? 3.10.2017 TiTi bouncing hi-yellow

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I think I would ride this out and see what she does today. If you have to keep changing the dose like that, you're not going to get any idea where she is. Unless one of the high dose people says otherwise, I'd suggest you give this dose a chance for a couple of days and see what it will do.
 
I think I would ride this out and see what she does today. If you have to keep changing the dose like that, you're not going to get any idea where she is. Unless one of the high dose people says otherwise, I'd suggest you give this dose a chance for a couple of days and see what it will do.

But I only reduced it to 10U instead of 10.5 (the earned reduction), as a tiny compromise to a 2unit reduction. I was hoping that, small tho' it be, it would help drain the depot.
I never meant to stay there.
 
Today I think you are saved by the bounce. If you ever want to drain the depot, you should try at least 1/3 off of the dose. So for an 11.5 unit dose, that would be something like 8-8.5 units. I would go up to 10.5 tonight.
 
I only gave her 10Units this morning to try and further drain the depot
I wouldn't call that much of a depot draining dose. I strongly suspect last night's 10u dose was still being influenced by the 11.5u previous doses. Going from 11.5u down to 10u is only a 13% reduction which isn't a big reduction. I do 25-33% one time reductions to drain the depot a bit, and some do closer to 50%. I would consider sticking with the 10u for a few cycles and see how she does. Of course, until the bounce clears, we don't really know where she will end up. As it gets closer to shot time, we can see where her numbers are, but Lev and Lantus crave consistency so I would try to stick with a consistent dose for a few cycles unless she dips low again. How fast does TiTi usually clear her bounces?


That's true, but with a depot that large, I think it would take a while to drain.
That is what I have been taught from the veteran high-dosers when dealing with a high dose cat. This is where the depot draining bcs becomes a handy tool to help let the depot adjust quicker, especially when the kitty decides to take a few back to back reductions and the bean is tired from multiple late night PJ parties.
 
Today I think you are saved by the bounce. If you ever want to drain the depot, you should try at least 1/3 off of the dose. So for an 11.5 unit dose, that would be something like 8-8.5 units. I would go up to 10.5 tonight.

I think it's time for me to clarify just how clueless I am about some of this. Sure I understand a lot, but I don't understand a lot, too.

  1. How do I know that the low BG numbers are caused by the depot vs too high an insulin dose? This time everyone told me the depot was too full, but I'd like to be able to figure it out for myself.
  2. And , by the way, how did the bounce save TiTi from going into the 20s again?
  3. So back to the 10.5 this PMPS. At least that I figured out correctly.
  4. Here's what I didn't understand about bouncing. I thought there'd only be 1 bounce - all the way up, and then all the way down, and then back to normal. Dunno why I visualized that, since most bounces (ping pong balls etc) bounce thru' quite a few ups and downs.:rolleyes:
 
How do I know that the low BG numbers are caused by the depot vs too high an insulin dose? This time everyone told me the depot was too full, but I'd like to be able to figure it out for myself.
If you take a reduction, then the next 6 cycles can be influenced by the depot of the larger dose you had just been giving. And especially in the first few cycles, the depot may have a strong influence.
And , by the way, how did the bounce save TiTi from going into the 20s again?
The bounce made her numbers go higher. If she hadn't bounced she would have started with lower numbers and been more likely to go lower. Maybe not the 20's since it's been a couple cycles since you shot the larger dose, but possible still below 50.
Here's what I didn't understand about bouncing. I thought there'd only be 1 bounce - all the way up, and then all the way down, and then back to normal. Dunno why I visualized that, since most bounces (ping pong balls etc) bounce thru' quite a few ups and downs.:rolleyes: Anyway, got it now.
Bounces are a totally confusing topic. :bighug: They go up, they go down, they swing around. A ping pong ball is a good comparison.

BTW, it's really your choice if you want to go to 10.5 or stick with 10 units tonight. Every change in dose makes it harder to figure out what size the depot thinks it is, so staying with 10 units does have it's advantages cause you've been shooting it for two cycles now. I just thought it might be too low a dose. Your call.
 
I wouldn't call that much of a depot draining dose. I strongly suspect last night's 10u dose was still being influenced by the 11.5u previous doses. Going from 11.5u down to 10u is only a 13% reduction which isn't a big reduction. I do 25-33% one time reductions to drain the depot a bit, and some do closer to 50%. I would consider sticking with the 10u for a few cycles and see how she does. Of course, until the bounce clears, we don't really know where she will end up. As it gets closer to shot time, we can see where her numbers are, but Lev and Lantus crave consistency so I would try to stick with a consistent dose for a few cycles unless she dips low again. How fast does TiTi usually clear her bounces?



That is what I have been taught from the veteran high-dosers when dealing with a high dose cat. This is where the depot draining bcs becomes a handy tool to help let the depot adjust quicker, especially when the kitty decides to take a few back to back reductions and the bean is tired from multiple late night PJ parties.

I've not had a successful temporary dose reduction. I have had returns to wildly unregulated high numbers. "Once burned" and all that. So I did a witsy reduction. Considering that it was actually a 1.5 reduction (the earned reducie from 11.5), it seemed a good compromise.

I'm still quite wary of such, because TiTi has been incredibly hard to regulate, in even a very coarse range of regulation. Only for a few weeks, and only twice in the last year, have I achieved any semblance of regulation into safe and healing numbers. It's very disheartening and scary, because I know the damage that staying in those high numbers is doing to her heart, kidneys, and well, her whole system.

As far as bouncing? It varies. If her numbers have been high for an extended period, it takes quite a long time. If low for an extended period of time, as lately, she usually clears in a few cycles.

I used to think CRF was hard to manage. HA! It's a walk in the park compared to diabetes.
 
If you take a reduction, then the next 6 cycles can be influenced by the depot of the larger dose you had just been giving. And especially in the first few cycles, the depot may have a strong influence.

The bounce made her numbers go higher. If she hadn't bounced she would have started with lower numbers and been more likely to go lower. Maybe not the 20's since it's been a couple cycles since you shot the larger dose, but possible still below 50.

Bounces are a totally confusing topic. :bighug: They go up, they go down, they swing around. A ping pong ball is a good comparison.

BTW, it's really your choice if you want to go to 10.5 or stick with 10 units tonight. Every change in dose makes it harder to figure out what size the depot thinks it is, so staying with 10 units does have it's advantages cause you've been shooting it for two cycles now. I just thought it might be too low a dose. Your call.

That clarifies things . Thank you.
Sigh. I, too, am concerned that 10U is too little. I cannot assume that TiTi's insulin needs will continue to decrease, so I'd rather go safe and shoot 10.5. As you know, and as I've just written Wes, it's been a real battle to get TiTi into safe numbers. And once there, she doesn't stay long. That's made me very wary of doing anything, including draining the depot, that might cause her to jump back into high numbers.

The 2 years that TiTi spent in totally unregulated doses of insulin has, I think , contributed to her tendency to go high, and stay high.
 
I'm still quite wary of such, because TiTi has been incredibly hard to regulate, in even a very coarse range of regulation. Only for a few weeks, and only twice in the last year, have I achieved any semblance of regulation into safe and healing numbers. It's very disheartening and scary, because I know the damage that staying in those high numbers is doing to her heart, kidneys, and well, her whole system.
If Titi has acromegaly, which we suspect, then you don't need to worry about healing numbers. There's a good chance her pancreas is already working. It's the growth hormone and subsequent IGF-1 that is blocking the cells and preventing her native insulin from getting in, hence the need for injected insulin. What you do want to do is keep her mostly in numbers below renal threshold, which varies by cat but is somewhere high blues/low yellows. High numbers make her kidneys work harder, but they shouldn't be a concern for the other organs.
 
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