4/6 Oberon +9 163, PMPS 323, +3 372

Lisa & Oberon

Lisa & Oberon

Member Since 2020
yesterday: https://www.felinediabetes.com/FDMB...-pmps-176-3-199-5-25-100-6-25-68-7-62.245734/

Oberon dove down overnight... DH checked until PM+10 (BG 54), gave some 15% and had to go to work. I just woke up to a starving cat, BG 40. I went ahead and fed him some 15% and his regular breakfast so I'll have to delay shot time until +14. Just want to get some additional eyes on this since I'm half asleep. I'll check him again in 20 min. This is his third drop below 50 at this dose, so he'll get a reduction, assuming I get to shoot at all. BCS may also be an option, depending on what he does.
 
He's at 79 now, thanks to the food. I'll do half hour checks and see where he is at +14 w/o more food. I've shot as low as 51 before, so I'm comfortable with shooting low numbers. It'll just be annoying to have to work the shot time back. But I'd rather do that than skip if I can manage it. (This is all because I looked at his SS last night and was noticing how long it's been since a skip, isn't it?)
 
Morning data: +12 40, +12.5 79, +13 78, +13.5 62, AMPS 57, +1 78, +2 78, +3 88, +4 111, +5 107, +6 148

Coming up, but not too fast so far.
 
For future reference, when you got that 40 at PS this morning, I would have waited 10-15 minutes and retested, to see what direction he was going, then add food as appropriate. Neko would often increase enough on that delay that I could safely shoot on time. If he had stayed 40's, then I would have gone with LC first. End of the cycle, the insulin action should be wearing off and less food needed.
 
@Wendy&Neko @Lisa & Oberon
Just because I feel like I have everything under control and then I start second guessing what I think I know, how come you waited to give the dose decrease when he was below 50 for three times? I thought if they get below a certain BG (no matter how many times) they get a reduction? Or is that a difference of Lantus vs Levemir? Howie has been sliding back down the scale which is great. I reduced him yesterday PM to 43 units as he was below 70. He was on that for 2 cycles (last night and this AM) when he got down to 68 again this afternoon so I decreased him again to 39. Should I have held him at 43 units longer? I remember from earlier this winter when he was sliding down the scale the first time, Wendy said that the 6 cycle rule didn’t really apply. Or with his acromegaly and being on cabergoline, I follow different rules? (That’s a question for Wendy). I’m so confused!

Good job keeping Oberon safe and under control!
 
Wendy&Neko said:
For future reference, when you got that 40 at PS this morning, I would have waited 10-15 minutes and retested, to see what direction he was going, then add food as appropriate. Neko would often increase enough on that delay that I could safely shoot on time. If he had stayed 40's, then I would have gone with LC first. End of the cycle, the insulin action should be wearing off and less food needed.
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I thought about stalling a bit, but he was ravenous (he doesn't usually beg like that) and I was half asleep, so I gave in and fed him. (I suspect that if he'd gotten some regular LC at +10 along with the 15% he might not have gone quite that low.)

Howiesmom said:
@Wendy&Neko @Lisa & Oberon
Just because I feel like I have everything under control and then I start second guessing what I think I know, how come you waited to give the dose decrease when he was below 50 for three times? I thought if they get below a certain BG (no matter how many times) they get a reduction? Or is that a difference of Lantus vs Levemir? Howie has been sliding back down the scale which is great. I reduced him yesterday PM to 43 units as he was below 70. He was on that for 2 cycles (last night and this AM) when he got down to 68 again this afternoon so I decreased him again to 39. Should I have held him at 43 units longer? I remember from earlier this winter when he was sliding down the scale the first time, Wendy said that the 6 cycle rule didn’t really apply. Or with his acromegaly and being on cabergoline, I follow different rules? (That’s a question for Wendy). I’m so confused!

Good job keeping Oberon safe and under control!
Click to expand...

There's different TR reduction rules for long-term diabetics (over a year)... you can wait for three drops below 50 (in different cycles) or one drop below 40, if I remember right. Not sure whether it's different for Levemir. With Oberon, I think the first couple of times he came down the dosing scale I was so worried about the antibodies "giving up" that I reduced too quickly sometimes and he ended up going right back up the scale. This time I'm trying to only reduce if I really have to, so I'm following these guidelines.

And there's the bounce, for real. 323 at PMPS. Normally I would consider R, but I'm really hoping not to be up that late to monitor. Plus he's been clearing these big bounces really quickly and I'm curious to see if he'll do that without the R on board. Not sure how the dose reduction might impact things, though. R in the morning if he needs it, though.
 
Lisa & Oberon said:
I thought about stalling a bit, but he was ravenous (he doesn't usually beg like that) and I was half asleep, so I gave in and fed him. (I suspect that if he'd gotten some regular LC at +10 along with the 15% he might not have gone quite that low.)



There's different TR reduction rules for long-term diabetics (over a year)... you can wait for three drops below 50 (in different cycles) or one drop below 40, if I remember right. Not sure whether it's different for Levemir. With Oberon, I think the first couple of times he came down the dosing scale I was so worried about the antibodies "giving up" that I reduced too quickly sometimes and he ended up going right back up the scale. This time I'm trying to only reduce if I really have to, so I'm following these guidelines.

And there's the bounce, for real. 323 at PMPS. Normally I would consider R, but I'm really hoping not to be up that late to monitor. Plus he's been clearing these big bounces really quickly and I'm curious to see if he'll do that without the R on board. Not sure how the dose reduction might impact things, though. R in the morning if he needs it, though.
Click to expand...
Howie won’t hit a year until June, but that is good to know. I realized I maybe should have tried a BCS instead of a reduction tonight to try and drain the depot a bit. I will wait for expert Wendy to help set me straight again! I think I get too excited about seeing lower numbers finally so jump to a reduction right away. @Wendy&Neko i wonder how much I’d mess him up if I went back up to 43 units tomorrow? My confidence is waning in what I think I know!

Sorry if I hijacked your post! I monitor your daily posts to see how Oberon does. I’m not in the habit of posting Howie’s info as many days he doesn’t have major movements that are noteworthy!
 
Howiesmom said:
Howie won’t hit a year until June, but that is good to know. I realized I maybe should have tried a BCS instead of a reduction tonight to try and drain the depot a bit. I will wait for expert Wendy to help set me straight again! I think I get too excited about seeing lower numbers finally so jump to a reduction right away. @Wendy&Neko i wonder how much I’d mess him up if I went back up to 43 units tomorrow? My confidence is waning in what I think I know!

Sorry if I hijacked your post! I monitor your daily posts to see how Oberon does. I’m not in the habit of posting Howie’s info as many days he doesn’t have major movements that are noteworthy!
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I hadn't looked at Howie's SS for a while... he's looking really good! I definitely don't mind the hijacking. :) But if you want more feedback about dose you might want to go ahead and make a separate post to get more eyes on it. Looks like you're using 70 as your reduction threshold? That's what I did for a while, until I realized it was taking him down a little too fast. But Howie's dosing situation is much different, so don't take that as criticism or advice!

@Wendy&Neko I saw on another thread that you had a death in the family; I'm very sorry to hear it. My condolences to you and your family. :bighug:
 
Long term diabetics the reduction rule under TR is once under 40, or a week in mostly normal numbers. For cats that don't hold reductions well (can be newer diabetics too), you can try a three times between 40 and 49 on separate day, or once under 40. Having said that, I ignored the "long term diabetic" rule for Neko, cause she held her reductions. And when she was on a roll down dose, if I didn't take the reduction at 50 (or 70 after SRT), the depot would catch up with me. Which resulted in 20's a couple times. :eek:

With the even larger doses like Howie's, the depot can be even more of a pain. You've done some close together reductions, but I've also seen that necessary when cabergoline action is happening - same thing happened after SRT. Safety first. And IAA by itself is different than IAA with acromegaly.

Thanks Lisa - it was my uncle, young for my family at 94. My 98 mother is now the last of 7 kids and feeling it.
 
Wendy&Neko said:
Long term diabetics the reduction rule under TR is once under 40, or a week in mostly normal numbers. For cats that don't hold reductions well (can be newer diabetics too), you can try a three times between 40 and 49 on separate day, or once under 40. Having said that, I ignored the "long term diabetic" rule for Neko, cause she held her reductions. And when she was on a roll down dose, if I didn't take the reduction at 50 (or 70 after SRT), the depot would catch up with me. Which resulted in 20's a couple times. :eek:

With the even larger doses like Howie's, the depot can be even more of a pain. You've done some close together reductions, but I've also seen that necessary when cabergoline action is happening - same thing happened after SRT. Safety first. And IAA by itself is different than IAA with acromegaly.

Thanks Lisa - it was my uncle, young for my family at 94. My 98 mother is now the last of 7 kids and feeling it.
Click to expand...
Thanks so much, Wendy. Should I stay at the 39 or go back up to 43 at this point? I was questioning about reducing him again after only 2 cycles. I am so sorry to hear about your loss. I hope your uncle lived a long full life.
 
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