3/8 Milo AMPS 321 +5 315 +6 285 +7 192 +8 125 +9.5 115 +10.5 113 PMPS 145 +4.5 267

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milosmommy

milosmommy

Member Since 2009
Milo yesterday

I can assume a a slight bounce from yesterday. Going to hold dose a few more days to see what kind of readings we get once we clear this bounce.
 
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I'm seeing a lot more blue during those AM cycles - how considerate of Milo.:cool:

If you wanted, you could increase tomorrow if you don't see green tonight, that'll be the 8th cycle, or you could wait one more day. From the 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.
 
You know me I am not one to give dosing advice, and I agree with @Wendy&Neko that Milo is probably going need another increase, unless you see more green, but I am going to just let you know what I see on Milo's spreadsheet and you can do with it what you will. I think it is always easier to make suggestions on someone else's spreadsheet than it is to make decisions on your own because there is way too much emotion involved.

Milo is seeing much better numbers and I love that, but at the same time he is still bouncing pretty hard. My suggestion would be to hold this dose for another day or so to see if you can get Milo to hang out in the BLUE most of the time and not bounce as hard. And then increase if you are still not seeing GREEN after another couple of days.

Now understand that I have no idea if this will work or if Milo will still bounce again once he gets down in to the green, but it sort of makes a bit of sense to me that if you can stabilize him in the BLUE than he might get use to those numbers and won't spike up as high once he starts hitting more GREEN.

I am very interested to know if this way of thinking is right or if I am totally off base here.
 
@Tina & Sammy - We've seen people try the approach you describe before. The advantage of increasing sooner, is that more insulin can also help reduce the height of the bounce. And personally, I'd rather see Milo get used to greens instead of blues. Remember, Milo's come out of remission and we like to be a bit more aggressive with those kitties, although an increase tomorrow would not be considered aggressive per the TR protocol.

And this is one of my favorite quotes from Steve and Jock (first kitty on Levemir) - the Kirsten he refers to is Kirsten Roomp, co-author of the TR protocol:
I'm most interested in Kirsten's reply, because she brings up an important related issue -- that it's much easier (with Levemir or Lantus) to maintain a cat in euglycemic ranges (say, 75-160 or so), than to maintain them at some randomly chosen range that scares some people less. Blood sugar simply seems to get more stable (in the non-complicated kitties) when you keep it near normal...because it's way harder for most diabetic cats to get regulated between 150-250 than it is between 75-150, but you won't know this until you try. This is, as Kirsten says, because hyperglycemia stresses the pancreas and makes regulation hard.
Click to expand...
 
I think I'll probably see AMPS and what we see tonight, but I will probably increase tomorrow AM unless something weird happens. I'm hoping a better AMPS than the 300 we've seen the past 2 mornings.
 
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