3/18 Star +4=49 +5=58 +6=58 +6.5=80 +7=74 +7.5=68 +8=108

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Re: 3/18 Star AMPS=403 +6=159

Love seeing that 159! Probably will entail a bounce, if Star follows the pattern. I'm starting to wonder if he has a panicky liver and will continue to bounce after every lower number.
 
Re: 3/18 Star AMPS=403 +6=159

The phrase seems to be "they bounce until they don't "
Over time, paws crossed, Star will bounce less. The lower numbers are healing numbers and Star will get more used to them as she has more of them.

It's really nice that she already came back to some blue. :thumbup
 
Re: 3/18 Star AMPS=403 +6=159 PMPS=117

Lol, Kat! Love your enthusiasm. :-D Looks like I need to start managing those afternoon snacks better. Star wasn't interested in his evening meal, so I gave him some turkey treats (reconstituted with a little water--he doesn't like them dry and hard!) to have some food in his tummy before shooting him closer to 7:00 than his usual 6:30. He has gotten wise to what happens at feeding times (testing and insulin), and he wasn't having any of that tonight. A little extra love and attention will go a long way, methinks.
 
Re: 3/18 Star AMPS=403 +6=159 PMPS=117

Rhiannon, I was going to ask about bounces, since my expectations have apparently been unrealistic. I know every cat is different, and every day seems to be different, at least this early in the treatment, but darn it, I would really like to say farewell to bounces! The name makes them sound like a ton of fun, but they really aren't. :-x
 
Re: 3/18 Star AMPS=403 +6=159 PMPS=117

No they sure aren't.
I watch all the bouncing...
Shadow didn't do that. She was a flat out surfer.... So once I learned that about her... I felt better. But it can also make you a little nervous
to go off for a while when your cat is sitting at 77. ;-)
 
Re: 3/18 Star AMPS=403 +6=159 PMPS=117

how does that go .... something like: better high for a day, than low for a moment....
 
Re: 3/18 Star AMPS=403 +6=159 PMPS=117 +4=49

Lol, you two! Star's punky appetite at dinner is, I think, responsible for the low number at bedtime. He did eat some, but he just wasn't hungry. Threw up a tiny bit (first time since his diagnosis). Tonight after testing at PMPS+4 he was ready for some food. Maybe he's just tired of the same thing all the time. He didn't really complain when I took away the dry food, which I did in the very beginning, and that surprised me because he really seemed to prefer it to canned. Maggie, my civilian, was in heaven--she always liked the canned food better (but she also loves human food, especially junk food, so she gets tiny bits of Doritos when we're having those, and she loves a taste of cream cheese or whipped cream when one of us has the container out). Anyway, I'm going to take another look through Dr. Lisa's chart and see if I can't pick up some FF or other just for some variety.

Also will test again shortly, at +5, to see if there's been a change. Not comfortable going to bed unless I know he's on the rise. nailbite_smile
 
Re: 3/18 Star AMPS=403 +6=159 PMPS=117 +4=49

Phyllis

Please feed a couple good tsp of LC food to get him up to surf and retest in 30 min.

I'll look for your post. Please don't wait any longer than 30 mins to retest. And please be sure and feed.
 
Re: 3/18 Star AMPS=403 +6=159 PMPS=117 +4=49 +5=58

Star got some LC food, then tested (58); got some salmon treats afterward. Now he knows what the glucometer's little beep means. @-) Looks like he's coming up. Didn't attack the food, but he's been grazing more today than devouring. Is it safe for me to go to bed, now that he's on the rise?
 
Re: 3/18 Star AMPS=403 +6=159 PMPS=117 +4=49 +5=58

Hi Phyllis, we like to see two rising numbers without food before calling it a night. Star is a bit low yet.
 
Re: 3/18 Star AMPS=403 +6=159 PMPS=117 +4=49 +5=58

So, since he had some food before the +5 check, does that mean I need to not feed him and check him again twice? Is that every 30 minutes, every hour, what? Not sure what to do.
 
Re: 3/18 Star AMPS=403 +6=159 PMPS=117 +4=49 +5=58

Normally, we'd feed a 58 with a tsp of LC because he's not at nadir yet. Then retest in 30. That's the normal way to handle these numbers.

Here's what Im seeing from his SS. He earned a reduction to 1.5u but the next morning you took his dose back up to 1.75u. I'm assuming you took him up because he bounced? Keep in mind that we don't dose on the PS numbers and you don't want to increase based on a bounce.

So he's earned another reduction. In the morning, if he bounces up high, you can shoot the 1.75u the a.m. cycle but then reduce to 1.5u tomorrow night and hold the dose long enough for the bounce to clear so we can see where he is.

If he doesn't bounce, then shoot the 1.5u in the morning.

See you in 30.
 
Re: 3/18 Star AMPS=403 +6=159 PMPS=117 +4=49 +5=58

At +5.5 he's at 55. Yes, I kept him at 1.75 because he bounced so high and was actually acting sick. I'll test him again in 30 minutes. Is he allowed to eat if he wants? And at what point, if any, should I give him a little HC food? Thanks so much for your help!
 
Re: 3/18 Star AMPS=403 +6=159 PMPS=117 +4=49 +5=58

I'd feed him some more LC...a couple tsp. as he gets closer to mid cycle, he might not need the boost from HC.

The other option you have is feeding HC to get him up because he's earned reduction, that way you can get to sleep sooner.

It's not a good idea to increase the dose based on a bounce number. You risk getting him overdose.

I've seen cats be at 400 at PS, 40 at midcycle, and 400 at the next PS. If you increase on a bounce number like 400 when he's been down into low numbers like he was, then you risk his numbers dropping too low.

So I'll see you in 30.....
 
Re: 3/18 Star PMPS=117 +4=49 +5=58 +5.5=55 +6=58

Tested at +6=58. Star ate about a teaspoon of HC food and another tsp of LC food that was on his dish--lapped them up. He is now trying to hide in the basement so I'll stop messing with him. It's cold down there, but I can't shut him out because there's no door, just the stairway. Anyway, I'll wait another 30 minutes and test again, once the food has had a chance to kick in. At least he doesn't hold a grudge.

This whole dosing thing seems so counterintuitive to me. I'm still learning how Lantus works, obviously. It's so hard to ignore highs in the 500's, even if they are probably a bounce. But I'll trust the experts and go with the lower dose of 1.5 in the morning (or evening, depending on his morning number) and hold it there for seven days (?) or until instructed to change it again.
 
Re: 3/18 Star PMPS=117 +4=49 +5=58 +5.5=55 +6=58

I know it is counterintuitive but the action of the liver in response to lower numbers causes the BG to rise but it's not rising from too little insulin. It's rising from increased counterregulatory hormones and glucagon. Have you read the TR protocol.

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.
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.

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. 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.
If an attempted reduction fails, go right back up to the last good dose.
Click to expand...


So take him down and if he doesn't get into green and blue once the bounce clears, then we increase the dose. If you have a question, Let us know.
 
Re: 3/18 Star PMPS=117 +4=49 +5=58 +5.5=55 +6=58 +6.5=80

I have read the protocol (I know you can't tell, but I have actually read it several times). And I do understand that it's the liver reacting, not the insulin itself. That's why I was wondering if Star has a generally nervous, if not actually panicky, liver, given his tendency to bounce. Instead of trying to make sense of it, I suppose I should just follow the instructions. Those "if-then" statements take me back to high school math, and my eyes start to glaze over. :? So, when it says "If kitty drops below 50," does that mean drops one time and then goes back up? Or drops and stays there? Still learning terminology.

Star is back up to 80 at the 6.5 check. Is he out of the woods? Should I leave food out overnight for him as I usually do? (We keep the house pretty chilly at night, and I think he needs the calories, plus he gets bored.)

Thank you so much for staying with me and guiding me through this. Sorry I'm being a difficult student. :YMSIGH:
 
Re: 3/18 Star PMPS=117 +4=49 +5=58 +5.5=55 +6=58 +6.5=80

You aren't being a difficult student and Star doesn't look any different than most newly dx cats who haven't been on insulin long. Some time stroll over to Gobbles condo and look at his SS. My own Lil girl still bounces but not badly. It's amazing to see how some of them just snap and go from horrible bouncing to beautiful numbers (look at Rex's condo and SS).

If they drop below 50 at any reading (for a newly dx cat), they get a reduction. So, yes...just one test below 50 earns that reduction.

I think because he's past mid cycle, if you leave food out for him, you can go to bed. I'd feel better if you could set a slsrm and recheck him in an hour or so just to be sure he's still rising.

Hope you get some rest and don't be worried about asking questions. That's why we're here....and the closer he can follow the protocol when he's so recently on insulin, the better his chances of going into remission.

Good job tonight! Sleep well.
 
Re: 3/18 Star PMPS=117 +4=49 +5=58 +5.5=55 +6=58 +6.5=80

Thank you again, so very much. Star and I really appreciate your help and your patience! :YMHUG:
 
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