11/13 Tiki PMPS 359, +3 337, Advice Needed
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Tonya and Tiki
Member Since 2011
Re: 11/13 Tiki AMPS 392, +3 224, +7 155, PMPS 359,
Tiki is all over the place. Does anyone have any thoughts? Is this just the way it is, or do his ups and downs mean something? I've had it suggested to me that perhaps a switch to Levemir might level him out as their cat had been up and down and all over the place before switching. There are so other visible health issues going on and he seems to act normal (or as normal as a cat will). I feed him half to a whole can of Classic FF's every 6 (ish) hours.
Tiki is all over the place. Does anyone have any thoughts? Is this just the way it is, or do his ups and downs mean something? I've had it suggested to me that perhaps a switch to Levemir might level him out as their cat had been up and down and all over the place before switching. There are so other visible health issues going on and he seems to act normal (or as normal as a cat will). I feed him half to a whole can of Classic FF's every 6 (ish) hours.
julie & punkin (ga)
Member Since 2011
Re: 11/13 Tiki PMPS 359, Advice Needed
i'd only choose to switch insulins when i ran out of the Lantus - so not sure how much you've got left. Lev isn't a miracle insulin - some cats have done better on it, but we've also seen some cats repeat the same patterns. it wouldn't hurt to change insulins, however, so if you want to try it nothing is lost by that. one difference that might affect your decision is the nadir on Lev. If you look on the New to the Group sticky there is a chart with a Lantus curve on it and some talk about the Lev curve. Perhaps someone with experience with Lev can comment on that for you.
speaking generally, we want to give enough insulin to bring the overall range down and help it flatten out. sometimes that means propping up the lower numbers so that the cat doesn't go low and cause a bounce, rather than just letting them go as low as they go. he's gone into the 50's several times with the 3.5u dose. one possible tactic might be to prop him up so he doesn't go low and see if a little more insulin would take the top off of the highs. does that make sense?
let's see what other ideas might be out there that would be helpful for you to consider.
i'd only choose to switch insulins when i ran out of the Lantus - so not sure how much you've got left. Lev isn't a miracle insulin - some cats have done better on it, but we've also seen some cats repeat the same patterns. it wouldn't hurt to change insulins, however, so if you want to try it nothing is lost by that. one difference that might affect your decision is the nadir on Lev. If you look on the New to the Group sticky there is a chart with a Lantus curve on it and some talk about the Lev curve. Perhaps someone with experience with Lev can comment on that for you.
speaking generally, we want to give enough insulin to bring the overall range down and help it flatten out. sometimes that means propping up the lower numbers so that the cat doesn't go low and cause a bounce, rather than just letting them go as low as they go. he's gone into the 50's several times with the 3.5u dose. one possible tactic might be to prop him up so he doesn't go low and see if a little more insulin would take the top off of the highs. does that make sense?
let's see what other ideas might be out there that would be helpful for you to consider.
Re: 11/13 Tiki PMPS 359, Advice Needed
Like Julie said, Lev isn't a miracle. Some cats continue to bounce. You also need to consider that the nadir is typically later than it is with Lantus. Will that work for your schedule?
One observation.... You may be holding on to doses for too long. If the nadirs that you're seeing aren't where you want them to be, then after 3 days you want to consider a dose increase.
Like Julie said, Lev isn't a miracle. Some cats continue to bounce. You also need to consider that the nadir is typically later than it is with Lantus. Will that work for your schedule?
One observation.... You may be holding on to doses for too long. If the nadirs that you're seeing aren't where you want them to be, then after 3 days you want to consider a dose increase.
Tonya and Tiki
Member Since 2011
Re: 11/13 Tiki PMPS 359, Advice Needed
Julie - yes, that makes sense. But not sure how to MAKE that happen. Increase the dose? Decrease the dose? And no, I don't plan on making any changes until I run out of my current vial of insulin which will be a long time from now. It's just the suggestion of making the change had me thinking (can you smell the wood burning...LOL).
Sienne - as for holding the dose, yes - I've wondered if I should be moving things along more/less frequently. I think I've been focused on nailing 3 times where the numbers have fallen to 50 or below and think I have to stay put until that happens, even when I should be giving in and moving the dose up. I think someone also once said, if the numbers came down to 50 (ish) then not to increase as it was working (thus the low number) which has also made me hang out longer than I probably should.
Tiki seems fine. He acts the same no matter if his numbers are up or down. And doesn't seem to act any differently than he did when he was OTJ (eat, sleep, eat, sleep, eat sleep, eat, sleep, harass the dog, eat, sleep etc etc etc). Last time there was such a clear path of progression. This time he is all over the place so I wonder if I am doing something wrong, or if this is just the way it's going to be and I should get over it.
Julie - yes, that makes sense. But not sure how to MAKE that happen. Increase the dose? Decrease the dose? And no, I don't plan on making any changes until I run out of my current vial of insulin which will be a long time from now. It's just the suggestion of making the change had me thinking (can you smell the wood burning...LOL).
Sienne - as for holding the dose, yes - I've wondered if I should be moving things along more/less frequently. I think I've been focused on nailing 3 times where the numbers have fallen to 50 or below and think I have to stay put until that happens, even when I should be giving in and moving the dose up. I think someone also once said, if the numbers came down to 50 (ish) then not to increase as it was working (thus the low number) which has also made me hang out longer than I probably should.
Tiki seems fine. He acts the same no matter if his numbers are up or down. And doesn't seem to act any differently than he did when he was OTJ (eat, sleep, eat, sleep, eat sleep, eat, sleep, harass the dog, eat, sleep etc etc etc). Last time there was such a clear path of progression. This time he is all over the place so I wonder if I am doing something wrong, or if this is just the way it's going to be and I should get over it.
Chris & China (GA)
Member Since 2013
Re: 11/13 Tiki PMPS 359, Advice Needed
Remember, Tiki is leading this dance...all any of us can do is follow.
I agree it's time to go back up and see how Tiki does...and re-evaluate it in 6 cycles
Remember, Tiki is leading this dance...all any of us can do is follow.
I agree it's time to go back up and see how Tiki does...and re-evaluate it in 6 cycles
Tonya and Tiki
Member Since 2011
Re: 11/13 Tiki PMPS 359, Advice Needed
Will increase tomorrow morning. (...reluctant dance partner. :YMSIGH: I want to lead! ;-) )
Will increase tomorrow morning. (...reluctant dance partner. :YMSIGH: I want to lead! ;-) )
Re: 11/13 Tiki PMPS 359, Advice Needed
Good luck with the dosecrease Tonya! Paws crossed for a bit flatter cycles.
One observation on your spreadsheet, I notice you are waiting for 3 drops under 50 before a reduction. I believe there is a second part to that, which is 3 drops under 50 OR one drop under 40 before a reduction. Any drop into the 30's demands a reduction.
I recently switched from Lantus to Levemir, but waited until I had finished my last Lantus cartridge. My Neko is a bit flatter now, but she had started to flatten a bit (for her) on Lantus once she starting getting into longer stretches of green. Two big things to consider if you do think about switching. First, there is that later nadir. Both Neko's onset and her nadir are a couple hours later than they were on Lantus. Of course ECID, but Neko's nadir now seems to be somewhere from +8 to +12. That means having to get used to shooting low but most important, it sometimes means getting up somewhere from +8 to +11 in the PM cycle. That does kind of interrupt the sleep cycle. So you have to think about working around that. Often I can get a +3 at night, then go to sleep and get up 6 or so hours later if I need to. On Lantus I could often get a +4 and call it a night. The second thing to consider is that you'll spend some time trying to figure out how Tiki looks on Lev. I felt like a newbie all over again for the first while.
Good luck with the dosecrease Tonya! Paws crossed for a bit flatter cycles.
One observation on your spreadsheet, I notice you are waiting for 3 drops under 50 before a reduction. I believe there is a second part to that, which is 3 drops under 50 OR one drop under 40 before a reduction. Any drop into the 30's demands a reduction.
I recently switched from Lantus to Levemir, but waited until I had finished my last Lantus cartridge. My Neko is a bit flatter now, but she had started to flatten a bit (for her) on Lantus once she starting getting into longer stretches of green. Two big things to consider if you do think about switching. First, there is that later nadir. Both Neko's onset and her nadir are a couple hours later than they were on Lantus. Of course ECID, but Neko's nadir now seems to be somewhere from +8 to +12. That means having to get used to shooting low but most important, it sometimes means getting up somewhere from +8 to +11 in the PM cycle. That does kind of interrupt the sleep cycle. So you have to think about working around that. Often I can get a +3 at night, then go to sleep and get up 6 or so hours later if I need to. On Lantus I could often get a +4 and call it a night. The second thing to consider is that you'll spend some time trying to figure out how Tiki looks on Lev. I felt like a newbie all over again for the first while.
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