23Feb2020/Maxi/AMPS(417) With Increased Dose/What Does This Mean?

Bellasmom said:
It means patience, let Maxis body get adjusted to the increase and see what happens, new dose wonkiness happens sometimes
Have a great day
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Thank you, Bellasmom.

But is 417 --after a week of 300s and 400s and now with the insulin increase yesterday to 2.75-- OK?

How long does adjustment take?
 
With a new dose, it could take up to 6 cycles before you start seeing the effects of the new dose. Blaze sometimes takes up to 10 cycles!:rolleyes: These cats! Give Maxi a few days on the new dose.
 
Sarah and Blaze said:
With a new dose, it could take up to 6 cycles before you start seeing the effects of the new dose. Blaze sometimes takes up to 10 cycles!:rolleyes: These cats! Give Maxi a few days on the new dose.
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Thank you, Sarah.

10 cycles? But aren't I supposed to increase the dose if his glucose is still too high after 6 cycles?
 
Bellasmom, I read this (http://www.felinediabetes.com/FDMB/threads/new-dose-wonkiness-ndw-and-failed-reductions.46012/) and I do see an explanation of Maxi's high number this morning.

I'm repeatedly told to be patient, then I calm down and remain patient, then I lose patience again...
Now I'm worried about having to keep increasing the dose. How much insulin do other kitties get? I mean how high a dose could he get to before the insulin works? It is possible that insulin just won't work for Maxi?
I just wish the medicine (insulin) would work already and normalize his glucose level so his body doesn't continue to be ravaged by high glucose.

Thank you!
 
could be a combination of NDW and a bounce from the blues you saw day before yesterday. keep increasing his dose as per the protocol:

Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
Since you are beginning to see nadirs under 200, you might want to hold the 2.75 for 5 days and see where it takes you. The first few cycles may go off in NDW and clearing the bounce. it might be day 3 or 4 before you really start seeing what this dose does for Maxi.
 
bambinaki said:
Bellasmom, I read this (http://www.felinediabetes.com/FDMB/threads/new-dose-wonkiness-ndw-and-failed-reductions.46012/) and I do see an explanation of Maxi's high number this morning.

I'm repeatedly told to be patient, then I calm down and remain patient, then I lose patience again...
Now I'm worried about having to keep increasing the dose. How much insulin do other kitties get? I mean how high a dose could he get to before the insulin works? It is possible that insulin just won't work for Maxi?
I just wish the medicine (insulin) would work already and normalize his glucose level so his body doesn't continue to be ravaged by high glucose.

Thank you!
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It is working....you had a stretch of blues the other day. It just happens and we sort of know that it does....no one likes weird numbers but your cat's body hasn't been doing what it should have been in regards to insulin for a bit. You are helping his system with the injections but every now and then it seem like their emergency system sort of kicks in - almost like a just in case and can raise numbers it seems.
In time, that overreaction in his body calms down as his numbers stabilize to the point where there is nothing close even to even almost activate the silly emergency system ( his liver will chill out).

Breathe, lather, rinse and repeat
 
"In time, that overreaction in his body calms down as his numbers stabilize..."

How much time? Can you give me a range? Best and worst case?
 
bambinaki said:
But Blaze's glucose numbers aren't high...?
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Not anymore, but if you take a look at his SS from 2019, his BG’s used to be high. He was constantly in reds, pinks and yellows and he would bounce like crazy any time his BG was lower than normal. That’s why I would hold new doses for 5 days (10 cycles) when we would either increase or decrease, because he was almost anyways bouncing for a few days after lower BG’s. Then after a few days, he would clear the bounce and start coming back down and THEN I would finally see the affects of the new dose. If after 5 days, he wasn’t coming back down and having nadirs under 150, then we would go back up to the last dose. His 2019 SS and his 2020 SS are totally different. We’ve been doing this for 6 months now and Blaze stopped the big bouncing around the beginning of January. We spent a lot of time in higher numbers with lots of bouncing and then something finally clicked with him and now we’re getting blue and green BG’s, but we definitely didn’t start like this. It took time and patience.
 
bambinaki said:
"In time, that overreaction in his body calms down as his numbers stabilize..."

How much time? Can you give me a range? Best and worst case?
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Every cat is different. Some stop the bouncing right away and some keep bouncing for a long time. People would tell me, they keep bouncing until they don’t. There’s no range of time, because every cat is so different. You just have to keep doing what you’re doing, and you’re doing awesome! You just have to be patient.
 
Question:

I was going to (if needed, per TR protocol) increase Maxi's dose after 6 cycles from 2.75 to 3 this coming Wednesday morning. Based on the above, maybe I should give it 10 cycles? But after 10 cycles, it will be Friday morning, and I have to leave town Friday morning through Saturday evening. I don't want my roommate, who will take care of Maxi while I'm gone, to do the dose increase.

Given the options of increasing after 6 cycles or after 13 cycles, should I wait 13 cycles and let the insulin settle (good) while also maybe letting his glucose numbers go too high more days (bad), or should I increase after 6 cycles?

(I don't want to increase after 7, 8, or 9 cycles because I want to monitor Maxi the days after the increase and I won't be able to monitor well at that time.)

Thank you
 
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Sarah and Blaze said:
Not anymore, but if you take a look at his SS from 2019, his BG’s used to be high. He was constantly in reds, pinks and yellows and he would bounce like crazy any time his BG was lower than normal. That’s why I would hold new doses for 5 days (10 cycles) when we would either increase or decrease, because he was almost anyways bouncing for a few days after lower BG’s. Then after a few days, he would clear the bounce and start coming back down and THEN I would finally see the affects of the new dose. If after 5 days, he wasn’t coming back down and having nadirs under 150, then we would go back up to the last dose. His 2019 SS and his 2020 SS are totally different. We’ve been doing this for 6 months now and Blaze stopped the big bouncing around the beginning of January. We spent a lot of time in higher numbers with lots of bouncing and then something finally clicked with him and now we’re getting blue and green BG’s, but we definitely didn’t start like this. It took time and patience.
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Thanks, Sarah. I'm glad Blaze is doing well now.
 
bambinaki said:
"In time, that overreaction in his body calms down as his numbers stabilize..."

How much time? Can you give me a range? Best and worst case?
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We had a strech of beautiful blues in the beginning of the year, had a vacation/ illness set back , got some glucose toxicity and now he's in the 300s again if you look at my SS.

I'd love a timeline but it honestly just depends on the cat. Being on TR and adjusting your doses as needed in the timeline will help ,but wonky numbers just happen.
 
bambinaki said:
Given the options of increasing after 6 cycles or after 13 cycles, should I wait 13 cycles and let the insulin settle (good) while also maybe letting his glucose numbers go too high more days (bad), or should I increase after 6 cycles?
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OK, first, I would have held the 2.5 a few more cycles....when you first start seeing blue (like you did on 2/21) you want to hold it for a total of 8-10 cycles.

Now that you're already up to 2.75, you could go ahead and hold it for a few more cycles and then see what kind of numbers you're getting. By Friday, we should have a pretty good idea of what to do while you're out of town
 
bambinaki said:
Now I'm worried about having to keep increasing the dose. How much insulin do other kitties get? I mean how high a dose could he get to before the insulin works? It is possible that insulin just won't work for Maxi?
I just wish the medicine (insulin) would work already and normalize his glucose level so his body doesn't continue to be ravaged by high glucose.
Click to expand...
First, a cat needs however much insulin they need, be it 0.1 units or 80+ units for some of the high doses. That latter is unusual, but I have seen it a couple times. And no, I don’t think Maxi is in that category, just using it as an example of cats needing what they need. Second, insulin is a hormone, not a conventional medicine. You don’t give a little more and see little better numbers. You keep increasing until you see a fitting dose. Patience is key.

Post and ask about petsitter dose a couple days before you leave, things can change over time.
 
Chris & China (GA) said:
OK, first, I would have held the 2.5 a few more cycles....when you first start seeing blue (like you did on 2/21) you want to hold it for a total of 8-10 cycles.

Now that you're already up to 2.75, you could go ahead and hold it for a few more cycles and then see what kind of numbers you're getting. By Friday, we should have a pretty good idea of what to do while you're out of town
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Thanks, Chris.
I wish I had known that. I didn't think that 2.5 might be the right dose for him since it wasn't working after 6 cycles. I didn't realize that about the blue.
I don't feel comfortable increasing the dose right before I leave town or while I'm out of town. (I'll be gone only 1 night - 2 days.)
 
Wendy&Neko said:
First, a cat needs however much insulin they need, be it 0.1 units or 80+ units for some of the high doses. That latter is unusual, but I have seen it a couple times. And no, I don’t think Maxi is in that category, just using it as an example of cats needing what they need. Second, insulin is a hormone, not a conventional medicine. You don’t give a little more and see little better numbers. You keep increasing until you see a fitting dose. Patience is key.

Post and ask about petsitter dose a couple days before you leave, things can change over time.
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Thanks, Wendy.

80 units for a little kitty?!
 
OK....so far he's had 3 cycles at 2.75....tonight's would be 4 and tomorrow (Mon) would be 5th and 6th.....If you aren't seeing blue by Tuesday morning, you could go up to 3U for Tues AM/PM, Wed AM/PM, Thurs AM......and then on Thursday, ask about what to do about the dose for your trip.

Make sense?
 
Chris & China (GA) said:
OK....so far he's had 3 cycles at 2.75....tonight's would be 4 and tomorrow (Mon) would be 5th and 6th.....If you aren't seeing blue by Tuesday morning, you could go up to 3U for Tues AM/PM, Wed AM/PM, Thurs AM......and then on Thursday, ask about what to do about the dose for your trip.

Make sense?
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Thanks, Chris.

Yes, makes sense. I miscalculated earlier about when the 6 cycles will be over. But I don't feel comfortable increasing to 3 units Tuesday morning because I'll be away from home most of that day and into the night, just before his PM test and shot. So, if there's no blue between now and Tuesday night or Wednesday morning (depends on how badly I need to sleep Tuesday night), I'll increase to 3 units at that time.

Thanks again.
 
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