10/2 Tomcat PMPS 113, +2=105, +4=70, +6=98

[tomtom13]

viewtopic.php?f=9&t=105319

Hello all

Well Tom has just been holding steady.....in good numbers (with a few exceptions) for 19 cycles now.....although he is starting to creep up a little when the little bugger should be creeping down!! All 5 P's are in place....with the additional one of: mouse hunter/killer! Can you believe I live with such a "monster"? I have a huge field of wild flowers and weeds that he likes to walk through and sometimes walks back out with a mouse in his mouth. I try and try to distract him to allow the little creature his freedom, but it never works. I always stand in horror as I feel so badly for the mouse...but at the same time I am so happy that tom is.......well....tom. back to his old self. My DH is always so proud of tom for his killings and when I protest about why oh why would a "just ate" cat want to eat again...Dh says: oh Kelly, it is just his nature....he can't help it. oh well

I never let him eat the mouse, by the way, as I am too worried my neighbors have poison out...not to mention parasites.

okay so the question about dosing is:

*****what should I do? ha. I don't know if I should try a small decrease....if I should try a small increase....or just hold tight? I mean what are the advantages to ALL the options?

edit: also need to add that I am feeding less and less carbs than I have in the past. I only feed 4-5% at shot time if his value is low...and then only feed 3% or less during the rest of the cycle. I don't know if this is advisable or not? I hate having to limit my variety...but if I need to, i will. does this tell me his dose is too low?


thanks all......your input is always such value to me

~kelly

~~~

 

[julie & punkin (ga)]

Re: 10/2 Tomcat PMPS 113, +2=105 dose?

Hi Kelly,

here's what i see:

10/2 so far - everything below 116
10/1 range of 88-141
9/30 range of 87-128
9/29 range of 63-145
9/28 range of 66-107
9/27 range of 72-111
9/26 range of 54-108

these are almost all normal numbers (under 120 is considered normal numbers), and you've gotten a lot of data there (yay you!) to see. all of these are on the same dose, 1.07u (how do you measure that, anyway?!?) and you went to that dose on 9/23, so by 9/26 any shed action should be mostly gone.

in other words, on this dose, you're being able to keep Tomcat in mostly normal numbers. The standard is that if you see mostly normal numbers on a dose for a week straight, you can try to sneak the dose down. a cat doesn't have to go below 50 for you to reduce. i bolded that part of the guidelines below.

if it were me, I'd probably continue holding this dose for another day or two and if the numbers stay under 120ish, i might try to shave the dose. this isn't a case where lower is better - you don't need to push a cat down below 50. it doesn't gain anything, and in fact, the numbers you're seeing are really great. I'd probably keep on just as you're doing because holding him in good numbers lets his pancreas heal and hopefully begin contributing its own insulin.

Does that make sense to you?

"General" Guidelines:
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Reducing the dose:
If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit.

Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
If an attempted reduction fails, go right back up to the last good dose.
Try to go from 0.25u to 0.1u before stopping insulin completely.

Random Notes:
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.
A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.
Sometimes a dose will need to be "fine tuned" by adding some "fat" or "skinny-ing up" the dose.

 

[julie & punkin (ga)]

Re: 10/2 Tomcat PMPS 113, +2=105 dose?

oh - about the carbs. i don't think it matters much what the carbs are, at least not in the range you're talking about. what matters is that you're consistent so that your insulin dose is well-matched to the carbs in the food.

i fed punkin 4% most of the time and used LC as much as possible first to encourage a surf. you do want to have something with carbs, either gravy catfood or karo or the equivalent in case you need to pull up numbers, of course.

what you're doing is working, so just keep on!!

 

[Sienne and Gabby (GA)]

Re: 10/2 Tomcat PMPS 113, +2=105 dose?

I agree with Julie re. a week of numbers below 120 means you can reduce. However, I'm not all that happy with the pre-shot numbers in the 140s. Tom is still spending a fair amount of time in blue numbers that are above 120. If it were me, I might be thinking about increasing the dose by a drop.

 

[tomtom13]

Re: 10/2 Tomcat PMPS 113, +2=105 dose?

Thank you both SO MUCH!!

the time and effort you gave me is so appreciated! Words just can't express how comforting it is to have such esteemed advice when I feel so alone on this journey!

I am going to take what you both said and ........most likely just hold the dose a few more days, as Julie suggested:

if it were me, I'd probably continue holding this dose for another day or two and if the numbers stay under 120ish, i might try to shave the dose. this isn't a case where lower is better - you don't need to push a cat down below 50. it doesn't gain anything

~~~I always wonder about that: if trying to get the cat below 50 should really be a goal?

and if Tom does not hold the under 120ish values...then I will do what Sienne suggested:

Tom is still spending a fair amount of time in blue numbers that are above 120. If it were me, I might be thinking about increasing the dose by a drop

i will try a few more cycles....OR NOT...depending on my mood...ha.....and a drop more it will be....


THANKS AGAIN!!!

i feel so much better

~kelly

 

[julie & punkin (ga)]

kelly, you are never alone in this. lots of people are in the boat with you & it's good to have the company and help each other. :YMHUG: we're just passing on the things that other people taught us.

i think your plan is a good one. sienne is right, you want as much time as possible spent under 120 and you are very close to being there. well done. it's great for Tomcat!