12/14 Eddie AMPS 71, +3.5/47, PMPS/90, +2/34, +4/44, +6/66

Status
Not open for further replies.
Jen&Eddie

Jen&Eddie

Member Since 2013
Happy Sunday LL!

Yesterday's Condo

Yesterday: AMPS/130, +1/136, +2/88, +3/67, +4/54, +4.5/59, +5/68, +6/81, +8.5/135, PMPS/205, +2/150, +3/116, +4/103, +5/113, +6/109, +7/120

Today: AMPS/71, +1/91, +2/67, +2/75, +3/61, +3.5/47, +4/53, +4.5/58, +5/57, +6/57, +7/73, +8/78, +10/70, PMPS/90, +1/64, +2/34 +2.5/44, +3/55, +3.5/51, +4/44, +4.5/47, +5/49, +5.5/56, +6/66, +7/83, +8/95

THANK YOU so much for stopping by and reading Eddie's update yesterday. Elise, Marilyn, Sienne, Carla, Ella, Wendy, and Marje - :YMHUG: :YMHUG: :YMHUG:

One point of clarification that came up in yesterday's condo -- I've been around long enough I should know this, and I thought I did, but maybe I'm misunderstanding. For long-term diabetics, the reduction cut off is 40 rather than 50. But, as I understand, a reduction is also earned by going under 50 but over 40 on three separate days. Is that not correct?

We've actually been using this approach to reductions for several months after we went up and down the dosing ladder a few times and decided that Eddie wasn't holding reductions, even though he was less than a year from diagnosis. We also "shave" his dose for reductions, rather than reducing by a quarter unit. With the help of calipers, each reduction is 1/8 of a unit, rather than 1/4 unit.

Yesterday, Eddie had a decent AM cycle, but headed into a rather disappointing bounce. He hit the 200's for the first time in about a week, which was a bummer. In the PM, he started to slide right back down but stopped in the low 100's and stayed there. In hindsight, he's had patterns like that in the past (albeit at higher numbers), of hitting some ugly high numbers shortly before earning a reduction. I do think that he tends to bounce worse before going down in dose.

I was really surprised this morning after his flat cycle last night, to get a 71 for a pre-shot. I even double checked the number. ;-) Eddie got some higher carb food (8%) this morning to hopefully keep him from dropping too fast, but he still hit 47 at +3.5 which was his third time under 50 on this dose, earning him a reduction (at least I think that's correct??). Anyway, he stayed beautifully flat and green all day! I think this might be the first time Eddie's ever had an entire cycle in the greens! :mrgreen: :mrgreen: :mrgreen: At PMPS, since he wasn't bouncing (yet), we took the 1/8 unit reduction from 1.125u to 1.0u. That's the lowest dose he's been on for at least 6 months. The 65 at +1 should have been a red flag to test in a half hour but I wasn't paying attention, and DH didn't know any better, so by +2, Eddie was at 34. :shock: This is the third time recently that Eddie has hit 30's immediately after a reduction, and I've previously chalked it up as depot action, so he doesn't earn another reduction.

While it would be great if he would cooperate and let us slowly inch our way down in dose, we may have to get creative if Eddie decides he doesn't want to take the slow train down. His nickname isn't "Fast Eddie" for nothing!

I've seen him hacking or coughing three or four times in the last three days, so I do wonder if he's working on a hairball so that could also account for some of the less wonderful numbers yesterday, too I suppose.

Have a great Sunday evening all and a great week!
 
Re: 12/14 Eddie AMPS 71, +3.5/47, PMPS/90, +2/34, +3/55, +4/

great to see you, jen! I've been wondering where you and Eddie have been - it's good to see he's doing so well.

I wouldn't try to prevent him from earning reductions by feeding him at this stage. And I would take the reductions when he earns them. With a 34 tonight, i'd take a reduction. Looking again at the guidelines:

Reducing the dose:
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.

Please do not let yourself become complacent or blasé about drops into the 20s or 30s.
If kitty drops into the 20s, a full reduction of 0.25u (or 0.5u if kitty is on a higher dose) is strongly recommended.
If your cat drops into the 30s, a full reduction of 0.25u is recommended. There are very few exceptions given for caregivers who have collected years of data and KNOW their cat's response to the combination of insulin and food backwards, forwards, and inside out.
Caregivers whose kitties have "High Dose" conditions may find the need to reduce in whole units or more.
Please ask for advice.

If anyone suggests otherwise, they are putting your cat at risk! Our kitties are not just numbers. They are living beings who trust us to look out for them. The TR Protocol is an aggressive method in itself. The modified version of the protocol is slightly more aggressive.

Keeping YOUR cat safe is the #1 priority of the FDMB.
Let's keep all our kitties in the Lantus Tight Regulation ISG safe by suggesting and taking appropriate reductions.

If an attempted reduction fails, go right back up to the last good dose as soon as you see kitty's numbers trending upwards. You don't have to hold the reduced dose for a certain number of cycles before taking the dose right back up. The guidelines listed under the topic "Increasing the dose" do not apply to a failed reduction.

Please use common sense in this situation. The "last good dose" is not the dose that just dropped kitty into the 20s or 30s. You want to resume momentum by finding a dose in-between the dose that dropped kitty too low and the reduced dose.
Click to expand...

I think you do qualify as a CG that knows your kitty inside and out. You're there, you monitor, and you put effort into understanding what's going on. At the same time, we've had conversations on TR in the past about the dangers of combining shaving with the 3 times under 50 method. I'd be concerned about the depot getting ahead of Eddie when you do that. Everything I've been told is that lower isn't necessarily better - you want normal numbers but 30's are not better than 70's. If he were mine, I'd let him go a little bit higher for his safety.

It's great to see him doing so well. You've done a super job! :mrgreen:
 
Re: 12/14 Eddie AMPS 71, +3.5/47, PMPS/90, +2/34, +3/55, +4/

Amazing. I'm so scatter-brained that all these calculations and reductions make my head hurt. Linear thinking is a challenge for me. (Thank goodness for FDMB and the wonderful people who help me!) He may be "Fast Eddie", but his beans are pretty darn quick, too.

Great to see you back.

Marilyn and Polly
 
Re: 12/14 Eddie AMPS 71, +3.5/47, PMPS/90, +2/34, +4/44, +5/

Hi Sandy and Marilyn! :YMHUG: It does look like Eddie's seeing green tonight, too (so far, anti-jinx). Since he's surfing, I'm not really actively intervening with these 40's, although I know I can let Eddie do that since I'm testing on the half hour and can get food in him if need be. Disclaimer - this is an Eddie-only thing!

Julie - It's so nice to see you again, too! :YMHUG: Between work obligations, trying to get out and do more fun stuff, and getting out of the routine, I failed at participating here for a few months. My work obligations are (hopefully) slowing down a tiny bit, and with the holidays coming up, I should have more time to be more active here. :-D

Thank you so much for your input! With Eddie no longer bouncing (much), I feel like some of our "tricks" may no longer be appropriate, but am terrified of messing things up and having climb the ladder back up in dose. nailbite_smile So, we've just kept on doing what we were doing before. I'm thinking maybe it's time to rethink our approach with where Eddie's at now?

Thanks for confirming that we shouldn't be aiming to prevent reductions at this stage. Hard to wrap our heads around that! ;-)

As for the reduction specifically, he just got an 1/8 reduction tonight before he hit the 30's. I was actually considering reducing again in the morning by another 1/8 unit for the exact reason you mentioned...depot gets too full. That has been an issue as Eddie's numbers have come down. Luckily, I was there to monitor. It was over Thanksgiving, and I was stuck with Eddie while DH got to go do fun times. :roll: I couldn't get Eddie to stay up despite Karo and HC several times so I could go out. Obviously, I can't do that when I'm at work. Recently, if you look at Eddie's SS, he likes to do his dips around +3 or +4, when I'm at work, and I had to leave him in the 40's at +2 on one work morning. You can see several spots where he very likely hit lower numbers we didn't catch. Do you think another 1/8 unit reduction, for a total reduction of 1/4 makes sense? That would put him at 0.875 units. Going forward, should we switch from "shaving" or 1/8 unit reductions to full quarter unit reductions? In the past, the 1/8 reductions have worked great, and I think that helped with the bouncing, as well as shooting through the bounce pretty aggressively.
 
Re: 12/14 Eddie AMPS 71, +3.5/47, PMPS/90, +2/34, +4/44, +6/

I don't know, jen. I think what you've been doing has been working, but at the same time he is skating pretty low and i think he would be healing equally well if he were up a bit higher. I wouldn't want to leave him in the 40's without checking him again within a half hour. There is just no safety margin at all there.

If he were mine, I think I would take the 1/8u reduction again in the morning. If he trends up after the reduction, then you can go back up in dose. He's been holding these recent reductions though, so i wouldn't be surprised if he held this one too. Sometimes cats go down the dosing scale very quickly and you have to stay up with their speed.

But . . . I'm not an expert, that's just what I would do. Maybe someone else has another idea.
 
Re: 12/14 Eddie AMPS 71, +3.5/47, PMPS/90, +2/34, +4/44, +6/

Thanks Julie!

An additional 1/8 reduction tomorrow morning is what I'm leaning towards.
 
Re: 12/14 Eddie AMPS 71, +3.5/47, PMPS/90, +2/34, +4/44, +6/

Wow, look at Eddie. :mrgreen: :-D I hope he holds this latest reduction.
 
Status
Not open for further replies.
Back
Top