4/14 CRYSTAL AMPS 175 +4 232 PMPS 320 | Feline Diabetes Message Board - FDMB

4/14 CRYSTAL AMPS 175 +4 232 PMPS 320

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suki & crystal (GA)

suki & crystal (GA)

Member since 2014
yesterday's R session

Crystal has started the day as she finished yesterday at 175. No R today so coming back into yellow numbers. I have to go out for a couple of hours and can't find her, I think she's found a cool spot in the shubbery out of the sun. bbl
 
One thing you can do...

If her numbers start climbing too quickly is to give her a little bit of R around +7 or +8. I wouldn't recommend the whole dose that you currently have on your scale, but if she is nearer to 300 when you get back, you could give her 1uR and see how it works in conjunction with that Lev onset - that's why I wouldn't give more than 1uR because you don't want her to come down too quickly.

Just an idea I thought I'd toss out there.
 
@Suzanne & Cobb(GA) , that's a really good idea, shame I didn't get back until nearly +11 so I've missed the deadline, drat. But I'll bear that in mind for future use, I was wondering whether I could use the R at a different time from PS, but don't have enough experience for that one, I've only just mastered giving R in conjunction with the Levemir. I didn't want to do R tonight as we are out quite a bit tomorrow morning and afternoon, not sure what time we will be back but in good time for PM shot. But definately Friday morning for another go with the R. Have a problem with Saturday as we will miss her PM shot at 18.00 completely and not likely to be home until nearly midnight, which would have been her +6. I'm wavering whether to just miss the shot altogether and given her the usual 06.00 shot the next morning, or try the 18 hour shift, I know it will throw her numbers out but unavoidable this weekend. What do you think?
 
I think the 18 hour schedule on Saturday sounds like a good one. It seems to not impact the BG's as much as a complete skip. And with R in your toolkit, you can use that too.

When you see a pink preshot and you can't monitor closely, you could always try a lower R dose than your usual scale, just to try to keep a lid on things.
 
suki & crystal said:
@Suzanne & Cobb(GA) , that's a really good idea, shame I didn't get back until nearly +11 so I've missed the deadline, drat. But I'll bear that in mind for future use, I was wondering whether I could use the R at a different time from PS, but don't have enough experience for that one, I've only just mastered giving R in conjunction with the Levemir. I didn't want to do R tonight as we are out quite a bit tomorrow morning and afternoon, not sure what time we will be back but in good time for PM shot. But definately Friday morning for another go with the R. Have a problem with Saturday as we will miss her PM shot at 18.00 completely and not likely to be home until nearly midnight, which would have been her +6. I'm wavering whether to just miss the shot altogether and given her the usual 06.00 shot the next morning, or try the 18 hour shift, I know it will throw her numbers out but unavoidable this weekend. What do you think?
Click to expand...
I would do the 18 hour shot. It's better than nothing -- and remember you have the R to give at that +18 to help bring her down some. I always hated making progress and then having to rearrange for an 18 hour schedule, so I know what you're feeling.

You're doing great with the R. And Crystal is responding to your doses quite well at PS times. The mid-cycle was just a suggestion on a day like today when she's in good numbers for the AMPS, but headed up. You just want to make sure that the R onset doesn't coincide with the L onset because then she can zoom down too quickly and set up a bounce and then you can get caught in an ugly bounce cycle. But...I think anytime in the second half of the cycle is fine to give a smaller dose of R (personally...I know others will disagree) because it can bring down that preshot number and sometimes, not always, that can help keep numbers lower and the Lev can really work. OR...and I always tended to overlook this -- it can hold the BG steady instead of climbing so high. So if you were to give a small dose of R at (this is all hypothetical) +9 with a BG of 250, that might hold the BG at 250 or 270 instead of jumping to 320. Of course, ECID always applies.
 
@Suzanne & Cobb(GA) @Wendy&Neko
Thanks Wendy & Suzanne for your thoughts. Can I just confirm that I have this right for 18 hour schedule: normal AMPS at 06.00 on Saturday morning, miss PMPS at 18.00 Saturday evening(as out) give shot at 12.00 midnight on Saturday night instead (possibly with R, normal dose depending on PS or slightly reduced? bearing in mind I will want to get to bed), then what, when is the next shot, 18.00 on Sunday?? then back to normal schedule with AMPS on Monday morning.

Referring to the the R onset not coinciding with the Lev onset, can you give me an example using one of her trial days as I'm still not sure exactly when the onset occurs, that would be a great help. Thanks
 
So you would do a 06:00 on Saturday morning. A midnight shot Saturday night. And then a 18:00 (that's 6pm, right?) shot on Sunday evening.
 
@Suzanne & Cobb(GA) thanks Suzanne for confirming that. Social life gets in the way sometimes but can play havoc with the dose times. Sorry I edited the above post (whilst you were typing your answer) to include the query about the R, no rush, just seeking clarification. thanks again.
 
This is not my strength...finding onsets, but looking at yesterday, it looks to me like the onset fell about +5 or +6. That's when Crystal's BG started moving...in my opinion. It looks like the 2.5uR kept her steady through +5 and then Lev kicked in and brought her down. (I'd love others to weigh in on that though @julie & punkin (ga) @Wendy&Neko).

I know you don't know about IAA, although I'm guessing we are assuming she has it. With IAA, onset can move around. Cobb would have onset sometime between +7 and +12. That was one of my reasonings to shoot a lower dose of R at a mid-cycle shoot versus a preshot. Does that make sense? I hope I'm making sense in my thoughts!
 
Crystal's cycles are really interesting - you shoot the R with the Lev, and the BGs slide down for about the next 12 hrs.

I'm reading the ss much like Suzanne. It looks to me like R gives an enormous boost to the Lev because it consistently lowers the BG that the Lev is beginning with. The the Lev takes off and just runs with it.

On a day you hadn't used R, it looks like the nadir of the Lev is (at least sometimes) around +9. If you want to use R at a different time in the cycle, I would simply wait until I'd tested and saw that the Lev was beginning to wane and her BGs were beginning to rise. I'm not sure that you need a completely different R schedule because you're shooting at a different time in the cycle. I think you ought to be able to use the same one.

But the way to know these things is to try it. You are cautious enough and you have a very good sense about this, Suki. Trust yourself. :bighug:
 
I agree that Crystal's onset seems to be somewhere around +5. Nadirs on cycles without R are somewhere between +7 and +12 for Crystal. Variability in nadir is not uncommon with IAA. I've seen Neko nadir anywhere from +5 (her onset) to +15, though it's most often between +9 and +12, unless her before bed test is about the same or lower than PMPS in which case it's earlier, unless it isn't. Yes, it's that complicated. Cats! :rolleyes:

It is interesting how R seems to really extend the duration of the Lev - a lot of her nadirs are later in cycles with R, especially those that get her into blue.
 
Wow, you certainly have the experts on the job today Suki!
We are sooooo lucky to have them to guide us:) They know so much more than the vets do with dosing and the behaviour of the cat with diabetes.

Hope your next R goes well. We never know what our kitties will do next, do we:joyful:
 
@julie & punkin (ga) @Suzanne & Cobb(GA) @Wendy&Neko

I totally agree Bron, I have the best possible team on Crystal's case. Thank you all so much for you input, I really appreciate all the time you took to explain everything. It's a bit early for my brain to be functioning (06.00) so I shall print this post and keep it for future reference with my R schedule so I can refer back when in doubt. So much still to learn. We are having a day off out from working in the garden and going up the coast for lunch so no R today, but back on track for tomorrow AM.

@Bron and Sheba - I found her hiding spot under a large shrub, her white paw gave her away - there is no escape Crystal!
 
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