3/21 Ruby (AT) AMPS 323 +1 401 PMPS 232 +3 282 +5 287

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arozeboom

arozeboom

Member Since 2011
Yesterday
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=66701

Last night at +6 she was 139

AMPS...323
+1 401
PMPS 232
+3 282
+5 287

Can I get some opinions on how she's progressing, based on her spreadsheet? She seems to have these giant bounces and I don't understand why. Is it basic liver panic? It almost seems like her swings are getting bigger, like on 3/19 she went from a PMPS of 176 to a +3 of 341. Yesterday she went from AMPS of 337 down to PMPS of 167, down to 116 and then back up over 400 this morning.

She's eating well, doesn't drink nearly as much water as she did in the beginning but still probably a little more than a healthy cat, litterbox use is pretty normal. She purrs like crazy, as usual. Grooms herself and Midgie, our civvie girl. Last night she had some really great numbers, but was still low key and sleepy. She hasn't played much in the past couple of days.

All of the Fancy Feast she eats is 4% or lower. She has the same pattern for eating most of the time. She'll eat about 1/2 to 1/3 of the can right away. Around +5 or +6 she'll go back and have a snack and then again around +9 or so. I take the food away at +10. She doesn't finish a full can most of the time, there is usually a little left. The only treats she gets are freeze dried chicken or freeze dried whitefish.

I'd appreciate any feedback.

Thanks
Amy
 
Re: 3/21 Ruby AMPS 323 +1 401 Feedback on Progress?

My work has kept me from posting very often lately, but Champ has been on Lantus now for just about a year. I'll give you my opinion, and I'm sure you've heard this before.... Ruby needs more insulin. Every decrease you've given her, she hasn't earned it. She needs to fall below 50 before you decrease her dose. In order for Lantus to work its magic, you need to follow the "rules." You don't necessarily have to follow the tight regulation protocol if that isn't right for you, but it's very clear that Ruby needs more insulin and that you need to NOT decrease the dose unless she earns it. Champ is a prime example of a great result of increasing the dose until you find that magical breakthrough dose and then, and only then, do you start to decrease, as your kitty EARNS the decreases. Take a look at Champ's SS from the beginning of this year until today. I almost don't like to talk about it in case I jinx it. I test A LOT, but you need to test as often as your wallet and your time allow. If money is tight (and it always is with me!!) or you work outside the home (I'm lucky to work at home) then you may need to test less. I found a great meter that a lot of us here on FDMB have started to use called the Glucocard Vital. Five boxes of strips (250 strips) cost only $46 at American Diabetes Warehouse so it's kept my testaholic addiction going without sending me to the poorhouse.

I hope this helps. Because I haven't been on very often lately, if I've missed something in the past about why you're on such a low dose or decrease the way you do, I apologize!!
 
Re: 3/21 Ruby AMPS 323 +1 401 Feedback on Progress?

We use an AlphaTrak meter which averages around 30 points higher than a human meter. So when we reduced her its only because she's been 80 or under on the Alpha, which would be about 50 on a human meter, technically "earning" her reductions. I have been following the guidelines and I haven't done any reductions without the support and recommendations from others here in Lantus Land.

We started at 1 unit, twice a day per our vet. When she hit 72 on her second dose, it was recommended to me here that I should reduce her because that is around 42 on a human meter. She was reduced again when she had a 78 test and then again after a 63...these all being AlphaTrak readings.

We've started moving back up recently because the lower dose was obviously not working.

I test as often as I can with being at the office for 10 or 11 hours a day. You can see the increase in my testing during evenings and weekends.
 
Re: 3/21 Ruby AMPS 323 +1 401 Feedback on Progress?

i'm sure patty's seeing the AT numbers and thinking those are human meter numbers. for some reason i have to have that smacked into me every time i look at a ss with anyone using an AT.

it looks to me like ruby is bouncing daily, but it's also resolving every day. i think you've got a 'failed reduction' and it means she needs more insulin as well. see if you get some input on it from others as well. with the nadirs you are getting in the 100's, the protocol would have you holding the dose for 6-10 consecutive cycles and then increasing by .25u. if you did have a fur shot day before yesterday, that would mean your count starts that evening. a fur shot resets your count.

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.
Click to expand...
 
Re: 3/21 Ruby AMPS 323 +1 401 Feedback on Progress?

We just did an increase on Sunday morning, so we're still in the holding pattern, I think. This morning began her 7th cycle at that dose.
 
Re: 3/21 Ruby AMPS 323 +1 401 Feedback on Progress?

it depends on if you do think that was a furshot monday morning. it says on your ss that you're not sure . . .

often when a person has taken reductions and they haven't held, you end up going back up higher in dose than you were before. don't be discouraged when you see the dose go up, it's just part of the dance! you're doing great, amy. and bounces resolving in a day is a good sign. at some point she will hopefully stop bouncing, as her body gets used to these better BG numbers.

edited to make it clear that when i'm talking about reductions, i'm talking in generalities, not about you personally, amy.
 
Re: 3/21 Ruby AMPS 323 +1 401 Feedback on Progress?

Gotcha!! It's not like you don't have the fact you use an Alpha Trak in LARGE BOLD LETTERS. Sometimes I wonder where my head is. ohmygod_smile

So it sounds like you're doing all the right things. Just keep increasing the dose every six cycles until you start seeing consistent blues and greens. I had a hard time wrapping my head around increasing doses at one point with Champ because he was getting some green numbers just about every day, but then he was bouncing way up to pink and sometimes red every day, too. I was given great advice, though it took a bit for me to see the wisdom in it and to follow it. I was told to keep increasing the dose and to use higher carb food to keep him from going too low so he can't earn a decrease, but this higher dose would bring the high numbers down (which is what you want). So in effect, the higher dose would bring the higher numbers down, but would also bring the lower numbers down, so you use food to get the lower numbers to stay higher than 50 (or 80 on the AT). After a while, you no longer see any pink, and then the yellow goes away, and then you start to reduce the amount of higher carb food you're using to manipulate the numbers and let the numbers creep down so you can start to slowly reduce the dose, and the numbers magically stay in the blues and greens. I'm not going to lie....the whole process was a bit of a pain in the rear, but worth it since it actually worked. Since you work outside the home, a timed feeder would probably be a necessity (if you don't already use one) so food is available when the low numbers hit and you're not home. Marje and Sienne are the ones who guided me through this.
 
Re: 3/21 Ruby AMPS 323 +1 401 Feedback on Progress?

The possible fur shot was actually Monday night, not in the morning. I realized I hadn't specified that so I fixed that in the notes now. What, you all can't read my mind? ;-)

The husband works at home but unfortunately has yet to get on the testing bandwagon. But at least he's there to keep an eye on her, just in case.

One thing I'm lucky with is the way Ru eats. She's not a scarfer, she's a grazer, so there is food available to her at all times other than the 2 hours before the AM and PM shots. That's the only reason I haven't gotten the auto feeders. She kind of auto feeds herself. I've paid a lot of attention to her eating habits and she's definitely a creature of habit. She eats some as soon as I give it to her, goes back for a snack around +5/+6 and then again around +9. Her bowl is very rarely completely empty.

So far we've pretty much managed to keep her dose changes to weekends so I can keep an eye on her. I also have horrific insomnia lately, so its not uncommon for me be up most of the night anyway.

I can't express how much I truly do appreciate the support, encouragement and guidance I find here every day. I'm not sure Ru and I would have held on this long without it. She went to the vet in January and had a curve done, testing in the 400s all day. The vet increased her dose and the next day Ruby was ringing in numbers in the 40s and 50s (at this point it was still a Relion meter). If I hadn't found you all here and been home testing her, we might not have made it thru that night.

The vet realized that Ru's a major stress spiker and agreed that its best for me to do her curves at home and fax them in. (well, that and the fact that she likes to pee on everyone at the office....that kind of makes them want me to keep her at home, too :shock: )
 
Re: 3/21 Ruby AMPS 323 +1 401 Feedback on Progress?

oh hahaha that's terribly funny. one time i was taking punkin to the vet and he had the "i gotta go" yowl. when i got him there i asked for a quick box and the vet tech was so unhelpful - said they didn't have any. really? as i held him he let it all go - right there in an arch in front of me and all over their floor. :-D she got to clean it up. i didn't mind the pee splashed on my flip flops at all cuz i figured . . . well you know. life university was visiting the vet tech. :lol: cat_pet_icon

i think overall ruby looks great - she's getting into lower blues every day. compared to when she started this is SUPER. she's just in the tweaking phase now. you should feel very good about her overall condition, amy.
 
Re: 3/21 Ruby AMPS 323 +1 401 Feedback on Progress?

The day we took her in for the curve, it was also for a urinalysis to make sure the bladder infection she had was gone. She was there for 8 hours, in her own quiet room at the end of the hall with a litter box and she refused to go. They called me to tell me I could pick her up and said they weren't able to get any urine from her, despite the room and box.

I got to the office and when they went to put her in her crate, she just let loose all over them. My stubborn girl held it all day long, until one of them picked her up. Luckily some landed in the litter box so they were able to use the sample. :o
 
Re: 3/21 Ruby AMPS 323 +1 401 Feedback on Progress?

Just wanted to stop by and say hi to you and Ruby! You're so good at posting Ruby's numbers every day, I haven't had a chance to post Morlei's numbers because somehow I always forget when I'm at home on my computer studying for my test next week yet I remember when I'm here at work and don't have her numbers with me. :roll:
I think you are doing great!!! We have Morlei up to 3.25u now, with a 0.25u increase scheduled for Friday morning. I told her all I want for my graduation present in May is to see some greens :mrgreen:

Have a great rest of the week!
 
Re: 3/21 Ruby AMPS 323 +1 401 Feedback on Progress?

I had another sit down with her last night and told her that she don't have to go green just yet if she would just stop with the bouncing. I'm pretty sure she was flipping me the bird when I got that 401 test this morning.
 
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