks like 9 hr would be better at this point.
 
Re: 1/24 Lucian AMPS HI,+2/324,+9.5/470,+10/HI - Shot

Good choice this cycle, I think.
One cycle at a time.:-)
 
Re: 1/24 Lucian AMPS HI,+2/324,+9.5/470,+10/HI - Shot

I don't see me getting any sleep for a while and poor Lucian is gonna be a pincushion! :o
 
Re: 1/24 Lucian AMPS HI,+2/324,+9.5/470,+10/HI - Shot

Debbie, with a HI PMPS, I don't think you need to worry overly. I think a +4 just to see how he's doing is good?
 
Re: 1/24 Lucian AMPS HI,+2/324,+9.5/470,+10/HI - Shot

I am with Carl on this one. Dosing earlier to try and prevent the reds/blacks might just be the trick for Lucian. One good thing about PZI....don't have to worry about 'depot'. Although we would normally....yes...normally... :roll: watch for dose overlap. Might not be too much of a concern with Tigger....oooops...I mean Lucian. :smile:

RumpelT went through the Tigger-stage for a while.

You are so very lucky Lucian is such a good patient. cat_pet_icon
Just have to take it one day...I mean cycle..at a time. :smile:

Jeeezz....our days are not "days"...they are "cylcles". :lol: :roll:
 
Re: 1/24 Lucian AMPS HI,+10/HI - Shot +2/543

@Carl, I really need to see what he's doing and when. I need that data to decide what to do with him later. We'll deal with it, it's been worse. I have a lot more freedom in choice with the PZI.

@Misty, I swear Lucian thinks he's Tigger too! Always have been a bouncy boy. :roll: If you had seen Lucian the 1st 6 weeks, you would have never thought he could EVER be a good patient. :o I had to 'kitty burrito' him for 6 solid weeks before he decided to let me do what I needed to. Now he's given up! He knows that fighting me will not prevail, I'm 'in it to win it' and I refuse to give up. Sleep be damned!

We'll just have to wait and see if the reduced time frame helps him. I'm hoping.
 
Re: 1/24 Lucian AMPS HI,+10/HI - Shot +2/543

Keep at it! I like how you can adjust PZI. That's one of the main things I loved about it. It might be really useful for a Tigger since it can be moved around. Sorry I don't have much advice but I'm watching all the same! :smile:
 
Re: 1/24 Lucian AMPS HI,+10/HI - Shot +2/543

Thanks Rachel, I appreciate that. It's tough to go back to being a noob after over a year into it. :YMSIGH:
 
Re: 1/24 Lucian AMPS HI,+10/HI - Shot +2/543

I bet! I was considering a move to the L insulins before Gypsy went to the bridge. We thought maybe that's what she needed and I remember being worried over a new kind if insulin, having no knowledge, and not knowing anyone on those forums! I'm glad you're here. I think you'll learn fast since you already have FD experience.
 
Re: 1/24 Lucian AMPS HI,+10/HI - Shot +2/543

Been thru Lantus and Levemir, now to PZI and hope that's the last stop.

Going to try to catch a couple hrs sleep. I'm exhausted.
 
Re: 1/24 Lucian AMPS HI,+10/HI - Shot +6/307

He's running almost identical to today's cycle, at this rate he'll be back to HI in 4 hrs.

If this cycle repeats the AM cycle, I'm going to need some advice and opinions or I'll go it on my own, do or die.
 
Re: 1/24 Lucian AMPS HI,+10/HI - Shot +6/307

Almost shot at +8, wish I had, by +9 he was almost to 600 again.
 
Hi Debbie,

Just so I'm following clearly...looking at Lucian's spreadsheet, you shot at PMPS +8 at a read of 377? What did he test at +9? Looks like he came back down nicely by AMPS (or whatever it should be labeled) +4. In the couple cycles you've got here, it looks like you're getting onset around +2 or maybe even a little sooner, and he's coming off those high numbers nicely. Then, it looks like he's holding somewhat steady from +4 till +8, and then blasts back up.

I wish I could offer advice but I have zero experience dosing on a schedule like this. From my new bean standpoint, the one thing I guess I'd watch for is for Lucian to settle into the dose a bit, as you may end up with more overlap than you want.

~O) Coffee and hugs to you and Lucian.
 
Although Simon never had really high numbers like Lucian, one thing they did have in common is the fact that it seemed to wear off early for him in the early days. I did not go to TID though. I just experimented with different doses and lo and behold, in a few weeks, his nadir started getting farther up the time clock. He used to hit his lowest numbers between two and three hours after his shot (and I always free fed Simon too..no meals for him or he would meow me to death as well..lol) and then start moving back up around hour 6. The only thing I can tell you is that nadir does seem to get later and later as the cat uses this insulin. It bangs them down really early in the beginning which I think bounces them back up quicker, but after a while, it starts to work and then it will go to hour 4 and then 5 and finally right where it should be at hour 6. At least that is what happened with Simon who never followed the rules either... :o ;-)

I know you are worried about Lucian being over 500 so often and I get that, but I think after a while on this insulin, he will settle in and you might see some late nadirs (ha, that rhymes! :lol: )

Keep the faith!
 
You might be able to increase. Honestly, Gypsy took several days to settle into a dose so I never changed until she'd say on a dose at least 3 days. But ECID. I might wait one more day, get a nadir (though you fmget lots of tests which is awesome!) and if still high, increase? Maybe even by .5? I'd personally think an increase is worth trying, but I'm not all that experienced. I could change Gypsy's dose like a pro but she's what I knew!! Trying to learn more here still.

Anyway, there's my two cents. I'm certain Sue or BJ will be along with theirs soon...and they are really good! :-D
 
Good morning, Debbie. I had hoped you might post before I have to leave this am, but hope you are getting some much needed sleep.

My advice (which is worth what you are paying for it :mrgreen: ) is to slow down. He is only on one unit. Yes, his nadirs are early and he is bouncing up. But you can't be sure yet whether that is because of too little insulin or short duration.

PZI is strange in that, in some cats, too much insulin (whether by dosing too often or giving too much)can create high numbers. Sometimes they reach a point and crash, but not always. Sev and Miss kitty are a perfect example:

https://docs.google.com/spreadsheet/lv?key=0AopnX-7vlQSUdExMQmUtalV1ckJFNEREWjRsNDdBaHc

The adage of this being a marathon, not a sprint, applies to cats changing insulin as well as newbies. If I were you, I would make one change - my perference is raising the dose to 1.5 - and stick with it a few cycles. If you are going with TID instead, then I would wait until he is above 350 and after 8.

I'll be gone this am but will check back in this pm.
 
It was a relief to get up and see all your advice.

I messed up on the SS, I didn't shoot at +8 it was +9, like I added to the original post here, editing with each test. Today I shot at +8 and but didn't raise him yet, just reduced the time between shots. Haven't quite figured out how to make the SS work with a shorter than average shot schedule. I'll just update here for ya'll.

With a TID schedule, this is going to be difficult. Can't take another night up, so I won't increase until tomorrow. Hoping he'll show us something.

Will start a condo for today, kinda hard to that to. Will start with the shot at 4AM EST.
 
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