12/12 Pumbaa PMPS/342 -insert your favorite curse words here

[Pumbaa]

Pumbaa's 12/11 thread is here.

I was so hopeful that Pumbaa would join the ranks of the "I don't bounce anymore" cats. *sigh*

What I don't know is what I missed that would have caused this bounce. He went from 105 @ PM +2.5 last night, to 80 @ PM +8. I didn't get a +6 last night because I was just dog tired after a massive amount of necessary yard work, and paying work, and life. My body demanded sleep.

I'm a human being and need restorative sleep. I really don't know how some people test every hour for days on end, or how the people who work outside the home deal with interpreting data when they aren't able to test regularly. I'm lucky because I work from home. But I also have extra demands on my time, as in with dealing with an aging mom and her cats/house/chores/shopping, etc. I'm not whining, I'm just saying that this is hard on all of us, and the unknown data could be so helpful to us.

So, in a nutshell, I don't know where this 342 came from, but wish I would have been able to test more, and maybe steer the numbers so that this bounce would not have occurred. Pumbaa didn't bounce like this from his 49 on 12/10, so why the 342 tonight?

Suze

 

[Wendy&Tiggy(GA)]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

I guess we just all do the best we can. I don't test as much as you, I just hope if the boys do drop that I catch it.. If not this time then maybe next.

As for the bouncing off of nothing, maybe his liver is just a little more panicky since the 49 the other day ... Wish this was more of an exact science but as sienne says, it's the cats calling the shots.. And they will do what they want.. Hopefully pumbaa comes down again soon though.

 

[tortie58]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

I am a stay at home 24 x 7 caretaker for my furry family & I dont test as much. :roll: Tell me about it, purple? We're in Black this morning, why? Who knows? Dont ask me, dont ask Rosy. Just make sure everything is "normal" & she'll come down. Curses wont help, Suze. Take a rest, relax. Tomorrow will be another day.

 

[Sienne and Gabby (GA)]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Suze --

I think once you let go of the notion that you can control Pumbaa's numbers, you'll feel a lot better. You can do the same thing from one day to the next and end up with vastly different results. Pumbaa is a cat. He's going to do what he wants to do. The more you try to get him to do what you want, the more oppositional he's going to be.

 

[Dale 'n' Chip]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

I've got an important post (should be a sticky) for you to print out and stick on the fridge.

And read it twice every day.

This is what got me though the darkest hours, the perhaps hundreds of times I was ready to throw in the towel.

It didn't really mean much to me the first time I took it in. But later on after I'd looked at dozens and dozens and dozens of spreadsheets, something clicked and I went back and dug up this gem of very important wisdom about the dance:

when i look at pumbaa's spreadsheet, i see a kitty who not yet reached his optimal dose. that's all. am i always right? nope. nobody calls it right every single time... i don't care how much experience they have under their belts.

there's a funny thing about using lantus or levemir with our kitties...
every time we increase the dose, we naturally expect to see better numbers. it *usually* doesn't work that way... which can be a HUGE source of frustration for us. more often than not, we'll increase and increase and increase and increase... while not seeing much of an improvement. and then a day comes along and BAM! kitty's green! woo-hoo! time to celebrate, right?

yes, and no.

yes because gosh darn it... we're finally seeing our precious kitty in "normal" numbers, but no because what happens most of the time? our celebration grinds to an abrupt halt because they lose it and return to those yucky higher numbers. as caregivers, this is where we feel like we're repeatedly and senselessly banging our heads against a brick wall, but if you look at enough spreadsheets you begin to understand this is pretty normal. the solution? keep on keepin' on. it's just going to take more insulin before you see most kitties flatten out into normal numbers and stay there!

 

[Pumbaa]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Wendy, Helen and Sienne:

I truly appreciate all of you telling me to just deal with how Pumbaa reacts, but I do know that you can steer some cats via foods, etc. I still don't know if I can do this with Pumbaa, but I'm sure going to try.

Chippendale's has done a great job of steering Chip to try and get better numbers. Chip's SS doesn't reflect what has been done, carb-wise, but there have been posts about this. And Carl brought up the steering via food ages ago. I've just started trying this in the last couple of days, and have to say that when I have been able to do this, it has worked! The problem is being able to test as frequently as needed to do this steering. And I haven't been able to catch some of the lows that have caused these bounces.

I am a control freak, and admit it. *LOL* If there is anything that I can be doing to provide better care for my Pumbaa, then I will be doing it. And if that means trying to control his bounces by feeding his lows with slightly higher carbed food, then that is what I will do. Until I find out that it doesn't help.

Thank you all for your responses! I appreciate it!

Suze

 

[tortie58]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Is Pumbba happy? That's the most important thing in a cat's life. Not figures or curves. Are you happy Suze? You can see quite a number of FD cats critical ill & yet having beautiful numbers. Health & happiness is the most important thing. cat_pet_icon

 

[Pumbaa]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Thank you for that ancient post, Chippendale's! It makes a lot of sense, but...

But I also know that you have been steering Chips and his numbers for months now, and would love to hear, publicly, about how you have been doing this, and what success you have achieved. I think this is really important to those of us who have bouncing/diving cats.

I would much rather "steer" Pumbaa to not have the low numbers that create a bounce, then just increasing his dose.

Suze

 

[Dale 'n' Chip]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Thank you for that ancient post, Chippendale's! It makes a lot of sense, but...

But I also know that you have been steering Chips and his numbers for months now, and would love to hear, publicly, about how you have been doing this, and what success you have achieved. I think this is really important to those of us who have bouncing/diving cats.

I would much rather "steer" Pumbaa to not have the low numbers that create a bounce, then just increasing his dose.

Suze

There is no *rather* to it, it's both. A minor goal from steering is of course to stop dives and prevent possible bounces. The more important issue is to be able to successfully take the dose up to breakthrough, and that seems to have a bigger impact on bounces from the resulting flat surfing and/or liver training.

The only thing extra I'm doing is heading off dives by feeding preemptively when I see it coming. I believe Sienne does the same thing. That's the only time I dose extra carbs over 80 or 100.

The other thing I do is steer to keep him over 50 which many people here do, some under the guise of hypo watch. I dose just enough carbs to keep him surfing 55-75 and (generally) not enough to bump him any higher.

 

[Pumbaa]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Exactly what I have been trying to do for the last couple of days.

 

[Dale 'n' Chip]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Overall this dose has looked pretty good. But keep in mind if he's still going *way* over 200 (for any reason at all) he's still due for the next increase at cycle 14 per classic Tilly.

If nadir blood glucose concentration < 200mg/dL but peak is >
200mg/dL (11 mmol/L)
Increase every 5-7 days by 0.25-0.5 IU depending on
if cat on low or high dose of insulin

 

[Pumbaa]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Helen, Pumbaa is happier/more active when his numbers are lower, and I'm happier when his numbers are lower and he's not bouncing. Aren't you happier when Rosy isn't bouncing? As for healthier, keeping him below 250 is also healthier for him, or we all wouldn't be trying to get our cats regulated, right? And, since I'm an admitted control freak *LOL* I feel better doing something proactive when I can, as in trying to steer him in the right direction if at all possible, to prevent the lows that cause the highs. Like Chippendale's explained:

The only thing extra I'm doing is heading off dives by feeding preemptively when I see it coming. I believe Sienne does the same thing. That's the only time I dose extra carbs over 80 or 100.

The other thing I do is steer to keep him over 50 which many people here do, some under the guise of hypo watch. I dose just enough carbs to keep him surfing 55-75 and (generally) not enough to bump him any higher.

Suze

 

[Carl & Polly & Bob (GA)]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Suze,
Reread what Sienne posted. Then reread what Jill said that Dale posted. Then put the meter down, pick up Pumbaa and snuggle him.
Get a nadir test, and a PMPS. And beathe deeply a few times.
Carl

 

[Pumbaa]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

There is no *rather* to it, it's both.

That's why the sentence ended, "...then just just increasing his dose". :smile:

Overall this dose has looked pretty good. But keep in mind if he's still going *way* over 200 (for any reason at all) he's still due for the next increase at cycle 14 per classic Tilly.

I'm not finding what you quoted on the Tilly's website. This is what I see:

Phase 3: Holding the dose

Try to keep the cat at a dose where the BGs are in the 50 to 200 mg/dl range for as much of the day as possible. The majority of cats are actually able to achieve consistent BGs in the 50 to <100 mg/dl range with consistent dosing.

The above seems to describe Pumbaa right now, other than his bounces, which are covered in the "as much of the day as possible", wouldn't you say?

I'm nailbite_smile about increasing Pumbaa right now, until he settles down again after this last bounce, simply because he has dropped below 50 twice on this dose. He still may need to go up a bit, but, as Sheila has pointed out, raising Pumbaa when his numbers are dropping like they are today causes him to drop lower than he would if he were raised on an upswing.

Input? Comments?

Suze

 

[Dale 'n' Chip]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

It's under Phase 2: Increasing the dose

If nadir blood glucose concentration < 200mg/dL but peak is >
200mg/dL (11 mmol/L)
Increase every 5-7 days by 0.25-0.5 IU depending on
if cat on low or high dose of insulin

And again under Phase 3: Holding the dose

If nadir or peak blood glucose concentration > 200mg/dL (11
mmol/L)
Increase dose by 0.25-0.5 IU depending on if cat on
low or high dose of insulin and the degree of
hyperglycemia

(BTW Kirstin Roomp of Roomp/Rand is Tilly )

...The above seems to describe Pumbaa right now, other than his bounces, which are covered in the "as much of the day as possible", wouldn't you say?

It says "peak blood glucose concentration"

Certainly 367 and 342 (and all the yellow and pink) are over 200 about any way you slice and dice. :mrgreen:

 

[Squeaky and KT (GA)]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Suze,
When you figure out how to stop Pumbaa's bouncing and throwing you wierd highs with no reason, I'll dance a HUGE BIG YARD DANCE!!! Pumbaa and KT must be kin - they both react a lot alike - no rhyme or reason! Do we just have wierd cats? Probably so....

Oh wait, I know why! Just 'cos they want to drive us even MORE insane! I think that's their mission.... :roll: :evil: like the awful 379 KT handed me last night...after a day of nothing but almost ZERO carb trying to break it...didn't happen.

Get some rest please! BIG HUG!

 

[Pumbaa]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Chippendale's: You used to call it Roomp/Rand, not Tilly's. Hence the confusion of which you were referencing. And actually, Tilly was Roomp's cat.

But, again quoting Roomp/Rand Phase 2, Pumbaa went below 50 twice so far on this dose, and he didn't get a reduction. So they kinda cancel each other out, right? :lol:

If nadir blood glucose concentration < 200mg/dL but peak is > 200mg/dL (11 mmol/L) Increase every 5-7 days by 0.25-0.5 IU depending on if cat on low or high dose of insulin.

If blood glucose is < 50 mg/dL (2.8 mmol/L) Reduce dose by 0.25-0.5 IU depending on if cat on low or high dose of insulin

 

[Pumbaa]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Lyresa,

Usually I am able to tell where Pumbaa's high numbers came from. If I didn't actually catch the low that caused the bounce, I can pretty much fill in the blanks and figure out where it happened based on the surrounding numbers.

So, if you compare the PM cycles on 12/10 and 12/11, it's pretty safe to assume that Pumbaa dropped lower than the 80 I caught on 12/11 at PM +8. Did he go down into the 40's again? I don't know, but it's possible due to the bounce that was triggered after 12/11's PM cycle. (Or maybe the bounce was just triggered by the entire stream of beautiful greens and blues from PM 12/9 and on.)

Other than feeding nearly 0 carbed food, like you did, I don't believe there is anything you can do for a bounce but let it run its course. But I am really jazzed about trying to steer Pumbaa away from the low numbers that cause the bounces by giving slightly (9%) higher carbed food. If that works, and if I can test enough to catch the lows before they get too low, this will be a miracle!

How are you and DH doing? I know your hands are full as the caregiver, and testing KT more would not be easy. Don't you wish we could set a timer and have their nadir at the same time every cycle? *LOL* That would make life so much easier! (((HUGS)))

Suze

 

[Dale 'n' Chip]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

So they kinda cancel each other out, right? :lol:

No I don't think so.

You don't want to just spin your wheels toggling back and forth like you did in early August. Stick with the protocol to bring down those highs, and (where you can) steer those lows with carbs, and possibly prevent even more bounces.

I don't know why everyone is always so fearful of the protocol. After they flatten out with sufficient dose, I strongly suspect it's actually safer surfing. At any rate I have figured out one thing, and that is that sticking with the protocol is almost certainly the only safe and effective approach. For almost any cat. :smile:

 

[Sienne and Gabby (GA)]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

I don't know why everyone is always so fearful of the protocol. After they flatten out with sufficient dose, I strongly suspect it's actually safer surfing. At any rate I have figured out one thing, and that is that sticking with the protocol is almost certainly the only safe and effective approach. For almost any cat.

YES!! That's not to say ECID. You can and maybe should modify based on having accumulated a solid amount of data on your cat when following the protocol and understanding what is or isn't working. You have to do due diligence first, though.

Dale is correct in that I use food in a particular way. If you go through Gabby's SS, you'll see she bounces. She used to bounce a lot more. She's also prone to precipitous drops. I use food to prevent her getting a reduction. Jill provided me with very good counsel with regard to attempting to use food to prevent dose reductions and to flatten the curve. My goal, should Gabby decide she agrees, is to get her into pretty consistently green numbers. So far, Gabby's pancreas gets tired or her dental problems may be a big influence on her maintaining the kind of consistency I'd like. I learned a long time ago, though, that trying to get Gabby to follow my rules is about as effective and rewarding as trying to herd cats.

 

[Pumbaa]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Chippendale's:

It's not being fearful of the protocol, it's being fearful of giving Pumbaa more insulin when he's already gone under 50 on this dose. And it's being fearful of doing the increase just when he's coming down from a bounce, without waiting for him to settle back into this dose.

 

[Pumbaa]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Sienne, I'm laughing at your, "...about as effective and rewarding as trying to herd cats" comment 'cause my Border Collie regularly herds my cats, successfully! The best is when Pumbaa is playing the "Mom wants to test me so I'm going to make her chase me around the house first" game, and Beck takes pity on me and herds the little guy for me. I wish I could get that on video! haha_smiley

...attempting to use food to prevent dose reductions and to flatten the curve. My goal, should Gabby decide she agrees, is to get her into pretty consistently green numbers.

Exactly. I can only control what I do, I can't control how Pumbaa responds no matter how much I pray, wish, cross my fingers, etc. But if I don't try using food to help prevent the lows that cause Pumbaa to bounce, I'm not doing my little guy justice, since he's dependent on me to put the food out for him. I can't even control if he eats it or not, but I can do things to try and entice him to eat when he needs to, based on his numbers.

Chippendale's: Pumbaa is also totally dependent on me for his insulin, and it's up to me as his caregiver to make the right decisions for him, for how much to dose him. And right now, today, this very minute, I am not comfortable increasing his dose based on his history. Would raising him tonight help prevent the bounces I am trying to prevent via food? Maybe. But it could also cause him to drop lower than he has been, and trigger more/higher bounces. I look at it this way, the world isn't going to end if I don't increase Pumbaa exactly after 7 days, right? (I'm laughing now because I only entered dates in Pumbaa's SS up until the 20th...that was totally unintentional.)

Suze

 

[Carl & Polly & Bob (GA)]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

I don't know why everyone is always so fearful of the protocol. After they flatten out with sufficient dose, I strongly suspect it's actually safer surfing. At any rate I have figured out one thing, and that is that sticking with the protocol is almost certainly the only safe and effective approach. For almost any cat.

YES!! That's not to say ECID. You can and maybe should modify based on having accumulated a solid amount of data on your cat when following the protocol and understanding what is or isn't working. You have to do due diligence first, though.

Dale is correct in that I use food in a particular way. If you go through Gabby's SS, you'll see she bounces. She used to bounce a lot more. She's also prone to precipitous drops. I use food to prevent her getting a reduction. Jill provided me with very good counsel with regard to attempting to use food to prevent dose reductions and to flatten the curve. My goal, should Gabby decide she agrees, is to get her into pretty consistently green numbers. So far, Gabby's pancreas gets tired or her dental problems may be a big influence on her maintaining the kind of consistency I'd like. I learned a long time ago, though, that trying to get Gabby to follow my rules is about as effective and rewarding as trying to herd cats.

As one who used to be "fearful of the protocol" (as anyone who was around this time last year might recall), I'll say it was because I didn't understand it. I never followed it, and it overwhelmed the hell out of me. A year later, not so much. Still haven't used it, but when I look back on the treatment routine I used on Bob, it was a lot more scary than TR. A year later, I actually think that following the TR protocol, to the letter, makes dealing with this condition much easier. How awesome is it that you have this document that tells you "if this happens, then you do this"? I would have killed for that with PZI.

It wasn't until I watched people follow the protocol, and watched how often their cats went OTJ that I finally "got it". Well, that, and I was gifted with a few patient tutors who took their time helping me learn and understand. My PM folders are full of "lessons". :lol:

ECID. The most used four-letter word on the board. And very true. But to some extent, every cat is the same too. For instance, they all bounce. Is there anyone here who hasn't seen a nice run of numbers, and everything is looking wonderful, who hasn't woken up one morning, poked the ear, and got all bug-eyed over what the meter said and not thought "where the HELL did THAT come from???" If so, I haven't seen their spreadsheet. It doesn't matter that kitty didn't bounce from a 49 two days ago, and you can't find a blank space since then that indicates he might have gone even lower to cause a bounce from nowhere. He might have bounced off an 80 or a 100. Nobody knows why, it just happens. Even cats have bad days. But it doesn't matter "why" every time. You just wait for the ugly pinks or reds to go away, and they always do (if they're due to a bounce anyway).

Two things Sienne said I'd like to highlight:

You have to do due diligence first, though.

I use food to prevent her getting a reduction.

Sienne, please correct my assumption if I'm wrong, but I'm taking this as "after I gathered a ton of data on Gabby, and I found that she had previously shown a tendency to fail a reduction, the best course of action was to NOT let her go low enough to earn one. That way, her mid-cycle numbers stayed up a bit, and the insulin continued to cause her preshot numbers to improve. At that time, I'd let her drop down low enough to earn the reduction, and her preshots would stay at lower levels even when I reduced her dose".

My point is, that only after seeing in black and white that following the protocol to the letter wasn't always working, you tweak it based on what you know - YOUR cat. But until you know for sure the protocol isn't working, the best way to deal with this is to stick with it. And bounces be damned. In my mind, I'd let Bob live on a freaking trampoline if it meant he'd go OTJ and I could get him below the renal threshold as quickly and as often as possible. What's better, living in the yellows and blues, or taking the occasional pink that will go away within a couple of days?

OK, I'll shut up now.

Carl

 

[Pumbaa]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Pumbaa is still bouncing as of this morning's (12/13) cycle. The below explains why, with a low of 49 in the last 3-4 day period, I am hesitant to raise him now. Even though he has finished 14 cycles at 3.0U.

http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=76617#p828676

How to know when to increase/decrease the dose during bounces is different. In the beginning we tend to be cautious about having people increase dose during a bounce. Overall, though, you just ignore the bounce cycles when you are making dose decisions. That's why we encourage people to try to get at least one spot check in every cycle, whenever possible. That makes it easy to know if they are still bouncing or if they went low again and started a whole new bounce. You don't really want to look at your spreadsheet one cycle at a time. Look at a 3-4 day period. What was the lowest number during that period? In general, that is the number you want to base your decisions on.

 

[Dale 'n' Chip]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Considering Pumbaa's history I'm not so much worried about those lows. Not with the Relion Prime meter which runs lower on the low end anyway. I'd really like to see more green... much more green. :mrgreen:

I agree about stepping back and looking at the greater dosing interval (and sticking with the scheduled increases when then numbers warrant) rather than getting into the weeds over every cycle, bounce and/or reading.

BTW a cycle or two either way is not make or break. But you don't want to sit around so long that he starts losing ground.

 

[Pumbaa]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Chippendale's: I'd like to see many more greens, too! I also don't want to "sit around" so long that Pumbaa loses ground. And trust me, when I saw his high numbers today, my first inclination was to go ahead and increase. But increasing due to high bounce numbers just isn't in Pumbaa's best interests. Waiting for him to settle back down is the way to go right now, based on his history. And, if he dives tonight, and I can catch a low and use 9% carbed food to try to steer it so that he doesn't bounce again, even better! We all win that way!

 

[Pumbaa]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

And bounces be damned. In my mind, I'd let Bob live on a freaking trampoline if it meant he'd go OTJ and I could get him below the renal threshold as quickly and as often as possible. What's better, living in the yellows and blues, or taking the occasional pink that will go away within a couple of days?

Carl, I agree with a lot of what you said, other than "bounces be damned".

Pumbaa has been living in greens and blues, other than the bounces, on this dose. That's why I don't care if "protocol" says to raise him now. Protocol shouldn't be based on the high numbers of the bounces, but should be based on the true numbers the cats have at that dosage level, especially the nadirs, once they have leveled out and are no longer bouncing.

Also, regarding the "bounces be damned"...weren't you one of the people who suggested to me that I try and control the bounces via feeding higher carbed food to prevent the lows? My response was that I didn't think that Pumbaa was carb-sensitive, based on my SS where I list the KCal values of his foods, daily. I never saw a difference in his numbers when he got 4/5/7% carbs, regularly, but I did see a difference when I introduced 9% carbs to try and steer his low numbers upwards. And I have been pleased with the results of my "attempting to steer". Pumbaa doesn't need to live on a trampoline if his normal numbers on a specific dose are below renal threshold, but the bounce numbers aren't.

I know that you had suggested that I drop Pumbaa back down to 2.75U when he hit 46 his first cycle on 3.0U. When others disagreed. I didn't decrease Pumbaa's dose, and am glad now, that I didn't. But there is so much conflicting information out there, that the caregiver would go crazy if we followed protocol to the T without taking our own cat's into consideration, which is what I am now doing with Pumbaa. And which is why I am not comfortable about raising him at this time, no matter what protocol states.

Suze

 

[Marje and Gracie]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Suze

Great condo today with lots of good info! I understand you do not want to increase his dose now. I think you have a couple options:

1. He is getting into greens and blues and has even gotten below 50 on this dose. So you could continue to hold it for as long as necessary to see if he will gradually flatten out as long as you are happy with his nadirs. But you will have to learn to ignore those bounces. For me, that's the tough part....I'm not big on patience.

2. Revise when you feed the curve and feed a higher low carb food overall. Maybe Pumbaa would do better if he ate the 7 or 9% all the time and maybe if you revised when you fed him so that his nadirs are a bit higher, you can flatten the cycle and increase the dose. That's basically what Sienne was telling you. You have the data. You just have to be able to test...and you do. It might take some time to bring those nadirs up so that there is not so much difference between the PS and the nadir and then you can increase the dose. As you lessen the amount he can drop quickly and keep the nadirs higher, he can flatten out more.

The second option is alot more time consuming.

I'm a control freak like you but I've quit asking where certain numbers come from and just accept it is what it is. I give Gracie at least ten cycles when I take her up or down and then go from there.

 

[Carl & Polly & Bob (GA)]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Suze,
When I suggested you feed the middle of the cycles, it had nothing to do with avoiding bounces. It was to stop him from going low so you could get some decent sleep and not be up all night waiting for the hypo to happen. Actually, a quick bounce lets that happen too... His bouncing doesn't concern me near as much as you running yourself into the ground.

And I'm not saying you should increase. The protocol indicates the opposite. He's dropped below 50 twice on this dose actually. I thought the first time was questionable since it was the 1st cycle on 3.0. I thought the 2nd time was him saying "I mean it Mom". That's where I differ from other opinions.

Carl

 

[Pumbaa]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Suze

Great condo today with lots of good info!

That it is!

I understand you do not want to increase his dose now. I think you have a couple options:

1. He is getting into greens and blues and has even gotten below 50 on this dose. So you could continue to hold it for as long as necessary to see if he will gradually flatten out as long as you are happy with his nadirs. But you will have to learn to ignore those bounces. For me, that's the tough part....I'm not big on patience.

2. Revise when you feed the curve and feed a higher low carb food overall. Maybe Pumbaa would do better if he ate the 7 or 9% all the time and maybe if you revised when you fed him so that his nadirs are a bit higher, you can flatten the cycle and increase the dose. That's basically what Sienne was telling you. You have the data. You just have to be able to test...and you do. It might take some time to bring those nadirs up so that there is not so much difference between the PS and the nadir and then you can increase the dose. As you lessen the amount he can drop quickly and keep the nadirs higher, he can flatten out more.

The second option is alot more time consuming.

Thank you for the two suggestions!

Suggestion #1 is probably the way I will go for now, especially since, a) more time-consuming doesn't fit in my current schedule, and, b) I just purchased four cases of 4/5/7% carbed food. I also bought 16 cans of 9% food, so I could mix some of the 9% in with the 4/5/7%, but it would be very difficult to figure out exactly how much to mix in to have a consistent carb %. I'll think about that.

Right now Pumbaa and Larry free-feed. They each get a 1/2 can of food in the morning, and again at night. Sometimes that is all gone mid-cycle, and I give them more to make sure that Pumbaa always has food available in case he starts to go low, and instinctively goes to eat. Or, as I have been doing, if his numbers start dropping too low or too fast, I give him a little of the 9% carbs to try and slow him down.

For me, it would be difficult to ignore a bounce because a high bounce usually means a low dive is coming. I know you can't do anything once they do bounce but ride it out, but I do pay attention to them simply because of the drops later.

I'm a control freak like you but I've quit asking where certain numbers come from and just accept it is what it is. I give Gracie at least ten cycles when I take her up or down and then go from there.

I've learned to accept that I can't control how Pumbaa reacts to insulin/food/etc., but at the same time, I want to be doing everything I can possibly do for him.

Suze

 

[Pumbaa]

Re: 12/12 Pumbaa PMPS/342 -insert your favorite curse words

Suze,
When I suggested you feed the middle of the cycles, it had nothing to do with avoiding bounces. It was to stop him from going low so you could get some decent sleep and not be up all night waiting for the hypo to happen. Actually, a quick bounce lets that happen too... His bouncing doesn't concern me near as much as you running yourself into the ground.

Why, thank you, Carl. (((HUGS))) My misunderstanding about your suggestion why to feed slightly higher carbed foods. I probably meshed your comments with other comments and things I've read. And I certainly do try to take advantage of those high numbers to get some sleep. Unfortunately, they usually occur during the daytime, instead of at night.

And I'm not saying you should increase. The protocol indicates the opposite. He's dropped below 50 twice on this dose actually. I thought the first time was questionable since it was the 1st cycle on 3.0. I thought the 2nd time was him saying "I mean it Mom". That's where I differ from other opinions.

And I appreciate your differing opinion!

Suze