31 July Girlie AMPS 682: increase dose?

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When following SLGS, you would hold the dose a week. She almost got a nadir below 150 yesterday. At that point on SLGS, you keep holding the dose, and hoping she'll stop bouncing as much.:rolleyes:
 
Wendy&Neko said:
When following SLGS, you would hold the dose a week. She almost got a nadir below 150 yesterday. At that point on SLGS, you keep holding the dose, and hoping she'll stop bouncing as much.:rolleyes:
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Thanks so much, Wendy. I'm re-reading some of the stickies now: I gave her 0.25 and will see how she goes for the rest of the week, then.

I guess I wasn't sure whether the 0.25 was meant to be a "real" reduction or just a "safe" reduction while I was out and about for two days.

Re: testing: I assume I should continue with the testing every two hours during the day - or can I make it every 3-4 hours? What would you suggest?
 
Girlie's mom said:
Thanks so much, Wendy. I'm re-reading some of the stickies now: I gave her 0.25 and will see how she goes for the rest of the week, then.

I guess I wasn't sure whether the 0.25 was meant to be a "real" reduction or just a "safe" reduction while I was out and about for two days.

Re: testing: I assume I should continue with the testing every two hours during the day - or can I make it every 3-4 hours? What would you suggest?
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I would start with +2 and +4 before deciding if more tests are needed.
 
AT +2 she was HI, so I tested that twice - both HI. Any thoughts? :eek:

I've re-read the SLGS page and there are remarks about lowering if below a certain number (and I'm using the AlphaTrak2), but nothing about HI readings, so I'm a little unsure.

Also, super dumb question! I can't believe I'm asking this now, but might as well: are the testing times (+2, +4, etc.) based on a) the time you do the AM or PMPS or b) the time you actually give the insulin injection? So if I do the AMPS test at 6:00 am but don't give the insulin until 6:30 am, do I do the +2 at 8:00 or 8:30? :confused:
 
Girlie's mom said:
AT +2 she was HI, so I tested that twice - both HI. Any thoughts? :eek:

I've re-read the SLGS page and there are remarks about lowering if below a certain number (and I'm using the AlphaTrak2), but nothing about HI readings, so I'm a little unsure.

Also, super dumb question! I can't believe I'm asking this now, but might as well: are the testing times (+2, +4, etc.) based on a) the time you do the AM or PMPS or b) the time you actually give the insulin injection? So if I do the AMPS test at 6:00 am but don't give the insulin until 6:30 am, do I do the +2 at 8:00 or 8:30? :confused:
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It's recommended you t/f/s (test/feed/shoot) within a few minutes. I did it in less then 5 minutes. Would that be possible for you?

I'm not sure about the timing. I'll let someone else weigh in.
 
Mandy & Rex said:
It's recommended you t/f/s (test/feed/shoot) within a few minutes. I did it in less then 5 minutes. Would that be possible for you?

I'm not sure about the timing. I'll let someone else weigh in.
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Hi Mandy,
I'm certainly not the model student in that respect - oh dear! :( I'm better in the evenings, but in the morning, she's already asleep on my lap or under the covers with warm ears, so it's easier to get the test done and then get the food/insulin.

I usually test, put out her food, then get the syringe set up. With trying to get to 0.25 accurately, I've been taking longer with the syringe. As she's a fussy eater, and she'll walk away from food if I come near, I need to do the shot after she's finished eating and moves away from it on her own. She generally comes straight to my lap, lies down, and waits for me to give her her shot.

How far in advance can you get the syringe ready? I'm just wondering how long it can sit outside the fridge (Lantus). The vet told me an hour max, but I'd be curious to hear what you all think as well.
 
What I did was test, get the syringe ready, get the food ready and put it down, then I shoot while Rex's head was in the bowl.

That's too bad Girlie won't eat if you're in the proximity. I have a cat like that who will leave the room if anyone but me comes in.

Lantus can be out of the fridge for 28 days, I believe. But if you want to have it last to the last drop (6 months), it needs to be kept in the fridge. I'm sure you already know that. If you're referring to the syringe, you cannot prepare it like the night before.
 
Mandy & Rex said:
What I did was test, get the syringe ready, get the food ready and put it down, then I shoot while Rex's head was in the bowl.

That's too bad Girlie won't eat if you're in the proximity. I have a cat like that who will leave the room if anyone but me comes in.

Lantus can be out of the fridge for 28 days, I believe. But if you want to have it last to the last drop (6 months), it needs to be kept in the fridge. I'm sure you already know that. If you're referring to the syringe, you cannot prepare it like the night before.
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I keep it in the fridge; I guess it would be okay, then, to prepare the syringe before I test and feed. Girlie's fine with eating with me in the vicinity - she just wouldn't want me to give her an injection while she's eating, and given her eating issues, I don't want to do anything that will put her off her food or make her walk away from it.

Is the problem with the delay between the testing time and the shooting time? Between eating and shooting there's a max of about 10 minutes delay, usually; she'll eat for about 5 min, come lie on my lap, and then she gets her syringe. I can certainly test, get the syringe ready before I feed her, and then shoot right after she finishes eating. Would that be better? There would still be a delay between the testing time and the final injection, but I can try to tighten that up as much as possible.

This morning was a longer gap as I was waiting for a reply on the board after she tested so high this morning: i wasn't sure whether to give 0.25 or 0.5 as I thought we might have just gone down to 0.25 for a few days when I'd be out of the house for a good part of the day. I'm still learning, but I understand now that with SLGS, I need to stay on the same dose for a week before changing anything.

We're better in the evening; I just like testing her in the morning while she's still half asleep and warm; she doesn't even notice it then. She's good about testing, and doesn't seem to mind the actual lancet itself: I think she's more just getting annoyed with me doing it so often and I think - as well - that her little ears are getting a bit sore (even with the Neosporin).
 
Another silly question: a cat could potentially go into remission using SLGS, couldn't they? Or do they need the intensive part of the TR to possibly go into remission?

At this point, I'm just hoping that Girlie will settle down and regulate into blues and greens, but of course, it would be great if she could go into remission. I suppose that takes more than just a few weeks, though, even with TR - is that right? Or could it go fairly quickly? I just want to do what's best for her (even if she is making typing a bit difficult because she's insisted on lying in my lap with her head on my left wrist...). Velcro Burmese: has to be as close to you as possible. Hence her pic: I had to move her cat bed onto my desk so she would let me do my class online and leave me (relatively) in peace. :)
 
@Mandy & Rex
I just looked at your profile: it looks like Rex went OTJ within two months with TR: that's great! Is that typical?

I've read the post on being able to go to work and do TR, but I'm feeling a bit uncertain about Girlie as she's been practising her dives, and I want her safe. I suppose one could start out doing SLGS and then try TR, or does it really have to be one or the other?
 
Girlie's mom said:
Is the problem with the delay between the testing time and the shooting time? Between eating and shooting there's a max of about 10 minutes delay, usually; she'll eat for about 5 min, come lie on my lap, and then she gets her syringe. I can certainly test, get the syringe ready before I feed her, and then shoot right after she finishes eating. Would that be better?
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Yes, 5-10 minutes is perfectly fine.
Girlie's mom said:
Another silly question: a cat could potentially go into remission using SLGS, couldn't they? Or do they need the intensive part of the TR to possibly go into remission?

At this point, I'm just hoping that Girlie will settle down and regulate into blues and greens, but of course, it would be great if she could go into remission. I suppose that takes more than just a few weeks, though, even with TR - is that right? Or could it go fairly quickly?
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Remission can be achieved with SLGS, but it does take longer.
Girlie's mom said:
@Mandy & Rex
I just looked at your profile: it looks like Rex went OTJ within two months with TR: that's great! Is that typical?

I've read the post on being able to go to work and do TR, but I'm feeling a bit uncertain about Girlie as she's been practising her dives, and I want her safe. I suppose one could start out doing SLGS and then try TR, or does it really have to be one or the other?
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I started with SLGS, but I got impatient so I switched to TR. What Rex did is not typical. Back to back reductions do not work as a general rule, but Rex insisted on back to back to back to back reductions. :blackeye:
 
Mandy & Rex said:
Yes, 5-10 minutes is perfectly fine.

Remission can be achieved with SLGS, but it does take longer.

I started with SLGS, but I got impatient so I switched to TR. What Rex did is not typical. Back to back reductions do not work as a general rule, but Rex insisted on back to back to back to back reductions. :blackeye:
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So it's okay if there's a delay between the test and the shot (say 20 minutes), but it's best to have the food and the shot back to back: is that right?
 
Girlie's mom said:
So it's okay if there's a delay between the test and the shot (say 20 minutes), but it's best to have the food and the shot back to back: is that right?
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You have up to 2 hours after the insulin to get food into the cat.

@Wendy&Neko, if one stalls after a PS test before giving insulin without doing another test, when does the clock start for the +hour tests - after that test or after the insulin?
 
I just looked at Rex's chart and see what you mean. You were testing back to back, so you must have been able to be at home or get home. I'm currently off work as still recovering from surgery, but once I go back to work it'll be hard for me to get home during the day; I certainly couldn't do it every day.
 
Girlie's mom said:
I just looked at Rex's chart and see what you mean. You were testing back to back, so you must have been able to be at home or get home. I'm currently off work as still recovering from surgery, but once I go back to work it'll be hard for me to get home during the day; I certainly couldn't do it every day.
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I work Monday to Thursday. Those 2 weeks before the OTJ trial, I was sick a couple days with bad headaches so I was able to monitor. The first time I shot a green was the day we had a bad snowstorm so it was perfect timing to stay home.
 
I think that the + is after shot time. If within 30 minutes I don't think it's an issue, as there isn't anything happening that would cause the BG number to change that much, unless really low or high.
 
Mandy & Rex said:
I work Monday to Thursday. Those 2 weeks before the OTJ trial, I was sick a couple days with bad headaches so I was able to monitor. The first time I shot a green was the day we had a bad snowstorm so it was perfect timing to stay home.
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Well, maybe I should try doing TR while I'm still able to work from home. I don't know when I'll be back in the office full-time, but it will definitely be two or three weeks, most likely, although I'll have to go in occasionally for meetings - but I guess I could leave HC food out on those days if I'm feeling nervous.

@Wendy&Neko , what do you think? Would it be worth me trying to do TR even if I can only do it for two (or three) weeks straight before having to go back to SLGS as I'd be back at work?
 
Girlie's mom said:
Another silly question: a cat could potentially go into remission using SLGS, couldn't they? Or do they need the intensive part of the TR to possibly go into remission?
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Cats on SLGS do go into remission. Perhaps not as high a percentage of cats as on TR, but we have lots of examples of SLGS kitties that are OTJ. And it really is ECID on how long or if a cat goes into remission. Neko was almost 5 years on insulin, fairly regulated, and never went OTJ, but she had a few complications. The IAA and acromegaly were out of my control. Since then, cabergoline has gone into trial and acro Marvin has seen the benefit. Other cats with a change in diet and insulin support practically fall into remission.

If you think you can do TR (and you definitely test enough to do so), then it totally makes sense to do for a short term. Some people work and still do TR. If you have a few weeks experience with it, you may decide it's fine to stay on TR. If you were following TR, I would increase to 0.5U at your convenience.

The clock on the + times starts after the injection. I would test, then feed, then load the syringe and shoot. It could take up to 15 minutes if the syringe was being fussy. Neko was on raw so took less than 30 seconds to finish her food, so I shot after she'd eaten.
 
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