3/19 Rupert PMPS 496,+2.5 475, +4, 408

Status
Not open for further replies.
Pip & Rupert

Pip & Rupert

Member Since 2012
yesterday's fun: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=66517

ok everyone... I really think that we did have a bad batch of insulin. Now I"m wondering on dose for this morning. We'd worked our way up to 2.25 but if that was based on essentially him not getting much or any viable insulin........ well, you get my drift.. Should I shoult the 2.25 or reduce? I think he stayed blue all last night, right on the very edge of green. I can check in +1 and +2.5 at the latest, and then won't be back here till +6.....

he looks AMAZING this morning. Me... well not so much! I stayed u till midnight and then was up at 2am to check him again.. then got up at 5 to make sure he was still breathing - at which point he was actually wanting to go outside, looking fab, so I let him go out (I'd shut the catflap when I went to bed not wanting another one of of those 3am in my jim jams chasing him around outside episodes!).

so thoughts please? My own personal thought it so back the dose down to 1.75 again, which would e a .5 reduction... too much???????

it's shot time NOW>!
 
Re: 3/19 Rupert AMPS 102 !! ADVICE PLEASE?!!! SHOT TIME NOW!

Sorry if I don't know that much background on Rupert, but if you are going to be around to monitor and test, and have all the needed supplies, I would go ahead and shoot the regular dose and let him earn his dosecrease.
If you shoot, I would start with a +1, +2, and +3 to see how he's doing.
He is surfing along, not dropping, so I'd shoot...if you're going to be home today.
 
Re: 3/19 Rupert AMPS 102 !! ADVICE PLEASE?!!! SHOT TIME NOW!

have not given his breakfast yet. He's sitting looking cat(2)_steam at me. Will test again at AMBG +.5 Am thinking a BCS may be necessary today, although I anticipate a big bounce .. given previous data.... although things have changed since then re his teeth, general health/attitude (all improved drastically)... and of course the 'unknown' re the insulin effectiveness the last few days. Reminder.. started NEW cartridge for last nights shot that generated the blue surf all evening into this morning.....on the 2.25 dose

and I have to go to work. so can do +1, +2 before I leave and probably back to do a +5......
 
Re: 3/19 Rupert AMPS 102 !! HELP! PLEASE?!!! SHOT TIME NOW!

stalling, can stall till 7am (one hour later) if necessary. just tested. he's holding steady at 97.. on both meters. ... waiting for advice but if I don't get any, I think I'll give him the 1.75 not the 2.25... might be the wrong thing to do, but I don't think I'm brave enough, yet, to give the full dose.....although I know stalling does = a reduction etc.etc. just concerned that the 2.25 we worked up to was based on erroneous data (i.e. insulin not even working) and before when he was at 2 units that were working, he did dippity dive a long way!...

waiting......! 15 more mins till decision time!
 
Re: 3/19 Rupert AMPS 102 !! HELP! PLEASE?!!! SHOT TIME NOW!

Hi Pip,
I agree with Dyana that you should shoot if you are around to monitor. You don't want him to lose momentum. If you are uncomfortable with shooting the full dose, do a BCS--maybe 2 units? I hope someone with better SS eyes will be along, but it is clear that you have to do something. Then check at +1 and +2 and be sure to be there for the +5. Don't forget that the stall will affect the time of your evening shot. Keep the time interval at 12 hours.

Good luck!

Ella
 
Re: 3/19 Rupert AMPS 102 wow, egads, I BCS'd... doh!

okay, I shot. I did a BCS or should that be a RBCS (Really BCS).... 1.75. I'll probably get in trouble for it but I just feel more comfortable doing that given the fact that we have a few factors to consider. He's now had some breakfast, mix of friskies and evo, didn't eat a ton though. Will encourage a snack at +1 and test then.. I'm going btb for a quick 45 min nap, this staying up till midnight and getting up at 2am and 5am is a little tiring and I have to try to pretend to be awake at work by 9am! Dearest DH went and cleaned the barn for me this morning so all I have to do is feed before I leave for work.

Hoping Rupie surfs this 'teal' (green/blue) wave today without giving me a heart attack. Also hoping I made the right decision re the lower dose.....just feel I don't have enough data on the 'new improved' Rupie (teeth) and new improved insulin combo to take an informed risk.
 
Re: 3/19 Rupert AMPS 102. whee! but I BCS'd...doh!

Morning Pip! I don't know if there is a BCS BOS award, but there should be. I understand your hesitation with all the factors you were considering. So I say, good job!
 
Re: 3/19 Rupert AMPS 102. BCS'd...doh! +1, 172 drat!

well, +1 and we are back up to 172.. which could be a food spike... could be a bounce... could be not enough juice. teee hee! But it's okay. he looks fine, is mightily annoyed at all the ear pokes this morning. Will try to get one more before I leave for work but feel confident he's going to be fine.. and sadly, feel confident he'll be up in the yellow at lunchtime!!! still... anything but red/black is good at the moment and if he does bounce.. it's for a good reason. Dose tonight will be 2u unless otherwise indicated/instructed I guess??????
 
Re: 3/19 Rupert AMPS 102. BCS'd...doh! +1, 172 drat!

I'm sorry, maybe I'm wrong, so take that under consideration, but isn't his dose 2.25, now? I don't see a test under 50 to show he needs to go to 2.00 tonight. Just my thoughts.
 
Re: 3/19 Rupert AMPS 102. BCS'd...doh! +1, 172 drat!

Dyana, thanx for the input, all appreciated. My logic behind is this: he was at 1.75 and it wasn't working, and getting worse and so we went to 2 and then 2.25 fairly quickly due to the scary numbers.. but then we figured out that the new batch of insulin was bogus and so I got brand new....and with the brand new, and an 'empty shed' he dipped rapidly into very close to green (no complaints here!)...I know we can get back there again, but I"m just a little concerned that the 2.25 or even the 2 might be too high for him .. course time will prove me wrong.. but hope you get my reasoning? I don't think he really 'honestly' earned the dosecrease to 2.25 so feel more comfortable with the 2 (although I shot a late 1.75 this morning so I guess decreased both by time and doseage cos I was BCS'ing) for tonight to see if I can figure out his patterns.

as usual, will await the wisdom of all of you this evening before I shoot. I"ll be shooting an hour later anyway (7pm) due to stall this morning.
 
Re: 3/19 Rupert AMPS 102. BCS'd.+1, 172<+2 208

+2 and a 208. Least I can go to work and not worry! He had a decent sized breakfast of MC and he seems quite happy in his usual spot, although annoyed at yet another poke.

have a great day everyone. ttyl
 
Re: 3/19 Rupert AMPS 102. BCS'd...doh! +1, 172 drat!

Hi Pip,
Good to see some lower numbers on Rupert. Just a few thoughts, if that is ok.

Pip & Rupert said:
My logic behind is this: he was at 1.75 and it wasn't working, and getting worse and so we went to 2 and then 2.25 fairly quickly due to the scary numbers..
Click to expand...

You were actually at 2u for 13 cycles (if I counted right), which is a good amount of time considering nadirs were between mid 100's and high 400's. Though I do understand why the wait...due to the dental.

Pip & Rupert said:
but then we figured out that the new batch of insulin was bogus and so I got brand new....and with the brand new, and an 'empty shed' he dipped rapidly into very close to green (no complaints here!)
Click to expand...
This is what you are assuming, and it could be correct that the other insulin was bad. ECID when responding to a dose increase, new pen, etc. I know my kitty was pretty sensitive and showed immediate results. I would think if the shed was 'empty' due to bad insulin it would take more than one shot to fill it back up enough to give such great numbers. If I am wrong, someone can feel free to correct my logic.

Pip & Rupert said:
...I know we can get back there again, but I"m just a little concerned that the 2.25 or even the 2 might be too high for him .. course time will prove me wrong.. but hope you get my reasoning? I don't think he really 'honestly' earned the dosecrease to 2.25 so feel more comfortable with the 2 (although I shot a late 1.75 this morning so I guess decreased both by time and doseage cos I was BCS'ing) for tonight to see if I can figure out his patterns.
Click to expand...

I think he did earn an increase. His numbers were high. Whether it be due to dental, eye, stress, food, bad insulin, or any other random reason. He was plain ol high, and you increased insulin to bring it down. That is what you have to do! As of today, he has not shown you that he is receiving too much insulin on the 2.25u. You shot a lower dose this a.m. because the preshot number was lower than you were comfortable shooting. Honestly, I would have done the same if Rupert were my cat. You have changed pens back and forth, got him a dental, bought new pens, raised dose, etc. I think reducing across the board at this point is just putting yet another variable into the mix making it difficult to see what he really needs.

All those observations aside...I think the most important thing to do is what YOU feel comfortable. I was never very brave with my kitty's dose for various reasons. If you are not comfy shooting the higher dose, then you do what you must. And, no...you do not get 'in trouble' for making the choices YOU think are best for your cat. ;-) People can disagree and offer different alternatives, yet you are the caregiver. YOU make the decisions based on the feedback and what will work for your situation.
 
Re: 3/19 Rupert AMPS 102. BCS'd.+1 172,+2 208

thanx Carolyn! always welcome various insights and eyes on the SS!

will see what he throws at me today, but am comfortable giving him the 2u tonight if that's what makes sense because I'm home and can test him hourly. Seeing that yellow at +2 makes me realize that I COULD have given him the 2.25 this morning.. probably! but till I have a bit more data I'll err on the side of caution. Hoping this doesn't throw things all topsy turvy yet again!! I'll probably be looking for input this evening PMPS!
 
Re: 3/19 Rupert AMPS 102. BCS'd.+1 172,+2 208

i can already tell you what the advice will be tonight, pip. every time a dose gets changed, BG can go wacky for up to 3 days. whatever numbers rupert has today will still be affected by yesterday's higher dose, so this cycle won't really tell us anything. the only case where this cycle is important would be if he went below 50.

your choice to change the dose was based upon the preshot number, which is fine, and you do have to do what you feel comfy with, but following the TR Protocol, dose changes are based upon nadirs. so barring a below-50 today, you would call this morning a token dose or BCS and return to the dosing plan from before. you would stay with that dose until you see a below-50 number.

here's your guide to that:

"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 consecutive cycles) 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.
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.
Try to go from 0.25u to 0.1u before stopping insulin completely.

Random Notes:
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.
A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.
Sometimes a dose will need to be "fine tuned" by adding some "fat" or "skinny-ing up" the dose.
Click to expand...
 
Re: 3/19 Rupert AMPS 102. BCS'd.+1 172,+2 208

Woohoo!!! Rupert, you are rockin' today! Way to scare your bean. :lol: :lol: Remember, Pip, it's all just a chance to gather data, whatever dose you decide. As long as you are there to test, he will be fine.
Liz
 
Re: 3/19 Rupert AMPS 102. BCS'd.+1 172,+2 208

thanx everyone. so it seems that unless he does something truly insane today, it will be 2.25 tonight to stick with the new dose.

I'm learning.. slowly!... thanx guys. Wish I could've been more BOS this morning.. that time will come soon enough I hope! If I didn't have to do this pesky work thing for a living I could stay home all day and play with Rupert.. although I'm sure after about the 5th earpoke in as many hours he'd be way beyond cat(2)_steam

funny-pictures-angry-grey-cat-sulks.jpg
 
Re: 3/19 Rupert AMPS 102. BCS'd.+1 172,+2 208

Pip & Rupert said:
I'm learning.. slowly!... thanx guys. Wish I could've been more BOS this morning.. that time will come soon enough I hope!
Click to expand...

Dearest Pip :mrgreen: ,
There is no competition here when it comes to BOS. We all have to do what we are most comfortable with. That is where the true BOS are revealed...when YOU do what YOU need to do for YOUR cat.

We all 'get it' at our own pace. There was a golden opportunity for learning today by NOT shooting the full dose. You now have some good information you can use for the next time this happens. Sounds to me like you ARE getting it!

And take it from someone who is staying at home with their cat everyday due to lack of employment...all they wanna do is sleep. We are boring them. :lol:
 
Re: 3/19 Rupert AMPS 102. BCS'd.+1 172,+2 208<+5 385

+5 and back to the pink. of course now I"m wondering is it due to BCS or a bounce?? guess time will tell!!!
 
Re: 3/19 Rupert AMPS 102. BCS'd.+1 172,+2 208<+5 385

Pip & Rupert said:
+5 and back to the pink. of course now I"m wondering is it due to BCS or a bounce?? guess time will tell!!!
Click to expand...

I am quite the over-thinker (just so you know ;-) ). I would probably just let that question be and keep on moving forward. :mrgreen:
 
Re: 3/19 Rupert PMPS 496. sigh, bouncy bouncy

PMPS and back up in his favorite red color.. still, methinks to be expected given the rapid attack on the blue floor last night. Hopefully he slows it down a bit this evening! He looks good, negative for ketones, clear eyes this evening. purry and full of him self. Eaten his EVO for dinner with his lysine.
 
Re: 3/19 Rupert PMPS 496,+2.5 475

creeping higher, sure hope he doesn't sneak into the black overnight, least he isn't diving.. sigh. he seems fine. mellow, stretched out in his usual spot on the couch, has had a little dinner, not a lot. Will give him a snack at +3.5, before I head to bed. Looks like I"ll get some sleep tonight, hopefully he'll have a nice surprise for me at AMPS. Hope everyone had a good day, and a great evening.
 
Re: 3/19 Rupert PMPS 496,+2.5 475

Those are so not fun numbers to see. I suggest you sleep through them. ;-)

I hope you get some rest. Nice job today, Pip!
 
*Almost* made it to the pink floor for his +4.. hopeful that perhaps he surfs some pink and a smidge of yellow the rest of the evening. He's been out for his pee, had a snack, looks sleek and in charge. Another windstorm tonight, not as bad as the past couple, warmer wind too. Rupert will be on top of the couch in a few minutes I'll be in bed and snoring in another few! Tomorrow is another day!
 
Status
Not open for further replies.
Back
Top