2/3 Dillan PMPS 151 +2 157 +3 182

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Dillan420

Dillan420

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Hello Everyone,
So I was shocked tonight when Dillan had his PMPS reading of 151, its his lowest number yet. I'm going to go read the Tilly Protocol again, but should I be reducing his Insulin dose because of the number and the fact that I do not get a morning reading (because of my situation, not because I don't want it, and I'm working on it)? Also tomorrow night I plan on changing his food portioning for his diet has even more wet food in it. Therefore if he drops as much as he did the first time he will be boarder line hypo. I know its best to have him right in this range for his pancreas and liver can repair, I don't know if I'm trying to be too cautious here or not. Thanks everyone

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Re: 2/3 Dillan PMPS 151 lowest number yet

Hi Mike,

I hope you can hang on until someone with more knowledge than I have comes along. Although ECID (every cat is different) and 151 is a very good PMPS number, dose changes are generally based on nadir numbers, not on preshot. I see you have a special situation and can't get AMPS. Can you get some (horrors, I know) middle of the night numbers to see where Dillan is going? Like maybe +3 or +5? Others may have a different take on this.
 
Re: 2/3 Dillan PMPS 151 lowest number yet

Hey Mike

well, this is a very nice PMPS number, and hopefully a gentle push in the right direction for that AMPS number before shot.

As u said, the dry is slowly being reduced, and you are about to go a little step further. The morning number is going to be crucial.

I'm not sure about dropping the dose in combination with the dry food elimination process, and with a lot of data missing especially the AM preshot number,
I hope you get some suggestions about that. I know it's a work in progress both for the testing and the dry food and I'm glad you are working on it. Keep going! :thumbup
 
Re: 2/3 Dillan PMPS 151 lowest number yet

I'm going to get a +2 and a +3 and if it follows the same trend as it did 2 nights ago +3 173 up to +4 180 I would think he is following the same trend. I think that its possible that he has a flat curve with an initial dip because of him still being on a partial dry food diet.

At +3 we usually give his food back to him as well so that should level him out until the morning.
 
Re: 2/3 Dillan PMPS 151 lowest number yet

Mike, if you want some advice, ou might change your subject line on your original post to include "Dose advice" or "help" or something similar.
 
Re: 2/3 Dillan PMPS 151 lowest number yet

Hi Mike
Glad to see you posting here with Dillan.
You are in good hands.
Ronnie is looking at your ss, and Lydia had a good recommendation when you need something very specific to edit your first post and out your question there.
 
Re: 2/3 Dillan PMPS 151 *Dose Advice*

Yeah I'll be on the whole time during my tests. I changed my thread title too, to attract some attention.

I wouldn't post any where else everyone at LL has helped me out sooo much words can not describe.
 
Re: 2/3 Dillan PMPS 151 lowest number yet

Mike:

You are getting some really good numbers and the PMPS is trending down. Unfortunately, we don't know about the other half of the cycle. I'm tempted to suggest that you don't make any further changes until you can be around to monitor more closely. Are you able to get AM spot checks over the weekend?
 
Re: 2/3 Dillan PMPS 151 *Dose Advice*

This weekend I will be doing AMPS +3 +6 +9 PMPS +3 +6 (+9 if needed). I know everyone wants info so I need to supply it. The only thing that worries me is that we are not changing anything and his numbers are dropping and thats the only reason why I was wanting a dose reduction. But I will keep his food at what it is until we have more testing.

Should I get a +1 or should I just wait for +2?
 
Re: 2/3 Dillan PMPS 151 *Dose Advice*

well, I'm dying to know what Dillan is doing in the morning, won't lie to ya :-D

if Dillan were my kitty, I would get a +2 tonight.

EDIT to add: and a +3 and a before bedtime check, sorry! :mrgreen:
 
Re: 2/3 Dillan PMPS 151 *Dose Advice*

I will get the +2 and +3 like I said and then we will give him the rest of his food (1 1/2 tablespoons). I do have the morning numbers from last weekend and the one day of testing but I have nothing to confirm that the numbers are right for everyday especially since they were so flat

(+3 will be before bedtime @-) )
 
Re: 2/3 Dillan PMPS 151 *Dose Advice*

Hi Dillan,
I know you don't know me, but I'm hanging out waiting on someone else's numbers so I thought I'd pop in. I see you have some questions and I'd like to give you some food for thought. You have an important criteria here that needs to be incorporated and that is your plan to remove dry food. In this case I would say that a dose reduction would be called for at that time. It will take 2 or more cycles for the last vestiges of the dry food interference to disappear so I would personally say to reduce the day you remove the dry.

If you are worried, and want to reduce your dose in preparation for the dry food drop, please *diligently* test for ketones. Do you have ketostix/ketodiastix? Other than that, you have a little room to play with a dose reduction if it would make you feel more comfortable. I would caution you that if you reduce the dose, please remove the dry just as soon as you can, to give him a little help. :) I like what Sienne had to say and would normally recommend that as well. However, I see you are uncomfortable with the changes you are seeing.

Now a little explanation. Lantus doesn't always work in sensical patterns. Sometimes the lowest numbers are AT the preshots.. especially when the body is well into adjusting to the dose (ie: the shed is almost filled or is filled). Generally, the only time we would make the call to reduce the dose would be a nadir at or below 40. Since your cat's shed is filling or filled, more numbers will be needed such as some +1s and +11s with some +2s and +10s as well. Don't worry about getting them all in the same cycle, just fill in as many holes as you can, as often as you can. Nadir, onset and offset have all yet to be determined at this time, and that information will go a long way towards the future dosing decisions you will make. Confusing now, but it will be clearer as you go along. :)
 
Re: 2/3 Dillan PMPS 151 *Dose Advice*

I tried to pick up some Keto-Stix last weekend but the pharmacy was out I will definitely get some tomorrow though. Right now I am only giving a 1/4 can of wet food (Wellness Chicken Formula) and a 1/4 cup of dry food (Hill's MD). I changed this last Saturday, I wanted to switch it to 1/2 can and then whatever the extra calories of the dry that I need to get to 175 calories which is twice a day.

The only reason why I'm hesitant with the numbers is that they are dropping and we are not doing anything, thats why I think that a dose reduction would be good and I could do it at the same time. I do not want to take away all dry food just because of the change in carbs (13% DRY to 3% WET), Dillan has no problem eating the wet food, I think he thinks its a treat :-D

This weekend like I said I will try and fill some of the blank spots for everyone.
 
Re: 2/3 Dillan PMPS 151 *Dose Advice*

Awesome, and if they don't have the Ketostix brand name, a generic will be just fine. :)

Not sure what is happening with the calorie counting, why are you doing that? The carb change will not shock Dillan's system by dropping them "cold turkey", but I'm confused on the calories. For instance, I feed by the ounce.. ie: healthy cats should get 6-8 ounces a day of wet food.. (stupid question, but is "ounce" a unit of measurement in Canada? Can't believe I'm so stupid I don't know this LOL) I used to be very very very strict with my cats when we first switched to wet food, which is of course very boring, but as time has gone by I've really relaxed. Now I just look at them, and feed them what they look like they need. If they are fat, we back down on the food a little bit. My two younger ones eat about 7-8 ounces a day, and we cut back to 6-7 ounces if they appear to be inflating. My older one is a whole different story. He's got acromegaly so the usual food rules do not apply to him. He eats closer to 12-14oz a day. In the beginning, it was like they all had hollow legs and couldn't get enough food. As they got used to the lack of bulk and the increase in protein, their appetites relaxed and I was able to cut back on the food distribution. If he's got a weight problem, just switching to wet food will start making miracles for you almost immediately. Don't let the calorie thing ruin your life, or make you do unnecessary math. :lol:
 
Re: 2/3 Dillan PMPS 151 *Dose Advice*

Yeah I forget where I read it on here but it said that if you switch you should try and keep the calorie amount the same. Yes we use ounces in Canada I think the cans are around 5.5 ounces. Do you think that I should just switch him cold turkey over to wet food? What do you think I should decrease the dose of insulin to?? I'm just going to go do the +2 test right now brb with the result
 
Re: 2/3 Dillan PMPS 151 +2 157 *Dose Advice*

I'm surprised that the +2 number did not drop out to a low 100. Not too sure what is happening here, but we will see what his numbers are doing at +3.
 
Re: 2/3 Dillan PMPS 151 +2 157 *Dose Advice*

Headed to bed, but wanted to address your last two posts..

First the food. He's already getting some canned right? He's transitioned enough. Most of us actually went cold turkey before we knew a thing about what we were doing. Some of us had some squirty kitties at first as they learned to process the extra protein but generally that is gone in the first week, if it even happens. If you yank that dry food completely, my advice to you will be to drop the dose to 1u the day you pull the dry food. That gives him time to work the carbs out of his system (1-3 days or so, every cat is different). You might lose a little progress, but you can't predict what will happen with no carb influence on his body. Don't worry, you'll get these pretty numbers back very quickly.

My cans are also 5.5oz. I just dole it out by the spoonful, the two younger ones ( 4 and 5, one non-diabetic, one diabetic in remission) get about 1/4-1/3 can 4 times a day. Lots of people use timed feeders, I do not, only because I am home. Initially he may seem hungry often, and that is because the bulk will be gone, the part that is so filling to them. Once his body adjusts to getting protein from much less product, he will settle right down into a more normal food schedule. In other words, if he's hungry, it's ok to give him an extra spoonful. ;-) Use some warm water to "soup" up his food, that should help the "full" feeling a little bit. A ratio of 60%-40% food to water should be nice.

Secondly, your +2 is beautiful! He's just surfing right now and probably feelin' pretty good too. Very nice response! Can't wait to see how he does without the dry food. He may drift down or up through his cycle, but it'll be a casual thing I think. Gotta head to bed, but it was very nice to talk to you and I'll pop by tomorrow and see how he's doing. :smile:
 
Re: 2/3 Dillan PMPS 151 +2 157 *Dose Advice*

Thanks for all of the help Carolyn. I will take another check at +3 to ensure that he is surfing, then I'm going to give him the rest of his food and I'm thinking that I will switch to 1 unit and all wet food tomorrow.

I definitely agree with you about not knowing what he is going to do with his numbers once he switches to all wet. But if the wait time is 1-3 days then I will be able to record the results of the change well over the weekend. Thanks again. :-D
 
So the number is going up just like previous data had said it would, its a little faster but not by much. I think you are right carolyn that he is hitting his nadir later in the time period around +10 or so. I will check it out this weekend by doing all of the testing so it should give us an idea of what is going on.
 
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