11/12 Bailey +4 133, +6.5 227, +9 251, PMPS 268

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Melissa and Bailey

Melissa and Bailey

Member Since 2011
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=56263

Good morning everyone,
We had a rather interesting night with some green numbers.. and now our AMPS is 104! Awesome!
I only gave her 0.5 units last night because I am a big chicken, but it seems to be working for her. I'm going to give her 0.5 again this AM and see how things go.
My DH has had several serious talks with Bailey since her dx, "Bailey, all you have to do is turn your pancreas back on! Then no more shots! C'mon Bailey, turn the pancreas back on!" etc. Too early to tell, I know, but maybe he finally got through to her? (anti-jinx) :lol: :lol: :lol:
 
Re: 11/12 Bailey AMPS 104

Melissa:

I wouldn't give her the .5 units today....I'd go back to your regular dose. The reason she did well last night is carryover. A dose can affect up to three cycles; in all likelihood, her 1u probably won't carry over that much.

You absolutely MUST allow her to earn her reductions. Dropping her dose this much without an earned reduction could really set her up for a setback.

I'm assuming since you have the AMPS up, that you shot. If you have not shot, please reconsider and give her 1u...her normal dose.

If you have shot the .5u, do not give her any more....just take her back up tonight.
 
Re: 11/12 Bailey AMPS 104

Marje, I have not shot her yet. OK, I will give the 1 unit. Makes me kinda nervous nailbite_smile but I will be around to monitor, and at least it's not the middle of the night, right? Hope you got some sleep and are feeling better!
 
Re: 11/12 Bailey AMPS 104

Good....I'm glad. I know it makes you nervous but her numbers don't yet indicate a need for a reduction.

And sorry...I didn't mean "carryover" but "shed action". The shed can affect 2-3 subsequent cycles. That's why sometimes when someone doesn't shoot because a number is too low, you don't necessarily
see the kitty's BGs pop way up.

Let's see what she does with the 1u today....because you drained her shed just a tad last night, it will be interesting to see what she does.....i.e. whether she goes up a bit while the shed fills or whether she can keep up
these great numbers. As long as you are there to monitor, I really believe that is the best way to go.

I'll also be around and will check in..I suggest you get a +1 and +2 to start and then we'll reassess. Sound ok?

Thanks...I'm so glad MJ and Anne were around. I got six hours steady sleep, got up and shot Grace, and then two more hours. Still sniffly but much better. Sure wanted that nyquil last night but was afraid it would conk me out too much. :lol: :lol: :lol:
 
Re: 11/12 Bailey AMPS 104

BTW...it's best to test, feed, shoot within about 10-15 minutes. So if this 104 was at +11.5, you might want to get a more accurate AMPS. Believe it or not, they can change in 15-30 minutes ;-) :roll: :roll: :-D
 
Re: 11/12 Bailey AMPS 104, +1 128

Our +1 is 128.
Yeah, that 104 was at 11.5.. but I am trying to move her back to our 12:30 schedule so I was planning to shoot 1/2 hour early this AM, and then again tomorrow (we got off track because I stalled last night).
So if I were to decrease her dose, I would wait until we were seeing numbers in the 40s, correct? And if we saw nadir concentrations in the 300s we would increase? Still trying to grasp the protocol.. I am still just mystified by her numbers most of the time. :?
I will chime in again with a +2 in a little while.
 
Re: 11/12 Bailey AMPS 104, +1 128

Good number.

I'm dealing with a phone call right now but will brb and answer your questions.
 
Re: 11/12 Bailey AMPS 104, +1 128

Here's the protocol:

"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.
•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.
Click to expand...

So...yes, if she drops below 50, then she earns a reduction of .25u. Right now, her nadirs are fine and I wouldn't increase her dose. The important thing is you have to be able to distinguish a bounce from a nadir so that you aren't misled into raising her dose if she is bouncing. She was bouncing on 11/8.

When the kitty is newly diagnosed and numbers are high, the liver acclimates to those numbers as normal. That's why we worry about cats staying at high numbers for very long because they get used to it and it take more insulin to start bringing the numbers down. Bouncing is caused by the liver releasing counterregulatory hormones and stored glucagon in response to numbers it believes are unsafe. The more time the cat spends in healing numbers (below 200), the better adjusted the liver becomes to those numbers and bouncing, hopefully, decreases. Some cats adjust quickly....others take much longer to stop bouncing. Bounces can take six cycles (72 hours) to clear. So if you get low numbers followed by high numbers, you don't want to increase the dose until the six cycles are up OR the bounce has cleared before then.
 
Re: 11/12 Bailey AMPS 104, +1 128

Our +2 is 120, nice and flat so far. I need to run a few errands and will probably post a +4 next, sound OK?
Thanks for your explanation, I think I was confused about the difference between bounces and regular old high numbers. Makes more sense now ;-)
 
Re: 11/12 Bailey AMPS 104, +1 128, +120

Yes....I think a +4 is ok since your +2 is greater than your AMPS. She's pretty flat really. One thing I would encourage when you can is to get some +3, +6, +9 numbers, too, so you can tell when she onsets. That's a really important piece of info to have. It looks like, last night, she onset at about +3 but I wouldn't draw gross conclusions just on one cycle.
 
Re: 11/12 Bailey AMPS 104, +1 128, +120, +4 133, +7 227

+7.5 is 227, still not too bad.
Bailey *might* have eaten some dry kibble earlier around +4; my mom's cat still eats dry food and lives downstairs from us. Bailey got downstairs unsupervised for ~15 minutes earlier... so who knows? We'll see where the #s take us.
ETA: I meant +6.5! :oops: I am off track today!
 
Re: 11/12 Bailey AMPS 104, +1 128, +120, +4 133, +7 227

Bailey...Binks is a kibble nut as well ohmygod_smile ...NO KIBBLES!!!!
 
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