11/28 George 479@amps; 439@+3 clearing the bounce?

[Gill & George]

Amps 444, +3 364, +5 225 +8 158

His BG is dropping fast, didn't expect this at all!!
It's great, but I am panicing now!
He was increased to 2u three cycles ago
Not sure what to do about his pmps???
Going to check in +8 1/2 see if he is coming up
If not will feed him some more (he will like that)

Advice please

Thanks

 

[Gill & George]

OK looking at the TR protocol seems like I should hold the current dose for 8-10 cycles,

+8 1\2 176

Seems like he is heading back up


Coppied from the TR sticky
"General" Guidelines:

• Hold the initial starting dose for 5 - 7 days (10 - 14consecutive 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.
  • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
  • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.

• 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:
The TR Protocol is an aggressive method in itself. The modified version of the protocol is slightly more aggressive. Let's keep all our kitties in the Lantus & Levemir ISG safe by suggesting and taking appropriate reductions.

• 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. See additional notes in the next paragraph about drops into the 20s and 30s. 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.

 

[Marycatmom]

There's just nothing as scary as a diving kitty! Take a deep breath, this is going to be fine. I've not heard of the meter you're using, but I'm assuming it's a human meter. 158 is not a low number, so he's perfectly safe, and now that he's heading up, you can relax. I don't give dosing advise, but you are correct that he has not earned a reduction. I would use this time before his next shot to make sure your hypo kit is stocked, just in case you need it tonight. Be sure you have plenty of test strips, high carb food, and honey, Karo, or maple syrup. This could be a breakthrough night for George! You may see your first green! Go George!!!!!

 

[Gill & George]

There's just nothing as scary as a diving kitty! Take a deep breath, this is going to be fine. I've not heard of the meter you're using, but I'm assuming it's a human meter. 158 is not a low number, so he's perfectly safe, and now that he's heading up, you can relax. I don't give dosing advise, but you are correct that he has not earned a reduction. I would use this time before his next shot to make sure your hypo kit is stocked, just in case you need it tonight. Be sure you have plenty of test strips, high carb food, and honey, Karo, or maple syrup. This could be a breakthrough night for George! You may see your first green! Go George!!!!!

Thanks,

It is a human meter, I got it b4 we became aware of this message board, its. UK manufactured meter and test strips were significant ly cheaper, but I realise now no one is using this type of meter, I have been considering buying another one of the preferred ones that have been found to be most reliable by users here.
I have just checked the kit have honey/maple syrup and carb food, plenty of strips, its going to be a restless night, might resort to sleeping on the sofa.
I am breathing now he's coming up, it was just so unexpected, did BG and fed George before going out for lunch with DH, got back did BG check fully expecting to see him heading up to pink again, but it seems like George is determined to have a colourful day, think he may be showing off to DH whose just got back from business trip.

Coffee, relax and check BG again in an hour.

Thanks

 

[Wendy&Neko]

George is fine as long as he is above 50 on your meter. If you are worried about tonight, get a +11 and post for advice.

 

[Gill & George]

George is fine as long as he is above 50 on your meter. If you are worried about tonight, get a +11 and post for advice.

Thanks Wendy
I'll do that, I'm nervous, excited, anxious, happy all at the same time this sugar Kittie care is one big roller coaster ride! 3hrs to go for his +11

 

[Wendy&Neko]

It is a wonderful sign of progress!

 

[Gill & George]

I know I'm being contrary, last week feeling blue cause all we saw was a sea of red, then panicking when we start getting better numbers, guess I just got it into my head that it was going to be a slow process with George, but guess he's decided to keep me on my toes.
174 @+9
Off to take the droolers for a walk and romp in the Spanish hills

 

[Paula]

GTS, you are doing a great job! Good sign of progress!
Yo, George
Cuz Michael here.

That 158 is nice. Blue is a good color for you. Try not to drop to low or bounce to high. A steady surf would be welcome

 

[Gill & George]

GTS, you are doing a great job! Good sign of progress!
Yo, George
Cuz Michael here.

That 158 is nice. Blue is a good color for you. Try not to drop to low or bounce to high. A steady surf would be welcome

Wow paula, I think its entirely posible that Michael couñd be georges long los californian cousin, theybare like two peas in a pod, BFG is also a big boy

 

[Gill & George]

Thanks Wendy
I'll do that, I'm nervous, excited, anxious, happy all at the same time this sugar Kittie care is one big roller coaster ride! 3hrs to go for his +11

304@+11,
I'm thinking that we are safe to stick with the 2u, would appreciate views on this.

Is george 'bouncing'?
What does this mean?
What are my options for tackling a bounce?
Gill

 

[Doodles & Karen]

It does look like he might be bouncing a little bit. There is nothing you can do but sit, wait and be frustrated

Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". Usually, a bounce will clear kitty's system within 3 days (6 cycles).

 

[Gill & George]

It does look like he might be bouncing a little bit. There is nothing you can do but sit, wait and be frustrated

Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". Usually, a bounce will clear kitty's system within 3 days (6 cycles).

By sit and wait I take it you mean hold current dose monitor and wait and see.
I know he's not that low but worried he'll dive even further tonight, still with a nadir of 158, we have some headroom there.

I'm thinking I should hold my nerve and hold the dose, I'm prepared to monitor through the night, and have hypo kit at the ready.
Gill

 

[Doodles & Karen]

Sorry, yes I did mean hold the dose @ 2 units. If he does bounce you can see high numbers for upto 6 cycles. We go though it often with Doodles unfortunately so that's where my "sit and wait, frustration" comes from.

 

[Wendy&Neko]

George isn't used to those lovely blues, so yes, you are likely seeing a bounce. As @Doodles & Sour Pea suggests, time to sit on your hands and wait - hold the dose. When it doubt, it's always good to review the TR protocol to see what to do next. The part in blue is what applies to George now. Hold the dose 8-10 cycles in total, this is cycle 4.

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.
  • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
  • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.

• 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.

 

[Paula]

Wow paula, I think its entirely posible that Michael couñd be georges long los californian cousin, theybare like two peas in a pod, BFG is also a big boy

I think Michael is going learn Spanish since he now has a cousin in Spain. They sure do look alike

 

[Gill & George]

George isn't used to those lovely blues, so yes, you are likely seeing a bounce. As @Doodles & Sour Pea suggests, time to sit on your hands and wait - hold the dose. When it doubt, it's always good to review the TR protocol to see what to do next. The part in blue is what applies to George now. Hold the dose 8-10 cycles in total, this is cycle 4.

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.
  • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
  • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.

• 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.

That's what I thought when I referred back to the protocol, but in light of my recent misinterpretations, I feel happier that an experienced member has confirmed.
Well I've shot the 2u, let's see how he goes.

On another note we are going away for 4 days, (in about 2 weeks) I'm fortunate to have a friend close by who isgoing to look after George, I'm confident that she can give him his insulin and she's going to pop round so I can show her how to home test which she is prepared to do, she looks after horses cats and dogss and had a diabetic cat allbeit quite a long time ago.
That being said I don't want to put unnecessary pressure on her, ideally I'd be happier leaving George stable even if its in slightly higher numbers, so perhaps best to avoid any dose change in the week leading up to her caring for him, just seeing how he can dive, I wouldn't want to put her in the position of having to deal with that sort of situation. Does that seem like a sensible approach?
She's very capable, I had thought that I might give her access to my account so. She could post for help, would that be acceptable? Or perhaps she could set up her own account as a temporary carer for George? Still a couple of weeks to go but I like to plan ahead.

Thanks again To everyone, I think I would be having kittens by now if it weren't for all your sage advice

 

[Gill & George]

I think Michael is going learn Spanish since he now has a cousin in Spain. They sure do look alike

Lol He's alright with the queens English, he came from a rescue centre near Windsor castle, so who knows there might be a royal conection
He's been studying hard though and his Spanish is improving, he'll be bilingual before we know it

 

[Wendy&Neko]

It'll be great if your friend can at least test at preshot time. Post here a few days before you leave for suggestions on a vacation dose. Blood sugar needs can change a lot in two weeks, but we usually suggest going conservative to keep him safe. You can always leave a sample syringes, filled with coloured liquid, to show her what the dose looks like.

 

[Gill & George]

It'll be great if your friend can at least test at preshot time. Post here a few days before you leave for suggestions on a vacation dose. Blood sugar needs can change a lot in two weeks, but we usually suggest going conservative to keep him safe. You can always leave a sample syringes, filled with coloured liquid, to show her what the dose looks like.

She's happy to test preshot, and absolutely gets the importance of this, she !ay possibly test more it just depends on how that fits in around her schedule.
I'll post up a few days before so we can decide on a conservative dose.
She's been a life saver, our usual carer was nervous about preshot testing, and couldn't comit to a 12 hr schedule for shots, so that made me nervous, but sians up to the task.

Thanks

 

[Gill & George]

Well after Georges morning cycles shenanigans, we are back in the red guess there's nothing for it but wait until the bounce clears.
Did a urine test, negative for ketones, and although positive for glucose on the plus side shows less glucose in his urine.

Thanks to everyone's support during Georges mini dive yesterday, you guys helped so much to ease our anxiety.

Gill

 

[Chris & China (GA)]

Yep...that's a bounce!!

We really need to hold a meeting of the FDMB city council and see if we can pass a law about locking up the trampolines when they're not under direct adult supervision.....lol

 

[Gill & George]

Yep...that's a bounce!!

We really need to hold a meeting of the FDMB city council and see if we can pass a law about locking up the trampolines when they're not under direct adult supervision.....lol

For future reference, if George decides to hop on that trampoline again is there anything I should/can do to try and convince him to get off and behave himself??

Hope China's doing well today and you get some rest, these kitties keep us on our toes

 

[Chris & China (GA)]

For future reference, if George decides to hop on that trampoline again is there anything I should/can do to try and convince him to get off and behave himself??

No, not really...one of the first quotes I learned here was "cats bounce until they don't"

The general idea is that as their body re-learns that it's OK to be in those "normal" numbers again, it'll stop reacting quite so much and the bounces won't be as high and won't last as long....but some cats bounce all the way to OTJ too