11/24 Pumbaa AMPS/159 +3/177 +7/252 PMPS/238

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Pumbaa

Pumbaa

Member Since 2012
NOTE: Pumbaa's SS is in reverse, with the most current data at the top.

Well, it took Pumbaa 8 cycles at 2.25U to get a blue number. While it took him a long time to settle into this dose, I am VERY happy that he came down in numbers relatively flatly, without any major swings!
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I was tempted to raise him to 2.50U tonight, because obviously his numbers are still too high and raising him is inevitable, but I want to raise him in the best possible manner and at the best possible time to prevent those nasty wide swings in numbers. So I'm open for suggestions. Should I just go up the full .25U, or should I do a skinny 2.50U and pray that that isn't too much of a shock to his system?

Suze
 
Go for the full 0.25U increase every 5 days. Technically when they are flat yellow like that it would be 3 days (with either version of the protocol) but 5 will be just fine. You want clear cut increases untill he goes wall to wall green, then you might *nudge* it down when it comes time for decreases. Don't worry so much about the "swing" or the shock to the system. That's kind of a red herring at this point. There's a good chance of New Dose Wonkiness with each increase, this is expected and normal. Just wait it out.

Now that we have Tilly, the protocol does the work for us. We don't need to dance on egg shells avoiding the swing. Just take him up methodically till the numbers come down and stay down. When he snaps wall to wall green then he can start the liver training and get used to those numbers, but not before he stays mostly green, because every pink bounce just undoes the progress. Flat yellow is not what you ever really want... though it is sure better than flat pink.

What you want is numbers 50-199 with (eventually) most being flat green.
 
Chippendale's: I know you speak the truth, from your heart, and from your research, and from your observations with Chip. You've done so much research on various protocols, and have tested so many things on Chip. And I know what I've seen on the spreadsheets of Chip and other cats.

While I so understand where Sheila is coming from about reducing these wide swings, I also see that the wide swings can be dealt with by increasing the dose until the cat simply stops bouncing, because his/her pancreas is healed enough so the liver no longer needs to shoot out all of those sugars.

At the same time, I do worry about Pumbaa needing longer than the TR 3 days to settle into a dose. And really don't want to have to stay awake all night thinking that the shoe is going to drop and he's going to go way low, as in hypo low.

Pumbaa will have his dose increase in the morning, to 2.50U.

I pray that this won't cause huge swings in his numbers.

Suze
 
The Tilly interval is 5-7 days when they have lots of blue and green, so once you get closer you can hold for 7 days without any problem.

If you see a big dive coming, feed it and stop it, those aren't really true nadirs anyway.

But I agree that the *new* you shouldn't have to worry so much if you miss one. Pumbaa will just bounce. I'm glad I didn't have to say anything about that, because now it will be on Sheila and Mel if there is some problem. But all you have to do is watch Autumn Solstice effortlessly surfing those 20's (for hours on end) to know we *way* overreact to to 30's and 40's.

And when they are surfing flat green on Levemir, there's just no surprises. Just look at Chip's spreadsheet. There is plenty of warning if they drift a little low. Much worse are the big dives. But they simply don't do that when they are already green. Flat green really is easier and safer, from what I'm seeing.
 
Dale, what is the definition of a "true nadir" and why isn't a "big dive" one?

Dale 'n' Chip said:
...because now it will be on Sheila and Mel if there is some problem.
Click to expand...

What the heck is that supposed to mean? I think the purpose of this board is to help others to treat their cat's FD well AND live their lives doing it. All of my comments to Suze were meant to reassure her that she can actually sleep at night without worrying that Pumbaa will hypo and die overnight (her words, not mine). So, you posting that comment is really not at all helpful and it implies that Mel and I made dangerous suggestions.

IMO, the fastest way to risk an unwanted low is to bash the BGs with insulin until you override the rebound response. It is the biggest reason why I will never do TR. A close second reason is that I want to live my life and not be either tied to my testing table or worrying about my cat when I have to leave for a few hours or while I am sleep.
 
I was totally joking... I wanted to say something similar for some time but how can you ever make a point like that?

The best way to make it is probably to look at Autumn's spreadsheet. My vet had me shooting blind 4U NPH potentially on an empty stomach which is probably why I don't worry so much now with Chip.

I think Tilly was carefully tweaked to be safe with *comparatively* minimal testing, and likely safer than the wild swings from keeping (some cats) under dose.

All of which is why I don't want to be giving dosing advise, I mean what do I know? ;-)
 
I figured Chippendale's was joking with that comment....especially since he followed it with the example of Mel being calm when Autumn is low. I think what he was doing was pointing out that I've been paranoid about Pumbaa going hypo, which I have admitted.

Also, I understand the benefits to both following TR and not. I don't follow it religiously because it's just too stressful on both me and Pumbaa. I follow it loosely, because the concept makes sense, but ECID and I'd rather watch Pumbaa and react to how he's reacting to the insulin, than strictly adhere to a protocol. Sheila, that's why I said that I also understand your approach to stopping the wide swings, as opposed to just constantly raising the dose.

Pumbaa needed a dose increase this morning because his high numbers are still above 250. I'm praying with all of my might that he reacts to this dose increase like he did for the most recent increase to 2.25U, as in calmly, without any wide swings. *fingers crossed*
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If Pumbaa starts bouncing and diving, I'm going to try reducing (slightly) the dose if he has a low PS number, and then watch and see if that helps him even out at all. I still haven't figured out if he's sensitive to the current dose injected or not, and I think that would be the key. It seems like sometimes he does react immediately to a changed dose, but other times it seems like the shed is in control.

I'm going to attempt getting a 2-hour curve today. Hope you all have wonderful Sundays!

Suze
 
Hi, everyone. I'm so happy to see Pumbaa having these "below threshhold" numbers. Ah, the stress of trying to find a way to control these swings. I know it too well. Hang in there, Suze. Remember the "whole cat report," whenever you can. I used to read that advice, and it calmed me quite a bit.

All my best,
 
Hi MommaDale!

I do tend to forget to do the "whole cat report" because normally, Pumbaa is just fine and dandy! I tend to just add that information when he's not acting like his normal, juvenile-delinquent self. *LOL*

Hope you had a wonderful Thanksgiving!

Suze
 
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