? 5/31 Misha AMPS=89 on AlphaTrak2, 42 on Relion--OTJ time?

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Squeakycats

Squeakycats

Member Since 2017
Hi, all! I'm wondering if it's time to give Misha an OTJ trial, or if it's time for me to get fitted for a new pair of patience pants...

I recently started using the Relion meter alongside the AT because I was curious whether he'd have earned himself an OTJ trial if I had just been using the Relion all along. He's reliably giving me enough blood that I can test from the same drop for both.

As you can see in his spreadsheet links, he's never had anything but green (or light green) on the Relion. On the AT, he has a mix of greens and low blues (the highest he's been was 143 on 5/20 for his PMPS, and that was an outlier; 122 is the next highest number). I have been trying to continue shooting at least a drop, but the Relion numbers have made me especially nervous about doing even that and then leaving him for the day.

On maybe 3 occasions, those lower numbers have been correlated with a behavior oddity--hiding under the bed. He doesn't act super-distressed, but that's not his favorite spot when he's feeling well; it's where he goes when he's sick. My civvie has taken to sitting with him at those times even though they normally don't hang out together much.

So--I'm wondering if it's time to give him a week off and see what he does, or if I need to keep doing my best to get a drop or two into him at times when I can stay with him (or even at times when I can't? yikes). I want him to have the best chance possible of a really strong remission, but I am scared to shoot these low numbers.

On the whole, I'd say he's doing well--eating well, not drinking/peeing too much, not horribly dandruff-y (though that may partly be because I've started brushing him daily).

What do you think? And if it does seem like OTJ trial time, is there a protocol for that? I will look around the stickies and see what I can find...thanks in advance for any advice!
 
What a great looking SS! And yes, I would say after a drop and all greens and a couple of NS that it is looking really good for an OTJ trial. So, this looks like it could be Day 1 OTJ trail if tonight he still doesn't get any insulin. :);):cat::D


ETA:

Here are the OTJ instructions:

o Start the trial on the next green pre shot.
o If she is green at your normal test times, no need to test further until the next "PS" time; just feed small meals and go about your day.
o If she is blue at your normal "PS", feed a small meal and test again after about 3 or 4 hours. If her number is lower 3-4 hours after a meal, then the pancreas is working!Post every day so we can monitor your progress and see if any tweaks are needed. She may have a sporadic blue number. Don't panic but post before you decide whether to shoot so we can have a discussion.
o After 14 days of no insulin, we have a party!!
Sometimes the trial doesn't work the first time and we have to give a little more support in the form of resuming insulin. It's not the end of the world if that happens; we just give her the support needed. Our goal is a strong remission and it's better to take our time to get that than to rush into remission just to have it fail later on.

Good luck with the trial!
 
Wendy&Neko said:
That's what I was wondering about. Typically we go from 0.25 units, to 0.1, then a drop.
Click to expand...
Okay, there are 2 SS linked. One is for AT2 and the other for the Relion . On the Relion SS you did go from .25 to 0.10 and a drop but then back up again to .25 then a drop for one cycle, then skips..... so I guess we aren't really sure where Misha is.

Just saw your PMBG of 109 with the Relion meter and you skipped. Not sure how for you to proceed as using both meters and posting the results is a bit confusing. @Wendy&Neko , would going back to 0.10 for a bit be the best possible result for Misha to do a OTJ?
 
This is the first of the OTJ trial instructions:
Start the trial on the next green pre shot.
Click to expand...
Tonight was blue.

Frankly I'm not sure what is the best way forward with the inconsistent dosing. Misha is very close, just not sure close enough. You could try a couple shots of 0.1 and see that that yields or even go to the drop dose. You could also proceed with the trial and cross your fingers. It's also not the worst thing if the trial doesn't work out and he has to go back on insulin for a bit.
 
I tried various ways of measuring tiny doses and never felt like I was being consistent--I finally got calipers a few days ago but haven't used them yet since I was worried about giving him anything at all. I'm totally willing to try to go back up if it would be helpful, though I'm so nervous about leaving him during the day, given that he has gone pretty low and had some behavior changes a few times. I definitely skipped around some in a way that probably wasn't good, without waiting enough cycles to see what a particular dose did--though I stuck with variants of the "drop" for a while there.

I'm sorry about the two-spreadsheet thing--I know everybody advises against it! I was initially just using the AT but then got the Relion when I ran out of AT strips at one point. And then, once I had it, I got curious what life would have been like in an alternate reality in which I had only ever used the Relion meter...specifically, whether he would've gone OTJ a while ago, since the Relion numbers are always green. If anything in the two sheets looks weird/inconsistent, it's probably because I'm keeping all of this stuff in my own more detailed spreadsheet that has info about food, weight, behavior, etc.; usually I enter it numbers directly into the AT and Relion sheets immediately after testing, but sometimes I'm rushing out of the house and end up having to copy it from the detailed spreadsheet later--probably resulting in some mistakes!

I greatly appreciate everyone taking the time to look at all of this stuff and offering such detailed info and advice. I will go look at the "how to measure" link again. I wish I worked from home so I could feel less nervous about it all...
 
Yes...blue on on meter (the AT), green on the other (the Relion--and even some light green there)...hence the dilemma :arghh: And hence the reason for everyone saying "just pick one!!!" Sigh. I want him to go into remission and stay there as long as he can, but I don't want to risk dropping him too low when I'm not here--which I suppose is exactly what everybody experiences. He's very good about testing and shots, and I can handle the expense, so it's not like I'm desperate to stop; just want to be safe.
 
If it were me, I would only use the Relion meter since the protocol (TR) and method (SLGS) is designed for human meters.

Looking at the Relion meter SS , how about if you go back to a drop consistently and let's see if it holds him in greens for 7 days before you start the OTJ. Does that sound reasonable?
 
Yes, that sounds ok! I'll have to reread the guidelines so I know what to do at times when I'm not sure whether to proceed with a shot--I don't have a sense of what I should consider "too low to shoot" with reference to the Relion numbers. Mornings are especially tough, as he has access to food to nibble on during the night, so it's always possible that he has eaten within an hour or two of his AMPS. I think the only way to be sure about that would be not to leave anything out at night, and then he would drive me completely insane. He is definitely a grazer.

I guess another approach would be to get up earlier to put away any food and then wait 2 hours before testing, but I would not have time to stall or re-test if I do it that way. Right now I try to test and shoot at 7:30 and then recheck a little after 9 if I'm worried; I guess I could instead take the food away at 7:00 and wait until 9 to do the test/shot, but that would mean I definitely couldn't get a +2 or anything close to it...what do you think is the better approach? (My work hours are a bit weird--I leave home at 9:30 and start work at 10:00, and I get home anywhere between 6:30 and 7:30.)
 
With TR we shoot any thing over 50. ( that is with a human meter). In the event he is under 50, if you can, stall 20 minutes or so without feeding and see if he comes up and if he is over 50, feed and shoot. If not, skip and proceed with the PMPS. If he can stay in all greens for 7 days, then I would say start the OTJ. This is just an insurance plan for you and Misha since the dose was a bit scattered in the recent weeks.

Fingers and paws crossed.
 
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Whew, you TR folk have nerves of steel! I am having a hard time imagining myself going for it if he's under 60, at least during the day when I have to be gone (night is a little better since we can have a PJ party if necessary). I know it's important to be consistent, and I'm guessing just leaving MC food around as an insurance policy would undermine the whole endeavor :rolleyes:. But ok: deep breath: I'll come and share my freakouts with the world on occasions when I'm afraid to proceed. When in doubt, though, I'll probably be conservative/chicken...I wish I had known about this site from the start and just started with SLGS. My vet is going to be getting an education (in a good way) when I talk with her next; I don't think she's aware that this amazing resource exists!

Thank you so much, everyone, for all of the help, information, and good wishes! Misha is sitting right here looking at me like he wants to share something--I'm sure it's "Thanks, everyone, for helping me get healthy and stay safe," not "Did you mean beans just seriously tell my mom to keep coming at me with needles?" :cat:
 
Squeakycats said:
be consistent, and I'm guessing just leaving MC food around as an insurance policy would undermine the whole endeavor :rolleyes:
Click to expand...

That's exactly what you would do if his numbers are too low and you need to leave. Give a bit of MC food. If at all possible, get a+2 before you leave and that will help you to know how to proceed.


My guess is that he will be OTJ soon.
 
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