4/14 Morlei AMPS 236 +11.5 192 +12 175 +12.25 197

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Becky & Morlei

Member Since 2012
Thought we were going to have another flat day.
But....at +5.5 we finally got some action!!

AMPS 236
+3 232
+5.5 138
+6 144

Lowest number we have ever had on either insulin!!
She's up to 7.5u. Decided to do a full unit increase because I was home all day yesterday and I wanted to try and get her out of those flat high 200s.
:-D :-D :-D :-D
Very happy day for us!

(I'm going to start posting more, I promise!)

ETA: Just so everyone knows, I carefully weighed the benefits and risks of doing a full unit increase. Because she reached 138 today we'll be sticking to this dose for at least 6 cycles. Didn't want anyone to think I'm nuts!
 
Re: 4/15 Morlei AMPS 236 +3 232 +5.5 138! Finally a blue!!

Just as an FYI, with a cat that's on a higher dose, we generally suggest 0.5u increases. It's usually not until a cat is well over 10.0u that a full unit increase is even a consideration.

Please remember that the effects of Lantus are cumulative. You may not see the effect of such a big increase until the next couple of days. Please, for safety's sake, monitor carefully.
 
Re: 4/15 Morlei AMPS 236 +3 232 +5.5 138! Finally a blue!!

Hi Becky - good luck with the new dose. How nice to see Morlei post some blues. Good that you were home to monitor when you increased. That should give you great data! Keep those blues coming Morlei. :-D
 
Re: 4/15 Morlei AMPS 236 +3 232 +5.5 138! Finally a blue!!

Yes Morlei! We'd love to see blue & more blue!
 
Re: 4/15 Morlei AMPS 236 +3 232 +5.5 138! Finally a blue!!

An increase of 1u for a cat with a high dose can be just fine... many high dose cats are using the 2 steps forward, 1 step back tactic if numbers seem stuck or if it's needed to get in front of resistance. You can easily drop back by .5u on the next shot if you feel that the 1 cycle at 7.5u accomplished what you wanted.

Increases of 1u are considered before the 10u dose mark, among high dose cats. I did not start 1u dose increases with Oliver until we hit 11u, but I was also giving him 4uR QID, so my approach was not with just Levemir. Many high dose owners have found the method up 1u, dn .5u works very well.

On your next shot, it would be an idea to drop off .5u to be safe... you caught Morlei's attention, so hopefully that's all you needed to bring her BG level down to some lower numbers.
 
Re: 4/15 Morlei AMPS 236 +3 232 +5.5 138! Finally a blue!!

Gayle Shadoe & Oliver said:
An increase of 1u for a cat with a high dose can be just fine... many high dose cats are using the 2 steps forward, 1 step back tactic if numbers seem stuck or if it's needed to get in front of resistance. You can easily drop back by .5u on the next shot if you feel that the 1 cycle at 7.5u accomplished what you wanted.

Increases of 1u are considered before the 10u dose mark, among high dose cats. I did not start 1u dose increases with Oliver until we hit 11u, but I was also giving him 4uR QID, so my approach was not with just Levemir. Many high dose owners have found the method up 1u, dn .5u works very well.

On your next shot, it would be an idea to drop off .5u to be safe... you caught Morlei's attention, so hopefully that's all you needed to bring her BG level down to some lower numbers.

Thanks, that was what I was thinking about doing. She was 170 at +9 so I don't think we'll have a high pmps tonight...DH has the day off tomorrow and will be staying up late tonight so he can definitely monitor her. I've actually had her on 7.5u for 3 cycles now, we started it yesterday morning because I was home all day. Her lowest number yesterday was 190. Today it was 138. So tonight I decrease the dose down to 7u and if her nadirs continue to be under 200 I'll wait the 3-5 days until considering an increase? And if her nadirs continue to stay under 200 but an increase is needed would I up it by .25 (as the protocol states) or .5 (because she could be considered a high dose kitty)?
And in the future, if the numbers seem stuck and I feel the need to increase by 1 unit again, I should only do it for one cycle then drop back by .5 at the next shot?

I'm glad that others have taken this approach, I thought I was being a little risky by doing it but I really felt the need to get in front of the resistance. She's been happy all day long, she's not a very active kitty but has been so loving and cuddly today that I know she's got to be feeling pretty good. I went out and bought a few more cans of med/high carb food just to be on the safe side. And we already have karo and dry food as well.
 
Re: 4/15 Morlei AMPS 236 +3 232 +5.5 138! Finally a blue!!

It's often necessary to veer off the usual path with higher doses and suspected resistance, but you still can hold to some of the basics. It's important to remember that the protocols are written for diabetic cats, ones with pancreas issues, and not insulin resistant cats. Some basics will remain, no matter what, such as shed and watching nadir, and being able to spot your cat's trends.
Some cats take a bit longer to realize dose changes, and once you know Morlei's style, you can work it to his advantage.

OK, on c1 of the 7.5u dose, you got a nice blue 190 at +6, and then a bit of a bounce maybe at c2 of 7.5u with the 326. On c3 of 7.5u, you got a nice recovery with amps of 236, and a longer string of blue which is good to see. Now, it's up to you if you want to continue at the 7.5u or drop back by .5u. No matter what you decide and do, it's all data and will help you know how Morlei reacts.

There are no hard and fast rules of holding for a definite 5 or 6 cycles because you cannot predict what BG numbers you will get. If you see numbers not coming down, you could consider being a bit more aggressive and increase every 5th cycle or even every 4th cycle.

It all depends on the boss's numbers, so wait till Morlei lets you know.
 
Re: 4/15 Morlei AMPS 236 +3 232 +5.5 138! Finally a blue!!

+11 186
+11.5 192
I'm a little worried, I've never shot a number this low.
I'm definitely going to back up the dose to 7u...ok you don't shoot a reduced dose because reductions are based off of nadirs, not pre-shot numbers right?
Ok I'll get a test in a few minutes to make sure she's rising, if she's rising am I ok to feed and shoot 7u? Or does it need to go back down to 6.5u? (That's contradicting my previous sentence but I'm freaking out a little).
 
Re: NEED ADVICE ASAP PLEASE +11.5 192 +12 175 Do I shoot??

+12 175
What???

Ok, stalling for another 15 minutes to see if it goes up.
 
Re: NEED ADVICE ASAP PLEASE +11.5 192 +12 175 Do I shoot??

+12.25 197
Looks like she's rising so I decided to give her some food and we'll shoot 7u and keep a very close eye on her tonight. I hope what I'm doing is right!! :?
 
Re: NEED ADVICE ASAP PLEASE +11.5 192 +12 175 Do I shoot??

Well done Becky you did good :-D I know it's the lowest number you've shot but it's a good thing to do that (shoot low to stay low) I am so happy to see Morlei's numbers move! For next time there was no need to stall looks like Morlei was having a double dip. Some cats will drop a little lower again at +12. Your trick to knowing it was a double dip is that she was higher at +11.5 and not lower than her nadir. Good job on the testing :-D

Usually when it's the lowest number you've shot you are advised to get a +1 as well as +2 but I think you are okay to wait until +2.

I am at work and shouldn't even be on here now but will check back in as soon as I get home (about an hour and a half).
 
Re: NEED ADVICE ASAP PLEASE +11.5 192 +12 175 Do I shoot??

Vyktors Mum said:
Well done Becky you did good :-D I know it's the lowest number you've shot but it's a good thing to do that (shoot low to stay low) I am so happy to see Morlei's numbers move! For next time there was no need to stall looks like Morlei was having a double dip. Some cats will drop a little lower again at +12. Your trick to knowing it was a double dip is that she was higher at +11.5 and not lower than her nadir. Good job on the testing :-D

Usually when it's the lowest number you've shot you are advised to get a +1 as well as +2 but I think you are okay to wait until +2.

I am at work and shouldn't even be on here now but will check back in as soon as I get home (about an hour and a half).

Thanks for checking up on me! And I'll definitely remember the double dip trick. I was hoping that's what it was but I was too busy freaking out when I saw the lower number to think haha.

+1 256
+2 260
+3 233

Looks like we'll be good for the night! I'm going to bed, DH will test and feed her between +4 and +5. He knows to wake me up if there's any problems and knows where the hypo kit is.
 
Very nicely done!
Yesterday's curve was great, and you were wise to wait for a rising number. If ever in doubt, wait for a couple rising numbers.
Hopefully, the drop of .5u will a good fit, and Morlei will continue with these good numbers.
 
Vyktors Mum said:
Sounds like your DH is lovely - can you clone him??
He is pretty good with the cats but can't remember to wash a dish to save his life! :lol:
But I'm very grateful that he's willing to help out in any way he can.
 
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