4/16 Rocky PMBG 52 +13 72 +14 105 +23 477!!

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Tina & Rocky

Tina & Rocky

Member Since 2013
Good morning,

viewtopic.php?f=9&t=117283&p=1231113#p1231113

It *looks* like Rocky might have surfed a few blue numbers since at least PMPS +4 last night. If so, that would be at least 9 hours that Rocky spent in the lagoon last night. :RAHCAT

I tested him at PMPS +6.5 (4:30am) and he was at 150. Then five and a half hours later for his AMPS he was still in the lagoon at 161. :mrgreen:

I think this is the first time that Rocky has surfed so many hours in the lagoon!! Yeah Rocky!! Has Rocky really learned to surf?

Now, I did my very best without calipers to give him the same "skinny" 2.25u this morning. Praying that the shot wasn't a drop less or a drop more of insulin.

BTW, yesterday at AMPS +3 when he was at 94 I did NOT do an HC or LC food intervention. That was his normal final no carb NVIV mini-meal of the morning that I fed him. However, seeing that 94 made me nervous so I tested him 1/2 hour after he had eaten. His BG had only gone up to 105. :cool:

I was HAPPY with that upward trend in BG at 94 rather than the Downward Dog. I don't think Rocky can learn to surf the greens until he has learned to surf in the lagoon.

Rocky's recap of yesterday:

AMPS 220 +2 129 +3 94 +3.5 105 +4.5 150 +7 266 +11 276
PMPS 254 +2 284 +4 138 + 6.5 150
 
Re: 4/16 Rocky 161 +1 192 +3 91 +4 101

Hi Tina!

I just saw your last post last night - sorry for things not being clear. it's perfectly possible that i'm encouraging you to be more aggressive and Sienne and Marje are encouraging you to be more patient. I'm not exactly seeing that, but of course we aren't all the same people and we have different styles. I think what you might be seeing is that they have encouraged you NOT to increase when you see bouncing high numbers, which I would agree with. Before you increase a dose, you want to know how low that particular dose will take Rocky, so you do need to wait out any bounces and see the "real low" before you make a decision on it.

What I saw in Marje's post yesterday and in mine was very similar. I don't see a conflict with it. Marje and I were both saying that there is no waiting time for seeing whether or not a reduction has worked. I know you're following Davidson - you can see examples on there of a reduction holding. Shawna reduced the dose every week or so and Davidson's numbers stayed in the same range. If he'd trended up, we'd have encouraged her to go right back to the last good dose.

What Marje was saying about reductions is that you don't want to mix and match strategies. One strategy is the "straight" protocol method - that's our first strategy for everyone new. If a cat goes below 50, reduce by 0.25u - in a new cat we have them reduce even if they hit 47 once. For many cats that works and they go right down the dosing scale til they go off. Then you have the cats that go below 50 and their dose is reduced, but their numbers don't hold in greens and they have to go back up the dosing scale. For those cats, once we see that, we have a couple of strategies to try.

One is to have the cat go below 50 three times and then reduce by 0.25u.

Another is to have the cat go below 50 and shave the dose a tiny bit. Then hold that dose and see if the numbers hold in greens, and if so, wait til they go below 50 again and shave the dose again.

If a cat gets into the 30's, we say automatically reduce by 0.25u regardless of anything else. safety first.

Where trouble starts is when people hold a dose to try to keep a cat in greens, not taking reductions when they should. Then the depot can "get ahead" of the dose that's needed, and you can see some really low numbers. In Marje's post about reductions, she had a snapshot of Gracie's spreadsheet that showed an example of that.

What I've been encouraging you to do is to hold up his lowest numbers so that he doesn't earn a reduction. That's another tactic that can be tried with a cat that is bouncy, which Rocky has been. By holding up his lowest numbers, you're able to give slightly more insulin and that has been able to bring down some of his higher numbers and i think, has reduced his bouncing some. Look at 4/14 when he had his last pink - he'd bounced from the green numbers that morning, but he barely blipped into pink and came down into yellows almost immediately. Then he stayed in yellows for his bounce but he cleared it by the morning of 4/15. So he's making HUGE progress. He's now clearing bounces in one day instead of his former 3 days.

So . . . I hope that helps to explain things. Your job is to take the information that we're giving you, sort through it and see what applies to Rocky and what you've seen works best for him. I'm going to be gone this evening, but if you have questions, post them and i'll try to answer tomorrow, or perhaps someone else will be able to answer as well.
 
Re: Shot hlp pls.. 4/16 Rocky 161 +1 192 +3 91 +4 101 +9 55

It is still 3 and 1/2 hours before Rocky's PM shot time. I just fed him 1/2 can of FF Classic Chicken to try and prevent him from dropping to a lower BG. I think that was acceptable, right? :roll:

Ok so he could go back up to the 100s or 200s, who knows maybe even higher. But, regardless of what his BG does, do you think that I should stay with the same "skinny" 2.25u that I've been working on with him? Or, do you think I need to go ahead and take a .25u at his evening shot? Maybe give him a "straight" 2.0u? (I really don't want to do that right now though.. I don't think it's enough insulin for him.)

I'm thinking if I have to do a reducie that I do one that is tinkered with-- like a "FAT" 2.0u.

Thanks!
 
Re: Shot hlp pls.. 4/16 Rocky 161 +1 192 +3 91 +4 101 +9 55

As long as he is above 50, I wouldn't change his dose until he earns a reduction.

I think you are fine to feed him a littleLC food until +10 or +10.5 and see if he comes up and surfs. I wouldn't feed him past +10.5 though unless he drops into the 40s. If he drops into the 40s, just give a tsp of LC and see if it brings him up.
 
Re: Shot hlp pls.. 4/16 Rocky 161 +3 91 +4 101 +9 55 +10 48

Thanks Marje!

Ok I fed him 1/2 can off LC FF-CC when he was 55 at AMPS +9. At AMPS +10 he is at 48, so his BG has dropped a tad bit. I just fed him a small bit of food this time. I fed him 1/4 can of the LC FF-CC.

I will test him again in 1/2 hour at AMPS +10.5. If he is still in the 40s I will feed him again even if he is at AMPS +10.5.

**UPDATE**

At AMPS +11 he is back down to 41.. I just fed him another 1/4 can of LC FF-CC. will re-test at 11.5.

I was going to give him a "FAT" 2.0u but I don't know if that is safe now for him.

I don't really want to stall either.. Can I give him a greatly reduced amount of insulin at his normal PMPS shot time? I don't feel like stalling.. I'm already one hour late on his shot time.. In other words, he gets his PM shot now at 10PM and then I feed him until 1AM. I don't want to be up until 2AM in the morning feed him..

Is it possible to give a 1.75u, 1.50u, 1.0u tonight, and then bump him right back up to say, a "FAT" 2.0u in the morning?

Or, can I skip the shot tonight and reduce his dose down to a "FAT" 2.0u in the morning? :roll:
 
Re: Marje? hlp now!! 4/16 Rocky AMPS 161 +10 48 +10.5 54 +11

hi tina. i don't post much any more, but i'm an old-timer from this group with years of experience. i took a look at rocky's ss and i'll be very honest...
with as much as you test... do yourself a favor. skip the shot. get a good night's sleep and restart in the morning. this is a terrific opportunity for YOU to recharge your batteries.

i've been at this for 8 years this coming july and that's exactly what i would do if i were in your shoes...
 
Re: Marje? hlp now!! 4/16 Rocky AMPS 161 +10 48 +10.5 54 +11

THANK YOU JILL!!​

I will definitely do that tonight. I won't give him a shot tonight.

How much insulin would you give him in the morning?

I have been "fine-tuning" his dose. Would ou start him all over a "straight" 2.0u? He didn't do so great on that dose of a "straight" 2.ou for 10 cycles, or 5 days.

Thanks again!
 
Re: Marje? hlp now!! 4/16 Rocky AMPS 161 +10 48 +10.5 54 +11

it all depends how well he holds reductions.
if he has a hard time holding reductions, i'd probably take him down to a fat 2 units in the morning.
if he holds reductions well you could try a reduction to 2 units.


fwiw, don't put too much stock into what he previously *did* on a dose. that was then and this is now...
 
Re: Marje? hlp now!! 4/16 Rocky AMPS 161 +10 48 +10.5 54 +11

Hi Tina,
I don't advise here anymore, because I have zero experience with Lantus. I used PZI.

But I feel comfortable saying two things.,.

At a dose of 2.0u, I wouldn't try to tweak it. I would make adjustments in .25u increments. With teeny doses, it might make sense to fatten or skinny a dose. With a dose as large as 2u, I believe the "F" or "S" technique is less useful, and the results are more "suspect". Others probably don't believe that, but I do.

You mentioned that the last time you were at 2.0, things didn't go all that great? Well, here's my theory, and it goes for any insulin...
Don't ever assume that what works today will work just as well a day or a week from now. More importantly, don't ever assume that what failed last time will fail again tomorrow. Cats are not machines, they change day-to-day. Rocky is not the same kitty he was last week. 2.0 might work better this time around.

Carl
 
Re: Marje? hlp now!! 4/16 Rocky AMPS 161 +10 48 +10.5 54 +11

Thanks again Jill :YMHUG:

I know, I know.. that was then and this is now.. but "then" wasn't very long ago, and Rocky doesn't hold reductions well.

It IS work to keep him out of the 40s right now. I am feeding him 1/4 can of the LC FF Classic Chicken about every 15 minutes. He's eaten (1) can + 1/4 can so far.

Would you skip his normal evening mini-meals? That would be ANOTHER entire 5.5 oz can of food that is divided into 4 mini-meals for 4 hours during his PMPS cycle. That feeding routine would start in 15 minutes. :roll:
 
Re: Marje? hlp now!! 4/16 Rocky AMPS 161 +10 48 +10.5 54 +11

can you feed him before you go to bed and then leave the rest out for him to nibble on throughout the night?
rocky's doing great. i'm more concerned about how long you can continue on this schedule without taking a break...
i'd hate to stop in here next week only to find you sick from exhaustion.
 
Re: bounces- 4/16 Rocky AMPS 161 +10 48 +10.5 54 +11 41 +11.

LOL Jill!!

The one problem that Rocky has not had since recovering from a nearly 14 day DKA stay in the hospital is his appy! :lol: Rocky will eat down nearly anything I put down in front of him right away-- except for lamb. And thank goodness he has that appy!! Whew..

It sounds like you would like me to continue feeding him his regular meal tonight. I was just concerned that feeding him that much food-- (2) cans, that is a total of 6.0 oz, 4% carb food, PLUS the (1) can of the 0% carb food that he normally eats for four mini-meals, would then send him on a crazy bounce since he's not getting his evening shot tonight.

I was thinking that maybe this "food intervention" to get him out of the 40s could substitute for, like, his 'normal' meal?

In other words, Rocky is getting 6oz. of 4% carb food as a food intervention, but it would also happen to replace his normal dinner. We would just consider that he started his dinner three hours early.

I can stay up and feed him mini-meals until his BG goes up. That's not a problem. But I won't do any testing tonight. :cool:

My husband wakes up at 4AM and I always wake up too. So I get Rocky's test then. My other cats wake me up to feed them at 6am, so that why I typically have a test at that time too.
 
Re: bounces- 4/16 Rocky AMPS 161 +10 48 +10.5 54 +11 41 +11.

I was thinking that maybe this "food intervention" to get him out of the 40s could substitute for, like, his 'normal' meal?
Click to expand...
absolutely! definitely consider whatever amount of food you've been giving him as part/all of his meal... otherwise rocky will end up rather, errr.... "fluffy".

if all goes well... when i have to intervene with food... alex doesn't get any more calories than on a normal day. i've always had to monitor her weight carefully. one of her nicknames is "miss piggy". that should tell you something. lol!

get his required calories into him and then hit the hay! :mrgreen:


fyi: food doesn't cause bounces to be any worse than they're going to be. bounces are caused by kitties dipping into numbers their body is not accustomed to OR by a fast drop. the effects of a LC diet will be out of kitty's system in a matter of hours.
 
Re: bounces- 4/16 Rocky PMBG 52

remember: if you're off schedule, you can easily shoot early after a skipped shot.
i have to feed my kitties, but i'll check back to see if you have any questions before i go to bed.
 
Re: bounces- 4/16 Rocky PMBG 52 +13 72

Ah... that's right.. I forgot that bouncing is from kitty's pancreas not being used to the lower numbers. I somehow always correlate the bounces with the percentage of carbs the cat has eaten to try to keep their BG above 50.

I guess I will try a "FAT" 2.0 with Rocky in the morning?? But if I gave him a "straight" 2.0u shot instead, how long would I have to wait to increase the dose again?

If I start seeing hours and hours in pink numbers I'm not going to like it.. And I think some people here would tell me that those hours spent in pink, red, and black numbers are a "bounce." If they say that Rocky is "bouncing" then I'm told to wait until I see green numbers again, or for at least 10 cycles of seeing no green numbers before I increase his dose. BUT-- If it's a failed reduction, I am told I can increase the dose ASAP.. so with the failed reduction one does not need to wait for 10 cycles....

How can one tell the difference between a bounce and a failed reduction? They are both higher numbers, correct? So what is the distinguishing characteristic between the two? :roll:

And Hi Carl!! -- I've been trying to fine-tune Rocky's dose in this 2.25u range because his system has been sensitive to it. I *wish* we were down to those micro-units!! :lol:

***UPDATE***

I fed Rocky his 1/4 can of NVIV at AMBG +12 and he ate all of it. I tried to feed him his 2nd mini-meal at AMBG +13 and he wouldn't touch it. I think he is finally full.
 
Re: 4/16 Rocky PMBG 52 +13 72

Just stopped by to see how you are doing. Nice to see green but you must be exhausted. Try to get some sleep.
 
Re: 4/16 Rocky PMBG 52 +13 72

Tonight is my night to sleep, Elise!! I am going to test Rocky the obligatory 1 more time (suppose to do it at least 2x without the food intervention).

I usually wake up in about 4 hours because my DH goes to work at 4am.That's why I get that test in. Then, the rest of the cats in the house POUNCE on my stomach, lick my face, bite my fingers, to wake me up to feed them at 6am. I stumble into the kitchen and feed them then stumble right back to bed.

Tomorrow I will FINALLY move Rocky's shot time back by one hour, so back to 9am - 9pm schedule instead of the current 10am to 10pm. That was killing me. I wasn't getting his last feeding of the night in until 1AM.

Thanks for checking in on us, Elise. I sure would like to see Max take a dip in the lagoon again.
 
Re: bounces- 4/16 Rocky PMBG 52

Tina & Rocky said:
I guess I will try a "FAT" 2.0 with Rocky in the morning?? But if I gave him a "straight" 2.0u shot instead, how long would I have to wait to increase the dose again?

If I start seeing hours and hours in pink numbers I'm not going to like it.. And I think some people here would tell me that those hours spent in pink, red, and black numbers are a "bounce." If they say that Rocky is "bouncing" then I'm told to wait until I see green numbers again, or for at least 10 cycles of seeing no green numbers before I increase his dose. BUT-- If it's a failed reduction, I am told I can increase the dose ASAP.. so with the failed reduction one does not need to wait for 10 cycles....
Click to expand...
i wish i had simple & direct sure-fire answers for you, but the thing is the answer to this question and most others comes from your observations and rocky's data. how long before you know a reduction has failed? how many cycles at a given dose does it take for you to know the numbers aren't going to get any better? following a reduction, how long does it usually take to lose the effect of the previous dose (that little "extra" help (depot) left on the reduced dose)? for alex, it's 5 cycles. after 5 cycles i KNOW the residual effects of the higher dose are gone. ECID. it may be different with rocky.

the guidelines of the protocol are great to follow while you're compiling the information needed to make these decisions on your own.

Tina & Rocky said:
How can one tell the difference between a bounce and a failed reduction? They are both higher numbers, correct? So what is the distinguishing characteristic between the two? :roll:
Click to expand...
a bounce will always be preceded by a drop into lower numbers than kitty's body is used to or a a fast drop. that's a given. it gets tricky when we're trying to figure out if the bounce is over and the high numbers we're seeing is in fact a failed reduction. first off, understand that you want to figure out (from data) how long it's been taking kitty to clear a bounce. to add to the confusion, this changes. all i can tell you is eventually you develop a feel for the rhythm.

a failed reduction manifests itself with numbers that trend upwards over more than one consecutive cycle. it's the upwards trend that signals the failed reduction. you won't see an upwards trend over several consecutive cycles when kitty is bouncing. you'll see more wobbling when kitty is bouncing.

there are also other factors to consider. for instance, a few days ago i reduced alex's dose. her numbers began to trend upwards that cycle, BUT (<---------- that's a big but) she's been sick, appy is way off, CKD & suspected IBD progressing. she was having an "off" day so i couldn't react to her numbers by taking the dose right back up. i decided to wait it out and sure enough, her numbers came back down.

imho, treating our diabetic kitties becomes an art rather than a science. that's why there are no black and white "rules" which are applicable to every set of circumstances.
 
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