5/29 Molly breakthrough day

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Michele&Molly

Michele&Molly

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I knew it was coming -

amps 215 fed and shot 2.25
+5 71
+6.5 57
+7 49 fed lc food

In the middle of vacuuming the pool - will check on her in a few.

Here comes Sheila's recommended .25 dose reduction :smile:
 
Here comes Sheila's recommended .25 dose reduction
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Not so quick.......First of all congratulations on the breakthru and a very nice cycle! I'm not so familiar with Molly's case but she is not a recently diagnosed cat so the procedure for reducing is a little different. Generally she would need to go below 40 to earn a reduction, or what works well for many cats that have difficulty maintaining good BG control after a reduction is to require them to go below 50 at least 2x (within a week to 10 days) on the same dose before reducing. And then all reductions (and increases) should be in .25U increments. I'm not a fan of skinny and fat! You have some pretty nice numbers at times, If you keep consistant with dose, meter, food, and schedule (as much as possible, we do have a life though :mrgreen: ) then you should be seeing more of that "good times".
 
Hey Michele,

Looking at SS ( last few days are missing) and knowing you are away during the day and worry about Molly going too low in your absence, If it were my Paul I'd have to pick one of thise pesky .10 reduction doses...

I know how frustrating they are, but MAN! They work magic on my PK! Giving .5 is not enough and .75 is too much on my little man...I get swooping vetsulin curves form him on both those doses, but the .6 I have hovered around the last 2 months- purrrfect!

Well, perfect for Paul, anyway. He is getting Peak/PS's in the 150's and highs of mid to low 200's...he spikes an occasional low 300 on me that I usually attribute to lawn mowing day or vacuum cat room day or full moon day.

I hate that .6 b/c I KNOW sometimes I am giving .55 or .65, but dangit- the curve is better than a straight .5 or .75, so whaddayagonnado, eh!?

anyway- so that's my 2 and a half cents worth.
 
The smaller the dose, the smaller the increments should be. .25U one way or the other is fine if you're over 2U, but especially once they reach 1.5U or less, the incremental changes should be smaller. Paul-Kyle is an excellent example of this.

The difference is in the percentages. .25U reduction from a 2.25U dose is only an 11% reduction, whereas a .25U reduction from a 1.5U dose is a near 17% reduction and when you get below 1U, .25U can be more than a 25% reduction!

I would like to see dose changes done on a percentage basis rather than a unit basis. A 10% change seems about right at most doses, but below .5U it gets even trickier. We suggest doing it in a drop by drop basis, as 1 drop is about .05U.

In the meantime, it's very difficult to determine the double <50 guideline for Molly as Michele does her best to get tests in. The very fact that she caught this 49 is only because it's the weekend. Michele is gun shy enough about shooting on low (below 150) numbers because she and her husband are gone a lot, that a dose reduction of .25U to 2U is probably the best course since that's a pretty hefty drop from 215 to 71 in 5 hours. We'd like to see less bounce too.
 
As someone who does know Molly's history And spent time reviewing her numbers earlier this week, I stand by my comment that her best dose seems to be somewhere between 1.75u and 2u.

Michele, this is an indication that the breakthrough you were waiting for is happening, but what was her PS tonight? That 49 is barely making the "reduce dose" grade - which I have ALWAYS read and believed was 50.

Right now you are looking for a lower PS, and then reducing only .25u, not 1u or something like you have in the past. You gotta wait for that uncomfortably (for you) low PS OR a dip farther below 50 (like 45 or something). Remember, she is safe down to probably 30-35. My guys have been there with no adverse reactions and so has Gandalf.
 
Sheila & Beau & Jeddie said:
As someone who does know Molly's history And spent time reviewing her numbers earlier this week, I stand by my comment that her best dose seems to be somewhere between 1.75u and 2u.

Michele, this is an indication that the breakthrough you were waiting for is happening, but what was her PS tonight? That 49 is barely making the "reduce dose" grade - which I have ALWAYS read and believed was 50.

Right now you are looking for a lower PS, and then reducing only .25u, not 1u or something like you have in the past. You gotta wait for that uncomfortably (for you) low PS OR a dip farther below 50 (like 45 or something). Remember, she is safe down to probably 30-35. My guys have been there with no adverse reactions and so has Gandalf.
Click to expand...

Ah, so you think she should wait to reduce till she sees actual lower preshots, rather than another below 50? That would probably help her in their situation, since it's difficult to get those mid cycle numbers often enough.

Have to agree with Sheila about the safety factor of low numbers on Levemir. Not that we want you to play with fire, but the thing is, until you witness them on a true low and what they do and how easy it is to bring it up, you will continue to be gun shy about shooting preshots below 150.
 
I think if she gets another below 50 and/or a low PS the dose can be dropped to 2u. But you are right, since Michele works all day (and sleeps at night), getting the evidence of a drop below 50 might not happen. It doesn't mean the drop isn't happening though. Molly does give an indication that her whole cycle is lower by giving the low PS's below 150 or even 125.

And before anyone starts quoting Tilly to me, I did just reread it. As I have said before, my opinion of it is that it is a good guideline, but that different cats, different human schedules and comfort levels make it necessary to customize it. I don't know the reasoning behind saying don't let the cat go below 50 in the beginning but then saying don't drop the dose until the cat goes below 50 three times in 10 days or below 40 (is it once?). I think for the reality of those of us that work all day and can't come home to check the cat, 50 is a safer does reduction number. I am not comfortable with knowingly allowing Jeddie to drop to the 50s when I am not there. And I know from reading all her posts that Michele is not comfortable with Molly dropping low. Heck, it was all we could do to convince her that 75 or 80 was safe.
 
Thank you so much for all your posts and advice. I love that you guys know me so well and understand my comfort level and well as my work hours.

You'd be proud of me, i didn't even flinch at the 49. Several times yesterday i caught her playing and demonstrating energy levels not typical for her so when it came to give the pmps, she was 201 and i stayed the course and shot 2.25u. Was definitely hopeful that yesterday's numbers were a sign of things to come but today she's right back to her blah numbers...

amps 288 fed and shot 2.25u
+5 279

Will update her ss now and then that little fur ball is on her own as it's 85f degrees here and am heading out on the boat to watch the air show (will try to take pics).

Thanks again for the advice and yes Vicky, i agree that dosing decreases (as well as increases) should be based on percentages. That's why, if we're ever under say 1.5u, you can do the math for me - big of me, i know :-D

Have a great day all!!
 
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