31-Oct Mav AMPS 468|PMPS 337|+3 270

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Christie & Maverick

Christie & Maverick

Member Since 2017
Yesterday

I had hoped to get some feedback on possibly increasing Maverick's dose, but I guess that didn't happen. I've kept him at 1.25u, assuming that reaching 79 once in a while is good enough.

I'll keep trying to do some more reading, as it seems I'm on my own. Sorry to have bothered anyone with my post yesterday, I was just trying to get a better understanding and some guidance.
 
Sorry no one gave some advice on dosing yesterday. Sometimes threads end up further down the list and are missed. If that happens just "bump" your post by adding any comment.

Maverick is seeing some good numbers on the 1.25 unit dose. This dark greens are great numbers for an AT2 meter. He is doing some bouncing from getting into more normal numbers, but it will just take some time for his body to adjust to being back in good numbers. As long as he is still hitting dark greens I would suggest holding the dose. With Lantus you are more concerned with how low a dose gets the numbers rather than the higher preshot numbers.
 
It's okay, thanks for the reply. I know things get busy here sometimes, and with my mid-cycle tests last night, I guess I'm just a bit tired this morning.
Tuxedo Mom said:
As long as he is still hitting dark greens I would suggest holding the dose. With Lantus you are more concerned with how low a dose gets the numbers rather than the higher preshot numbers.
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I understand, and have been applying this thinking, but it seemed he was getting into a repeat pattern from six cycles ago, where he briefly hits the dark green then other nadirs are just high blues or yellows thereafter. I thought maybe I was missing something with the TR protocol, as we have been on 1.25u for 8 days.

I'll keep on going with 1.25u. I appreciate your help.
 
Alicia & Maggie said:
Hey, I checked in on you yesterday, but don't feel comfortable giving advice. :bighug: You probably already know, but you can tag someone specific by including their user name, like this @Alicia & Maggie , and it will notify them specifically. Hope you see some downward action soon. :)
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You are always so supportive, that is very much appreciated :bighug:. I am mostly frustrated at the fact that Maverick likes to drop in a few greens just when I think it's time to increase, then promptly floats along for 6 cycles lol. I wish he would stop reading his condos o_O
 
Christie & Maverick said:
It's okay, thanks for the reply. I know things get busy here sometimes, and with my mid-cycle tests last night, I guess I'm just a bit tired this morning.

I understand, and have been applying this thinking, but it seemed he was getting into a repeat pattern from six cycles ago, where he briefly hits the dark green then other nadirs are just high blues or yellows thereafter. I thought maybe I was missing something with the TR protocol, as we have been on 1.25u for 8 days.

I'll keep on going with 1.25u. I appreciate your help.
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From the TR protocol:

http://www.felinediabetes.com/FDMB/threads/lantus-levemir-tight-regulation-protocol-tr.1581/

"
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.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • 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."
"when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing."
Now this is where you have to do some rough estimating. The 100 number would be 5.5 mmol/L ( I am in Canada so I understand mmol) However this protocol is based on using a human meter and the AT2 meter reads higher than the human meter. Normal numbers on an AT2 meter would be in the 4.0-7.0 range which Maverick is hitting at nadir right now. What ideally you would like to see happen is for the bouncing to even out and for the preshots to start to drop into lower ranges, but that can take some time to accomplish. TR is a more aggressive protocol and the one thing you don't want is to cause the numbers to drop too low and possibly risk a hypo.
 
What is Mav's feeding schedule like? While he's hitting those greens at night which are good nadirs, he's had some pretty big drops early in the cycle. (4 out of the past 5 PM cycles). I'm seeing those drops at night are causing more of the bouncing during the day. Many times there's not much you can do but might think about getting some +1, +2 & +3 and if he's already dropping at any of those points feed a little LC. It would be an experiment but maybe it'll help flatten him out. Of course it doesn't happen every cycle so you'd have to experiment more then a cycle or two. The good news is, he's clearing bounces quickly.
 
Thank you for the suggestions, I have been so focused on number of cycles and doses, I wasn't sure if the level of bouncing Maverick is doing in one part of the day could be better managed. I'll give it a try. It is more difficult using the AT2 meter; Since the numbers in the protocol don't correlate well with what I see. I've been thinking about switching to a human meter. And, I constantly have to convert from mg/dl to mmol/L.

Maverick gets fed smaller amounts of food usually at test time, and larger meals 3x a day (breakfast, lunch, dinner). I have started counting calories and weighing him, to make sure I'm not overfeeding him.

Anyway, thanks again.
 
Glad to see the US sheet looks much better now. I am too new to this game to give any dose advise, but I would think those 70s & 80s with an AT meter means hold the same dose.
 
Bronx's dad said:
Glad to see the US sheet looks much better now. I am too new to this game to give any dose advise, but I would think those 70s & 80s with an AT meter means hold the same dose.
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Thanks for always looking in on how we are doing! And pointing out my spreadsheet issues :), hope Bronx is doing well. Yes, those intermittent 70s and 80s...just wish I could get more of them :rolleyes:
 
Sorry I didn't respond yesterday. DM broke her hip 4 weeks ago and life has been on fast forward since then. I busted her out of hospital and delivered her home today (involves a ferry ride), so I am hoping to have more board time now.

Karen has hit the nail on the head with the food suggestion. I think it would be good to try to prop up those lower numbers, so you can get a smidgen more insulin in him. He isn't getting the same meals AM and PM. I would try to make both cycles feeds be the same, or at least closer and the same amount of calories. Maybe add a +3 in the PM? His isn't extra food, just different portion sizes.
 
Wendy&Neko said:
Sorry I didn't respond yesterday. DM broke her hip 4 weeks ago and life has been on fast forward since then. I busted her out of hospital and delivered her home today (involves a ferry ride), so I am hoping to have more board time now.

Karen has hit the nail on the head with the food suggestion. I think it would be good to try to prop up those lower numbers, so you can get a smidgen more insulin in him. He isn't getting the same meals AM and PM. I would try to make both cycles feeds be the same, or at least closer and the same amount of calories. Maybe add a +3 in the PM? His isn't extra food, just different portion sizes.
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Thanks so much Wendy, I'm sorry to hear that your DM broke her hip, those can be challenging injuries to recover from, best wishes for a good recovery. I had to chuckle at your comment that you busted her out of the hospital! You have often provided guidance and reassurance, please don't apologize that you weren't available last night. You can only do so much here, and having a real life outside as well, I always appreciate your input.

I'll try and reconfigure my feeding portions, I was trying to get more calories in earlier in the day, but balancing the am/pm feeding makes a lot of sense. He really is doing great, the numbers sometimes are just what they are.
 
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