5/20 Billie AMPS 302 +2 249 PMPS 195 +2 140 +3 112 +6.5 256

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Deanna & Billie

Deanna & Billie

Member Since 2014
Hello! Here is Billie's condo from yesterday: viewtopic.php?f=9&t=118991

She's higher than I've seen her again today with an AMPS of 302. That's higher than she has been at the vet under stress as well. I'm still wondering if there is some bouncing going on. I got a +5 from her in the middle of the night, and she was at 143, so she's definitely not staying high all the time, but ever since she had that nice 85 on Saturday, I have seen a lot of 250-300 numbers that I had not seen before. I'm not sure what to make of it.

Does this sound like bouncing? Should I wait it out? Or, do you think her numbers are just high and warrant a dose increase? The vet recommended starting her at 1 unit and I went with 0.75 just to be cautious at first.

I hope all your cats are doing well today!
 
Re: 5/20 Billie AMPS 302 +2 249

Bounces can last 6 cycles after a low event and Billie is showing a decent drop for today's cycle. Today is the 6th cycle after low so she could be finishing off the bounce. In addition, there was a fur shot and the effects of that can show up later.

From the protocol, with the relevant bits in bold:
"General" Guidelines:

Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).

Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).

Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose:

Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
Click to expand...
Tomorrow is the 10th cycle since Billie started insulin, so I'd keep holding the dose, unless she goes under 50. In addition, Billie saw that green number and the protocol suggests counting 10 cycles after the first green that before increasing.

To further complicate matters, there was "fur shot" two days ago. Take a look at Jill's post on Counting Cycles. Specifically:
Because of the cumulative nature of Lantus and Levemir... stalling, shooting a reduced dose, shooting a BCS dose, skipping a shot, and fur shots can alter the effect on the insulin/depot on any given dose. If you have to do any of these things, the cycle count starts over. If you don't start over, you run the risk of kitty becoming over dose.
Click to expand...
Due to that fur shot, you cycle count started over 2 nights ago. Today is just considered the fourth cycle after that fur shot. I'd hold this dose.
 
Re: 5/20 Billie AMPS 302 +2 249

Wendy, thank you so much for the detailed response! It sounds like there are a lot of factors at play, and all I can do for now is hold the dose and keep testing. I'm still getting used to everything, and it's intimidating! I really appreciate your help.
-Deanna
 
Re: 5/20 Billie AMPS 302 +2 249

I'd agree with Wendy about holding the dose.

There is so much to learn, Deanna. Keep asking questions and before long you'll have a lot of it down!
 
Re: 5/20 Billie AMPS 302 +2 249

Thank you!! Billie's PMPS is looking better tonight - 195. We'll see how she does over the next couple hours!
 
Re: 5/20 Billie AMPS 302 +2 249 PMPS 195 +2 140

Billie's +2 is 140 down from 195. Should I be concerned about that drop?
 
Re: 5/20 Billie AMPS 302 +2 249 PMPS 195 +2 140

It does seem to be Billie's pattern to often be lower at +2 than at preshot. Yes, you need to pay attention to it - you can give some low carb food to see if she'll "surf" as she gets into green numbers. You're probably still feeding her another regular meal, aren't you?

The drop itself is only 55 points in 2 hrs, so roughly 27 pts/hr, which is fine. Drops of over 50 points an hour can sometimes trigger a bounce, but this isn't too fast.
 
Re: 5/20 Billie AMPS 302 +2 249 PMPS 195 +2 140

I'd get a +3 test. Hard to say at this point what is going to happen next.
 
Re: 5/20 Billie AMPS 302 +2 249 PMPS 195 +2 140

Thank you Julie and Wendy! I am giving Billie more low carb wet food and will get a +3 in a bit.
 
Re: 5/20 Billie AMPS 302 +2 249 PMPS 195 +2 140 +3 112

112 on the +3! I am loving this blue, just hoping she doesn't drop too much. I still haven't figured out how much dropping is normal.

Update: 110 at +4! Fingers and paws crossed for smooth sailing!
 
Re: 5/20 Billie AMPS 302 +2 249 PMPS 195 +2 140 +3 112 +6.5

I woke up to get a +6.5 expecting low numbers, but she's at 256. A bounce from the tranquil blue numbers we saw earlier?
 
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