4/14 Fred AMPS 476 Help with R, please

Discussion in 'Lantus / Levemir / Biosimilars' started by Purrberry, Apr 14, 2021.

  1. Purrberry

    Purrberry Member

    Joined:
    Dec 11, 2020
    @Wendy&Neko ...I know I asked about this a bit ago. But I feel like I am in an endless cycle with Fred, and it has to be taking its toll on him.

    We hit 90 early Tuesday morning, the first green in a very long time, and certainly after his pancreatitis bout. However, even with my joy at seeing the number, I knew he'd pay for it. The main trouble is, when Fred has a bounce they last for DAYS. So for the sake of a few hours in good numbers, he suffers for three days flat and high. I'm desperate to get his body used to lower numbers, and I feel that maybe the R could help me do that...even just a little bit.

    If Fred is hitting 90 (and that's just what I caught) then I'm not comfortable just upping his Lantus. By SLGS, he was only one point away from a reduction. So I really would like to try the R, and would appreciate any guidance from those experienced with using it.
     
  2. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Here is the link to your last post here: https://felinediabetes.com/FDMB/threads/4-10-fred-4-308-amps-365-3-348-pancreatitis-dx.245999/ We ask that you include those links so it's easy for us to go back and check the history.

    I agree Fred needs more insulin, I'm not sure R is the way to do it. Let me talk with a few people and see if they think R is the way to go. If so, I personally do not have time to help with it right now, but someone else might. Any chance of doing away with dry and moving to TR? He really needs more Lantus. Being on a dose where he briefly sees the 90's (still very safe) will not get him to a point where he gets comfy with greens.
     
  3. Purrberry

    Purrberry Member

    Joined:
    Dec 11, 2020
    Sorry...I will remember to link next time.

    I appreciate you reaching out on Fred's behalf. Please know that I absolutely don't remotely pretend to have more wisdom than those on this board with years of experience and practice. It's thanks to this board that I learned about R (and so many other things) in the first place!

    Though I know there is some room when hitting a number like 90, I also know that I may not have caught something lower. And with the 20% meter variance, that 90 could have been 72, or it could have been 108. I really do not want his magic dose to make itself known by Fred going hypo. It's too scary for me. Just getting to those few greens that we've seen shows his body *can* get there, but then freaks itself out. So I thought the R might be the tool to get him down a bit, and thus give the Lantus something to "grab on", as I've heard people say. My hope is that he could then be a bit more "steady as she goes"...not have such dramatic swings.

    I've cut his dry by about 75%, but he will fight to the last for that last 25%. As a cat who was hoarded, he has that mentality.
     
  4. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    R is something we usually add for people following TR. For one thing, using R requires extra testing. For another, how dry food impacts the numbers is not as clear as it is to wet/raw. R can be a great tool to use, but there is a lot to learn about when to, and more importantly, not to use R. In the wrong hands it can make the situation worse. Too much R can make the bouncing even worse, which is why we suggest people start with someone helping them out. Typically it is cats with ketones or with diagnosed high dose conditions that we suggest using R.

    How is Fred's pancreatitis? Is the flare over? Was he gaining anything for pain relief? I've seen p'titis impact numbers, so wondering if that is in the picture too.

    Playing "what if" games with meter numbers will drive you crazy. Do you mind adding AT to your signature, so we know you are using a pet meter.
     
  5. Purrberry

    Purrberry Member

    Joined:
    Dec 11, 2020
    I understand...I do. I know any tool can go awry in the wrong hands.

    Fred is (knock on wood) doing well now. He's acting fine, with the exception of his higher numbers. He's very hungry when in the 300's. I just wish there were something that could help prevent the flares, rather than treating them when they happen.

    I've tried to add a couple of things to my signature, but it says it runs too many characters too long. So I have to cut it down to the bare minimum. Not sure if there's something I'm doing wrong?
     
  6. Purrberry

    Purrberry Member

    Joined:
    Dec 11, 2020
    Oh, MAN. This cat sure does make my life interesting. He was all over us at dinner....wanting table food, etc, even though he had had his dinner. I thought, "Dang it, he's high again". He fought me on the PMPS test, which is not normal at all. I almost just shot him, figuring I knew what was what when I finally got a test in. He was at 109!! Gaaaahhh!

    I panicked. I gave him 3.5. I've never had a PMPS that low, and if he weren't on 6u, I'd have gone for it. So I gave him 3.5. Chicken shot. :( I knew he wouldn't come up any time soon...that I know from data.

    As you have said to me a few times.....they will surprise you! You're SO RIGHT! Scary!
     
  7. Liz & Minnie

    Liz & Minnie Well-Known Member

    Joined:
    Feb 4, 2021
    I think you can make space if you edit the spreadsheet link - highlight the text "Fred's SS" and click on the link icon, then paste the url of your spreadsheet into the popup. "Fred's SS" will show as a hyperlink in blue and you can delete all the "https://docs...etc" which should clear up some text (I think!)
     
  8. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    When you shoot your lowest yet, a +1 and a +2 are a good idea to see how the cycle will go.

    And by the way, size of dose doesn't make a difference in how you shoot low numbers. But given your experience to date, a partial dose (or BCS - big chicken shot) is a good way to gather data for the next time you see a lower preshot.
     
  9. Sandy and Black Kitty

    Sandy and Black Kitty Well-Known Member

    Joined:
    Dec 31, 2009
    Stay focused on the transition to all wet low carb. Once accomplished you will have a solid foundation to work from.
    That one change alone has potential to reduce overall BG and in turn reduce insulin needs.

    With SLGS after a week on a given dose evaluate the dose by doing a 12 hour curve (testing every 2 hours) OR an 18 hour curve (testing every 3 hours).
     
    Suzanne & Darcy likes this.
  10. Purrberry

    Purrberry Member

    Joined:
    Dec 11, 2020
    I can't seem to get that to work... :-/

    Yes, I'm a big fan of the +2. Last night by +2, he was already up to 275. :banghead: In the past, however, he's continued to drop for a time. Full of surprises is my Fred. It's why I struggle to get any kind of consistent picture.

    We are trying...so hard. There are a number of factors in play, including the fact that Fred will not touch commercial wet. If I leave a block of frozen raw in the timer feeder for him to eat later, he won't touch that, either. So when I'm not home or asleep, his dry (which is a mix of Dr. Elsey's and YA) is the only option. Even then, he will sometimes not eat it. He much prefers to wake me up 4 times! :rolleyes:
     
  11. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Oct 8, 2020
  12. Purrberry

    Purrberry Member

    Joined:
    Dec 11, 2020
    Thank you @PerfumedCatMom OMG...I am usually much better technically than this. Am I doing this adjustment in my signature page? I'm afraid I'm going to accidentally delete the link to Fred's SS.
     
  13. Katherine&Ruby

    Katherine&Ruby Well-Known Member

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    Oct 8, 2020
    Yes, click on your name on the top of this page and go to Signature.
     
  14. Purrberry

    Purrberry Member

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    Dec 11, 2020
    Got it...thank you!
     

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