2/2 Yoyo AMPS 245,+4 178,+5 173,+8.5 261,PMPS 309,+4 196,+8 318

Long stream of yellows might be telling us something, come on down Yoyo
Have a great day Debra
 
Bellasmom said:
Long stream of yellows might be telling us something, come on down Yoyo
Have a great day Debra
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Good morning,
Please explain what is a long stream of yellow's is telling us? I noticed it is flat, which I think is good, but his numbers are too high. Please let me know your thoughts.
 
Debra and Yoyo said:
Please explain what is a long stream of yellow's is telling us? I noticed it is flat, which I think is good, but his numbers are too high. Please let me know your thoughts.
Click to expand...
I think the long string of flat yellows means it's a bounce that is about to break. It's important to keep track of those because if the bounce is about to break on its own, and you increase at the same time, the cycle can be extremely active.
That happened once to Bailey when her low preshot number was at the end of a full cycle of dropping numbers. I gave her regular shot, and she dropped even more @+1. I then had a hard time getting her to come back up, and that doesn't usually happen with Bailey.
Yoyo's been in yellow for a while, though, so I don't how to interpret that. If you are considering an increase, you can always post a dosing question.
 
Hmmm, all of the above is true.
But if I'm honest I'm not seeing anything that indicates this is a bounce. Sure he dropped from pink to blue but that was over 8 cycles ago so any bounce should have cleared (6 cycles for a bounce to clear/usually) sometimes high numbers are just that, high numbers, and they are just indicating that kitty needs more juice.

Yoyo has been on this dose for 14 days now. and for the last 7 cycles it does seem like the nadirs have crept up, he has previously bounced then cleared the bounce within 2 cycles, if you look to last weeks numbers you can see that. So taking a long time to clear the bounce is not his usual mode of operation. So chances are that what we are seeing here is a dose that has gone stale, nadirs have crept up telling us he needs more juice.

I would run a curve today (in line with SLGS a curve should be run once a week and you would look to the nadirs to see what to do), if you run a curve and don't see any blue, then I would take him up the full 0.25 to 0.65u (guess you use a caliper)
Getting him into lower numbers will really help the weight issue too.

Of course cats being cats, he will probably make me out to be a liar and give you a nice blue cycle today:rolleyes:
 
Rosie & Bailey said:
I think the long string of flat yellows means it's a bounce that is about to break. It's important to keep track of those because if the bounce is about to break on its own, and you increase at the same time, the cycle can be extremely active.
That happened once to Bailey when her low preshot number was at the end of a full cycle of dropping numbers. I gave her regular shot, and she dropped even more @+1. I then had a hard time getting her to come back up, and that doesn't usually happen with Bailey.
Yoyo's been in yellow for a while, though, so I don't how to interpret that. If you are considering an increase, you can always post a dosing question.
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You wrote such a cute post this morning, you should be a "writer"....you sure have a way with words, I was smiling through the entire post:cat:
 
Debra and Yoyo said:
Somehow he is reading my posts. I'll have to keep the door shut;).....He just dropped to 178;
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hahaha
nice to see the blue, I'd let him see your computer, seems like the dosecrease threat worked a treat.
Great to see the blue but seriously though if he doesn't go below 150 I would still take him up, in line with the SLGS guidelines below
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
 
I'm definitely interested in seeing where Yoyo goes this cycle. When I was reviewing your spreadsheet, I was thinking along the same lines as Gill. Yoyo hasn't seen a green in two weeks, and he doesn't seem to stay overly long in blues. I agree with Gill, if he doesn't go below 150 I would increase.
 
I third the thoughts on the increase. Yo-yo is getting stuck in a sea of yellow and going days with even seeing high blues. He is spending a lot of time above renal threshold. As per SLGS, time to take him up by 0.25 units.
 
Gill & George said:
hahaha
nice to see the blue, I'd let him see your computer, seems like the dosecrease threat worked a treat.
Great to see the blue but seriously though if he doesn't go below 150 I would still take him up, in line with the SLGS guidelines below
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
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I agree, but with SLGS, I thought I am supposed to wait 7 days for nadirs to be more than 150
 
Debra and Yoyo said:
I agree, but with SLGS, I thought I am supposed to wait 7 days for nadirs to be more than 150
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Technically you wait a week on a given dose before performing a curve to see where Yoyo's nadirs are. Here's the full portion of what Gill shared from the protocol:

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
So on SLGS, say you'd curve on Saturdays, increase Saturday PM or Sunday, and then curve the next Saturday again. Basically you'd run a curve each week to check in on where Yoyo's nadirs are and make adjustments as necessary. You'd use the guidelines above to see where your dose should be for the next week.
 
Nice try, Yoyo, trying to escape the dosecrease threat with that 173.
Next time you want to avoid a dosecrease, read the protocol and go below 150. :joyful::joyful::joyful:

*waiting to see if he will defend his honor tonight. Otherwise, looks like a consensus on the dosecrease.

Debra and Yoyo said:
I was smiling through the entire post:cat:
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Glad it made you smile! Best part is, it worked! Bailey did a slow glide down. Now, the question is did the other kitties follow her lead and surf safely today?
I think Bailey is telling Yoyo that a dosecrease is not such a bad thing. Her dosecrease worked out ok, she feels great, and now she gets to play and keep me up all night long. :)
 
Debra and Yoyo said:
I agree, but with SLGS, I thought I am supposed to wait 7 days for nadirs to be more than 150
Click to expand...
Hi Debra

As Gill explained, typically you do a curve once a week and see where the nadir is before deciding the dose. But here’s the thing: you are basically doing curves every day. That’s the data you want to use to decide if you need to make a dose change. Usually when we see members doing SLGS, it’s because they (a) either work and aren’t there during the week days to catch the nadirs or (b) they are feeding dry food still or (c) they are just worried about doing TR; perhaps you fall into this category because you are certainly testing plenty enough to do TR. I’m sure you’ve addressed that and I’m not trying to change your mind. But...the point is that most people doing SLGS don’t have your data. Take a look at Furball’s SS. Carla does test more when she’s home instead of just doing one weekly curve but you can see on days she works, there’s very little data.

SLGS is a guideline and should be implemented based on the data you have, your availability and ability to test, and how long you’ve been here and understand your cat’s cycles, etc. There’s nothing wrong with you waiting a week to change a dose (unless a reduction is earned) but you also want to base your decision on the data you’ve gotten all week. The data is telling us that of all those cycles the last week, YoYo has only seen a nadir below 150 twice and it wasn’t far below 150. Obviously, if things change and you can’t test like you are now, you’ll have to make decisions based solely on the weekly curve.

I stress “you” because my advice pertains to you and YoYo so any readers doing SLGS need to take into consideration that Debra tests much more than most doing SLGS and has as much data as a member doing TR.

The other thing I’d like to bring to your attention is the dose changes. Both TR and SLGS are designed for safety and SLGS particularly is with some of its extra built in guidelines like taking reductions if the BG drops below 90. However, dose changes even for SLGS are done in 0.25u increments and not the small changes you’ve been doing. Some members make dose changes in smaller increments because their cat is usually just about all green and the dose needs a tiny bit of fine tuning. For a newly diagnosed cat with nadirs generally above 150, you really need to be doing those dose changes in 0.25u increments. SLGS is already a lot less aggressive approach and, I hate to be so candid here but I will, you are likely stalling her progress by not doing the dose changes by 0.25u until she gets to the point where she needs a little extra to bring the BG down just a bit into green nadirs. I did read back on your 1/19 condo (the day you increased) to see your reasoning and I understand your issue with syringes.

Sorry to be so blunt but I’d be remiss if I wasn’t truthful with you that it’s really best to be sure you are giving the correct dose changes.
 
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Rosie & Bailey said:
Nice try, Yoyo, trying to escape the dosecrease threat with that 173.
Next time you want to avoid a dosecrease, read the protocol and go below 150. :joyful::joyful::joyful:

*waiting to see if he will defend his honor tonight. Otherwise, looks like a consensus on the dosecrease.


Glad it made you smile! Best part is, it worked! Bailey did a slow glide down. Now, the question is did the other kitties follow her lead and surf safely today?
I think Bailey is telling Yoyo that a dosecrease is not such a bad thing. Her dosecrease worked out ok, she feels great, and now she gets to play and keep me up all night long. :)
Click to expand...
I agree with everyone that Yo does need a dosecrease. I just thought that I had to hold for 7 days before I gave him a dosecreas from last seeing 150 or less on his nadirs. I'm not sure if the other members know that I am following SLGS and not TR.
 
Marje and Gracie said:
Hi Debra

As Gill explained, typically you do a curve once a week and see where the nadir is before deciding the dose. But here’s the thing: you are basically doing curves every day. That’s the data you want to use to decide if you need to make a dose change. Usually when we see members doing SLGS, it’s because they (a) either work and aren’t there during the week days to catch the nadirs or (b) they are feeding dry food still or (c) they are just worried about doing TR; perhaps you fall into this category because you are certainly testing plenty enough to do TR. I’m sure you’ve addressed that and I’m not trying to change your mind. But...the point is that most people doing SLGS don’t have your data. Take a look at Furball’s SS. Carla does test more when she’s home instead of just doing one weekly curve but you can see on days she works, there’s very little data.

SLGS is a guideline and should be implemented based on the data you have, your availability and ability to test, and how long you’ve been here and understand your cat’s cycles, etc. There’s nothing wrong with you waiting a week to change a dose (unless a reduction is earned) but you also want to base your decision on the data you’ve gotten all week. The data is telling us that of all those cycles the last week, YoYo has only seen a nadir below 150 twice and it wasn’t far below 150. Obviously, if things change and you can’t test like you are now, you’ll have to make decisions based solely on the weekly curve.

I stress “you” because my advice pertains to you and YoYo so any readers doing SLGS need to take into consideration that Debra tests much more than most doing SLGS and has as much data as a member doing TR.

The other thing I’d like to bring to your attention is the dose changes. Both TR and SLGS are designed for safety and SLGS particularly is with some of its extra built in guidelines like taking reductions if the BG drops below 90. However, dose changes even for SLGS are done in 0.25u increments and not the small changes you’ve been doing. Some members (and I was one of them) make dose changes in smaller increments because their cat is usually just about all green and the dose just needs a tiny bit of fine tuning. For a newly diagnosed cat with nadirs generally above 150, you really need to be doing those dose changes in 0.25u increments. SLGS is already a lot less aggressive approach and, I hate to be so candid here but I will, you are likely stalling her progress by not doing the dose changes by 0.25u until she gets to the point where she just needs a little extra to bring the BG down just a bit into green nadirs. I did read back on your 1/19 condo (the day you increased) to see your reasoning and I understand your issue with syringes.

Sorry to be so blunt but I’d be remiss if I wasn’t truthful with you that it’s really best to be sure you are giving the correct dose changes.
Click to expand...
Thank you...I appreciate you telling me these things. I was just posting above that I thought if Yoyo's numbers went below 150 in nadirs, that I was to hold the dose for 7 days, then if after 7 days his nadirs are greater than 150 I would do a dosecrease. But I think you are telling me that I test enough so that I can do the dosecrease in .25 unit increments without waiting 7 days.
So since I gave Yoyo .40 units, should I now increase to .65 Units or do .75 Units?
 
Debra and Yoyo said:
Thank you...I appreciate you telling me these things. I was just posting above that I thought if Yoyo's numbers went below 150 in nadirs, that I was to hold the dose for 7 days, then if after 7 days his nadirs are greater than 150 I would do a dosecrease. But I think you are telling me that I test enough so that I can do the dosecrease in .25 unit increments without waiting 7 days.
So since I gave Yoyo .40 units, should I now increase to .65 Units or do .75 Units?
Click to expand...
Actually, I was just saying that you don’t have to base your decisions solely on one curve you do once a week. Under SLGS, you typically do hold the dose 7 days. However, again, it’s a guideline and not a hard and fast rule. If you want to stay somewhat conservative, hold the dose 7 days. If you want to be less conservative, consider TR where you can give him the doses changes exactly when you need them.

It would certainly be easier for you if you were at a dose which was simpler to draw than 0.4u or 0.65u. However, I wouldn’t advise raising him to 0.75u. You have two options:

--increase the dose to 0.65u
--increase the dose only this once to 0.5u just to get you back on a line (I know this is in opposition to what I told you but I’m trying to make the dosing easier for you) and then going forward, give the increases/decreases in 0.25u.

If it were me, I’d probably increase to 0.5u and if he’s not seeing some much better numbers (between 90-150) than just this once, I’d increase after six cycles. This is not consistent with the SLGS guidelines but again, my recommendation is to help you get to a dose that’s easier to do while not leaving him at a dose that might not work (e.g. 0.5u) for too long; it does look to me like he needs a 0.25u increase but it is likely best to get there with the second option.

How does that sound? Your choice :)
 
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Marje and Gracie said:
Actually, I was just saying that you don’t have to base your decisions solely on one curve you do once a week. Under SLGS, you typically do hold the dose 7 days. However, again, it’s a guideline and not a hard and fast rule. If you want to stay somewhat conservative, hold the dose 7 days. If you want to be less conservative, consider TR where you can give her the doses changes exactly when you need them.

It would certainly be easier for you if you were at an easier dose to dose than 0.4u or 0.65u. However, I wouldn’t advise raising her to 0.75u. You have two options:

--increase her to 0.65u
--increase her only this once to 0.5u just to get you back on a line (I know this is in opposition to what I told you but I’m trying to make the dosing easier for you) and then going forward, give the increases/decreases in 0.25u.

If it were me, I’d probably increase to 0.5u and if she’s not seeing some much better numbers (between 90-150) than just this once, and if you stick with SLGS, I’d increase after six cycles. This is not consistent with the SLGS guidelines but again, my recommendation is to help you get to a dose that’s easier to do while not leaving her at a dose that might not work (e.g. 0.5u) for too long because it does look to me like she needs a 0.25u increase.

How does that sound? Your choice :)
Click to expand...
Thank you for taking the time to explain things to me and to advise me. Tomorrow morning I will increase his dosage to .50 unit. If after 6 cycles, (3 days), nadirs are greater than 150, then I will increase his dosage to .75 unit. I want to get his numbers into the lower blue numbers.
Again, thank you!
 
Debra and Yoyo said:
Thank you for taking the time to explain things to me and to advise me. Tomorrow morning I will increase his dosage to .50 unit. If after 6 cycles, (3 days), nadirs are greater than 150, then I will increase his dosage to .75 unit. I want to get his numbers into the lower blue numbers.
Again, thank you!
Click to expand...
You’re welcome!

NOTE: This advice is for YoYo only for this circumstance. We normally do not flip flop between SLGS and that’s not the goal here. We just want to get to an easy to shoot dose that’s easier to change by 0.25u. Because its likely that such a small increase (0.1u) won’t be what YoYo needs, we don’t want to leave him there. We just want the depot to adjust and then Debra can either continue with SLGS or she may choose to move to TR...up to her.
 
Debra and Yoyo said:
Thank you for taking the time to explain things to me and to advise me. Tomorrow morning I will increase his dosage to .50 unit. If after 6 cycles, (3 days), nadirs are greater than 150, then I will increase his dosage to .75 unit. I want to get his numbers into the lower blue numbers.
Again, thank you!
Click to expand...
Good plan.

Thanks @Marje and Gracie for weighing in. You said it so much better than I would.
 
Marje and Gracie said:
Hi Debra

As Gill explained, typically you do a curve once a week and see where the nadir is before deciding the dose. But here’s the thing: you are basically doing curves every day. That’s the data you want to use to decide if you need to make a dose change. Usually when we see members doing SLGS, it’s because they (a) either work and aren’t there during the week days to catch the nadirs or (b) they are feeding dry food still or (c) they are just worried about doing TR; perhaps you fall into this category because you are certainly testing plenty enough to do TR. I’m sure you’ve addressed that and I’m not trying to change your mind. But...the point is that most people doing SLGS don’t have your data. Take a look at Furball’s SS. Carla does test more when she’s home instead of just doing one weekly curve but you can see on days she works, there’s very little data.

SLGS is a guideline and should be implemented based on the data you have, your availability and ability to test, and how long you’ve been here and understand your cat’s cycles, etc. There’s nothing wrong with you waiting a week to change a dose (unless a reduction is earned) but you also want to base your decision on the data you’ve gotten all week. The data is telling us that of all those cycles the last week, YoYo has only seen a nadir below 150 twice and it wasn’t far below 150. Obviously, if things change and you can’t test like you are now, you’ll have to make decisions based solely on the weekly curve.

I stress “you” because my advice pertains to you and YoYo so any readers doing SLGS need to take into consideration that Debra tests much more than most doing SLGS and has as much data as a member doing TR.

The other thing I’d like to bring to your attention is the dose changes. Both TR and SLGS are designed for safety and SLGS particularly is with some of its extra built in guidelines like taking reductions if the BG drops below 90. However, dose changes even for SLGS are done in 0.25u increments and not the small changes you’ve been doing. Some members make dose changes in smaller increments because their cat is usually just about all green and the dose needs a tiny bit of fine tuning. For a newly diagnosed cat with nadirs generally above 150, you really need to be doing those dose changes in 0.25u increments. SLGS is already a lot less aggressive approach and, I hate to be so candid here but I will, you are likely stalling her progress by not doing the dose changes by 0.25u until she gets to the point where she needs a little extra to bring the BG down just a bit into green nadirs. I did read back on your 1/19 condo (the day you increased) to see your reasoning and I understand your issue with syringes.

Sorry to be so blunt but I’d be remiss if I wasn’t truthful with you that it’s really best to be sure you are giving the correct dose changes.
Click to expand...
Hi Marje, Sorry to be writing to you on an older post but I didn't know how else to contact you. I tagged you a couple of days ago and I haven't heard back from you. I am trying to get dosing advice for Yoyo. I hope I am not bothering you.
 
No, you aren’t bothering me. DH is on vacation so we’ve been out hiking and traveling around. I had it on my list today to post some dosing advice for you.

I’ve got just a few things to take care of right now and then I’ll be back on. Sorry for the delay! I hadn’t forgotten about you all.
 
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