3/15 Orion AMPS 319, +2=347 Done bouncing?

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Airway

Airway

Member Since 2013
Orion is too high but consistent since last night. I'm guessing he will eventually need more than 2u?
 
He certainly looks like that drop on the 13/3 set him up for a bounce, which potentially may last for up to 6 cycles. It's possible that he went lower than that 95 as it seems he was on his way up by then.

I'm not sure which protocol you have decided to follow, but even on TR you would be looking to hold that starting dose for 5-7days.
Additionally when you first see green, you would look to holding the dose for at least 10cycles.
I know it's hard to see those high numbers, but try to be patient for the moment and lets see if he makes it to green again once the bounce clears, I'd look to it clearing tonight or tomorrow morning, I'd watch for a +2 that was significantly lower, that might give you the heads up to an active cycle.

From the TR sticky (highlighted the points that are applicable to Orion)

GENERAL GUIDELINES:
  • Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
  • Each subsequent dose is held for a minimum of 3 days (6 consecutivecycles) unless kitty earns a reduction (See: Reducing the dose...).
  • Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

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.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
 
Airway said:
What number do I consider to be his nadir?
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Typically, it's somewhere around +5 to +7, but some cats like nadir a little earlier or later, and some cats regularly switch it up. :rolleyes: Remember, cats don't like to be predictable! The best way to figure it out is to try to catch a test or two in the +4 to +8 range every day for a few days and see where you get your lowest number. OR you can do a curve one day, but if he's bouncing at the time, it may not tell you much. Bounces typically happen, especially in cats new to insulin, following a large drop in BG or after they hit a number that is lower than they are accustomed to and can last up to 6 cycles.
 
Airway said:
Is his curve so far today typical for Lantus?
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This is looking like a bounce cycle, which is where numbers stay relatively high and flat (though they can bobble about a bit), it's his liver at this point that is driving the numbers, rather than the insulin.
So it wouldn't necessairly exhibit the 'typical' smile shallow smile curve that lantus is famous for, though we wouldn't expect to see that until a kitty is pretty well regulated.

The following example below is an example of an active cycle. Taken from the new to the group sticky, I recommend you read it if you haven't already (I know I had to read it countless times, and I still look back to refer to it:))

Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

 
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