2/27 Viamo AMPS=423, +5=199, +6=128 Back in the blue range! Should we hold dose?

Teo

Teo

Member Since 2020
Previous post

So... Today we had Viamo's first nadir under 200! Well, not his first one ever, but he had hit the "blue zone" only once before, and we were not following TR yet.

AMPS was still high as usual. Should we wait more cycles before changing the dose again? This is what is the TR protocol suggests for cats new to the <200 range.

I just hope he does not go to a flat high curve again.
 
I think that holding the dose for 1 or 2 more cycles could be beneficial.

But I'd like some other experienced lantus users to comment on this.
Most of the experienced people are still at work, at their jobs.
Hopefully, you will get another answer later from another person.
 
  • Like
Reactions: Teo
If you're following TR and you haven't seen any greens you can increase after 6 cycles on the same dose. Those mid-cycle blues are nice, but I think Viamo could use a little nudge. If you're able to monitor, I'd increase. Looks like he likes to start and end high...but that happens...preshots are typically the highest of the day...
 
Sue and Luci said:
If you're following TR and you haven't seen any greens you can increase after 6 cycles on the same dose. Those mid-cycle blues are nice, but I think Viamo could use a little nudge. If you're able to monitor, I'd increase. Looks like he likes to start and end high...but that happens...preshots are typically the highest of the day...
Click to expand...

We have already given the seventh injection with this dose (3.5 u) but we could increase tomorrow morning. The increase would be to 3.75, just a quarter unit up.

I wasn't sure about increasing the dose because I had read that it was prudent to wait a bit more when kittens went on the blue range for the first time. This is stated on the documentation about TR as something normal to do.

I know too that his values at the beginning and ending of the cycle still have to get better, but I really wouldn't want to make him bounce just because I rushed.

Anyone else have an opinion?
 
That was quite the bounce tonight! Because you saw lower blues, I would normally suggest holding a couple more cycles, but I think all you would be seeing for those cycles is bounce numbers. Might as well go up to 3.75 units.
 
I never knew how to deal with bounces. Is increasing the dose even useful in that case?
 
It's unlikely that the bounce will resolve and numbers drop back to their usual/better range this cycle. Bounces usually take several cycles too clear.
 
What did you mean by the moment the bounce is "breaking"? This is where it shows I'm not a native speaker ;)

I'm writing here minutes before giving Viamo his morning shot so I should decide now whether to increase. Would that be beneficial for his bouncing cyclces? He had 451 at AMPS, not that bad at least for now.
 
Good morning, Teo.

Both Wendy and Sienne meant that you should have increased the dose this morning to 3.75U.
It's ok that you did not.
You should increase the dose to 3.75U for this evening, the PMPS insulin dose.

Wendy and Sienne would be much better at explaining what they mean by "when the bounce is breaking" than I could explain it.

They can tell you what to look for, what signs in the BG (blood glucose) numbers to watch for, to know when a bounce is getting ready to clear.
This is when using colloquial speech is an issue for people who do not understand English quite as well.
This is when using some of our standard terms is not enough.
This is a situation when we have to explain more clearly what we mean.
So here is my attempt to provide you with some examples of what to look for when the "bounce is breaking".

I've tried to give you some comments and provide example spreadsheets for you to look at.
By providing some examples, I hope this helps you to see some of the patterns to look for to tell when a bounce is clearing.

Wendy said "Bounce breaking cycles often have later nadirs." Look at Moe's spreadsheet for 02/26/2020
Moe's Spreadsheet

Wendy made this comment on Cassandra & Garfield's post a couple of days ago.
"He's breaking a bounce. Those cycles can have some downward momentum." Meaning a cats BG can be lower at the end of a cycle, a couple of hours before the pre-shot. If Cassandra had not tested at +10, later in the cycle, she would not have known the BG (blood glucose) levels were still decreasing, dropping that late in the cycle.
Look at Garfield's spreadsheet for the date 24/02/2020. Garfield’s Spreadsheet

Look at Zhoom Boy's spreadsheet on 2/22/2020 Zhoom Boy Spread Sheet
He was breaking a bounce during the AM cycle that day. The trend or direction of the blood glucose (BG) numbers was down, down, down during the cycle.
You can see how Zhoom Boy's BG levels started out pink at the pre-shot test, dropped to the yellow range, kept dropping into the blue range shaded numbers, then down into the green range shaded numbers.

Those are 3 recent examples of spreadsheets I could find to have you look at.
They show you the pattern to look for when a bounce is breaking.
When a bounce is breaking, it does not have to be those specific range shaded numbers, pink, to yellow, to blue, to green.

What you are doing is trying to see the pattern or direction of the blood glucose levels.
You are looking for the downward trend in the BG levels.
Does that help you to understand more Teo and Ana?

@Wendy&Neko
@Sienne and Gabby (GA)
 
From the New to the Group Sticky Note, this is the definition of a bounce:
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

Breaking a bounce means that the glucogon, glycogen and counter-regulatory hormones (all sugars) that were dumped in the blood stream are cleared out (go away). The cat's body no longer sees the situation as an emergency.
 
You must log in or register to reply here.
Back
Top