3/14 Pepper AMPS 342, +6 308, PMPS 346

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Re: 3/14 Pepper AMPS 342, +3 352

Follow directions Pepper!! Thank you!!
Have a great day Nancy! hugs to you and scritches to Pepper... mary and ollie
 
Re: 3/14 Pepper AMPS 342, +3 352, +6 308

Hi Paula, in the interest of keeping advice on the board, I am replying to your PM here.

I wrote this post in Jazzy's condo in 2011, but my thoughts are still the same so I'm just copying/pasting here. I would love to see some discussion from other high dose caregivers.

Libby and Lucy said:
Some of you might not be aware that there are several different opinions on how to best manage acros’ numbers. So many of the conversations between acro beans these days occur off board, and I think it would be great to have more high-dose presence in LL so people can learn. I keep getting a lot of questions about Jazzy and acro, so I know folks are trying to learn and I appreciate that!

Obviously I can only present my own approach and show how I have arrived at my approach. In my opinion, just like with “regular” diabetes, everything boils down to finding a range where your cat is both comfortable and safe. That range might be different for every cat. A lot of my thoughts do begin and end with "what would Jojo do?" but the concepts also have to make sense to me or I won't be able to buy into them.

Here are the acro spreadsheets that I have studied and have chosen to follow. Primarily I follow their methods with Jazzy, because this is what I want her spreadsheet to look like. I’m not there yet, but this is what I’m striving for. :smile:

Porscha
Buckwheat
Chika
Boo
Milo

(Boo and Milo both had Stereotactic Radiosurgery and went OTJ, but the early parts of their spreadsheets are very applicable and impressive).

Long story short, what worked for most of those kitties is following the Tight Regulation Protocol. They increased/decreased according to protocol, sometimes increasing in larger increments but for the most part they did things the same way the rest of us do. I have done some fumbling around with Jazzy, and that is pretty much where I have landed with her too, except that I do skip shots when she is green and I have to leave.

You do need to be more cautious with acro cats in green numbers – because most acros have a functioning pancreas, sometimes if you use low carb food to try to bump up a number, it can actually stimulate the pancreas to produce more insulin, sending the number lower instead of higher. That can make it difficult to control fast drops. I don’t subscribe to the theory that a green number is dangerous for all acros, if it is a flat green. Others do try to avoid all green, and for some cats that is a smart choice. Fast drops into green are more of a concern, until you know how your cat responds to carbs. Just like everything else, you’ll have to experiment to see how your cat responds to low carb and high carb foods, and use that information to determine what range is best for your cat.

Just to use Jazzy as an example, I have learned that she actually gets a good food spike from low carb. High carb can give her 60 points or more, which is usually a lot more of a bump than she needs. I have had an opportunity to shoot low and monitor a couple of times, and she has done fine. I’m perfectly comfortable with Jazzy surfing green when I’m home (I wish she would do it more often). I’m not confident enough yet to do that when I won’t be home, though she would probably be ok. I hope she’ll give me a chance to try again soon. She obviously feels better and is a lot less mean when she is lower, so I would prefer to keep her in blue/green all the time. My other cats would prefer that too, since she doesn’t attack them as often when she is in happy numbers. :lol: I’m running her higher than that right now because I don’t always feel well enough to monitor late at night. My goal for now is to keep her under renal threshold 24/7, and eventually get her to blue/green 24/7. Jazzy is just one cat, and acro cats truly exemplify the “Every Cat is Different” mantra. I’ve seen others that need a whole can of HC (or more) to slow down a drop. If I had one of those cats I’m sure I would be a lot more gun-shy about green!

Lantus vs. Levemir for high dose cats– I believe that is an individual decision as well. I switched Jazzy to Lev mainly so I would have experience using it so I could help others on FDMB. She would growl and try to bite when I shot her with Lantus, so I hoped Lev might help with that if it stings less. Nope, she still growls and tries to bite with Lev! I can’t say whether Lev feels any different to her or not. Jazzy is doing fine on Levemir, but her numbers aren’t all that different than they were once we got to a good dose of Lantus. I’m still not sure if Levemir was the right decision for me. With Levemir’s late onset, I usually go to bed before her onset. That means I have no idea how her PM cycles run, and sometimes she surprises me in the morning. At least with Lantus, if I went to bed at +4, I would have some clue as to how the rest of the cycle was going to go.

I would be interested in reading how others approach treating their acro kitties, spreadsheets, etc. I admit that this is the approach that makes the most sense to me, but I know other people use different methods and those methods must make just as much sense to them.

Comments?
Click to expand...
and now I have another spreadsheet to add to the study list:

Tommy
 
Re: 3/14 Pepper AMPS 342, +3 352, +6 308

Wow. What an interesting spreadsheet Tommy has. Thanks for sharing, Libby.

Nancy, I'm sorry I wasn't here to see your post yesterday. I also would have given you the BOS Award. I'm glad you could be home to monitor him.
Next time you get a number similar to +9.5 113, maybe try to get a +11, so you can compare that +11 number to your PS number. That will help you with your decision to shoot.
You're doing great with Pepper. :cool:
 
Re: 3/14 Pepper AMPS 342, +3 352, +6 308

Thanks for your post, Libby. I appreciate hearing about your approach and it's great to see the other cats' spreadsheets.
 
Re: 3/14 Pepper AMPS 342, +3 352, +6 308

Hi Nancy, another acrocat bean thoughts on dosing. BTW, you did great yesterday! I haven't shot that low yet, but would probably do the same as you.

First, Neko's spreadsheet is by no means a model SS. She LOVES!!!! to bounce. I can count on two hands or less the number of days when there wasn't some bounce involved. But because she bounces so much, it also influences how I dose. I want Neko to be in green. The more she is in green, the less she bounces. Her flattest days were those when she'd been seeing a lot of green in previous days. Today is a perfect example. Her first green in a while last night and today we mega bounce. I also know that Neko gets about a 20 point bump with 1 tsp of HC so I can control the greens without a lot of HC. That's where you need to experiment and find out how Pepper responds to carbs. I still need to go back and experiment with MC sometime. If I do HC too late in the cycle, Neko zooms up too much (again, like last night). Just wish she'd do that during the day when I'm less interested in sleep and more interested in experimenting. :lol:

The working pancreas is both something to watch out for and something to take advantage of. Back when I started this dance, I started Neko on a meal scheme of main meal and a +1, +2, and +3. Her onset is somewhere a bit after +2. That means if she is diving, that +3 LC meal could cause her to go south faster, and I have been surprised by that. Last night I tested her just before her +3, knew she was diving, so added a small topper of HC to the +3 mini meal to slow it down a bit. On the other hand, sometimes a working pancreas can haul down an ugly number. Again for reasons of history, Neko gets a +9 to +9.5 snack during the day. I do a mix of no carb plus a 1 tsp of 1%. I've often seen this snack pull her numbers down a bit for a more respectable PMPS. And just to keep me guessing, the pancreas doesn't always go into action.

On the Lantus vs. Lev discussion, I have definitely thought about it. I asked the internal medicine vet at CSU what she thought, and she said that she didn't think it worth the change for Neko specifically. Neko does not seem to react to the Lantus shot, now, nor when she was at higher doses. The other complicating thing with Neko is that her nadir roams a lot, so knowing where she is not long after onset gives me better predictability at night. I must admit that I still contemplate the change, as I would love to be able to ease the bouncing.

Sorry to talk about us in your condo - but thought you'd like to hear other opinions. Pepper, time to ditch the bounce! More blues please.
 
Re: 3/14 Pepper AMPS 342, +3 352, +6 308

Hi Wendy. Thanks for posting on my condo - I definitely want to hear your opinions and how you manage Neko. The +9 snack is an interesting idea that I'm going to try.
 
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