1/31 Shadoe pmps 383 +6 238

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Yesterday recap:
400 - amps
317 - +2
340 - +3
338 - +4
349 - +5
382 - +6
373 - +7
360 - +8
396 - +9
383 - +10
373 - +11
349 - pmps
322 - +2
310 - +4
365- amps

We woke to a pink number, test and shot were uneventful; after yesterday's testing marathon, Shadoe has given up on hiding now.

Shadoe is the same as yesterday, eating little so far, but really likes to have her food soupy now. She licks out the water, and I add a bit more to the food that's left. We are not using the auto feeder as the food would be wasted and I am adding water to the food repeatedly.

If we are to get to lower numbers, Shadoe will need a dose increase.
Unless there are any good reasons to wait, I would like to go ahead with at least 6u tonite at 6pm.

Question: are increases always 0.25u or at what point would the increase be 0.5u. I recall a mention of the two amounts but not the specifics. I thought one was for in the higher doses and while 6u is not all that high, it's definitely getting up there.
A girl I know who is diabetic is on the same Lantus dose as Shadoe right now. :sad:
 
Re: 1/31 Shadoe amps 365 dose increase tonite

my goodness. well, personally i was just wondering whether you wouldn't raise by 0.5u in this case. numbers are very flatly high.
i've been dosing lantus for 17 months now and i've only raised by 0.25u. don't think it would hurt you to go up by 0.25u but no need to hold the dose for this long. you can go up every 3 days as long as you have midpoint data to show shadoe isn't going too low on a dose. your spreadsheet certainly justifies an increase.
i think it's more than time to up the dose now, tho. so if you want my vote, i'd say yes on tonight. wish you coulda gone up this morning.
 
Re: 1/31 Shadoe amps 365 dose increase tonite

That's a very flat cycle that Shadoe had yesterday. Hope the increase helps and you start to see some better numbers very soon.
 
Re: 1/31 Shadoe amps 365 dose increase tonite

Thanks for your vote, Chris.

Lynee, me too; all this pink is not good.

Yesterday was the first full day Shadoe had no fluids, so we needed to see how she was reacting to the current dose without the effects of the fluids. Her ss clearly shows that any good numbers she has had over the last few weeks were more than likely the influence of the SQuids.

My vote is for the 0.5u, but only if it's proper.
 
Re: 1/31 Shadoe amps 365 dose increase tonite

i had thought about 0.5u, but i'd recommend a 0.25u increase this time. probably a better idea to see how shadoe does on an increase without fluids. let's see what some of the higher dosers think, tho, if they see this thread. they have more experience deciding whether to bump up by 0.5 at this point.

(are you still gonna give fluids occasionally? i give them whenever cleo looks/acts a little punky.)
 
Re: 1/31 Shadoe amps 365 dose increase tonite

Thanks Chris,
I am OK with just a 0.25u increase, but I don't want to stay any longer on this one. I had wanted to increase earlier, but did not get word on the amount, so I waited. I need to increase at PM as I am away all hours between am/pm shots.
I asked about the larger increase because I was not clear on what circumstances would suggest the larger increase is needed.

As for the fluids, I did double check with the vets office to get the OK to stop and 'observe' how Shadoe does. She is on day 2 with no fluids, is not licking her lips at all, is eating bits through the day, and the LB has still a fair decent amount of action, so I know she is getting liquids in her OK. The stool is just fine, but phew! stinkier lately. It is for those reasons we stopped the fluids, and I still have about 500ml left in the bag in case we need it.

Shadoe seems to like her food to be more soupy now. I had started adding more and more water to her food when she was just not eating at all, and she was OK to lap up the liquids. When getting SQuids, she was happy enough to eat ordinary out-of-the-can food with no added water, but I went back to adding water when she was not getting those extra fluids.
I think the decision is in: all food must be watered down or I get dirty looks.

I will watch for less LB action, licking lips, and a cutback on eating as signs we may have issues again; I don't have a clue what other signs would signal a return - pancreatitis signs I don't know.

Shadoe's numbers were all over the place [I saw no pattern], so I don't know about giving fluids intermittently. I feel more comfy giving Shadoe the soupy foods, even if I give her a bit of can tuna, I put in water and she loves it.

She is a sly one who complains about nothing except when she wants the chair I am sitting in, and then I get the meows and hang dog face.
 
Re: 1/31 Shadoe amps 365 dose increase tonite

definitely, if you are getting midpoint tests as well as preshots and you're not seeing enough good numbers (blues and greens), you are able to increase your dose every 3 days. generally people are asked to wait and get more data because they don't have midpoint tests to see how low the cat goes on a dose. no reason to wait for word otherwise. many cats tolerate higher numbers quite well but they feel a lot better in lower ones.

hard to tell with pancreatitis kitties. some just meatloaf and drink more water. normally we expect higher numbers to be a clue but not all cats run high. i think a lot of owners just notice that the cat seems "off"--not acting like normal--so they start treating it as pancreatitis automatically.
 
Re: 1/31 Shadoe amps 365 dose increase tonite

Gayle, you are working so hard with Shadoe, and it shows..I'd go with the 0.25U as I am here a long time & know you can always up the dose if necessary..Also Shadoe is recovering & keeping things easy now seems indicated..I never realized how fragile cats are till I had them--What's with that 9 lives thing? confused_cat confused_cat confused_cat When you increase doses you should go slow.
Anyway, I always water the food down, as my kitties are prone to constipation..
Hope for a speedy recovery with some beautiful numbers & good luck with the dose crease! :mrgreen:
 
Re: 1/31 Shadoe amps 365 dose increase tonite

I think I'll save strips and Shadoe's ears till pmps; she is hugging those pinks like her life depends on it. Her +7 is, what else, pink 355. :YMSIGH:

So it's time for a nap, Shadoe already curled up and went to sleep after this test, then we will see how her numbers are affected with a move up to 6u.
 
Re: 1/31 Shadoe amps 365 dose increase tonite

Hi Gayle
You never know when that extra .25 will kick in. Remember vet #3 told me I can bring Max from 5.5-6.5 last week?
Can you imagine if I did that??? OMG.
It was mentioned in my condo a while ago that when they hit these higher numbers and depending on the nadir I could have done a .5 increase. I never did.
Worst is in 3 days you go the extra .25. Nice and slow. You had no choice but to keep this dose for much longer than you would have otherwise due to the fluids you have been giving Shadoe. Now that you stopped giving them maybe we will see some changes.
Paws crossed for an increase tonight, whichever one you will be comfortable with.
Thinking of you guys!!!!
 
Re: 1/31 Shadoe amps 365 dose increase tonite

hi gayle! i would vote for the .25 increase too because i am cautious and not from loads of experience...but then i looked at the tilly protocol

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.
Click to expand...

looking at your ss, in theory you should increase by .5 IU, but that doesn't seem like it should be the case for shadoe - recovering from p-itis and just stopping fluids...

just throwing this out there for others to read and respond. also, have you visited the high dose forum and checked out those ss and forum? that might be stating the obvious.
 
Re: 1/31 Shadoe amps 365 dose increase tonite

Ronnie,
That hang dog face is something I am sure you have seen. Surely Luna and/or Bast have used it at some point in time.
hang·dog (hngdôg, -dg) adj.
1. Shamefaced or guilty.
2. Downcast; intimidated.
n. A sneaky or despicable person.

or another source:
Main Entry: long face
Part of Speech: noun
Definition: sullen face
Synonyms:
black look, dejected look, face as long as a fiddle, frown, gloom, glumness, hangdog look, sad face, sullen look

Shadoe has learned to play me well; she comes along with that look, and tosses in that quivering weak little meow. Works every time; snacks come out galore and she gets lots of attention too. That's the sneaky and despicable about her haha_smiley

Amy,
I feel the same about going slow, but only because of the p-itis, not knowing if it's totally better, and fluid stoppage. Otherwise, I would be leaning more towards the +0.5u since she can't seem to even buy a blue or string 2 yellows together with her current dose.
In the section you quoted, I am fine with the clear parts but what is fuzzy is the low or high dose - there are no ranges or dividing line, so exactly when is it decided that you are giving a high dose.
I think it's clear that Leo's 20+u is high dose; what's the cutoff? 10u? 15u? 20u? If I knew a number, I'd be good to go.

:YMSIGH: so, in an hour, we will go with 6u and see how it goes.
 
Re: 1/31 Shadoe amps 365 dose increase tonite

In the section you quoted, I am fine with the clear parts but what is fuzzy is the low or high dose - there are no ranges or dividing line, so exactly when is it decided that you are giving a high dose.
I think it's clear that Leo's 20+u is high dose; what's the cutoff? 10u? 15u? 20u? If I knew a number, I'd be good to go.
Click to expand...

agreed...and since EICD i imagine that's hard to say, but there must me some kind of guidance. hint, hint to anyone out there with that guidance. :smile:

i also think .25 can do wonders...someone else said that in your condo and i agree...u just never know and we all have our fingers and paws crossed tonight's increase brings some lower numbers.

now about that hang dog face
black look, dejected look, face as long as a fiddle, frown, gloom, glumness, hangdog look, sad face, sullen look
Click to expand...
:lol: :lol: :lol: cats all over LL are cursing your description of how they manage to manipulate us into another treat, pet, snuggle! i think luna has ronnie wrapped around his paw so much that ronnie doesn't even recognize the trap!
 
Re: 1/31 Shadoe amps 365 dose increase tonite

Amy and Six said:
i also think .25 can do wonders...someone else said that in your condo and i agree...u just never know and we all have our fingers and paws crossed tonight's increase brings some lower numbers.
Click to expand...

I did! I did! and look what Max did last night, at the 8th cycle.
But for sure Gayle, I of so little experience cannot tell you what to do about the incresae. The 2 of us have been dancing the same dance with Max and Shadoe and you just never know.
This weekend it was Max's turn, now it's Shadoe's!!
The others will come in and help you.
 
BUMP

I agree, it's possible, Shadoe hasn't found her ideal dose...ya never know...

and yea, Gayle, I've seen that look in my kitties faces..little buggers
 
Re: 1/31 Shadoe amps 365 dose increase tonite

Best of luck with the increase! Hopefully, Shadoe will find her ideal dose soon. The flat pink cycles are very frustrating!
 
Re: 1/31 Shadoe amps 365 pmps 383 +2 383

UGH, I can't believe it.

Shadoe has redefined, is the epitome of flat pink.
pmps and +2 are identical; I am thinking why even bother testing?
Just save strips and be confident that no matter what the + is, Shadoe will be pink.

Where's that NDW? None in the Shadoe household.
 
Re: 1/31 Shadoe amps 365 pmps 383 +2 383

gayle, shadoe hasn't been tested for insulin auto antibodies (IAA test) or acromegaly (IGF-1 test)?
we used to talk of high dose as 8u or higher but the def may have changed. you might want to post on the high dose board and ask. remember, the people there started out with lower doses and moved up like all of us before they started having to dose more aggressively.

concern i have if shadoe doesn't have IAA or acro is that his body fights the insulin so the longer you stay on a dose the easier shadoe fights it. that's why it's really important to keep raising every 3 days until you see a promising response, and then not to sit on that dose too long so shadoe can't overcome it again.

remember, when you raise the dose you have increased the size of the shed and need to fill the larger shed first before the numbers respond, so you might not see a response this specific cycle. i'd PM jill and libby, tho, to see if they think you should go up by 0.5u next. i'd be tempted to do that if shadoe doesn't respond to this current dose increase in a few more days (3 days at this dose). but yep coz of the pancreatitis and full moon i thought it better to try 0.25u this time.

wouldn't hurt to get a ketone test in there, tho, to make sure shadoe's not having problems with insufficient insulin. even a trace amount there would argue for raising up by a higher increment.
 
Re: 1/31 Shadoe amps 365 pmps 383 +2 383

Gayle and Shadoe said:
I am thinking why even bother testing?
Just save strips and be confident that no matter what the + is, Shadoe will be pink.
Click to expand...

As I felt the same way yesterday Gayle. Barly tested Max during the day and look what he
did last night. We just don't know when it will kick in.
I feel your distress. Lets hope this one will break.
 
Re: 1/31 Shadoe amps 365 pmps 383 +2 383

Thx Randi,
Yeah, I know that the two of us have been going through the same struggles with Max and Shadoe and who knows, Shadoe may just come down when I least expect it. I just get so discouraged when I see no change at all!..

Thx Chris,

I will stop by the vet's office and ask for them to do the legwork and find out where we can send the tests for Shadoe for IAA and IGF-1; I really think we need to get those out of the way to know once and for all what's going on with Shadoe.
I was agreeable to go slow because of Shadoe's recent issues, but if we need to get more aggressive, I am all for that if it gets Shadoe to a better place.
As for ketones, I am bad that I always forget to record that I do test for ketones with keostix every chance I get, and that all her vet test results so far have been negative. I last tested in the LB earlier today and also yesterday, both negative.

I had asked the vet's earlier about the two tests but their lab does not have them. I left it at that for the moment, but will tell them I want to have them done, no discussion.

In the meantime, would it be a harm to begin a more aggressive approach, doing only the 3days wait, then upping the dose by 0.25u? Shadoe has never gotten any real decent numbers on her own; her first green was on the day that she received her first dose of fluids at the vets, otherwise, she has been my super pink girl with no ketones ever.

I really would like to have some guidance, and it's not going to come from the group of vets I see as they know less than I do about FD right about now. Sad but true.
 
Re: 1/31 Shadoe amps 365 pmps 383 +2 383

Gayle, you will get the answers from others but I will pass on what was told to me by Jill, and yes, ECID.
I had a speck of blue with Max at 5.5. Jill said that I could stay longer or if I was ready to be aggressive and prepared to monitor him, increase the .25 at the 7th cycle.
I did just that and I am assuming that is what led us to last night.
You are tough enough to handle this and you will dose as is suggested and what is in your heart. :YMHUG: :YMHUG: :YMHUG: :YMHUG:
 
Re: 1/31 Shadoe amps 365 pmps 383 +2 383

you're doing fine, Gayle. ((((hugs))))

The reason I didn't suggest an increase yesterday yet was because I thought Shadoe might still be bouncing from that lovely blue. She could still be, but you still have plenty of room to increase the dose. I see on her spreadsheet that you went with the 0.25 increase, that's a good choice (yes, IMHO you're in the territory where you could increase by 0.5 but part of it is gut too, this dose got her some blue so it's not unreasonable to slow down the increases). Already today's numbers were better than the last two days, so hopefully the new dose will be a good one. If not, we can go up again in 3 days.
 
Re: 1/31 Shadoe amps 365 pmps 383 +2 383

Hi Gayle..
Here's some info on IGF/IAA Tests in US... If you are Canadian, Wendi/Milo can help :) http://felinediabetes.com/FDMB/viewtopic.php?f=12&t=375

I am going to stretch the advice you have received regarding .25u.. I think the numbers have gotten ahead of you and you are quite safe to increase 1/2u. However, if you would like to stick to a .25u increase, I would recommend you hold your doses no more than 6 cycles. If it turns out Shadoe is acro/iaa, we can approach even more aggressively, if you are willing.
 
Re: 1/31 Shadoe amps 365 pmps 383 +2 383

Carolyn,
thankyou, thankyou.

I am not a patient person, even on a good day, but this site and the protocol has trained me to go slow. If I had my druthers, I'd be let's roll!
So yeah, I am all for going with a .5u increase.
Because I went from 5.75u to 6.0u on tonite's pm shot, I suppose I will need to wait for the 6 cycles. That's ok, but if Mz Shadoe is still hugging those pinks, I am more than game for going up .5u to 6.5u.

I will get ahold of Wendi/Milo because I want to take the info on testing to my vet and then they can't have any excuses.

Seriously, if need be, I can take some of my vacation from work to be home to watch super close in any aggressive approach.

And aggressive is one of my middle names, ask anyone! :-D
 
Re: 1/31 Shadoe amps 365 pmps 383 +2 383

Hoping the increase works...sometimes a little bit more is all that is needed. If it doesn't do anything
in the 3 days, as Libby and everyone suggested, you will try another increase. You are doing a great job
and thinking all the time...
Little Shadoe will now have to see what she will do with this....we are all hoping for some changes here for both
of you...((Gayle))
 
Re: 1/31 Shadoe amps 365 pmps 383 +2 383

Gayle and Shadoe said:
Carolyn,
thankyou, thankyou.

I am not a patient person, even on a good day, but this site and the protocol has trained me to go slow. If I had my druthers, I'd be let's roll!
So yeah, I am all for going with a .5u increase.
Because I went from 5.75u to 6.0u on tonite's pm shot, I suppose I will need to wait for the 6 cycles. That's ok, but if Mz Shadoe is still hugging those pinks, I am more than game for going up .5u to 6.5u.

I will get ahold of Wendi/Milo because I want to take the info on testing to my vet and then they can't have any excuses.

Seriously, if need be, I can take some of my vacation from work to be home to watch super close in any aggressive approach.

And aggressive is one of my middle names, ask anyone! :-D
Click to expand...

Ok hold that dose 6 doses. On the 7th dose, if you aren't seeing a REALLY good response, go 1/2u to 6.5u ONLY!!! Don't make me yank on your reins :D I've been there, it's frustrating! PS Send me a PM on the 5th dose so I remember to come look ok?

Now.. to anyone reading this and wondering if you should do this with your cat, the answer is NO. You should never ever do this unless you have a suspected insulin resistant cat, and by suspected, I mean suspected by someone else. :mrgreen: Shadoe is a high dose cat, and this dose increase could be considered safe for her, where a lower dose cat could go straight into overdose and rebound and give you all kinds of confusing (read: epic fail) results. If you have questions regarding this protocol, post them in your condo please and ask for experienced eyes. Under no circumstances should this advice be used on a cat that is not high and flat and the cat must already at a high dose.

EDITED to hide the fact that my eyes are crossed and my math is apparently bad tonight lol
 
Re: 1/31 Shadoe amps 365 pmps 383 +2 383

Thanks Carolyn,
I will wait the 6 cycles at this current 6u dose and send you a pm on the 7th to see what you think.

I did pm Wendi to ask for info on getting the IAA and IGF-1 tests for Canadian vets, and will take the info to my vet when she replies. Until we know what's up with Shadoe's aversions to the nicer BG numbers, I have no problem to stick with the go slow approach.

Thanks again for your help and guidance.

To others, all of Shadoe's dose changes have been only the 0.25 and always after waiting several cycles as required.
You can see Shadoe's numbers on her ss.
 
Re: 1/31 Shadoe amps 365 pmps 383 +2 383

Well you get to go a LITTLE faster now, that should make you kinda happy right? :mrgreen: Please note I did bad math and said 6.25u originally and meant 6.5u so I hope you noticed I edited it.
 
It looks like Shadoe is done for this cycle; either more yellows or back to her pinks, so I will head to bed and then catch a +11 in the morn.

She had some good eats, visited the LB, and is now asleep on a pair of my socks.
 
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