12/30 Silver AMPS 432 +6=227; +8=290; PMPS 346 +4=351

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@Tracey&Jones you're good at seeing patterns - is there a pattern going on the last two days eg....I THINK I am seeing one - 12/17 PMPS he is low blue, then pink all evening then red the next morning at AMPS. Looks like same thing is happening now - 12/29 - low blue at PMPS, pink all evening and red this morning at AMPS. Based on that, I am hoping for a yellow PMPS and blue tomorrow. I am also seeing that there are less days between the blues - used to be four now only two. Are these the patterns we are to watch for? I do wish he could get used to staying in blues so less bouncing - how will he ever get used to it if he bounces right back up after dipping one little toe in blue.
 
Silver at shot time. Sooo hard to disturb him - he buries himself without help from me. Cozy cat.
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Stacy & Asia said:
My civvie Toki tucks herself in under blankets. So funny!

I hope Silver comes down for you soon, I know how frustrating it is, but when you find that good dose, all will be well, waiting is the hardest part. :( :bighug:
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It is. But when I find the good dose and he hits green a reduce. So is there ever a good dose? I am going to get a + 6 in 45 mins. He’s bouncing so likely pink or yellow. IF the pattern that I think I am seeing holds true then he should be out of the bounce tomorrow and I can’t do a curve as I have church.
 
Juliet said:
So is there ever a good dose?
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Sometimes there's a dose that's good for a moment. :p Seriously though, a cat's insulin needs change over time. It's very uncommon to be able to find a dose and stick to it for any length of time.

Continuiing on yesteday's discussion on test strips. ADW does not ship to Canada - but I live 45 minutes from a post box on the US side, so that's how I got my cheaper test strips. We did have one member who found a reshipper in the US who would receive US goods and reship to Canada. However, you'd really have to buy in bulk to make that cost effective and hope for no shipping delays. Bravo test strips are fairly cheap on line. Buying on Ebay like you are doing is also a good source.
 
Wendy&Neko said:
Sometimes there's a dose that's good for a moment. :p Seriously though, a cat's insulin needs change over time. It's very uncommon to be able to find a dose and stick to it for any length of time.

Continuiing on yesteday's discussion on test strips. ADW does not ship to Canada - but I live 45 minutes from a post box on the US side, so that's how I got my cheaper test strips. We did have one member who found a reshipper in the US who would receive US goods and reship to Canada. However, you'd really have to buy in bulk to make that cost effective and hope for no shipping delays. Bravo test strips are fairly cheap on line. Buying on Ebay like you are doing is also a good source.
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I did look on the ADW website - way too expensive for strips. Cheaper on ebay. If I were to get bravo strips that would mean buying yet another meter. Everyone yesterday said to stick to one meter. And I never have enough $ to buy in bulk. I have to buy only 50 strips at a time.
 
Tracey&Jones said:
Looks like Silver has come down a bit today, that was nice of him.
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Very. That’s +6 tho so I’m hoping he’s not back into pinks for PMPS. I’ll do a curve over the nmy at couple days. I’m not seeing improvement from 1.75 to 2u. Still no greens and a lot of bouncing. Blues are similar. Not lower.
 
True but it seems he is clearing quicker. He seems to like a dose to start with and then moves on. You may end up going up again here shortly. The next couple of days will help find that out with the extra tests. You close to a week now aren't you? Wonder if you can bump up a little quicker to take advantage of the days off you have. Like maybe tomorrow. Hope someone comes along with more dosing experience then me.
 
Tracey&Jones said:
True but it seems he is clearing quicker. He seems to like a dose to start with and then moves on. You may end up going up again here shortly. The next couple of days will help find that out with the extra tests. You close to a week now aren't you? Wonder if you can bump up a little quicker to take advantage of the days off you have. Like maybe tomorrow. Hope someone comes along with more dosing experience then me.
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I really don’t like all these increases at all.
 
With SLGS, you hold the dose a week. Today is day 5. You are also supposed to hold the dose if you see nadirs between 90 and 150. You did see a 126 the first day of the increase.

However, it does look like he will probably need to go a little higher at some point, just not sure it's now. On the last increase, he did show some action the first day of the increase - which would be nice to monitor if you could do so tomorrow. Not sure how long you are gone with church though. My other concern is what if he didn't show a reaction to the dose until the third cycle of the increase, like he did when you went up to 1.75 units. That puts you right back on your work day when you can't monitor. Best to gather what data you can on the current dose, perhaps he'll show you at times you are around tomorrow. Then decide what to do with the dose.
 
Wendy&Neko said:
With SLGS, you hold the dose a week. Today is day 5. You are also supposed to hold the dose if you see nadirs between 90 and 150. You did see a 126 the first day of the increase.

However, it does look like he will probably need to go a little higher at some point, just not sure it's now. On the last increase, he did show some action the first day of the increase - which would be nice to monitor if you could do so tomorrow. Not sure how long you are gone with church though. My other concern is what if he didn't show a reaction to the dose until the third cycle of the increase, like he did when you went up to 1.75 units. That puts you right back on your work day when you can't monitor. Best to gather what data you can on the current dose, perhaps he'll show you at times you are around tomorrow. Then decide what to do with the dose.
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I hear you but SLGS supposed to be tailored right? I hate the increases but surely they’re better done when I can watch? No greens at all so he is still too high. I really want to switch to TR but I don’t think that’s possible as dosing based on nadirs I can’t get weekdays. I don’t like holding the dose a full week when it’s clear he is still too high right? There are no patterns that I can see. He took three days to respond to the 1.75 but he responded the same day when he went up to 2u. He seems to do his own thing.
 
Oh and I’m not around on Sundays. Gone from +2 not back for several hours. Possibly catch a +7 if I leave early. I’m hoping if I did decide to increase - that I’d see action on Monday when I’m home all day. I’m going to get to the stage where he falls into green when I’m at work and will have to deal with it when it happens. I see many BCS in our future.
 
Grrrr this boy! Will keep dose the same tomorrow as per @Wendy&Neko and see if he can show me more blue....another three days before we can increase. The frustrations of SLGS when you can't do TR. Wish I could.
 
Tracey&Jones said:
It is hard when they are bouncy - you just don't know increase or wait. SLGS is to keep things slow and to know for sure.
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I know. But I am sure he needs another increase and delaying the inevitable doesn’t make sense. The bouncing is so discouraging. Does it ever get better?

Plan to do curve on Monday and hoping that it’s not yet another bouncing curve. Increase Tuesday I’m presuming.
 
Juliet said:
Increase Tuesday I’m presuming.
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Unless he decides to show us differently.
Juliet said:
Does it ever get better?
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Wrong person to ask, as you can see from my thread Jones sees a green for the first time in three weeks and ran scared. And here I thought we had the bounce kind of beaten with adding in the higher carb to prevent his free fall. Today is day seven for me, will need to decide tomorrow if he gets a increase or not. I am thinking not in light of that green, will probably hold off till the next weekend to see.
 
Bouncing is very frustrating. Try to ignore them - I know, harder said than done. :bighug: He is starting to see some nice low blues.
 
Juliet said:
I hear you but SLGS supposed to be tailored right? I hate the increases but surely they’re better done when I can watch? No greens at all so he is still too high. I really want to switch to TR but I don’t think that’s possible as dosing based on nadirs I can’t get weekdays. I don’t like holding the dose a full week when it’s clear he is still too high right? There are no patterns that I can see. He took three days to respond to the 1.75 but he responded the same day when he went up to 2u. He seems to do his own thing.
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Juliet said:
Grrrr this boy! Will keep dose the same tomorrow as per @Wendy&Neko and see if he can show me more blue....another three days before we can increase. The frustrations of SLGS when you can't do TR. Wish I could.
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Tracey&Jones said:
It is hard when they are bouncy - you just don't know increase or wait. SLGS is to keep things slow and to know for sure.
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Juliet said:
I know. But I am sure he needs another increase and delaying the inevitable doesn’t make sense. The bouncing is so discouraging. Does it ever get better?
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I'd like to comment on this exchange because I think there's an often over-looked point here and in other's threads...

The reason why it's not a good idea to increase Silver's dose at the moment is you really don't "know" how low the 2u dose is taking him. It has nothing to do with whether you're following SLGS or TR. Increasing the dose without knowing how low that particular dose is dropping blood glucose can be dangerous.

For example, what if he dropped into greens on 12/27 (AM cycle)? He could have been in greens (how low? who knows?) and then was on his way up at PM shot time... bouncing into 300s in the PM cycle. The same could be said for the AM cycle on 12/29... and PM cycle that night. If he dropped into low greens and you raise the dose prematurely, you could be setting him up for a hypo next week when I assume you'll be back to work.

"If" he continues this pattern that he's had over the last few days, he may repeat tomorrow. Just a suggestion... I know you mentioned having plans, but try to get a mid cycle test if at all possible. If not possible, don't forget about those "in the door" and "out the door" tests. Sometimes even bits of data will help give you clues as to how you should proceed. Make sense?

Suggested reading: Should I Increase the Dose?
 
Jill & Alex (GA) said:



I'd like to comment on this exchange because I think there's an often over-looked point here and in other's threads...

The reason why it's not a good idea to increase Silver's dose at the moment is you really don't "know" how low the 2u dose is taking him. It has nothing to do with whether you're following SLGS or TR. Increasing the dose without knowing how low that particular dose is dropping blood glucose can be dangerous.

For example, what if he dropped into greens on 12/27 (AM cycle)? He could have been in greens (how low? who knows?) and then was on his way up at PM shot time... bouncing into 300s in the PM cycle. The same could be said for the AM cycle on 12/29... and PM cycle that night. If he dropped into low greens and you raise the dose prematurely, you could be setting him up for a hypo next week when I assume you'll be back to work.

"If" he continues this pattern that he's had over the last few days, he may repeat tomorrow. Just a suggestion... I know you mentioned having plans, but try to get a mid cycle test if at all possible. If not possible, don't forget about those "in the door" and "out the door" tests. Sometimes even bits of data will help give you clues as to how you should proceed. Make sense?

Suggested reading: Should I Increase the Dose?
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Thanks for that. You won’t have seen in previous threads that my AMPS and PMPS are in the door and out the door tests. I’m up at 5:45am. I feed test and shoot at 6am and am out the door at 6:15. Not back until 6:15pm. Sundays I’m at church 8:30am not back til 1:30pm (Silver’s +7) so I do the best I can on the evening cycle but can only catch nadir on Saturdays. On Sundays I can get a +2 in the am cycle.

That’s why I find this so frustrating as I will never know how low a dose is taking him during the week. However when he has had a blue PMPS and I’ve tried to stay up - he’s been very flat and not gone anywhere near green. But I also believe he very likely DID go into green on 12/27 and 22/29.

I do not know the answer to this, given my very tight schedule. The days I do a curve so far have all been days he has been bouncing and it’s hard to tell reliability of a bouncing curve. Any suggestions very welcome.
 
Jill & Alex (GA) said:



I'd like to comment on this exchange because I think there's an often over-looked point here and in other's threads...

The reason why it's not a good idea to increase Silver's dose at the moment is you really don't "know" how low the 2u dose is taking him. It has nothing to do with whether you're following SLGS or TR. Increasing the dose without knowing how low that particular dose is dropping blood glucose can be dangerous.

For example, what if he dropped into greens on 12/27 (AM cycle)? He could have been in greens (how low? who knows?) and then was on his way up at PM shot time... bouncing into 300s in the PM cycle. The same could be said for the AM cycle on 12/29... and PM cycle that night. If he dropped into low greens and you raise the dose prematurely, you could be setting him up for a hypo next week when I assume you'll be back to work.

"If" he continues this pattern that he's had over the last few days, he may repeat tomorrow. Just a suggestion... I know you mentioned having plans, but try to get a mid cycle test if at all possible. If not possible, don't forget about those "in the door" and "out the door" tests. Sometimes even bits of data will help give you clues as to how you should proceed. Make sense?

Suggested reading: Should I Increase the Dose?
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I read the link. Very interesting. But what to you do when you CANNOT get nadir except one day a week? My health is not good (recovering from brain surgery) and I cannot stay up through the night.
 
Juliet said:
That’s why I find this so frustrating as I will never know how low a dose is taking him during the week. However when he has had a blue PMPS and I’ve tried to stay up - he’s been very flat and not gone anywhere near green. But I also believe he very likely DID go into green on 12/27 and 22/29.

I do not know the answer to this, given my very tight schedule. The days I do a curve so far have all been days he has been bouncing and it’s hard to tell reliability of a bouncing curve. Any suggestions very welcome.
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I feel your pain! I have been "so lucky" to be ill and able to follow Quintus these last weeks.

I would do the curve anyway even if he's bouncing -- because if he's bouncing on curve day, could it be he's bouncing on others too? Even on a bouncy day it might be interesting to see how low he goes.

Juliet said:
But what to you do when you CANNOT get nadir except one day a week? My health is not good (recovering from brain surgery) and I cannot stay up through the night.
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The safe thing to do would be to hold the dose, imho, even if it's too low, until you can be sure. Otherwise, as Jill says, you really run the risk of a hypo because you do not know where he is going when you're not able to monitor.

Idea: is there anybody around you who would be willing (and able) to learn how to test, and drop in once or twice a day to do spot checks? Or even, somebody you could "hire" to come and do a curve or partial curve during the week when you're at work? (Easier said than done, I've thought about it for Quintus and have trouble thinking of somebody, but who knows...)
 
Stephanie & Quintus said:
I feel your pain! I have been "so lucky" to be ill and able to follow Quintus these last weeks.

I would do the curve anyway even if he's bouncing -- because if he's bouncing on curve day, could it be he's bouncing on others too? Even on a bouncy day it might be interesting to see how low he goes.



The safe thing to do would be to hold the dose, imho, even if it's too low, until you can be sure. Otherwise, as Jill says, you really run the risk of a hypo because you do not know where he is going when you're not able to monitor.

Idea: is there anybody around you who would be willing (and able) to learn how to test, and drop in once or twice a day to do spot checks? Or even, somebody you could "hire" to come and do a curve or partial curve during the week when you're at work? (Easier said than done, I've thought about it for Quintus and have trouble thinking of somebody, but who knows...)
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But according to this - I’d be permanently holding the dose which doesn’t make sense. I always do do the bouncing curve but it doesn’t shed any light on weekday activity. And no. There is no one around me st all. I am here in this country alone. My friends are very few and the one who pet sits for me could not get the hang of testing. She tried. So I had to halve Silver’s dose, prefill syringes for 6 days and leave the country (when my mom took ill last month). All the wrong things to do but I had no choice.
 
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And I have no money to hire anyone. My finances are tight. All the spare $ I have goes on Silver’s supplies. I barely spend any $ on food. It’s needed for Silver. And before anyone says it - there’s no way I’m giving him up. He and his sibling have been my sole companions for 11 years. I do the very best I can for him.
 
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So, this is just a wild hypothesis, and bear in mind I'm not very experienced in FD and don't know what a SS of a cat "on too much juice" can look like. But would it be possible that Silver is on too high a dose and the high values you're seeing are because he's bouncing and bouncing? You've probably already thought of this...

If I look at your Scotland trip, upon your return with 0.25 he did manage to give you a green PS. Then you got a series of red and purple PS numbers and upped the dose. But we don't know for sure those red and purple PS were not reactions to drops when you couldn't test, do we? I'm probably completely wrong here, but trying to think "outside the box". He's only been back OTJ since october, right, and last time around he seems to have gone OTJ pretty fast?

(Remind me what country you live in?)
 
Stephanie & Quintus said:
So, this is just a wild hypothesis, and bear in mind I'm not very experienced in FD and don't know what a SS of a cat "on too much juice" can look like. But would it be possible that Silver is on too high a dose and the high values you're seeing are because he's bouncing and bouncing? You've probably already thought of this...

If I look at your Scotland trip, upon your return with 0.25 he did manage to give you a green PS. Then you got a series of red and purple PS numbers and upped the dose. But we don't know for sure those red and purple PS were not reactions to drops when you couldn't test, do we? I'm probably completely wrong here, but trying to think "outside the box". He's only been back OTJ since october, right, and last time around he seems to have gone OTJ pretty fast?

(Remind me what country you live in?)
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Purple??

I'm in Canada and it was advice from this board that said to increase and that it was too late to go backwards. Second remissions are much much harder and it is likely that he built up some kind of glucose toxicity being on too low a dose when I was gone. It is not possible to suddenly drop back to 0.25 and start over - as I was told on here.
 
Stephanie & Quintus said:
So, this is just a wild hypothesis, and bear in mind I'm not very experienced in FD and don't know what a SS of a cat "on too much juice" can look like. But would it be possible that Silver is on too high a dose and the high values you're seeing are because he's bouncing and bouncing? You've probably already thought of this...

If I look at your Scotland trip, upon your return with 0.25 he did manage to give you a green PS. Then you got a series of red and purple PS numbers and upped the dose. But we don't know for sure those red and purple PS were not reactions to drops when you couldn't test, do we? I'm probably completely wrong here, but trying to think "outside the box". He's only been back OTJ since october, right, and last time around he seems to have gone OTJ pretty fast?
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That is backwards thinking about bouncing. The idea with increasing the dose is to get the cat's body in lower, more normal numbers so they will get used to those numbers and stop bouncing. When the cat is not used to normal numbers, their body panics and releases hormones to raise the BG back up and that causes bouncing. If you don't increase the dose, the bouncing may stop, but the cat will stay in high BG numbers. The way to stop bouncing is to increase the dose so the cat spends more time in normal numbers and gets used to them. Each cat is different in how long it takes for this to happen. Once you reach a good dose, the numbers will change and start coming down overall. We have a saying that this is a marathon and not a sprint.
 
Since you came back from Scotland and have been increasing the dose you can see progress on Silver's SS. There is less red and pink and more yellow and blue showing up. I know it is frustrating, but hang in there. You are doing your best for Silver. :bighug:
 
carfurby said:
Since you came back from Scotland and have been increasing the dose you can see progress on Silver's SS. There is less red and pink and more yellow and blue showing up. I know it is frustrating, but hang in there. You are doing your best for Silver. :bighug:
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Thanks Carla
 
carfurby said:
The idea with increasing the dose is to get the cat's body in lower, more normal numbers so they will get used to those numbers and stop bouncing.
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Yes, I understand that. But let's imagine we're giving a cat too high a dose. The cat is diving into the lime greens, but staying out of clinical hypoglycemia, because its body is (justly) panicking and sending it up to high BG. It would look like the cat needs a higher dose, right? Isn't that what we mean by "sometimes too much insulin can look like too little"? This is what I was thinking of.

And to be clear, I don't think I'm right. I just wondered if it was a hypothesis worth considering.
 
Stephanie & Quintus said:
Yes, I understand that. But let's imagine we're giving a cat too high a dose. The cat is diving into the lime greens, but staying out of clinical hypoglycemia, because its body is (justly) panicking and sending it up to high BG. It would look like the cat needs a higher dose, right? Isn't that what we mean by "sometimes too much insulin can look like too little"? This is what I was thinking of.

And to be clear, I don't think I'm right. I just wondered if it was a hypothesis worth considering.
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I don't think so. The old timers on this board have given advice to increase and I trust those that have been here a long time.
 
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