12/24 Silver AMPS 385 PMPS 344 +3=398 hating these pinks. Depressing

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J

Juliet

Member Since 2017
Ok Silver time to come down and give me some more blues - preferably show me a little :D.
He always seems to be high in the mornings. A rare blue AMPS but not usual. I will do a curve tomorrow or Tuesday but I really am hoping for a non-bouncy curve. How do you make an accurate decision on dose increase or decrease if he is bouncing on curve day?
 
I think if he is bouncing you can't make a decision to increase or decrease, you've got to hold the dose until the bouncing stops to see how it's really doing.
 
Alicia & Maggie said:
I think if he is bouncing you can't make a decision to increase or decrease, you've got to hold the dose until the bouncing stops to see how it's really doing.
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Yes I figured that. But I might have to make a guess at doing it anyways based on his "non-bouncing" numbers as I can only catch nadir at weekends. Hoping to get a curve in before the end of the Christmas break but I think he needs an increase - not seen any greens.
 
Hopefully the curve day will give you some insight. In the meantime here are a few thoughts/observations.

Good job getting the night time tests as that helps. He gave you a nice 103 preshot at PMPS on 12/18 which is a beautiful number on SLGS. With the skipped shot it can take 4- 6 cycles for the depot to fill again. The morning of 12/21 with the AMPS of 139 was also a good number but with a reduce dose the depot was disrupted. What I mean by 'good number' is if you are catching tests between 90-150 SLGS says to hold the dose. So while he may be bouncing at times, it's not always a bounce, it's disruption in the depot causing wonky numbers. Even so it does look like with the data you have there is room for an increase but think it's a good idea to grab more spot checks these next few days and do your curve.
 
Doodles & Karen said:
Hopefully the curve day will give you some insight. In the meantime here are a few thoughts/observations.

Good job getting the night time tests as that helps. He gave you a nice 103 preshot at PMPS on 12/18 which is a beautiful number on SLGS. With the skipped shot it can take 4- 6 cycles for the depot to fill again. The morning of 12/21 with the AMPS of 139 was also a good number but with a reduce dose the depot was disrupted. What I mean by 'good number' is if you are catching tests between 90-150 SLGS says to hold the dose. So while he may be bouncing at times, it's not always a bounce, it's disruption in the depot causing wonky numbers. Even so it does look like with the data you have there is room for an increase but think it's a good idea to grab more spot checks these next few days and do your curve.
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Will do what I can but I’m not around too much. Have to do reduced shots when I’m gone all day. Just can’t take risks. Easier on the pm cycles. I just wish I was home all day all the time and he might get better quicker. I know I’m delaying his progress.
 
Getting so fed up with this. I get a few blues then right back into pink. Should I be increasing the dose? He has been on this dose over a week now but I haven't been home to catch a nadir or do a curve in a few weeks.
 
I would stick to what Karen advised. Tonight is only the 7th cycle on a consistent dose, so we really don't know what this dose will do with a stabilized depot. And this dose got him sooo close to green with that 5.7 on the 18th. Which with meter variance could of been green!

It is like he sees a blue....runs up to red/high pink then tries a yellow maybe and does a :eek: and then sits in the pink again. Then we have the NS and BCS mudding the waters a little bit.

I wonder if he will clear tomorrow.
 
Tracey&Jones said:
I would stick to what Karen advised. Tonight is only the 7th cycle on a consistent dose, so we really don't know what this dose will do with a stabilized depot. And this dose got him sooo close to green with that 5.7 on the 18th. Which with meter variance could of been green!

It is like he sees a blue....runs up to red/high pink then tries a yellow maybe and does a :eek: and then sits in the pink again. Then we have the NS and BCS mudding the waters a little bit.

I wonder if he will clear tomorrow.
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I don’t understand what you both mean about only the 7th cycle. He’s been on 1.75 u for 11 days?? I will always shoot a reduced dose for the am cycle if he’s too low to shoot but his dose hasn’t changed. Just that one shot.
 
Juliet said:
I will also shoot a reduced dose for one cycle if he’s too low to shoot but his dose hasn’t changed. Just that one shot.
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But that 1 low shot disrupts the depot. Which will cause some wonky numbers. With Lantus, part of the shot goes to depot and part to be used. So when you do a lower shot you make a withdrawal from the depot. So I was counting from that low dose to see how many cycles from that are we...to determine if the depot is stable or not.

This is from the depot sticky in the L&L forum:

Have you ever wondered why, when you are giving the same amount of insulin every time, the response is different in each cycle? Sometimes the numbers go up for the whole cycle, sometimes they go down, sometimes they stay flat, and sometimes they actually “curve.” The answer often lies in the depot. Did you skip a shot or give a partial shot at some time in the past few days? That can result in higher numbers for several days as the depot replenishes some of its lost stores. Did you increase the dose? This can result in a change in the size of the depot and can lead to a temporary adjustment in the amount of insulin available for use. Did you decrease the dose recently? A dose reduction will usually result in a need for less stored insulin. The excess may be released into the bloodstream faster than usual, especially if several dose reductions are done back-to-back.

Consistency is really important with Lantus.



 
Tracey&Jones said:
But that 1 low shot disrupts the depot. Which will cause some wonky numbers. With Lantus, part of the shot goes to depot and part to be used. So when you do a lower shot you make a withdrawal from the depot. So I was counting from that low dose to see how many cycles from that are we...to determine if the depot is stable or not.

This is from the depot sticky in the L&L forum:

Have you ever wondered why, when you are giving the same amount of insulin every time, the response is different in each cycle? Sometimes the numbers go up for the whole cycle, sometimes they go down, sometimes they stay flat, and sometimes they actually “curve.” The answer often lies in the depot. Did you skip a shot or give a partial shot at some time in the past few days? That can result in higher numbers for several days as the depot replenishes some of its lost stores. Did you increase the dose? This can result in a change in the size of the depot and can lead to a temporary adjustment in the amount of insulin available for use. Did you decrease the dose recently? A dose reduction will usually result in a need for less stored insulin. The excess may be released into the bloodstream faster than usual, especially if several dose reductions are done back-to-back.

Consistency is really important with Lantus.


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So how can I do this? Because as his numbers come down I will never manage consistency. I will NOT shoot a low blue or green and leave him 12 hours. To me that is so irresponsible. So his depot and dosing will always be inconsistency as his number come down. There must be others in my position. What did they do. I can’t cope much longer with this. It’s taking a toll on my health and I need to get this cat regulated very soon.
 
You are helping Silver. He is getting insulin that helps. I can't comment on leaving him for 12 hours as I have never been in that position. I have always had someone around/or coming in earlier than me to check up on him. Maybe put up a thread in community asking how others with long work days do it while using Lantus.

Have you checked the other insulin options? My vet tried to get me on Prozinc, but I didn't mind the Lantus and knew I could work with it.
 
Tracey&Jones said:
You are helping Silver. He is getting insulin that helps. I can't comment on leaving him for 12 hours as I have never been in that position. I have always had someone around/or coming in earlier than me to check up on him. Maybe put up a thread in community asking how others with long work days do it while using Lantus.

Have you checked the other insulin options? My vet tried to get me on Prozinc, but I didn't mind the Lantus and knew I could work with it.
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Well I just got that Lantus from the supply closet being sent to me so I have to stick with it.
 
Well that give you a few months to see how things workout with Lantus and research to see if there is something better for you.

Chin up...it could be way worse and he is getting better...he is just very bouncy. Some cats are like that.
 
Tracey&Jones said:
Well that give you a few months to see how things workout with Lantus and research to see if there is something better for you.

Chin up...it could be way worse and he is getting better...he is just very bouncy. Some cats are like that.
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How does the bouncing stop? He hits blue then bounces for like 8 cycles. Hits blue and all over again. Not seen any green at all.

Think I’d prefer to stick with what I know. Changing insulins is a whole new learning curve I have no energy for.
 
One thing to keep in mind, kitties that come out of remission are often bouncier the second time around. Nothing much you can do about it. He will bounce less once he gets more comfortable in normal numbers. It's a process, but timing is up to Silver's body. My girl loved to bounce too. I was thrilled when after year she stopped bouncing to red. :rolleyes:
 
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