3/30 Star PMPS=107 +2+114 +4=64 +4.5=59 +5=53 +5.5=75

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quilterkitty

Member Since 2013
yesterday's condo

Okay. I know this is NOT the protocol, and I know Star might pay for this a bit in the long run, but I'm running an experiment with him today. Don't be mad. :smile:

Star's AMPS was 57. Now, if that had been an out-of-the-blue number, I might have stalled feeding (really hard to do in the morning, as Star is practically eating the paint off the walls by then), retested in 20, etc. But he has been spending late nights in the 50's, and I have been wondering what would happen if I skipped a shot. This morning gave me an opportunity to test a theory. I did not shoot him. Checked him at +1 (after food): an expected rise, but only to 74. Checked again at +3 (I went back to bed and got up at +1 but missed the +2--these late nights and early mornings are really starting to wear me down): another expected rise, but only to 83. I'm trying to get Star to use some of that insulin in his depot, so when I shoot him tonight (a reduced dose of .25) MAYBE he won't drop so much at the PMPS+4 mark.

It seems like the past few days I've been in a cycle of giving Star insulin, watching him drop, and then using food combinations to bring up his numbers. I know this is just good food-insulin balance management, but I would like to see Star level out in the 70's or 80's rather than the 40's and 50's.

I realize the protocols and recommendations are there for a purpose, but as everyone says, every cat is different. So I'll keep posting the numbers today and tomorrow, when I should really see the effects of the skip, and next week, and we'll just see what happens. His dose is so tiny at this point that I expect a small change. Yes, I could be wrong, but unless I try it, how will I know?
 
Re: 3/30 Star AMPS=57 +1=74 +3+83

I don't think what you did was a problem at all. There are times when you need to deplete the depot a bit so the numbers don't keep dropping the way Star's have been.

Just as an FYI, by virtue of 20/20 hindsight, it may have been a better strategy to drop the dose from 0.75u to 0.5u rather than a fat 0.5. Star is newly diagnosed and probably could have handled the reduction. I think those drops in the PM cycle have been telling you that there's too much insulin on board. As an alternative to skipping, I think you could have reduced Star's dose to 0.25u. In fact, depending on what his numbers look like tonight, you may want to drop the dose to 0.25u.
 
Re: 3/30 Star AMPS=57 +1=74 +3+83

What I am hoping to see is for the numbers to come down "on their own" at some point today. That could indicate his system is trying to regulate itself.

If they continue to rise, you have the option of giving him a shot at whatever time you choose today, since you skipped this morning. That would mess up your 12/12 schedule going forward however.

I know that some people would have shot the 57 or stalled and shot a little bit higher a number. I don't think that I personally could have. I probably would have just shown Bob the pen of insulin and waved it in front of his nose, then asked him"Is that enough juice for this morning?"
 
Re: 3/30 Star AMBG=57 +13=74 +15=83

Ha, Carl! Star did see me take the Lantus pen out of the fridge, so maybe that worked! I have a theory about what will happen today and tomorrow, but I'm keeping it to myself until I see what happens (anti-jinx insurance). :lol: Unless he goes too high, which I really don't expect, I'll hold off until his regular 6:30 p.m. dosing time. But I'm home all day, so I'll keep an eye on Star and his numbers.

Sienne, I actually reduced him to the .5 fat against advice (which was to keep him at .75 for the p.m. shot and reduce in the morning). I probably should have bitten the bullet and gone all the way to .5, but I wasn't sure about it. Definitely going to .25 tonight, though. Yay, Star! (He's oblivious--napping next to me.)

And Rhiannon, I will make those changes. Figured there was a way to show the no-shoot, but my brain was too tired to think it through. :?
 
Re: 3/30 Star AMBG=57 +13=74 +15=83 +18=90 +21=76

Hi! I'm just out & about passing out easter eggs and thought I'd stop in to say hello :-D
 
Re: 3/30 Star AMBG=57 +13=74...+21=76 PMPS=107 +2+114 +4=64

Star has had a good day as far as his numbers go. He was sort of quiet and napped most of the time, but maybe he's tired from all the late nights, too. :smile: He is currently at 64, four hours after dinner and his .25 shot. When his usual numbers were over 100, a 64 would keep me up for a while, but given that his averages have fallen, I'm not concerned about it. Should I be? He always gets food before bedtime, so will somebody look at his spreadsheet, please, and tell me if I can give him his bedtime snack and turn in? Thank you so much! (And Easter blessings to you all!)
 
Re: 3/30 Star AMBG=57 +13=74...+21=76 PMPS=107 +2+114 +4=64

Just cause I'm like this nailbite_smile , how about a +5 and then feed him and go to bed? This looks much like the PM cycle from the 28th, and he dipped a bit at +5.
 
Re: 3/30 Star AMBG=57 +13=74...PMPS=107 +2+114 +4=64 +4.5=59

Naturally, he dropped a bit. That is his pattern, isn't it? I think his nadir must be around +8. Sigh. So, some LC food and re-check in 20?
 
Re: 3/30 Star AMBG=57 +13=74...PMPS=107 +2+114 +4=64 +4.5=59

Thinking ahead to tomorrow, because there's not always a Lantus expert online at 6:30 a.m.--if Star is in the 50's again at AMPS, and given that I will not be home for a couple of hours later in the morning to manage any low numbers, is it better to skip the a.m. shot, or reduce the dose again (even if he hasn't fallen below 50 but is consistently in the "safe" lower greens), or what? I think that if I had shot him even .25 this morning, I would have been dealing with some really low numbers. Today I could have managed it (but I don't see a logical reason to put Star in that position in the first place); tomorrow I can't. What say you, Lantus gurus?
 
Re: 3/30 Star AMBG=57 +13=74...PMPS=107 +2+114 +4=64 +4.5=59

quilterkitty said:
Thinking ahead to tomorrow, because there's not always a Lantus expert online at 6:30 a.m.--if Star is in the 50's again at AMPS, and given that I will not be home for a couple of hours later in the morning to manage any low numbers, is it better to skip the a.m. shot, or reduce the dose again (even if he hasn't fallen below 50 but is consistently in the "safe" lower greens), or what? I think that if I had shot him even .25 this morning, I would have been dealing with some really low numbers. Today I could have managed it (but I don't see a logical reason to put Star in that position in the first place); tomorrow I can't. What say you, Lantus gurus?
Click to expand...

I am not a guru. I just read a lot. And the wonderful people here "put up" with my opinions even though I've never used the insulin because, well, because they're wonderful people...

If tomorrow morning is a repeat of this morning.... then you should do an "instant replay", in my opinion. If you aren't going to be around to keep an eye on him, then you also don't need to be worrying over low unseen numbers.

Looking back on this morning, would you have done things differently? If not, then I think that answers your question?
 
Re: 3/30 Star PMPS=107 +2+114 +4=64 +4.5=59 +5=53

Reading a lot gives you guru status (especially reading a lot of condos and spreadsheets and seeing patterns). So your opinions are valid. :-D Given today's numbers (they were exactly what I expected), I would not have done anything differently. So that presents an interesting situation: if I skip the morning dose more than a few times but give the regular (for now) evening dose of .25, will the insulin depot slowly deplete, or is that small dose once in 24 hours enough to keep it going? And maybe it's a moot question, because I truly believe Star is headed off the juice very soon, and depleting the depot gradually is exactly what I want to do if I am to see whether his pancreas is working well.

Star turned up his nose at the food I offered before and just picked at it, so I added a little of his favorite (FF salmon) to catch his attention. Will test again in 20. But honestly, I expect at least one more dip before I see a rise.
 
Re: 3/30 Star PMPS=107 +2+114 +4=64 +4.5=59 +5=53

So that presents an interesting situation: if I skip the morning dose more than a few times but give the regular (for now) evening dose of .25, will the insulin depot slowly deplete, or is that small dose once in 24 hours enough to keep it going?
Click to expand...

I can't answer that question. The "usual" thing, I think, is to split a dose in half and give it every 12 hours. I'm not sure what effect shooting only once a day has on the depot. From what I've watched, doing it that way doesn't really work well on bigger doses - like if you were shooting 2u once per day. It makes the numbers really wonky. But you're also dealing with a bigger depot on a 2u dose.

I don't know if I'd be able to split .25u in half with any degree of accuracy. But I've "watched" people do it when you get close to OTJ territory. You'd need to get more input, particularly from people who've had success with measuring micro-doses. The smallest dose I ever gave Bob was .25u, and in a U40 syringe it was total guesswork for me. Those syringes didn't have 1/2 unit marks.
 
Significant leap at 5.5. Do I need to test again in 20 to see if it holds before giving more food and calling it a night? cat_pet_icon
 
Wow, that must have been challenging! I've read other people's accounts of reducing the .1u dose to just a drop or so, but how do you even measure that? Maybe you get a feel for the syringe (become one with the syringe) and use the Force or something. Seems like it would be really hard to be consistent, but maybe at that point consistency isn't as much of a factor as it is with larger doses.
 
Significant leap at 5.5. Do I need to test again in 20 to see if it holds before giving more food and calling it a night?
Click to expand...

His PM cycles of late on the spreadsheet seem to say that at this point, Star is good to go. I think you can leave a bit out and get some shut-eye.
 
Phyllis

I'd see where he is in the morning. A dose can affect up to six subsequent cycles so you could still be seeing effects from the .5u depot.

I think it's more important for you to find a dose you can shoot twice a day. Shooting once a day can make the depot a little wonky....yes, more so with higher doses...but it's still better to try and give the dose bid.
 
Okay, thanks, Marje. I don't like skipping a dose but didn't know if the reduction rules are firm or flexible. Seems like I'm up late every night managing Star's "safe low" numbers, and I would really like to get him consistently in the 70's and 80's. Not sure that will happen as long as he's on Lantus, even once his curves are predictably flat. :smile:

And thanks, Carl, for sitting up with me again. Sometime I'd like to hear Bob's story (10 weeks to OTJ? Impressive!). :thumbup
 
They are a guideline. But sometimes the caregiver can get a better feel for when a reduction is needed. If you take him down and his numbers rise, you can always increase the dose again.
 
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