2/22 Munchie AMPS 493

[ewest]

last condo

Thanks all for the feedback yesterday. Is the danger of increasing during a bounce that they may drop out after the bounce has cleared?

"The drop from 414 to 209 is substantial." Yeah, I've noticed this type of drop for her a number of times recently. Last night she did this as well: 581 to 336 by +4. 2/19 same: 532 to 348. *Does this indicate something in particular?*

I'm holding the 1.5 this morning but wondering if I should bump her up to a 1.5F tonight or if I should get another evening reading tonight to see if bounce has cleared. I know their response to insulin can change over time but haven't yet been successful increasing her past 1.5 for any extended period without her earning a reduction. What I don't understand about her numbers is when she earns a reduction but hasn't gotten regulated on the dose. I'll try skinnying the dose if she earns one I think.

In terms of the homeopathic remedy, she hasn't had it for about a week. I usually don't have to repeat the remedy but my homeopath and I were trying to see if repeating might help her since she had such great results the first time it was used (sometimes with chronic conditions it has to be repeated).

 

[Dyana]

I'll try to get some eyes on your post about your questions for tonight's dose. And, yes, if the kitty is coming down from a bounce and also has a dose increase at the same time, she may dive down too fast and too low, and just set up another bounce.

 

[Sienne and Gabby (GA)]

Is the danger of increasing during a bounce that they may drop out after the bounce has cleared?

Yes! That's exactly right. Some cats can clear a bounce with a vengeance!

"The drop from 414 to 209 is substantial." Yeah, I've noticed this type of drop for her a number of times recently. Last night she did this as well: 581 to 336 by +4. 2/19 same: 532 to 348. *Does this indicate something in particular?*

What it indicates, at least to me, is that this is likely to be why Munchie is so bouncy. Bounces don't occur only because a cat drops into low numbers. They can occur due to a big, relatively fast drop in numbers.

I'm holding the 1.5 this morning but wondering if I should bump her up to a 1.5F tonight or if I should get another evening reading tonight to see if bounce has cleared. I know their response to insulin can change over time but haven't yet been successful increasing her past 1.5 for any extended period without her earning a reduction. What I don't understand about her numbers is when she earns a reduction but hasn't gotten regulated on the dose. I'll try skinnying the dose if she earns one I think.

If the bounce has cleared, I would increase. You're doing a good job of getting tests at night. What I would suggest, though, is increasing by 0.25u. Adding some fat to a dose makes sense if you're in lower numbers and trying to zero in on a good dose. I don't think Munchie is there yet so I'd encourage you to stick with the protocol and take the full increase.

If you think that having Munchie spend more time at a dose as a means of getting her entire level to come down is that you can use a slightly different approach. If you go to the TR Protocol (vs. our modified version), one option is to lower the dose only after there have been 3 drops below 50. (A drop in numbers below 40 always gets a reduction.)

Phase 4: Reducing the dose
When the cat regularly has its lowest BGs in the normal range of a healthy cat and stays under 100 mg/dl overall for at least one week, attempt to reduce the dose. Alternatively, if the nadir glucose concentration is 40 - <50 mg/dl at least three times on separate days, try lowering the dose. If the cat drops below 40 mg/dl once, reduce the dose immediately!

 

[PeterDevonMocha]

Hi guys .. glad you got your questions answered .. now if munchie would just come down and stay down .. hear that little miss? have a great day guys!

 

[ewest]

Re: 2/22 Munchie AMPS 493 PMPS 374

Thanks All. Well, I was ecstatic that her PMPS was not a red. (and she was happier I could tell with her energy)

I'm not clear with her when her bounce has "cleared" because unfortunately the more I wait, the more she seems to bounce again. I increased tonight and am hoping that was okay. The pink was certainly better than her morning red. **If folks think I should have waited, let me know and if you can share your reasoning so I understand, that would be helpful.** Waiting 6 cycles with her is what I've often done in the past, but unfortunately she just seems to come up with more bounces during that 6 so that leaves me a little more confused about how to judge when a bounce has "cleared". Any insight on this would be great.

(Not having her daytime numbers makes me a little nervous with increasing but we can know pretty much for sure she wasn't sailing in the greens today. Plus I was able to check her urine right when I got home and her glucose was +2 and if she was in even blues for significant period of time, it would be less than that.)

Let's hope she does a gentle descent into better numbers tonight and not a nose dive.

 

[ewest]

So far, so good. +2.5 is 301 from a PMPS of 374...more gradual than last few nights.

 

[Dyana]

I think about 35 points an hour is purfect. Keep it going down nice and easy Munchie.