11/26 Lovey PMPS 385 + 8 145? One more question?

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lovey11

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Lovey has been bouncing a lot especially on the 2.5 dose and I raised the dose to 2.75 last night. Last night I had a steep drop and some blue numbers and maybe some lower blue or ?

I have been getting a high reading in the 300's at +5 quite a few times in the morning with the 2.5 dose. Today with the 2.75 I got another 311 at +5 but I did a reading at +3.25 and got a 226. So the Bg went up about 90 points? Did it dip low at 4 and then bounce or what? Would a number start to come down and than just start to go up so early in the cycle?

Any ideas I would really appreciate it?
 
Re: 11/26 Lovey AMPS 302 +3. 25 226 +5 311? Advice Pleas

lovey11 said:
Lovey has been bouncing a lot especially on the 2.5 dose and I raised the dose to 2.75 last night. Last night I had a steep drop and some blue numbers and maybe some lower blue or ?

I have been getting a high reading in the 300's at +5 quite a few times in the morning with the 2.5 dose. Today with the 2.75 I got another 311 at +5 but I did a reading at +3.25 and got a 226. So the Bg went up about 90 points? Did it dip low at 4 and then bounce or what? Would a number start to come down and than just start to go up so early in the cycle?

Any ideas I would really appreciate it?
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Some times it takes a while for the new dose to build the depot up. Hopefully in a cycle or two, you'll see her getting into some more steady and lower numbers. I'm one to talk, with the bounciest kitty here, I think.
Today's numbers look a lot like yesterday's but the dive from 311 to 226 may have triggered her liver to kick in and raise her up again. Or, maybe you fed her at that 226 and the food effected her BGs?
 
Re: 11/26 Lovey AMPS 302 +3. 25 226 +5 311? Advice Pleas

Dyana, thank you. I am confused. Lovey had a 200 pt drop last and she did not bump up. This drop was only about 75 points? I did not feed her

since 1.5 so it can't be food. I called my "new" vet but the secretary called and said she can't give me advice until I come in for a glucose curve

done by her and then she will advice me. Do you think it would be Ok after a few cycles of 2.75 and I continue to see this. that I go back to the 2.25

and see if less insulin is better in the long run. I would rather have consistent blues and low yellows than pinks half the time. I am just worried that it is too much insulin and Lovey's bounciest made me miss the right dose.

I am a little afraid for Lovey to stay at the vet all day. She is a very timid cat.
 
Re: 11/26 Lovey AMPS 302 +3. 25 226 +5 311? Advice Pleas

I wouldn't want my cat to stay at the vet all day either, when you can do the curve at home where she is comfortable and not stressed all day long.
Can you bring in a copy of a hometested all day curve to your vet, or email it to him, and ask him what he thinks?

It depends, I guess, on what range you are striving for. Most want their cat in the healing range as much as possible.
I looked at your spreadsheet and I don't see that many normal (80 to 120) numbers when you were giving the 2.25.
I would try to stick with the 2.75 through the weekend and see if Lovey doesn't show you some greens or lower blues on this dose. It sometimes takes 6 cycles for a depot to be adjusted to a new dose.
 
Re: 11/26 Lovey AMPS 302 +3. 25 226 +5 311? Advice Pleas

Thanks for you input and advice Dyana. I am just in a funk today.. Thanks
 
Re: 11/26 Lovey AMPS 302 +3. 25 226 +5 311? Advice Pleas

Hi Catherine,

Since you just increased the dose I think Lovey's insulin depot is still filling, plus you may have a bounce from that blue last night.

If you haven't read it yet, here is a great condo about the Lantus Depot: What is the Insulin Depot?

Specifically to quote from that post:
How long does it take to fill or empty the depot?

Again, from Boulder Medical Center:

Size of subcutaneous depot: The variability in absorption is increased and net absorption is decreased with increasing size (number of units) injected.

Practical experience on FDMB shows that as a generalization, the depot can affect up to 6 cycles. The time tends to be less when a cat is on a smaller dose, and more when a cat is on a larger dose. Other factors can apply as well, but using the generalization of 6 cycles is a good starting point until you have learned your particular cat's patterns.
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AND, also from that post:
Now you are probably asking "How on earth can I use this information to understand my cat?".

Try to look at your spreadsheet not in 12-hour cycles, but in “waves” of action over a period of several days. Look for overall trends more than individual numbers. If something jumps out and doesn’t seem to make sense, go back 2-3 days and think about any changes that might have occurred in insulin, timing, exercise, health, food, etc. If the big picture is making sense but you see one cycle that doesn’t fit, then keep that 20-50% variation in mind and just wait it out.
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Also, until Lovey levels out a little more (which takes time - ECID & Lovey is still new), the more testing you do, the more swings you'll probably catch. Not all cycles are the classic "U" shape - they come in many forms, some slide up or down / \, some are upside down "N"s, regular "N"s, "W"s, some are "M"s, etc. Tigger can have "M" shaped cycles. Sometimes I think it may be the depot filling, it may be food, it may be stress / infection, it may be the dose isn't strong enough, or it may be just because :lol: The important thing is to try & discover patterns over time that will give you more insight into Lovey's specific reponses to the insulin.

Again, I can't stress enough it's important to note what times you feed, what carb %, and how much. You can learn to 'steer' Lovey to some degree with food carb%. Again, that's something that develops over time.

You're doing a great job with Lovey, and the more testing you do, the better you will be able to see patterns develop over time. That said, each cycle is unique to some degree.

I know its hard to have patience when we want the best for our cats. Has anyone given you a pair of patience pants yet? :lol: I've already blown through a couple pair, but it helps to have them. Also to remember this is a marathon & not a sprint.
 
Re: 11/26 Lovey AMPS 302 +3. 25 226 +5 311? Advice Pleas

I understand. I have had my share.
Try to look at the good things. Is Lovey feeling well and purring and playing? Is she enjoying her food, and is her coat soft and healthy looking? We'll get her numbers better, it just takes patience, lots of patience.


In the mean time, between tests, you can go to PetsMart :) to get treats
J.D.


Well, you can make sure you have plently of supplies, MC, HC, test strips, and treats.
Dyana
 
Re: 11/26 Lovey AMPS 302 +3. 25 226 +5 311? Advice Pleas

Thank you Suzanne. I need a few pair of patient pants. I guess it is fear more than anything else. I was worried that is was the somogyi effect because of the patterns that I have been seeing. I read that days of high numbers can also mean too much insulin and a missed or almost hypo with the cat's liver
dumping more glucose to compensate. I saw longer and more bouncing with the 2.5 dose so I was questioning this?
 
Re: 11/26 Lovey AMPS 302 +3. 25 226 +5 311? Advice Pleas

Hi Catherine,
I'm not as accomplished at reading other peoples' speadsheets as many here are, but I would think that Lovey's numbers indicate that she does not need less insulin and probably will need more. I think that you should hold the present dose and let her settle in. This is only the second cycle on the present dose. New Dose Wonkiness (NDW) often happens when a dose is raised. Just try to follow the protocol (as it is set forth in the "Stickies") and don't try to compare individual numbers (or cycles) so minutely. It's the big picture that is important. Sometimes you will get a dip and then a rise again. FD is not predictable. Lovey has not been on Lantus for very long and at the beginning you have to expect that not everything will go according to the ideal plan. (In fact, hardly anything ever goes according to the ideal plan! We are dealing with CATS, after all!). So hang in there, follow the protocol, and try not to worry. The protocol is designed to be safe.
I certainly don't think you need to bring Lovey to the vet to do a curve. (It probably would not be representative, since vet stress would play a role.) You can do a curve easily yourself. Just pick a day when you will have time and do one.

Did your vet tell you to use the AlphaTrak meter? (vets like to sell them because you have to buy the strips from the vet). You can save a lot of money on strips if you switch to one of the "human" meters, like the Relion Micro or Relion Confirm (available at Walmart, but of course NYC is wise and does not allow Walmart into the city!). No matter, you can order the Arkray Glucocard 01 Mini from American Diabetes Wholesale (click on the ADW box at the top of the forum). The Arkray Glucocard 01 meters are the same meter as the Relion Micro/ Confirm and use the same test strips ("Relion" is Walmart's brand name for the Arkray meters). ADW has great deals on Glucocard 01 Sensor test strips, and a good "package" that includes meter and strips:
http://www.americandiabeteswholesal...ose-monitoring-kit_4042.htm?source=SiteSearch

Good luck and try not to worry. Just follow the protocol!

Ella & Rusty

p.s. I see that others have given you the same advice while I was writing this. Good!
 
Re: 11/26 Lovey AMPS 302 +3. 25 226 +5 311? Advice Pleas

Thank you both very much for your understanding.
 
Re: 11/26 Lovey AMPS 302 +3. 25 226 +5 311? Advice Pleas

Thank you Ella! I appreciate your thoughts and advice. Thank you Dyana and Suzanne! I do feel better.
 
Re: 11/26 Lovey AMPS 302 +3. 25 226 +5 311? Advice Pleas

You're doing a wonderful job, you're really looking out after Lovey, and Lovey's doing much better, too. One of the primary reasons you're testing is to monitor & make sure Lovey's safe - if he starts to go low, you can "correct" his course back into safe BG ranges with food.

We ALL go crazy in the beginning, and rightly so to a degree. There's so much to learn, & we haven't got a good handle on how our kitty responds in different situations.

I think it's really important to ask all the questions you're asking. I'm still pretty new & still a big PIA with all my questions! :lol: :lol: :lol: I think it scares members more when new people try to handle it all on their own & don't post numbers or ask questions.

AND- even the most experienced members still have 'gotcha!' moments (See Marje & Gracie's yesterday condo), so its important to remain vigilant.

I was VERY worried about Symogi when I first started in LL - many are, so you're not alone! If you do a search on this board, you'll find some wonderful discussions about it. Here's a more recent condo discussion that is pretty exemplary of a Symogi discusion: Symogi discussion condo

Marje, Sienne, Carl, Jill and others are some great experienced members to "follow" around on the Board - you'll find people asking your same questions, having similar issues, & you can learn alot from the experienced member feedback.

Again - you're doing an great job, so pat yourself on the back. I don't know how to give you a pair of patience pants - hopefully someone who does will come along!

Remember to breathe,
 
Re: 11/26 Lovey AMPS 302 +3. 25 226 +5 311? Advice Pleas

I think what Dyana & Ella said are really important, both re. holding the dose, your Alphatrak and NDW (new dose wonkiness)!
 
Re: 11/26 Lovey AMPS 302 +3. 25 226 +5 311? Advice Pleas

Happy Caturday Catherine and Lovey!!

Regarding your concern about the crazy numbers...any time you change doses, it's possible to get a few cycles of "wonky numbers" that don't make any sense. You just hold on for the ride that Lovey is taking you on

You must be THIS tall to ride. This ride is not recommended for pregnant woman or anyone with heart problems. Please keep your hands inside the ride at all times
 
I overslept probably but I got a 145 at +8 today. Worrying gets you really tired. Her nadir is around +5 based on some of my numbers. I have one more question about the whole discussion about too much insulin, steep drops, following the protocol, somogyi effect.
I did get a 78 on my second day of 2.25 but I didn't reduce because the 6 cycles of 2 before that only were yellow

numbers. Did you notice that on my spreadsheet? I didn't understand bounces too much at that time and my 2 unit numbers could have been bounces. I didn't follow the protocol. Maybe 2 units would have shown some nice numbers after that cycle? I did have some blue numbers at 1.75. I had a 102 at 1.75 which is a green number for alpha trak. That is lower than anything I got so far on higher doses but I probably got lower with 2.25 and got +4 blues but did not test after.

I know that worrying about mistakes is pointless but does it shed any light on the current picture? have any of you done a similar thing with a marginal numbers? In my head I said that with the margin on the alpha track I could consider it an 80 in light of my readings, but ....
 
I know how you feel, and I had the same worrys way back when.

What I'm seeing on Lovey's spreadsheet right now, is that she is getting some nice blue numbers consistantly in the night cycles. It would be great if she could get them in the daytime cycles too, but she seems to be bouncing a little in the day and going lower at night. But, they are quick bounces, so that is good.
 
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