4/14 Jez AMPS 195 +2 138 +3 89

[morrieb1]

I think we are done bouncing and back on track....at least the numbers look like I expect. I've gone back to a regular .5 last night because I wasn't paying attention - but the preshot is good this morning so I'll just leave it there and call it a mini-reduction.

Now, I could use some advice on what I should do with the next low preshot. Like Doombuggy, I can't monitor often on the weekdays because of work. The protocol gives me three choices: stall, skip, or shoot a reduced dose. I've actually tried all three....and once I did both - stalled for an hour and then cut the dose. All of them seem to have the same effect - I get a bounce for the next cycle or maybe two and then we are back on track. Stalling beyond an hour isn't generally possible because of my work schedule.....I shot at +15 on Friday because I came home, saw she was up to yellow, and figured I'd have the weekend to get her back on track - and it looks like it worked.

Here's what I'm thinking might be happening....

Back when I started home testing, about a month into Jez's diagnosis, Lantus was working longer than 12 hours for her and so the vet had me on once a day....and when I switched to twice a day I had a few too low to shoot times right off and some stalls as well. Looks like we're back to that pattern - and when I read the sheet, I think Lantus is still hanging around longer with her....a lot of times those +2 numbers are lower than the preshot. So every few days those overlaps are enough to give me a low preshot...

Now obviously there is no way I can shoot on a 14 hour cycle even if that made sense to try. But if I'm understanding the concept of Lantus correctly, it is really important to shoot a consistent dose to enable the shed to stay filled and to maintain a nice steady curve in good numbers....so although I was thinking - continue to stall when I can and skip when that doesn't work - and don't shoot below 160 (I'm still a bit unnerved by her ability to dive).

But if you (and that includes all of you over here that care to weigh in ) think a reduced dose is a better choice because of the consistency......or for that matter if I should take her down to .25 as her regular dose and see what that does, I'm up for it.

 

[MommaOfMuse]

Re: 4/14 Jez AMPS 195

I'm going to give you another option...Shooting low to stay low. Now it is scary to do this when you can't be around to monitor, but the last option is to set a low no shoot number of say 120 (high end of normal) and shot the full dose into a low number. If that is something you want to consider I would try for a curve today since she did give you a low preshot this morning, see how far she will drop today and base the decision on how to handle the next low preshot on that curve's nadir. If she doesn't drop below 50 today then you should be safe to shoot low to stay low, if she does drop below 50 today then she will have earned a reduction and you can take her down in dose.

However, with Autumn I learned that once I got to .5u it worked better to reduce her by less than a full .25u, it was better to start reducing drop by drop, because if you think about it a .4 is still a 10% reduction in dose. Just my 2 cents worth.

Mel, Maxwell, Autumn & The Fur Gang

 

[morrieb1]

Re: 4/14 Jez AMPS 195

I'm going to give you another option...Shooting low to stay low. Now it is scary to do this when you can't be around to monitor, but the last option is to set a low no shoot number of say 120 (high end of normal) and shot the full dose into a low number. If that is something you want to consider I would try for a curve today since she did give you a low preshot this morning, see how far she will drop today and base the decision on how to handle the next low preshot on that curve's nadir. If she doesn't drop below 50 today then you should be safe to shoot low to stay low, if she does drop below 50 today then she will have earned a reduction and you can take her down in dose.

However, with Autumn I learned that once I got to .5u it worked better to reduce her by less than a full .25u, it was better to start reducing drop by drop, because if you think about it a .4 is still a 10% reduction in dose. Just my 2 cents worth.

Mel, Maxwell, Autumn & The Fur Gang

Thanks Mel - I just got a +2 138 and that's with a bit of food in it.....today is a great day to run a curve. But you see what I mean about her dropping earlier - so all the information about how you can shoot low because the number is rising concerns me.....because I'm not sure the number IS really rising at +12 like the "shoot low" sticky says. That said - those low number troubles were at a higher dose, so if you'd like to share a set of your BoS - I'll drop my don't shoot number

But I think if I have to drop I'll probably start with .25 unless you send me the really big set........

 

[MommaOfMuse]

Re: 4/14 Jez AMPS 195 +2 138

LOL Lets just see where she goes today. But if she is dipping like this with food on board you may have some pancreas action. And who knows she may tell us today on the curve which way to go, as she just might earn herself the reduction. Afterall that is the purpose of curves to adjust the dose on.

Mel, Maxwell, Autumn & The Fur Gang

 

[morrieb1]

Re: 4/14 Jez AMPS 195 +2 138

LOL Lets just see where she goes today. But if she is dipping like this with food on board you may have some pancreas action. And who knows she may tell us today on the curve which way to go, as she just might earn herself the reduction. Afterall that is the purpose of curves to adjust the dose on.

Mel, Maxwell, Autumn & The Fur Gang

She's definitely heading downstairs - edit =- but she seems pretty happy hanging around 100
AMPS 195
+2 138
+3 89
+4 108
+5 99
+7.5 269
+8 292
+10 252



But a gorgeous day, open windows, happy cats, and plenty of testing strips....I'm going to treat this like a workday in the sense that the food will stay where it is and I'll make sure there's a bit more at noon (like the frozen one I set out in the morning when I work)....and I'll leave her alone unless she gets scary low.

Edit "I am not sure what triggered the bounce....thought she bounced off a 117 yesterday - so maybe it just is what it is.

 

[nckitties3]

Ya know, since you work and put out frozen, etc, you might try doing it on a weekend day, exactly like you do during the week. Don't feed any more often, put out the frozen, etc, as if you weren't home, except run your curve.

I am so grateful I am not working right now, I couldn't handle Lucian if I was. Only time in my life I'm glad to be unemployed. Of course, I have some income from the Worker's Comp, albeit a small amount, I can get by, it's just hard. Had to make some changes and get some outside help, but, hopefully, we'll make it.

Her numbers look great. As I understand it, it's better to reduce the dose and shoot twice a day, than to keep the dose and shoot once. Lantus doesn't work well like that and Vets don't seem to understand that sometimes. Lantus is taken once a day in humans, but twice in cats, due to the faster metabolism. I am still constantly amazed by what Vets DON'T know. But like Mel has said, it's impossible to know everything about every animal and every disease.

It's up to us to learn and use our knowledge to help our cats, we ARE their best bet for treatment, the vets certainly aren't. My blood still boils every time I think about Lucian's vet. :evil:

 

[morrieb1]

Ya know, since you work and put out frozen, etc, you might try doing it on a weekend day, exactly like you do during the week. Don't feed any more often, put out the frozen, etc, as if you weren't home, except run your curve.

I am so grateful I am not working right now, I couldn't handle Lucian if I was. Only time in my life I'm glad to be unemployed. Of course, I have some income from the Worker's Comp, albeit a small amount, I can get by, it's just hard. Had to make some changes and get some outside help, but, hopefully, we'll make it.

Her numbers look great. As I understand it, it's better to reduce the dose and shoot twice a day, than to keep the dose and shoot once. Lantus doesn't work well like that and Vets don't seem to understand that sometimes. Lantus is taken once a day in humans, but twice in cats, due to the faster metabolism. I am still constantly amazed by what Vets DON'T know. But like Mel has said, it's impossible to know everything about every animal and every disease.

It's up to us to learn and use our knowledge to help our cats, we ARE their best bet for treatment, the vets certainly aren't. My blood still boils every time I think about Lucian's vet. :evil:

Hey Deb, that's what I'm doing. Unfortunately my errands took longer than I thought so I missed a 6 and the 7.5 is such a jump that I'm going to test again now and see if it was a fluke - Nope we are bouncing - but I have no idea off what.

And I know what you mean...but I think my vet was looking to give me an easier treatment plan - not that she "didn't know" twice a day was best. She knew I was pretty much at my budget's limit by the time she finished that second curve (I was in over 2 grand at that point). They weren't saying anything about home testing - and this had been the second curve in three weeks at almost 300 a time. So she was trying to keep the cat safe from a hypo and give me a life.

I don't fault her for that. A cat getting insulin once a day and not going too horrifically high inbetween is much better than a cat that goes hypo when the owner isn't home or has an owner debating euthanasia because they don't think they can meet the requirements of caring for a diabetic cat.

 

[nckitties3]

You are fortunate to have your vet then, Lucian was not so lucky.

 

[morrieb1]

You are fortunate to have your vet then, Lucian was not so lucky.

For years I was fortunate - now they've expanded to a dozen vets and some are better than others - you need experience to know who to ask for and who to avoid. I've had some bad experiences with other pets, so I know where you are coming from - and I'm sorry Lucian wasn't treated properly.