4/5 Eddie AMPS 224, +10/62, PMPS 161, +2/316

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Jen&Eddie

Jen&Eddie

Member Since 2013
Yesterday: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=116673

Today:
AMPS = 224 (1.5u)
+2 = 252
+5 = 154
+6 = 113
+7 = 93 :mrgreen:
+8 = 75 :mrgreen:
+9 = 76 :mrgreen:
+10 = 62 :mrgreen:
+10.5 = 70 :mrgreen:
+11 = 73 :mrgreen:
+11.75 = 99 :mrgreen:
+12.5 = 114
PMPS (+12.75) = 161 (1.5u)
+1 = 329
+2 = 316
+4 = 324

Good morning LL!

Eddie made it through his first Lantus cycle last night without event. ;-) I am really curious to see if Eddie has nice smooth flat cycles as his depot fills.

I'm so fortunate to have a partner who is an active participant in caring for Eddie. DH usually does the shooting in the AM and lets me get a little extra sleep. Previously, on ProZinc, he'd test at 5:00 AM, when he got up, come in and wake me up to tell me the number and then shoot as instructed. I am not a morning person (especially with Eddie regularly keeping me up till 1:00 or 2:00 am or later), but amazingly, I never told him a wildly incorrect dose while still mostly asleep! :-D I often had to text DH in the morning after getting to work because I could not remember what I told him to shoot. :shock: This AM, DH came in to tell me what Eddie's pre-shot number was, and I said "that's fine, go ahead and shoot." DH replied, "I know...I already shot." I'm definitely liking not having to think through five different variables in determining what to shoot! :smile:

Eddie's hanging out in the computer room/cat room/man cave with DH watching biddies on the cat stand. Despite 8 inches of snow yesterday, most of it has melted already, and the sun is shining today! DH and I have tickets to see the MN Wild play the Pittsburgh Penguins tonight. I'm super excited! I LOVE hockey and haven't been able to go to a game yet this season! :-D

A little bit lower AMPS this morning which is nice to see. :smile: And, I thought of a couple questions. :smile:

On food, we have been doing the following: we "split" the pre-shot meals of 12 oz. of wet food into two meals, (split amongst 5 cats) which ends up being approximately 1.25 oz per meal. The first portion is fed at shot time, and the second portion, we "aim" to feed at +2 as our schedule allows. Sometimes it's a bit earlier, sometimes it's a bit later. Then, we usually feed another 1/2 oz. or so "lunch" or "midnight" snack at around +6, depending on when I can get home from work for lunch. Eddie's nadir on ProZinc varied wildly between +6 to +12, so usually the +6 was before nadir. With Lantus, would it be wise to move that snack to +5 or a little earlier in the cycle?

Also, how, if at all, does the fact that Eddie was previously on ProZinc for about 3.5 months factor in to how we follow the TR protocol? Thankfully, Eddie did respond to ProZinc, but it was pretty unpredictable. Do we proceed as though Eddie is starting from "scratch" and has never been on insulin, or is he handled differently since he was previously on insulin but not tightly regulated?

For now, what should we consider as a "no shoot" cut off number? I'm comfortable handling low numbers in the 40's and even the 30's, but was never able to safely shoot much below 200 on ProZinc without crashing Eddie about 50% of the time. During the day, I can't monitor all that closely, but night time "pajama" parties are no problem.

Happy Caturday everyone!
 
Re: 4/5 Eddie AMPS 224, +5/154

you'll probably want to start with a 150 no-shot number, unless you're going to be home and feel comfortable monitoring, have strips, high carbs, etc. Usually people will gradually drop down the preshot number they feel comfortable shooting, but since you've got a lot of experience, i'd think you could opt to shoot lower if you want.

Read through this sticky on http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147 Shooting and Handling Low Numbers. It's got lots of great info on it and can help you make decisions on when to shoot a reduced dose, when to stall, and when to skip a shot. Experienced people will shoot even as low as 50's once they know their cat and how their cat is likely to respond. As you shoot lower numbers, you'll find that the Lantus "curve" becomes a line. That's ideal - a flat cat is a happy cat, feels good, and the pancreas can heal. Take a look at Davidson's spreadsheet and Boot's ss to see 2 newly diagnosed cats that are approaching OTJ trials. Particularly look what happens to the cycle curve as they shoot lower preshot numbers.

You want to be "data ready" to do this. There's a whole section on that in the link above.
 
Re: 4/5 Eddie AMPS 224, +5/154

+6 = 113

Looks like this is shaping up to be a pretty nice cycle! :smile:

Thanks for the info Julie! I'm sure I will post here for guidance if we get a 150 or lower pre-shot number. That's one of the huge reasons I decided to switch insulins - the ability to shoot low to stay low with Lantus. :smile:

Davidson and Boots have the most beautiful green spreadsheets! :mrgreen:
 
Re: 4/5 Eddie AMPS 224, +5/154

those are the ss we hope for for everybody newly diagnosed!

Eddie is already having a nice response - no diving, which is awesome, and a blue nadir on the second day! i think you'll be happy with the switch.
 
Re: 4/5 Eddie AMPS 224, +5/154, +6/113

Oh my, look at Eddie go! He's really working the Lantus today. :-D :-D

The next couple of days you'll get a better idea of where his onset and nadir typically are on Lantus. Until then, it's going to be hard to say what the feeding schedule should be. But you are correct that feeding most if not all before nadir is best. Lantus nadirs can also vary between cats and even in one cat. We have a number that nadir quite early +2-+4 and some that nadir late in the cycle. Neko was quite variable in her Lantus nadirs, from about +3.5 to +13, although typically later in the day cycle and earlier in the night cycle. :roll: Part of that is her IAA condition though which can delay action.
 
Re: 4/5 Eddie AMPS 224, +5/154, +6/113

+7 = 93 :mrgreen:

Yay! A green! I didn't expect him to get these kind of results this quickly. I'm one pleased mama bean. :smile: Late nadirs were part of Eddie's modus operandi on ProZinc so it wouldn't surprise me if he had a little bit later nadirs on Lantus as well. Maybe he's just got a little slower metabolism or something?

Eddie laid the smack down on our little diva civilian Princess a while ago. She deserved it. :lol: I shouldn't *encourage* him to do that, but it does secretly make me happy that he's slowly getting back to his rightful spot as "pack leader." Now, he's cuddled up sleeping with Princess in the bedroom.

Since Lantus action tends to not be as sharp, should I be getting a +7.5 or will a +8 do it to see if he keeps going down?
 
Re: 4/5 Eddie AMPS 224, +5/154, +6/113, +7/93

I think you can go an hour before the next test. Earlier on in the cycle I might say sooner or if you were in the 50/60's for sure.

Don't forget putting Mr. Greenio in your first subject. Eddie's showing off now. :mrgreen:
 
Re: 4/5 Eddie AMPS 224, +5/154, +6/113, +7/93

Wendy&Neko said:
Don't forget putting Mr. Greenio in your first subject. Eddie's showing off now. :mrgreen:
Click to expand...

He is totally showing off, isn't he? :-D :mrgreen:
 
Re: 4/5 Eddie AMPS 224, +6/113, +7/93, +8/75, +9/76

Hi Jen

I haven't had a chance to welcome you and Eddie to our LL family so welcome!!! We are all anxious to help.

We don't actually have a "no shoot" number here. We have a "stall, don't feed, and post for help" number of 150 mg/dL. You do have a lot of experience with low numbers and so I think it is more a decision of what you feel safe to shoot and go to work just as anyone who works. Sometimes, if kitty is on a roll, we suggest taking the dose down (even if a reduction is not earned) so you can shoot the same dose safely twice a day. I'm hoping this weekend will give you an idea of how Eddie responds to lantus (although it can change) initially. While PZI is not a depot insulin, sometimes you can see the effects of PZI on a subsequent cycle and I'm wondering if this quick response to lantus is a little overlap of the two insulins? Just a thought but it might be off base.

You might want to look at Hershey's SS and be sure to look at the 2011-2012 tab at the top. Scroll down and you'll see Libby was shooting PZI and then switched to Levemir and she continued to shoot lower numbers.
 
Re: 4/5 Eddie AMPS 224, +6/113, +7/93, +8/75, +9/76

Thanks Marje!

Hershey's SS looks familiar - I think I studied his SS when we started thinking about a switch. :-D

It will be interesting to see where Eddie's at for PMPS this evening. I may very well be posting for help on if/what to shoot if he doesn't start climbing back up, since DH are going to be leaving right after +1 and not be back till probably +6. We can always see what he's got planned with a +1 test, and feed a bit higher carb dinner to front load him a little, and shut him in a room with a timed feeder if need be.

I know Carl had posted a sticky in PZI about "carryover" and I do think you see that sometimes with ProZinc. Sometimes active cycles are followed by another active cycle even with a reduction, so there might be a small unpredictable depot effect. I've been a little suspicious that Eddie's flat yellow cycles on ProZinc as of late have been bounces, so maybe he's finally clearing the most recent one, hence the movement today?
 
Re: 4/5 Eddie AMPS 224, +6/113, +7/93, +8/75, +9/76

I did see Carl's post and it was a good one but carryover is when the effects last longer than normal duration for that insulin and overlap is when the effects of one shot are diminishing as the next is onsetting.

Because bounces can take up to six cycles to clear, it is very possible that his last PZI bounce is clearing now. That is how it appears.

Just be cautious about the +1 because you might see a food spike and think everything is ok. That would be typical. It's usually the +2 with lantus that tells us if the cycle is going to be a normal, active lantus cycle (+2 would be similar to PS) or a very active cycle (+2 would be much lower than PS). I think if you see a +1 that is lower than the PS, I'd definitely leave some HC out.
 
Re: 4/5 Eddie AMPS 224, +7/93, +8/75, +9/76, +10/62

+10 = 62 :mrgreen: :shock:

Hmmm. Well this is unexpected.
 
Re: 4/5 Eddie AMPS 224, +7/93, +8/75, +9/76, +10/62

He's clearing a bounce and so you actually would expect that he would keep dropping; in fact, he could even keep dropping after his PMPS. We don't know how he does when he clears bounces but some cats will continue to drop.

You want to be cautious about shooting a dropping number with no data on lantus. I would probably get a +11 to see if the drop is continuing.
 
Re: 4/5 Eddie AMPS 224, +7/93, +8/75, +9/76, +10/62

Thanks Marje!

Will definitely get a +11. Will hold off on making any shooting plans for the PM until we see where Eddie's going. :smile:
 
Re: 4/5 Eddie AMPS 224, +7/93, +8/75, +9/76, +10/62

Eddie is certainly keeping you on your toes today. Good luck with tonight's shot. I hope he surfs safely for you tonight.
 
Re: 4/5 Eddie AMPS 224, +7/93, +8/75, +9/76, +10/62

Sounds good. I'll check back in in just a few; I have to feed my little Principessa. I saw his +10.5 and he's surfing. Good!!
 
Re: 4/5 Eddie AMPS 224, +8/75, +9/76, +10/62, +11/73

still surfing. thats good at least!

If you can test and post about +11.75, that would be great.
 
Re: 4/5 Eddie AMPS 224, +8/75, +9/76, +10/62, +11/73

He's coming up a bit but not as much as I had hoped. If you were going to be home, I'd encourage you to shoot but with you going out and us not having the data for Eddie on Lantus, I'm not so encouraged to have you shoot a full dose.

You could shoot a reduced dose but we don't know how much of his Lantus depot has built. Usually it takes more than just two cycles. The reason the depot is important is because if there is one, then the effects of a reduced dose might not show up until late in the cycle or even tomorrow.

The other option is to stall if you can afford to be off schedule. You can test at +12.5 and if he's come up a lot more, shoot and if he hasn't, check right before you leave and if he's up, then shoot at that time.

What do you think?
 
Re: 4/5 Eddie AMPS 224, +8/75, +9/76, +10/62, +11/73

Thanks Marje!

Marje and Gracie said:
You could shoot a reduced dose but we don't know how much of his Lantus depot has built. Usually it takes more than just two cycles. The reason the depot is important is because if there is one, then the effects of a reduced dose might not show up until late in the cycle or even tomorrow.
Click to expand...

I'm not quite sure I understand this part...

A half hour off schedule for tomorrow is OK if he's risen by +12.5, so stalling works. Our normal shot time is over two hours before I leave for work during the week, so there's room there.
 
Re: 4/5 Eddie AMPS 224, +8/75, +9/76, +10/62, +11/73

If you only stall 1/2 hour and then are able to shoot, then you can get back on schedule easily before Monday.

Lantus and levemir are depot insulins and so, usually,the first several shots go towards filling the depot and the cat only uses a portion of it. When the depot is full, the cat uses the insulin from the entire shot. The depot is what allows these long duration insulins to work. Every shot you give is cumulative in nature. The depot, once established, from a dose can affect up to (and in some cats more than) six cycles.

So if a kitty is running low at PS and has a good depot, if you just slightly reduce the dose to safely shoot, you are likely to still see the same cycle as if you shot the full dose unless kitty decides to bounce. Depending on the cat, the dose, and other factors, it can take a cycle or two to partially drain the depot and longer to fully drain it.

With Eddie, I'm assuming he doesn't have much of a depot yet and so if you shot a reduced dose...or maybe even a full one....you might not see the depot influencing the numbers like you would a kitty with an established depot.

Does that make sense? We just have to be more cautious since you won't be there to test.
 
Re: 4/5 Eddie AMPS 224, +8/75, +9/76, +10/62, +11/73

Marje and Gracie said:
If you only stall 1/2 hour and then are able to shoot, then you can get back on schedule easily before Monday.

Lantus and levemir are depot insulins and so, usually,the first several shots go towards filling the depot and the cat only uses a portion of it. When the depot is full, the cat uses the insulin from the entire shot. The depot is what allows these long duration insulins to work. Every shot you give is cumulative in nature. The depot, once established, from a dose can affect up to (and in some cats more than) six cycles.

So if a kitty is running low at PS and has a good depot, if you just slightly reduce the dose to safely shoot, you are likely to still see the same cycle as if you shot the full dose unless kitty decides to bounce. Depending on the cat, the dose, and other factors, it can take a cycle or two to partially drain the depot and longer to fully drain it.

With Eddie, I'm assuming he doesn't have much of a depot yet and so if you shot a reduced dose...or maybe even a full one....you might not see the depot influencing the numbers like you would a kitty with an established depot.

Does that make sense? We just have to be more cautious since you won't be there to test.
Click to expand...

Yes! That definitely makes sense. Thank you for clarifying! Darn! Wish we didn't have plans tonight. :sad:
 
Re: 4/5 Eddie AMPS 224, +8/75, +9/76, +10/62, +11/73

You're welcome.

Yes....it would be a good night to see where he is with lantus and what he'll do. You'll have to decide if he's still not coming up, whether you want to try a reduced dose and leave out HC or skip.
 
Re: 4/5 Eddie AMPS 224, +8/75, +9/76, +10/62, +11/73

+12.5 = 114

Doesn't look like he's rising real fast.
 
Re: 4/5 Eddie AMPS 224, +8/75, +9/76, +10/62, +11/73

Nope he's not.

So your options are:
1. continue to stall to +13 and hope he shoots up ;-)

2. shoot a reduced dose (which we normally don't do if we stall but because you are going out, I want to be really cautious)

3. skip

Your decision.
 
Re: 4/5 Eddie AMPS 224, +8/75, +9/76, +10/62, +11/73

Well, after discussing it with DH, I don't want to lose out on the opportunity to keep Eddie in good numbers and to get a feel for how Eddie's going to do with Lantus, so I'm going to stay home.

So, where he's at with the 114 at +12.5, do I shoot the full 1.5u?
 
Re: 4/5 Eddie AMPS 224, +8/75, +9/76, +10/62, +11/73

Aaah Jen. I'm so sorry! It's important for us to have our fun time. Are you sure? You can skip and he'll be back at in within a few cycles.

If you decide you want to stay there and you are up for possibly having to manage the cycle with food, yes, you can shoot the full dose that he's on, feed, and get a +1 and +2.

If he's coming up, can you go late?
 
Re: 4/5 Eddie AMPS 224, +8/75, +9/76, +10/62, +11/73

I'll survive :-D ! I can watch the game on TV. Gotta time outings to coincide with his bouncing. ;-)

I'd like to take the opportunity to shoot low, since Eddie's presenting the chance here. :smile:

I am OK with managing low numbers with food (or at least I did OK with ProZinc dives).

Here we go! :-D :mrgreen:
 
Re: 4/5 Eddie AMPS 224, +10/62, PMPS 161

PMPS = 161
+1 = 329

I snuck in one more test before his shot about 15 minutes after the 115 at +11.5, and it read 161, so looks like he was getting to shoot up at that point.

Well, shoot. Boing. Hopefully he comes back down easily. The upside is this is great info to see what a cycle might look like if he's clearing a bounce, and what he might be planning if he's running a bit low towards the end of the cycle. Each piece of data (in my mind) is another piece of the puzzle! :smile:

Thank you all for holding my hand through stalling, and especially Marje! I'll probably get a +2 to see what he might do next.
 
Re: 4/5 Eddie AMPS 224, +8/75, +9/76, +10/62, +11/73

I was afraid he do this. Can you still make it to the game?

I'd get a +3 or even a +4 if you stay home but I hope you will try to go see the hockey game.
 
Re: 4/5 Eddie AMPS 224, +8/75, +9/76, +10/62, +11/73

Marje and Gracie said:
I was afraid he do this. Can you still make it to the game?

I'd get a +3 or even a +4 if you stay home but I hope you will try to go see the hockey game.
Click to expand...

Thanks Marje! :-D DH found a buddy to go in my place. That's OK though! I'm settled in for the night, flipping back and forth between the game and the Game of Thrones marathon on HBO. New season starts tomorrow night!

Just to clarify, should I skip the +2 and just get a +3 or +4, or get each of those tests?
 
Re: 4/5 Eddie AMPS 224, +10/62, PMPS 161

Since you're still gathering data, and you are home, I would get the +2 and the +3 or +4. You can never have too much data.
 
Sorry....I fell asleep once I knew he was safe. :oops: :oops: :oops: The Principessa and me had a late night and it looks like it's stacking up for another one.

Normally, I am a HUGE fan of the +2 for every single cycle. I was going to give you and Eddie a break tonight since he got a lot of tests today, especially the late end of the cycle, and he was high enough that a +3 OR a +4 would have been fine. But Carla is correct. For data purposes and in most every cycle, I'd be getting that +2 without fail.

We can hardly wait until Game of Thrones starts!! I'm really sorry you had to miss the game; I know you were really excited.

Love Eddie's profile. He and his sibs are all so gorgeous!
 
Thank you Marje! I hope you get some rest! I know exactly how that goes! In fact, I may very well sneak in a little nap tonight myself. :smile: Thank you for all your help today! :smile:
 
+4 = 324

Sigh. Looks like probably a high flat bounce cycle. Eddie, you had a beautiful cycle today, with no scary drops...nothing to panic about my little Edwompasaurus . Am I likely safe in grabbing maybe one more test before bed in a few hours and calling it an early night tonight?

And our shot time can be moved up 15 minutes tomorrow AM, and another 15 minutes tomorrow PM? Is that right?

Thank you all for keeping an eye on us today! :smile: We're not starting completely from scratch here, but it feels close! :lol:

Edited to add: Minnesota blew out Pittsburgh 4-0. :-D Was kind of a boring game, actually.
 
Sorry you missed the game, but I guess it was a good data gathering experience. One of the joys of a Lantus depot is that missing a cycle isn't quite as bad a thing because there's still a little juice in there to help out. Just as well the game was a blow-out. ;-)

I think if you catch a before bed test and he's still up there, you are good to hit the pillow.

You can move shot times around 15 minutes a cycle, or 1/2 hour one time during the day. Some cats are more sensitive than others to shot time moving. I move Neko around a lot and find the 15 minutes doesn't make a difference.

An exciting first day for Eddie - looking forward to seeing what he does next. Good job today Jen!
 
Thank you Wendy!

Will probably grab a +6 and if it's still high, get to bed early for a change. :-D I'm thrilled with how well Eddie responded to the Lantus today, and I'm looking forward to see how he does as his depot builds. Eddie was doing pretty well in liver training school in ProZinc for a while. Then, he must have forgotten everything he learned and had to go back a grade or two. Hopefully, he hits the books and gets back to being a good liver "student" again here soon. :smile:
 
I agree with Wendy.

One thing I will add is that if Eddie is still high in the morning, I'd shoot at my regular time and make the time up in one fell swoop because I think you were only about 45 mins late in shooting.

Here's some info on Getting Back on Schedule.

Hope you get some rest. Great job today!!
 
Marje and Gracie said:
I agree with Wendy.

One thing I will add is that if Eddie is still high in the morning, I'd shoot at my regular time and make the time up in one fell swoop because I think you were only about 45 mins late in shooting.

Here's some info on Getting Back on Schedule.

Hope you get some rest. Great job today!!
Click to expand...

Ok great! Thanks for the info!
 
oh my, that is definitely a bounce tonight, but what an awesome run of greens Eddie had today! woot!

sorry you missed the game, but at least it was a boring one! :lol:

sleep well. see ya tomorrow.
 
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