10/1 Apollo PMPS 310, +3 229, +6 220

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Re: 10/1 Apollo AMPS 159, dose?

Good morning John - nice night last night....Apollo earned a reduction with that 49!

Wait for someone else more experienced to come along and confirm....but if you follow the books...he doesn't appear to be having a bounce yet with his AMPS, so you would take your reduction on this shot and shoot a 2.25U dose (0.25 less than the previous dose). Are you going to be around today to test?

Congratulations - your hard work thus far has paid off already!
 
Re: 10/1 Apollo AMPS 159, dose?

it looks like it has been almost 1/2 hour since your last post. I would test again and if he is higher or the same, go ahead and shoot your new dose of 2.25 units. If he's lower than the 159 please post again. Our rule of thumb is that whenever you shoot your lowest ever preshot reading, get a +1 and +2. They normally are going up at +1 and +2 so you have a couple of hours for the numbers to rise before the insulin starts to work. If the numbers are still going down at +1 and +2, then you know you might have an active cycle and can feed at those times to help level things out. Does that sound good?

Apollo is doing so well! And you handled last night like a pro. I can't believe he was once on 10 units BID.

Here is the post on Low Preshots. I bet you didn't expect to need this so soon!
 
Re: 10/1 Apollo AMPS 159, dose?

Thanks Jessica and Libby. Also Apollo hasn't eaten as much as he usually does in the morning. He ate maybe 1/3 of a 3oz can. Probably because I was feeding him small amounts throughout the night.

He also tends to eat 1-2 more times over the next 1-2 hours or so.
 
Re: 10/1 Apollo AMPS 159, dose?

My only concern is he sometimes doesn't want the small food snacks to raise him back up if he gets low. Also I am completely exhausted from last night and would rather him not go anywhere near that low again, but not much can be done about that, right? I need to get some sleep, so tired.

I will test him again right now and report back.
 
Re: 10/1 Apollo AMPS 255 (after 30 min wait)

After waiting 30 minutes, Apollo's AMPS is now 255.

Going to give him 2.25 dose now. Thank you for your help.
 
Re: 10/1 Apollo AMPS 255 (after 30 min wait)

go for it. Now you know you can shoot lower preshots, because he came up 100 points in 30 minutes. He did the same on 9/26.

I'm still sleepy here and just realized that technically Apollo did not "earn" a reduction last night. For long term diabetics, we usually use under 40 as the reduction number, or else going under 50 several times. If you're going to be around most of the weekend then I would probably try holding the 2.5 dose a little longer. The longer we can hold onto doses (safely), the better the chance that the reductions will stick.
 
Re: 10/1 Apollo AMPS 255 (after 30 min wait)

Good Morning ~O)

Apollo is looking good!

Hope you can grab a few zzzz's today! Sleepless nights unfortunately come with the territory.

Quick question - I see you shot at +12.5, when did Apollo last eat, prior to that test?
 
Re: 10/1 Apollo AMPS 255 (after 30 min wait)

For future reference, Apollo has been diabetic for over a year. Newly diagnosed cats (i.e., within a year from diagnosis) get a dose reduction if their numbers drop below 50. For a cat that's been diabetic for more than a year, the cat needs to drop below 40. There are always other considerations but that's the fundamental. We make it a little harder for a cat to earn the reduction once they've passed the one year point.
 
Re: 10/1 Apollo AMPS 255 (after 30 min wait)

Sandy and Black Kitty said:
Quick question - I see you shot at +12.5, when did Apollo last eat, prior to that test?
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I tested him at 7:30am EST and he was at 159. He then ate over the next 30 minutes. I then tested him again and he was at 255. But like I said he did not eat his usual amount, since I was giving him food during the night and also left our some food after I went to bed as a safety net.
 
Re: 10/1 Apollo AMPS 255 (after 30 min wait)

Sienne and Gabby said:
For future reference, Apollo has been diabetic for over a year. Newly diagnosed cats (i.e., within a year from diagnosis) get a dose reduction if their numbers drop below 50. For a cat that's been diabetic for more than a year, the cat needs to drop below 40. There are always other considerations but that's the fundamental. We make it a little harder for a cat to earn the reduction once they've passed the one year point.
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Ok. I already went with the 2.25 dose this morning. Isn't him dropping below 40 very dangerous and increasing his likelihood of a hypo?
 
Re: 10/1 Apollo AMPS 255 (after 30 min wait)

John & Apollo said:
I tested him at 7:30am EST and he was at 159. He then ate over the next 30 minutes. I then tested him again and he was at 255. But like I said he did not eat his usual amount said:
As another note for the future....if you're stalling on a dose, don't feed. It's impossible to tell if that 255 was truly a rise or if it was related to food. Since you're going to get a +1 and +2 and will be around today, all will be OK, but just be alert that the absolute confidence that the number was rising is gone due to food being on board.
Click to expand...
Click to expand...
 
Re: 10/1 Apollo AMPS 255 (after 30 min wait)

John & Apollo said:
I tested him at 7:30am EST and he was at 159. He then ate over the next 30 minutes. I then tested him again and he was at 255.
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For future reference in general we don't feed after +10. When stalling for a rise, also don't feed. We recommend this so that the PS number will not be artificially inflated from food, which could lead to excitement a couple hours down the road :o .

eta - dipping below 40 is fine and safe - as long as you are monitoring and prepared to steer the cycle with food if needed. I know this feels scary - been there. Going down the dosing ladder is much more emotional than going up! (and being sleep deprived just adds to it!) Hang in there John - you are doing great!
 
Re: 10/1 Apollo AMPS 255 (after 30 min wait)

John & Apollo said:
Isn't him dropping below 40 very dangerous and increasing his likelihood of a hypo?
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If you are testing, the likelihood that your cat would be in that low of a range for very long is minimal. Gabby has dropped into the 20s and been completely asymptomatic. (I'm not recommending surfing in the 20s!) The danger is if a cat sits in low numbers for hours and hours.

One option for dose reductions is to allow your cat to drop below 50 on three occasions before taking the reduction.

John -- I think you're stressing about the numbers. Apollo is doing incredibly well. I think you are so unused to seeing the numbers that you are worrying a lot. It will get easier and you will get more comfortable with the numbers. The lesson from this morning is that it would have been very safe to shoot the 159. Your +8 from last night compared with your initial AM test (159) would tell you that numbers were rising.
 
Re: 10/1 Apollo AMPS 255, +2 322

Sienne and Gabby said:
John -- I think you're stressing about the numbers. Apollo is doing incredibly well. I think you are so unused to seeing the numbers that you are worrying a lot. It will get easier and you will get more comfortable with the numbers. The lesson from this morning is that it would have been very safe to shoot the 159. Your +8 from last night compared with your initial AM test (159) would tell you that numbers were rising.
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Yeah I see those low numbers and worry that the next shot will make him plummet too low and that I won't be able to bring him back up to normal on my own. Also I have no confidence where his numbers are going to go after each shot, and thus feel like I am on "call" 24/7, and hardly sleeping and not comfortable leaving the house. I'm just exhausted. I never expected he would need such constant monitoring. I love Apollo and want to do everything in my power for him, but there still needs to be some life balance for this to work long-term.
 
Re: 10/1 Apollo AMPS 255, +2 322

it looks like he has started his bounce, so you can take a break today. Maybe grab one test somewhere in the middle of the cycle, but otherwise take a day off. His last bounce lasted two cycles, so you might get tonight off too.

He will level out, I promise. The way I looked at it with Lucy (who was also a bouncer) was that it was worth the investment of time upfront to get her to a place where we would be able to live comfortably long-term. Going OTJ was a bonus that I didn't expect. What I was aiming for was for her to be nicely regulated in flat blue and green. Getting to that point requires some work, but once you're there then life is easy. You're actually in the toughest part of the journey right now. When they first start healing and going down the dosing ladder is exhausting, but it's worth it.
 
Re: 10/1 Apollo PMPS 310

Apollo's PMPS was 310. Went back to 2.5 dose.

Also for PM feeding gave him a Lifelink Xobaline Methylcobalamin B12 pill and sprinkled some Fortiflora onto his food. He seemed to really take to the Fortiflora. We shall see if it increases his appetite and food intake.

Thanks again for everyone's help and support. I got a small nap in today, so feeling a little more refreshed.
 
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