? 24/4/2020/Nell/is bouncing over? Time to increase dose?

N

Nell

Member Since 2020
Please could someone help me with Nell’s dose moving forward.
I was planning to follow TR particularly as she is wearing a Libre CGM and I am at home a lot but she started “bouncing” although it seems, unless it’s my imagination, yesterday and today there seems to be a bit less yo-yoing? Is it safe/a good move to increase her dose, starting in the morning, and by how much would likely be optimal?
 
Hi Ruth
I would hold the dose longer. you are seeing some greens and quite a few lower blues and the TR says that if your cat to new to numbers under 200, it is recommended to hold the dose for at least 8. -10 cycles before increasing. And also says . .. when your cat starts to see nadirs under 100 hold the dose for at least 10 cycles before increasing.

She will probably come down to blues again soon when she comes off the bounce.
 
Hi Bron,
Thank you for your help. Her numbers since her 6pm dose have dropped substantially and quickly - what a merry-go-round it’s so unpredictable... i definitely won’t increase her dose tomorrow.
 
Hi Bron,
Sorry to trouble you again but when would I consider increasing the dose? She didn’t drop as low as I feared she might last night but should I be concerned about her getting up to the 300’s and spending most of the day in the 200’s? She has been on this dose for 5 and a half days (11 cycles?) - do you count the 10 cycles from the start of the dose or the last nadir under 100?
 
Hi Ruth, I would start counting the cycles From when you started seeing the green on pm cycle 21/4.
I would hold it for 10 cycles as you are seeing some green nadirs. So you are up to cycle 8 now so you could increase tomorrow night if she doesn’t start showing you more greens.
At the moment Nell is bouncing from the lower numbers.....if you look over the last 6 days you will see after she drops into blue and green numbers she bounces up into yellow and pink numbers. But you are lucky....she only bounces for a couple of cycles.....some cats bounce for 6 cycles.
They often go up higher at the end of a bounce before they drop down so you may see lower numbers tonight.
 
Thanks Bron - I’ll probably check in with you again tomorrow if you don’t mind. I’m terrified of doing something awful to her. I’m not getting any real help from the vet unfortunately. She was very keen for me to email her the Libre’s results on Friday but then didn’t get back to me so I can’t thank you enough for being there.
 
Nell said:
Thanks Bron - I’ll probably check in with you again tomorrow if you don’t mind. I’m terrified of doing something awful to her. I’m not getting any real help from the vet unfortunately. She was very keen for me to email her the Libre’s results on Friday but then didn’t get back to me so I can’t thank you enough for being there.
Click to expand...
Absolutely no problem at all. I’m here most days in our afternoon / evening. If you are stuck and no one is around, you can PM me and it will show up on my phone and I can come online.
It constantly amazes me how casual some vets are with FD.
I’m just glad you found us and we can help you.
Would love to see a photo of Nell. You can upload one into the avatar.
 
Thanks again Bron. I am really thankful to have found the group and the help for my special girl. I keep hearing from the vets “ah well she is sixteen...” but that’s just so defeatist... she deserves better than that! I’ll see what I can do about a photo.
 
Nell said:
Thanks again Bron. I am really thankful to have found the group and the help for my special girl. I keep hearing from the vets “ah well she is sixteen...” but that’s just so defeatist... she deserves better than that! I’ll see what I can do about a photo.
Click to expand...
That makes me really mad. I don’t know why they bothered to become vets if that is their attitude. We have lots of cats here that are older than 16 and they all do pretty well. It is not diabetes that is the cause of their ultimate demise. I would struggle to think of one cat that’s death was caused by diabetes. If the diabetes was not being treated properly other issues can arise that can make them very ill, but if you are doing what you are doing now there is no reason to think Nell will not go on as before. Nell is actually doing really well for a newly diagnosed cat. Many cats don’t respond to the insulin as quickly.
 
Hi Ruth, are you new to the group? If so, WELCOME! If not, well that's maybe because I work a lot and have missed out on your first few posts!

If you post again today or soon, please set your title up like this 4/25 Nell AMPS#338 - it really helps us all keep track of when what was posted by whom...and if you could copy and paste the url from your last post into your new one - that way people like me:rolleyes: will know what was said previously...

Thanks so much and WELCOME!:bighug:
 
Sue and Luci said:
Hi Ruth, are you new to the group? If so, WELCOME! If not, well that's maybe because I work a lot and have missed out on your first few posts!

If you post again today or soon, please set your title up like this 4/25 Nell AMPS#338 - it really helps us all keep track of when what was posted by whom...and if you could copy and paste the url from your last post into your new one - that way people like me:rolleyes: will know what was said previously...

Thanks so much and WELCOME!:bighug:
Click to expand...

Apologies Sue - I typed the date in without thinking. I’m from Australia and we write our date differently to the US!
Thank you for the Welcome - I am relatively new (only one previous post) and still finding my way around, albeit it slowly. I will try and copy and paste my previous post in (I’m not great with technology!)
 
Bron and Sheba (GA) said:
Hi Ruth, I would start counting the cycles From when you started seeing the green on pm cycle 21/4.
I would hold it for 10 cycles as you are seeing some green nadirs. So you are up to cycle 8 now so you could increase tomorrow night if she doesn’t start showing you more greens.
At the moment Nell is bouncing from the lower numbers.....if you look over the last 6 days you will see after she drops into blue and green numbers she bounces up into yellow and pink numbers. But you are lucky....she only bounces for a couple of cycles.....some cats bounce for 6 cycles.
They often go up higher at the end of a bounce before they drop down so you may see lower numbers tonight.
Click to expand...

Hi Bron,
Just wanted to pick your brains again... Nell had relatively high numbers last night and first thing this morning - they started to drop late morning, so, I wondered if instead of tonight, should I increase the dose tomorrow morning? If she goes low is she likely to go in the cycle of the increase or the next cycle do you think? I want to be as alert as possible just in case!
 
Good question and great you can see she is dropping down and coming off the bounce.
I would not increase tonight but wait and see what she does. She might drop lower tonight.

Every cat is different (ECID) so it’s hard to say when she might react to the change in dose. Some cats react immediately and others don’t. Others react as the depot fills with the new dose adjustment. That’s why collecting data is so important and you get to know your cats reactions.you may not need to increase tomorrow
.
 
Bron and Sheba (GA) said:
Good question and great you can see she is dropping down and coming off the bounce.
I would not increase tonight but wait and see what she does. She might drop lower tonight.

Every cat is different (ECID) so it’s hard to say when she might react to the change in dose. Some cats react immediately and others don’t. Others react as the depot fills with the new dose adjustment. That’s why collecting data is so important and you get to know your cats reactions.you may not need to increase tomorrow
.
Click to expand...

OK thanks Bron and thank you for such a quick response! I won’t increase tonight - I’ll see what happens overnight. Only trouble is I don’t know what I’m looking at re the patterns!
 
Nell said:
OK thanks Bron and thank you for such a quick response! I won’t increase tonight - I’ll see what happens overnight. Only trouble is I don’t know what I’m looking at re the patterns!
Click to expand...
Looking at her SS it looks like she is coming off the bounce. She may well drop further before PMPS. Hopefully She will then not take fright and bounce again but drop lower into low blues and hopefully a green. If she does that (drops to a green) you would not increase the dose.

If she goes back up into yellows and pinks you know she is bouncing again. But the good thing is her bounces don’t last long.
 
Thanks again Bron. I hope I haven’t stuffed up - she was coming up slightly pre dose and got to 10.6 (about 190) and I went ahead with the shot without thinking... I hope I won’t cause any problems shooting under 200 - I’m a nervous wreck.
 
Bron she’s dropped to 8.8 (158) within half an hour of the shot - should I be worried?
 
Bron and Sheba (GA) said:
Looking at her SS it looks like she is coming off the bounce. She may well drop further before PMPS. Hopefully She will then not take fright and bounce again but drop lower into low blues and hopefully a green. If she does that (drops to a green) you would not increase the dose.

If she goes back up into yellows and pinks you know she is bouncing again. But the good thing is her bounces don’t last long.
Click to expand...

This is all such a worry.
 
Nell said:
Bron she’s dropped to 8.8 (158) within half an hour of the shot - should I be worried?
Click to expand...
Nell said:
Thanks again Bron. I hope I haven’t stuffed up - she was coming up slightly pre dose and got to 10.6 (about 190) and I went ahead with the shot without thinking... I hope I won’t cause any problems shooting under 200 - I’m a nervous wreck.
Click to expand...
No you haven’t stuffed up. She is just dropping lower and faster because she is coming off the bounce.
Did she eat well?
The onset of the insulin will not be until+2 so she is ok.
I will be around for several hours yet and will keep an eye on you.
Just get another test in an hour to see how she’s going down let me know.
Do you have some high carb food if needed?
 
Thanks Bron - she did eat her usual amount and I’ve just scanned her again and her reading is 11.2 (201) now (an hour and twenty minutes since her shot and about 50 minutes since the 8.8 (158) reading). I do have some high carb food on hand in case. I never thought I’d be glad to see 11.2 - you need nerves of steel for this! I’ll update the SS and post the numbers/direction of things as the insulin kicks in. Again, I can’t thank you enough.
 
Nell said:
Thanks Bron - she did eat her usual amount and I’ve just scanned her again and her reading is 11.2 (201) now (an hour and twenty minutes since her shot and about 50 minutes since the 8.8 (158) reading). I do have some high carb food on hand in case. I never thought I’d be glad to see 11.2 - you need nerves of steel for this! I’ll update the SS and post the numbers/direction of things as the insulin kicks in. Again, I can’t thank you enough.
Click to expand...
You are very welcome. I remember the first time Sheba dropped low(pre forum days) she was down at 3.2 and I couldn’t get her to come up higher. It was 1 am and I woke my husband to drive me to the ER and my daughter to move her car out of the driveway....then Sheba decided she would come up a bit. But I had given her so much honey and dry food ( horror but didn’t know any better) that she was sick the entire next day from too many carbs. and the first time I got a lower than normal preshot....it was 9.2.....I had people to dinner and all I could think about was what to do with Sheba....again pre forum days.It was so hard trying to make conversation when all I could think of was what am I going to do!
 
Hi Bron - yes thank you for waiting. I’ve just scanned again and updated the SS - she was 10.7 just going into the +4 mark. I’ve scanned in between the hour points and since the 9.5 about 50 minutes post-shot she seems to be going up and down a little between 10.5 and 11.2. At this stage everything seems to be OK touch wood! Nothing like your 3.2 scare ... yet. I’ll stay up a bit longer to make sure she’s OK - she often seems to go into her lowest #s at the +6 to +8 point.
 
Hi Bron - yes thank you for waiting. I’ve just scanned again and updated the SS - she was 10.7 just going into the +4 mark. I’ve scanned in between the hour points and since the 9.5 about 50 minutes post-shot she seems to be going up and down a little between 10.5 and 11.2. At this stage everything seems to be OK touch wood! Nothing like your 3.2 scare ... yet. I’ll stay up a bit longer to make sure she’s OK - she often seems to go into her lowest #s at the +6 to +8 point.
 
Nell said:
Hi Bron - yes thank you for waiting. I’ve just scanned again and updated the SS - she was 10.7 just going into the +4 mark. I’ve scanned in between the hour points and since the 9.5 about 50 minutes post-shot she seems to be going up and down a little between 10.5 and 11.2. At this stage everything seems to be OK touch wood! Nothing like your 3.2 scare ... yet. I’ll stay up a bit longer to make sure she’s OK - she often seems to go into her lowest #s at the +6 to +8 point.
Click to expand...
Having a flat curve so far. And two cycles in a row in Blue. That’s a first.
 
Yes, she hasn’t yet shown blues in one cycle following into another. Let’s keep our fingers crossed! Hopefully I was needlessly worried sick - it wouldn’t be the first time!
 
Nell said:
Yes, she hasn’t yet shown blues in one cycle following into another. Let’s keep our fingers crossed! Hopefully I was needlessly worried sick - it wouldn’t be the first time!
Click to expand...
What are you actually worried about?
If you are testing you are in control and you have the tools to bring the BG up....food and if necessary honey.
 
Bron and Sheba (GA) said:
What are you actually worried about?
If you are testing you are in control and you have the tools to bring the BG up....food and if necessary honey.
Click to expand...
You’re absolutely right! I think it’s got a lot to do with self-confidence. I’ve just scanned her again (at +5) and she’s 12.2 - so much for the blues!
 
I hope so! Thanks again for your support - I think it might be safe to head off to bed - I’ll do another scan for piece of mind before I go but I’m sure she’ll be fine.
 
She basically went from the low/mid teens to high teens and is now at 18.6 pre-shot do I increase a touch?
 
Bron and Sheba (GA) said:
Sorry no one got back to you Ruth
Good move increasing the dose. I think you waited long enough to see if she would coming down further.
Click to expand...
Thanks Bron. She is down from a pre-dose 18.6 to 13.1 at +3. It really was such a tiny bit more insulin - from a fat 1U to what I think is 1.25U. I wish I had those syringes with the helpful dose markings on them. Why on earth can’t we get them in Australia? I wonder if anywhere in the US would ship them here...
 
You must log in or register to reply here.
Back
Top