4/26 Tyler PMPS 303 Reduction +2 308 +4 178

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Brian & Tyler

Brian & Tyler

Member Since 2014
Yesterday' Condo

Hello all, today is homework day!!! yay...

Tyler is doing well, dipped a little low at +5 this morning. I wonder how low he has been going during nadir when I am at work... but he seems to feel great and is still using the litter box like normal. :mrgreen:
 
Re: 4/26 Tyler AMPS 232 +5 49 +6 80

Hi Brian:

I am not an advice giver, so please don't take this as gospel, but since Tyler would be considered a "newly diagnosed" cat, I believe that 49 earned him a reduction! Hopefully someone else with more experience will be along to confirm or deny that, but I think that's what this means:

If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. See additional notes in the next paragraph about drops into the 20s and 30s. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
Click to expand...

If no one else chimes in before it gets close to your next shot time, alter your subject line to include something like "reducie?" or "dose question". Good luck, and if I'm right, congratulations! :mrgreen:
 
Re: 4/26 Tyler AMPS 232 +5 49 +6 80

Hi Brian:

I am not an advice giver, so please don't take this as gospel, but since Tyler would be considered a "newly diagnosed" cat, I believe that 49 earned him a reduction! Hopefully someone else with more experience will be along to confirm or deny that, but I think that's what this means:

If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. See additional notes in the next paragraph about drops into the 20s and 30s. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
Click to expand...

If no one else chimes in before it gets close to your next shot time, alter your subject line to include something like "reducie?" or "dose question". Good luck, and if I'm right, congratulations! :mrgreen:
 
Re: 4/26 Tyler AMPS 232 +5 49 +6 80

Thanks, Tricia.

He's been diabetic for quite a while now, but was diagnosed in October 2013. We came to the board on March 22! So I'm not sure whether you would call him newly diagnosed or not. But that would be great to get a reducie. I'll wait for others to chime in. Also, he is on Orbax Antibiotics for a UTI... I don't know if that would have any effect but according to his numbers, it looks like it might, though(?)
 
Re: 4/26 Tyler AMPS 232 +5 49 +6 80

Hi Brian, a BG drop below 50 earns a cat what we call a "reducie." A drop into a 40s number means to take a .25u decrease in the amount of insulin that you give to Tyler.

The reason why that is the "protocol" here is because the insulin is collecting in the cat's depot. This dose of insulin may have been too much for Tyler, so the next time you go to shoot the same dose you might find his BG in the 30s and we consider that getting close to the danger zone. We don't want cats surfing the 40s and especially not the 30s.

In your very first post this morning, can you please go back and edit the subject line to read:

Shot help 4/26 Tyler AMPS 232 +5 49 +6 80

And then fill in the (?) for the 'Post Icon' above the subject line

The other thing is, we like folks to get a +1 and/or a +2 around here because it sometimes can tell us which direction the cat's BG is going, up or down. Right now we don't know if Tyler's BG went even below that 49 at +5 and then came back up. If that did happened his BG will probably bounce, meaning, you will see some much higher numbers in a little while.

I think that the experienced advise givers on FDMB *might* tell you to drop Tyler's dose by .25u for his PMPS shot because we don't know how low he went and how long he stayed at that low BG. I hope that they see your post and advise you soon.
 
Re: 4/26 Tyler AMPS 232 +5 49 +6 80

Good catch on that 49 Brian! Keep on surfing there Tyler. :mrgreen: :mrgreen: :mrgreen:

I agree with Tricia and Tina - Tyler has earned a reduction of .25U down to 1.0U. :-D Cats who have been diagnosed less than one year are considered newly diagnosed so going below 50 earns that reduction.

ETA: Keep testing for another hour. Karo will wear off and you want to make sure his numbers don't wobble back down again. You want two hours without influence of food before you slow the testing.
 
Re: shot help 4/26 Tyler AMPS 232 +5 49 +6 80

I tried to get him again @ +10, but he wouldn't bleed. I have to make run for more strips before PMPS. Be back soon
 
Re: shot help 4/26 Tyler AMPS 232 +5 49 +6 80

What technique are you using to get the blood from his ear? What gauge needle are you using?
 
Re: shot help 4/26 Tyler AMPS 232 +5 49 +6 80

One thing that Tina mentioned that I think is really important is to get a +2 test every single cycle that you are able to do so. I know your work schedule doesn't always allow it but it will give you a really good idea of where he might be headed. If the +2 is similar to or lower than the PS, then you are likely to see an active cycle.

The other thing that I can recommend, and again, I know it can be difficult with your work schedule so I do understand, but any time you are able to get a +10 or +11 test, it will tell you if you are possibly shooting a dropping number. It did look like he was going up last night when you went to bed but he might have gone up higher than 232 and then headed back down. We know it can be difficult to do and so I'm just suggesting you do it when you are able to. It just gives you some more info to know what's going on at PS.

Good luck with the reduction!
 
Re: 4/26 Tyler AMPS 232 +5 49 +6 80 +11.5 285 PMPS 303 reduc

OK ladies, sound off after this one...

I took the general advice and did a reduction, but to a fat 1.0, basically the plunger was at the bottom of the black 1.0u mark, instead of centered.

I hope this is ok for him. I will try and get a +2 in the AM, but the PM, that will only be possible on days that I do not work my evening job, which after school lets out, I will be working 3-5 days at my second job (probably more like 5 days), and my day job will still be 9-5 M-F.

I am still new to this, so how is it that we just increased to from 1.0 to 1.25u, and now are going back to 1.0u so soon? I get that he had a 49 @ +5, but should he really get a reduction based off of that alone? I know that I am not available to test as much as most of you here, but I try!!! I will say that I am an incredibly slow learner with this, and I appreciate all the guidance.

I will chime in with a +2 here soon. Thanks for all the help.
 
Re: 4/26 Tyler+5 49 +6 80 +11.5 285 PMPS 303 Reduction +2 30

+2 is 308... Higher than PMPS... Did we do the right thing by reducing? I dunno. We'll see...
 
Re: 4/26 Tyler+5 49 +6 80 +11.5 285 PMPS 303 Reduction +2 30

His blood glucose is most likely bouncing from going to below 50 at AMPS +5... We don't know how long he was at 49, or in fact he even was lower that that from AMPS +1 thru AMPS +4.

I was told that when the cat's liver senses that there is not enough insulin it sends out like a warning signal. Then, the cat's pancreas responds by making as much insulin as it can. So, you end up with the amount of insulin that you gave him from the shot (which was too much), and then the stuff that his body makes.

I don't know if I explained this very well.

The other thing I've been told MANY times is that this Feline Diabetes is a "dance." There is no sprinting to the finish line. We're goin' up, and we're goin' down.. It isn't until Tyler is tightly regulated that you'll start to see more of a flat line in BGs.

The others can explain it better than me. If you look at Rocky's chart you'll see that we started low and then at one point had to increase his insulin all the way to 2.25u.. now he's been sliding back down the scale again, not needing as much insulin from the syringe. I've been told this means his pancreas may be healing. :smile:
 
Ok, so he dropped rather quick drop over the last couple of hours, but I'd say nothing to worry about. I'll be back to report for +6.
 
Hey Brian!! Good catch on the 49 and congrats on the reducie!!

He's most likely just bouncing from the low today. Mr Liver said "wait a minute! I'm not used to that number! Call out the troops!"....and then lots of stored sugar and hormones went into battle!

To clear it up a bit...you didn't "just go up" to 1.25..Tyler had been on that dose about 14 days! Depending on how each cat reacts to any given dose, we sometimes go up as often as every 3 days....sometimes longer (which is why you were at 1 unit so long...he was getting good numbers at nadir, so as long as he was, that was a "good dose" for him!)

When his nadir's started going up, we suggested you increase to 1.25 and you did...if he STILL hadn't gotten better nadirs within 3-5 days, we would have suggested you go up to 1.5

Each dose takes time to settle in so you can really see what it's going to do...but we don't want them staying in high numbers too long either, so the protocol says to increase if you're not getting those good nadir numbers, and to decrease when they go under 50. (There's also still bouncing to consider, as well as New Dose Wonkiness, but we can deal with those subject another time...LOL)

Cats being cats (and therefore sworn to drive us beans crazy trying to figure out what they're doing) make this dance the "adventure" it is!

When they show us the dose is too high, we reduce...when they show us the dose isn't high enough, we go up...and since the cat's in charge, and doesn't seem to want to read the manual, all we can do is hang on for the ride they're taking us on.

Tyler's doing great, and so are you!
 
Looks like he may be clearing that bounce quickly!

Not too fast there Tyler...just slide gently on down...No diving allowed!!

Just a quick note....it's best to take the reductions exactly as the protocol says right now. We save the "fat" and "skinny" doses for when we're right there on the edge of the "best dose"

If you look at China's spreadsheet, you'll see she's been at 1.5 for quite a long time, but getting really nice nadirs. Today she dipped below 50 BUT since she's not a "new diabetic", and in the past, every time I reduced her, she'd "fail the reduction" and we'd have to go right back up, I decided that maybe somewhere between 1.5 and 1.25 might be a "perfect" dose for her. In this case, since she's not new, and I have lots of data to support the decision to go with a "skinny" 1.5, that's what I did.

Tyler is still considered a "new" diabetic, so if I were you, I'd just stick to the 1 unit instead of the "fat" 1 unit (but if you decide to stay with it, on your spreadsheet you'd enter f1.00 for "fat 1 unit"

It's possible his "best dose" is between 1 and 1.25, but until we see how he does at the 1 unit dose, it's too soon to say (as well as there's just not enough data yet on Tyler to recommend a "fat" or "skinny" dose)...we don't know how Tyler is going to do regarding holding his reductions. He may hold them well (which is great!) or you may have to go right back up to 1.25 (when he's done clearing the bounce). It's just too soon to say.
 
Wow, look at that.. he has already dropped 130 points in 2 hours!! @-) Looks like he is clearing that bounce pretty fast. :mrgreen:
 
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