29/10 Remi PMPS 88, +1 101, +2 95, +4 99

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phlika29

phlika29

Member Since 2014
Morning

Remi is VERY vocal this morning :-D causing a right racket which is what I love. He also moaned last night for us to come to bed which he hasn't done for quite a while :-D

Hopefully today will be much like the last couple and we get a run of greens :mrgreen:

Thanks everyone for all of your help and support over the last few weeks.

Sarah
 
Re: 29/10 Remi AMPS 103, +1 88, +2 70

So i mucked up slightly on the feeding this morning. he had his usual 20g at AM shot time, then I saw he had dropped quite quickly at +1 and so put down some more. He just licked all the sauce stuff and had a nibble. But that meant he wasn't hungry at +2 and so refused to eat what I would normally give him (20g). So instead I just gave him a small handful of his normal low carb treat-freeze dried chicken (which he loved). So now he is out of sync and I don't know if I have given too little or too much to prevent him from dropping below 50.

My partner is at home until +6 so will continue to monitor, just not sure how interestedd remi will be in his food.
 
Re: 29/10 Remi AMPS 103, +1 88, +2 70,+4 77

So those snacks bought him up slightly at +4 he is 77. He is now eating his normal 20g wet and my partner will retest at +6.
 
Re: 29/10 Remi AMPS 103, +1 88, +2 70,+4 77

looks like he's surfing along very nicely today! What a lovely change in his spreadsheet from last week. You're on day 4 of no yellow BGs.

I don't think you need to try to keep him from going below 50 at this point. That's for cats that are on a pretty good dose and getting good nadirs, but still have some higher numbers in the cycle. Remi looks like he's going to need a dose decrease before long, so just let him tell you when that needs to happen by him going below 50. You'll be able to steer him and pull him back up safely.
 
Re: 29/10 Remi AMPS 103, +1 88, +2 70,+4 77

Thanks Julie. I agree the new colours are great :)

I think what worries me is that if I let him go below 50 I will have to give him some high carb food (plan to give him his normal treat with a drop of honey). But what will happen then? I am worried about him bouncing really high and upsetting his good run and then it not resettling again. I know you only give a couple of treats so perhaps it won't affect it too badly but it's just fear of the unknown I guess. I think if I hadn't have given him food early in the cycle today he might have gone below 50.

In theory if he goes below 50 do you give a dose decrease at the next shot of if he is bouncing do you wait for that to clear?
 
Re: 29/10 Remi AMPS 103, +1 88, +2 70,+4 77

when he goes below 50, you just need to give a couple of drops of karo/honey/pancake syrup to pull him up, or about 1 teaspoon of the gravy from a can of high carb cat food.

it will bump him up a few points, but that will only last for a short time. It won't cause high numbers in the same way a bounce does. In fact, it would be good for you to learn how many points a treat with a drop of honey will raise him. Bounces are caused by a cat getting into normal numbers when they aren't used to them - Remi is likely done bouncing because his body is accepting normal numbers as normal. Cats can lose that "familiarity" and begin bouncing again, but at the moment, there's no reason to think that Remi would bounce, although if he gets into the 30's he might because that's what the liver is designed to do to save him.

The risk of tinkering with his nadirs to prevent him from going below 50 is that he may become overdosed. The dose that was just right now will become too large as his pancreas heals and begins sputtering insulin out too. So you want to let him go below 50, do the "low numbers dance" which means to give him enough carbs to get him over 50 again, then retest in 20ish minutes to see if he's there.

I think in Remi's case, I would take the dose reduction at the next shot. As I said above, I doubt that he's going to bounce at this phase. I wouldn't decrease his dose tonight just because he might have gone below 50 today. He didn't, and it wasn't like you worked hard, giving him lots of carbs, to keep him above 50. You didn't, did you? Just a little food? As long as that's all you did, go ahead and feed him during his cycles as normal with regular low carb food, and if he goes below 50, refer to the Handling Low Numbers sticky for the official recommendations on how to handle him. Then reduce his dose by 0.25u with the next shot. He may just gently work himself off of insulin. Wouldn't that be fantastic?!
 
Re: 29/10 Remi AMPS 103, +1 88, +2 70,+4 77

Julie

Thankyou so much to take the time to explain that so clearly. I feel I understand so much better now and so slightly more confident. Tonight he was even lower at pre dose: 88

Yes you are right so far I have just been feeding remi his normal low carb food but just at slightly different times and amounts than before. From tonight I am just going to try to go back to feeding him as I normally would and if he goes low just deal with it as you said. I certainly don't want him overdosing. My plan is not gravy as he has a sensitive tummy but just a drop of honey on his treat.

When he does go low I will reduce him down to 1 unit. On that point I am still amazed how much my bd micro syringes vary in their markings. I always double check with a metal ruler and the syringe tonight was way out. I didn't quite trust just doing it with the ruler and so started again with another syringe but even so the lines never line up.

I would love it if he could come off the insulin :-D . Tonight he gave me another indicator that he is feeling better, his obsession with plastic bags suddenly reappeared. He spotted the plastic bag with the syringes in and did the best he could to get to them. Nice to see but if he gets to chew on one they are terrible for his asthma

Many thanks

Sarah
 
Re: 29/10 Remi PMPS 88

the inconsistencies of syringe markings is a huge problem. That's why many people use calipers, but that's essentially the same as your metal ruler. If that works, awesome! the main thing is to be as consistent as possible in dosing.
 
Re: 29/10 Remi PMPS 88

Hi Sarah.

Remi is looking wonderful. It's great to hear about old behaviors returning as he starts to feel better. I know it makes you happy, too! :-D
 
Re: 29/10 Remi PMPS 88

I have ordered the calipers but they are taking an age to arrive. So in the meantime I use the ruler but I have to say that I can never believe that the syringe is that far out and so often sort of hedge the dose between the ruler and the syringe. Sometimes I think It would be easier if the syringe had no markings at all!
 
Re: 29/10 Remi PMPS 88

Tricia & Cinco said:
Hi Sarah.

Remi is looking wonderful. It's great to hear about old behaviors returning as he starts to feel better. I know it makes you happy, too! :-D
Click to expand...

Thanks Tricia. I don't want to get my hopes up too much and so I feel cautiously optimistic that remi is making good progress :lol: . When he had pancreatitis it was one step forward and two steps back. In the end I refused to discuss improvements to my work colleagues as whenever I did we seemed to have a set back but it is great to share this small steps with people on the forum.

Remi has a big character, that I love. He demands a lot of attention and I am seeing glimpses of this again. When he is is on form I can hear his meows right down the end of my 100ft garden, usually because we have dared leave him alone for five minutes.
 
Re: 29/10 Remi PMPS 88

I suspect your markings ARE that far off. Marje did a little test and found that the syringes might be as much as 0.5u off from one to another. Even if you just pull out 5 from your box and compare them, you'll probably find that they are not the same.

I never used calipers - they weren't used on FDMB when I started and i never switched, but i see that they work well for many people. The inaccuracies of the syringes are talked about in the latest PDF and the author points out that people on the German Katzen forum make paper "rulers" showing the different doses, then use those for a comparison instead of calipers. I suspect your metal ruler is better than believing the syringe markings.
 
Re: 29/10 Remi PMPS 88

Amazing that something that is meant to be accurate can be so off :shock: I have tried printing out the paper ruler for the bd micro syringes but can quite get it to work out for me. I think I will stick to the metal ruler and trust it more now we have had this discussion.
 
Re: 29/10 Remi PMPS 88, +1 100

Looking great Remi. :mrgreen: I love that he hollered for you to get into bed last night. :-D Besides going below 50, the other way a cat can earn a .25U reduction is to spend 14 cycles in normal numbers. From the protocol:
Reducing the dose:

If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. See additional notes in the next paragraph about drops into the 20s and 30s. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
Click to expand...
Hard to say at this point which way Remi will choose, and he might choose one method one time and the other at a different dose.

I too have to use the BD syringes and now that I'm using calipers, I find the markers are out as much as 1/3 of a unit. :roll: The ruler sounds like a great way to handle the differences.
 
:-D Wendy. Yes he is very bossy. At a certain time in the evening he will get up and go and sit at the top of the stairs calling for us to come to bed. When he used to live with his sister (they had a terrible falling out and after six months of trying to help them work it out she went to live with my mum) you could hear him tell her off outside the bedroom door if she made too much noise.

I have a feeling that if I had stuck rigidly to the metal ruler we might have seen some readings under 50. I just couldn't get my head around the markings being that far out but from now on going to trust the ruler more. Now I could kick myself as I do think my dose has varied. I have to say with regard the dose reduction my preference would be for the 14 cycle reduction :-D is that when he stays between 120 and 50 the whole cycle ?

Many thanks

Sarah
 
what a character!

yes, that's when a cat spends 7 days (14 cycles) on the same dose, between 50-120. Then you try to reduce the dose by 0.25u and see if the green numbers hold. It's a nice easy way to reduce. Some cats do it that way, some drop under 50. I suppose they're showing their personalities! The mellow non-dramatic, or the reductions with drama and flair. :lol:
 
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