10/10 Oberon PMPS 413/2.4, 1U R, +1 385, +2 329, +3 361, +4 348, +5 312, +6 367

What a beautiful evening into early morning :bighug:!
You definitely have traction. Best with today’s R!
 
He's on his way back down back into the pinks... now we'll see whether he stays there (his usual pattern) or continues to drop.

Three R trials at 0.75 so far... in the first he had a drop of about 25-30 points at +3/+4. The second one was during the big dip. At +4 he was down 120 points, but any effect of R is overlaid on the dip. Today at +4 he's down 44 points but also breaking a bounce. I think I'm comfortable moving up to 1 U of R at the next trial. This is his 6th cycle at 6.5 U of Lantus, and because of the 4th cycle dip he'll stay at this dose for another 4 cycles. That lets me play with R for a while without having to also think about changes to the L depot.
 
What makes you think he's breaking a bounce? We don't use R if you think it's a bounce breaking cycle. What I see is R keeping a lid on the bounce.
 
I'm thinking of his "default" BG as being about 350 ± 30 or so. Every time he has a big dip (below 200), he immediately pops up to over 400, but then within a cycle or so is right back in the 300s, back to "normal" for him. (This is really easy to see on his BG vs. Date graph tab.) So the 400s are his brief bounce, and right now he's coming out of the bounce (425 this morning) and probably settling back to his normal pattern. This is a change from how I was thinking of it initially, when I learned that it can take up to 6 cycles to break a bounce. I figured he was just continuously bouncing in the 300s. But with the IAA, I think the 300s aren't a bounce, they're due to a lack of effective insulin. It's possible that the R today kept the bounce from going even higher than it would have. But maybe I need to be thinking about all this differently?
 
Having said that, he's back up to 401 at +9, so it does look like the R was helping.

ETA: So what do we think about 1.0 U of R this evening?
 
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It’s like a bad story problem. :banghead:....if train A leaves and Train B leaves and then the pancreas waits to leave :smuggrin:.

Good Luck with the 1unit of R :bighug: tonight.

Hopefully Wendy is sitting down enjoying family and friends (if possible with the pandemic :() for the Holiday weekend. I could go for a big TG meal right now albeit as long as someone else is cooking and cleaning up :p!
 
Oh Oberon...that liver of yours must have been fully stocked with plenty of supplies for the 'danger' of that one little ole green...

I hope you'll get used to those lovely greens and blues soon...come on now, no need to freak out there...come on back down soon :)
 
Tomlin said:
It’s like a bad story problem. :banghead:....if train A leaves and Train B leaves and then the pancreas waits to leave :smuggrin:.

Good Luck with the 1unit of R :bighug: tonight.

Hopefully Wendy is sitting down enjoying family and friends (if possible with the pandemic :() for the Holiday weekend. I could go for a big TG meal right now albeit as long as someone else is cooking and cleaning up :p!
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And sometimes the drawbridge is up, and sometimes there's a cow on the tracks... It was bad enough trying to wrap my brain around two regulatory hormones and a flaky pancreas... now I have to figure out the immune system as well!

Sue and Luci said:
Oh Oberon...that liver of yours must have been fully stocked with plenty of supplies for the 'danger' of that one little ole green...

I hope you'll get used to those lovely greens and blues soon...come on now, no need to freak out there...come on back down soon :)
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I actually don't think it's his liver so much as the antibodies taking a break and then restarting, so blood insulin levels effectively go up suddenly and then come right back down. I'm sure there's some liver/glucagon action as well, though, which is what makes sorting this out so complicated. And I suspect he's also got some glucose toxicity from having BG so high for so long, so even once the antibodies permanently give up it may take a while for his pancreas to wake back up, if it ever does. So many moving parts...
 
I missed Oberon's exciting day yesterday. Nice to see him lower! I hope for many more lower number days for him in the very near future.:bighug:
There are so many moving parts to this disease, that's for sure.
 
Lisa & Oberon said:
And sometimes the drawbridge is up, and sometimes there's a cow on the tracks... It was bad enough trying to wrap my brain around two regulatory hormones and a flaky pancreas... now I have to figure out the immune system as well!
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:eek::arghh::woot::nailbiting:.;)........is there a zipper o_O to take a peek....if only!!

You are wrapping your head around quite a bit....to say the least!! Hoping to see some more positive traction :cool:.
 
Morning data: +10.25 323, AMPS 425/1.4, +1.75 410, +3 401, +4 387, +6 383, +9 401.

329 at +2... wonder if he'll make it into the lemons this evening.
 
Tomlin said:
:eek::arghh::woot::nailbiting:.;)........is there a zipper o_O to take a peek....if only!!

You are wrapping your head around quite a bit....to say the least!! Hoping to see some more positive traction :cool:.
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I think what's really driving me bonkers is that I have a sample size of 1 and no control group. So if something changes, is it because of something I did, or was it coincidence? My scientist brain is screaming that this would never get through peer review. :bookworm: :arghh:

OK, that and my complete lack of a magic scanner that would tell me exactly what's going on and how to fix it... I'll have to put that on my Christmas list. :woot:
 
Lisa & Oberon said:
I think what's really driving me bonkers is that I have a sample size of 1 and no control group. So if something changes, is it because of something I did, or was it coincidence? My scientist brain is screaming that this would never get through peer review. :bookworm: :arghh:

OK, that and my complete lack of a magic scanner that would tell me exactly what's going on and how to fix it... I'll have to put that on my Christmas list. :woot:
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Oh you are speaking to the choir!! I’ve got my own N of 1....well actually two cats that are N of 1s right now but sometimes that’s all you have and you have to go with it :p. Thank God for case studies or series because one I read led me to try something for one of my cats and it worked!

In the meantime, if you manage to get the magic scanner PLEASE lend it to me because I have a gut microbiome I’d like to take a peek at o_Owhen you are done with it :cool:!!
 
Tomlin said:
Hopefully Wendy is sitting down enjoying family and friends (if possible with the pandemic :() for the Holiday weekend.
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Did a drive by (plus ferry ride) to my parents, dropping off turkey dinner/pumpkin pie. They are in their late 90's, didn't want to chance anything. Amazing how many people were ordering small turkeys this year - no one is having large dinners.
Lisa & Oberon said:
And I suspect he's also got some glucose toxicity from having BG so high for so long, so even once the antibodies permanently give up it may take a while for his pancreas to wake back up, if it ever does.
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I found 5 days in higher numbers was enough for glucose toxicity for Neko, so yes, you are battling that resistance too. Once the antibodies give up, it can be a crazy roller coaster down the dosing scale. Protocol sort of goes out the window. Back to back reductions, larger reductions than normal, BCS's, all part of the routine. It's not sample size of 1, but you have to dig for the other data points.
 
Wendy&Neko said:
Did a drive by (plus ferry ride) to my parents, dropping off turkey dinner/pumpkin pie. They are in their late 90's, didn't want to chance anything. Amazing how many people were ordering small turkeys this year - no one is having large dinners.




I found 5 days in higher numbers was enough for glucose toxicity for Neko, so yes, you are battling that resistance too. Once the antibodies give up, it can be a crazy roller coaster down the dosing scale. Protocol sort of goes out the window. Back to back reductions, larger reductions than normal, BCS's, all part of the routine. It's not sample size of 1, but you have to dig for the other data points.
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Wow! 90....that is so great and so nice that you were able to bring them a special TG meal and spend time with them :bighug:



Sounds like quite the experience :eek:! Damn antibodies:mad:
 
361 at +3... popping back up again. Apparently he's scared of lemons?

Wendy&Neko said:
Did a drive by (plus ferry ride) to my parents, dropping off turkey dinner/pumpkin pie. They are in their late 90's, didn't want to chance anything. Amazing how many people were ordering small turkeys this year - no one is having large dinners.

I found 5 days in higher numbers was enough for glucose toxicity for Neko, so yes, you are battling that resistance too. Once the antibodies give up, it can be a crazy roller coaster down the dosing scale. Protocol sort of goes out the window. Back to back reductions, larger reductions than normal, BCS's, all part of the routine. It's not sample size of 1, but you have to dig for the other data points.
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Wendy, I'm glad you got to see your parents, even if briefly and from a distance, and help them celebrate. The whole holiday season is going to be very strange this year.

Not looking forward to the roller coaster, but I'll be glad when the ride's done! (What's BCS?) As we wait for the ride to start, is there a target ratio of Lantus to R that seems to be optimal? Long-acting insulin is better in general, but R gives more flexibility for dealing with sudden changes. Where's the sweet spot? (I know, ECID...)
 
BCS = big chicken shot (deliberate one time reduction in dose), used with higher doses to reduce the depot.
Lisa & Oberon said:
is there a target ratio of Lantus to R that seems to be optimal? Long-acting insulin is better in general, but R gives more flexibility for dealing with sudden changes. Where's the sweet spot? (I know, ECID...)
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Glad you answered your own question. :p For starters, the amount of R that works for a cat varies widely. Neko never needed more than 0.5 units and got up to 8.75 units L. I've seen a cat on 30 units of L, need no more than 0.5 units R. And I've seen a cat regulated on 60 units of Levemir and 20 units of R. :eek: That particular caregiver didn't want to give more than 2 shots of Lantus per cycle, so maxed out the L at 60. When the suspected IAA broke (cat lived where no access to IAA testing, but also acro), it was an easy drop off the R dosing.

When figuring out amount of L and R, you are balancing a couple things. First, you want to try to get the cat in as good a numbers as possible. Once you have a good handle on shooting R at preshot, it might be worth experimenting with R in the second half of the cycle, when he's on his way up. The second thing to balance is the ability to quickly drop the dose without a depot headache. I wasn't using R when Neko's IAA broke, so had some fun times! I started using it when her tumour ramped up again. The trick some people do with larger dose cats is that BCS (or skip) to reduce the depot. Again, size of BCS that works is ECID.
 
And 348 at +4...

Right now I'd be happy just to more consistently get him out of the pinks... doesn't look like we're close yet with either Lantus or R.

I'll be interested to try R midcycle later. So do people sometimes give R at preshot and midcycle in the same cycle? Or is it an either/or thing?
 
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