4/22 Rocky PMPS 296 +2 226 +4 81 +5 92 +177

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Tina & Rocky

Tina & Rocky

Member Since 2013
Good morning,

viewtopic.php?f=9&t=117605&p=1233940#p1233940

I'm not sure if anyone looked at yesterday's condo but I was thinking that possibly that AMPS +11 reading was an inaccuracy so what we are seeing now is not really a bounce but instead a trend toward higher numbers and not a bounce.

Well, let's see if this same dose of 1.75u does any good to lower his BG in this AMPS cycle today.

Rocky's recap of yesterday:

AMPS 318 +1 348 +3 185 +4 145 +7 182 +11 235
PMPS 180 +2 148 +4 127 +8 215
 
Re: 4/22 Rocky AMPS 221

Thank you for calculating that, Alexis.. I find it extremely helpful. :YMHUG:

Well, that meter variance means that Rocky did not bounce from that diving drop from 348 t0 143.. Instead what Rocky did was show us a few blue numbers on the straight 1.75u dose and is now on his way back up, in the yellow numbers right now.

I probably should have increased his insulin dose for his AMPS shot to a a 'fat' 1.75u instead of giving him another straight 1.75u. I'm kinda bummed about that right now. :cry:

His BG dropped too low on both the straight and fat 2.0u dose.
 
Re: 4/22 Rocky AMPS 221

Really any of the numbers can be within a 20% range. I wouldn't get too caught up in numbers except for too low. Below 50, regardless of variance, is important to monitor. Otherwise, just take the number at face value or you'll make yourself crazy!

Since Rocky is newly diagnosed, I wouldn't worry about fine tuning a dose and just follow the protocol with .25u increases/decreases.
 
Re: 4/22 Rocky AMPS 221

What is the reason that a CG should not attempt to fine-tune a dose for their cat if the 2.0u is too much insulin and the 1.75u dose is not enough?

It doesn't make much sense to me to have the kitty's BG bouncing all around between those two doses if neither of them are the correct dose for him. Seems like it would be more confusing to the cat's liver and possible cause harm.

As far as 'settling in' to a lower insulin dose, I really do not understand the use of this term. Exactly what is suppose to happen with a 'settling in?' Does it suppose that the cat's pancreas is going to get accustomed to a dose of insulin that is too little for him or her and then suddenly start producing enough insulin on it's own? :roll:

It seems to me that the CG would want to find the best and most accurate dose of insulin and give that dose ASAP.
 
Re: 4/22 Rocky AMPS 221

A modification made here does allow for fine-tuning the dose but I believe that's typically done with calipers to ensure the same exact dose is given each shot. I may have missed that you use calipers, if so, then fine tuning is an option.

However, the newest version of the protocol (linked in the Tight Reg sticky) does not use fine-tuning. According to the protocol a dose should be evaluated every 5-7 days when nadir is under 200 and peak is over 200.
 
Re: 4/22 Rocky AMPS 221

Then I think the newest version of the protocol should tell the CG that calipers are MANDATORY if the CG is going to attempt to fine-tune. Besides that it has been said on FDMB that many cats went OTJ without the use of calipers.

I'm not waiting 5 to 7 days with Rocky on a dose of insulin that isn't helping to lower his BG and I was told that I could raise his insulin dose ASAP if it wasn't helping to lower his BG.

If you look at Rocky's SS chart I see the bounce because of his BG dive drop on 4/19 from a YELLOW number to a green number BELOW 50, of 39. His BG then spends a very shot time in the blues and moves right into pink numbers.

It is more likely that yesterday during his AMPS cycle that the 235 was really a 188. The reason this is an important distinction is because what it shows us then is that his BG has moved from spending several hours in lower blue numbers to higher yellow numbers, and right now he is back into pink numbers. I do not believe this is a second bounce. I believe this is a failed reduction. I wouldn't doubt it if his BG goes into the reds, even touches black today. It will be from not enough insulin and not from a second bounce. His chart is showing a trend upwards in numbers and not a drastic shift from blue to pink numbers. There's an entire stretch of many, many hours overnight in yellow numbers there.

I'm not sure if anyone else sees it but me-- but a straight 2.0u is too much insulin for Rocky and a straight 1.75u for Rocky is not enough. He needs the fine-tuning.
 
Re: 4/22 Rocky AMPS 221 +357

There is no reason to wait 5-7 days to increase Rocky back. From the protocol sticky:
If an attempted reduction fails, go right back up to the last good dose as soon as you see kitty's numbers trending upwards. You don't have to hold the reduced dose for a certain number of cycles before taking the dose right back up. The guidelines listed under the topic "Increasing the dose" do not apply to a failed reduction.

Please use common sense in this situation. The "last good dose" is not the dose that just dropped kitty into the 20s or 30s. You want to resume momentum by finding a dose in-between the dose that dropped kitty too low and the reduced dose.
Click to expand...
Rocky cleared his bounce last night, but didn't get into greens so I think fattening up the dose is a good idea.

Alexis - the new Roomp/Rand document that is linked has two tables of protocols. The second one is for what they call the intensive method for those that test more (like Tina does) and it uses three days like the protocol sticky we use here.

Before people here used calipers, they used the drop method of dosing. Hold the syringe up, twist the plunger and count the number of drops you get in one unit. Use that number to find a dose in between 1.75U and 2.0U. The use of calipers is recent here - also used to overcome inconsistencies in syringes. For example, I can only get BD's in Canada, and I've noticed the zero line up to 1/3 of a unit off between syringes. Many people here still use the drop method successfully.
 
Re: 4/22 Rocky AMPS 221 +357

That's what I get for trying to give advice when I'm supposed to be thinking at work! :-D

ETA: I went back and checked. Maybe I'm misunderstanding this?

If nadir blood glucose concentration is <11.1 mmol/L (<200 mg/dL)
but peak is >11.1 mmol/L (>200 mg/dL)

Increase every 5–7 d by 0.25–0.5 IU depending on if cat is on low or high
dose of insulin

Sorry to hijack your condo Tina, I'm curious to know if I'm not reading correctly....
 
Re: 4/22 Rocky AMPS 221 +357

Sorry for the hijack Tina. Alexis, you were reading the bit on increasing the dose. From our sticky we say to hold longer the first time you get to a blue number so that agrees with the newer document. Rocky is no longer in the initial increasing the dose phase, he's had some reductions.
 
Re: 4/22 Rocky AMPS 221 +357

No hijacking here, just sharing of information, Wendy.. It's all good. Thank you for your help. :cool: :YMPEACE:

And Alexis I do appreciate that you care and that you want to help me. It's so hard to figure out what the best thing is to do for Rocky.

I would be pleasantly surprised if he was back at a blue number by PMPS.. If so, I would be probably want to leave his dose at the current 1.75u.

I've got tons of things to get done today so not sure how much I'm going to be able to test.
 
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