5/6 Bud AMPS 210 did I do the right thing?

[Stacym20]

http://www.felinediabetes.com/FDMB/threads/5-1-bud-pmps-359-3-207-were-home.137197/

After surfing in some nice numbers Saturday night, I increased Bud's does to 0.75 on Sunday night. Haven't been seeing great numbers that I chalked up to new dose wonkiness. Plus I realize I'm not getting enough mid cycle tests to see the whole picture. He threw me a 210 this morning which I was thrilled about, but being concerned that I wouldn't be home to monitor, I reduced the dose to 0.5 and fed some medium carb food.Yes, I know Levemir is not dosed based on preshot, but with few and far between lower preshots, I was concerned with not being home to monitor.

So my questions are:
1. Was that increase Sunday night the right thing to do?
2. Would you have shot 0.75 this morning with a lower than normal preshot and not being able to monitor?

 

[Chris/China (GA)/Garfield]

1. Was that increase Sunday night the right thing to do?

I would have probably held the .5 instead of increasing because of all the skips due to your daughter being in the hospital. Each time you skip a dose or shoot a "different" dose, the "shot clock" starts over. We'd like to see at least 6 consecutive cycles a week at the same dose before deciding on an increase (since you're on SLGS, each dose is usually held for 1 week and then a curve is done to evaluate the need for an increase)

2. Would you have shot 0.75 this morning with a lower than normal preshot and not being able to monitor?

Generally, our "no shot" limit here is 150, but I understand how you can be concerned when you can't be there to test and see a lower than expected number.

I'd go back to .75 tonight and hold that dose for at least 6 cycles for a week (unless he drops below 50 90)

If you can get a curve this weekend, it might be soon enough for us to see if he needs to increase a little sooner, but the SLGS protocol says to hold each dose for 1 week

 

[Sienne and Gabby (GA)]

Generally, our "no shot" limit here is 150....

I believe that Jill/Alex had posted in another condo a week or so ago that the "no shot" number for those following SLGS is 200.

The two different approaches makes it challenging. FWIW, regardless of whether you're following SLGS or TR, at some point you will need to get comfortable shooting progressively lower numbers. I generally coach new members to start thinking about what your comfort level with regard to the next lowest number you'd be confident (or relatively confident) shooting. I have to leave for work in the morning and I've set my shot times so I can get a +2. I don't know if that would work for you but if you have any flexibility, it may be something worth considering. Likewise, if it makes sense, a timed feeder may help as a bit of added insurance that there's food available if Bud's numbers start to drop and you're not home.

 

[Amy&TrixieCat]

You've gotten some great info. It may take a little time for Bud to re-settle in from the skipped shots, too...just something to keep in mind. Ultimately, you hold the needle and have to do what you are comfortable with...every one is different with that comfort level. As Sienne said, though, you'll eventually get comfortable with inching down how low you're willing to shoot.

 

[Stacym20]

We'd like to see at least 6 consecutive cycles a week at the same dose

Good point. I did not think of that. I was basing my decision on increasing as looking at the 0.5 as a failed reduction.

I'd go back to .75 tonight and hold that dose for at least 6 cycles for a week (unless he drops below 50 90)

If you can get a curve this weekend, it might be soon enough for us to see if he needs to increase a little sooner, but the SLGS protocol says to hold each dose for 1 week

Sounds good! We should be home this weekend.

at some point you will need to get comfortable shooting progressively lower numbers

I should have clarified my question, I did shoot this morning, just at a reduced dose of 0.5 instead of the 0.75 I had been giving. I was wondering if I should have shot 0.75, or if I did okay reducing knowing I wouldn't be home. And the evening of 5/2 I shot a full dose of 0.5 (his full dose then was 0.5) with a preshot of 137. So I'm comfortable shooting lower now than I was before, just not fully yet if I'm not going to be home. Although I do need to think about what number is my cut off to not shoot at all if I won't be home.

I have to leave for work in the morning and I've set my shot times so I can get a +2. I don't know if that would work for you but if you have any flexibility, it may be something worth considering.

I like this idea, and I'll have to think what is logistic to me as I'm out of the house for 10 hours a day during the week.I'm just not good about getting up any earlier than I absolutely have to... lol!

Likewise, if it makes sense, a timed feeder may help as a bit of added insurance that there's food available if Bud's numbers start to drop and you're not home.

I fed him some medium carb as I was heading out the door at about +1, but I would feel better knowing he could get some medium carb food around +3 or +4 instead. I just need to figure out what would work best with 6 cats in the house.

Thanks for the replies!

 

[Tiger(GA) and Ruth]

No dosing advice from me I just wanted to say I'm glad your daughter is home safely and hope she's doing well!

 

[Darin & Charlie]

Good point. I did not think of that. I was basing my decision on increasing as looking at the 0.5 as a failed reduction.


Sounds good! We should be home this weekend.


I should have clarified my question, I did shoot this morning, just at a reduced dose of 0.5 instead of the 0.75 I had been giving. I was wondering if I should have shot 0.75, or if I did okay reducing knowing I wouldn't be home. And the evening of 5/2 I shot a full dose of 0.5 (his full dose then was 0.5) with a preshot of 137. So I'm comfortable shooting lower now than I was before, just not fully yet if I'm not going to be home. Although I do need to think about what number is my cut off to not shoot at all if I won't be home.


I like this idea, and I'll have to think what is logistic to me as I'm out of the house for 10 hours a day during the week.I'm just not good about getting up any earlier than I absolutely have to... lol!


I fed him some medium carb as I was heading out the door at about +1, but I would feel better knowing he could get some medium carb food around +3 or +4 instead. I just need to figure out what would work best with 6 cats in the house.

Thanks for the replies!

I am a multi cat house also, and wandered the same, how to get food to my charlie if I was not going to be home during his cycle, I feed PS, +2, and +4. I started seeing people talk about timed feeders, so I bought one and figured when and if I needed to use it, I would put Charlie, litter pan and feeder in a closed room. I have yet had to do this, I like to be overly prepared.

 

[Stacym20]

No dosing advice from me I just wanted to say I'm glad your daughter is home safely and hope she's doing well!

Thank you! She returned to school yesterday, but think it might have been a bit too soon as she had to stay home, today. But she's being quite rambunctious tonight so I'm sure she'll go back to school, again, tomorrow. She's got a ways to go, but she's on the right track!

 

[Stacym20]

I am a multi cat house also, and wandered the same, how to get food to my charlie if I was not going to be home during his cycle, I feed PS, +2, and +4. I started seeing people talk about timed feeders, so I bought one and figured when and if I needed to use it, I would put Charlie, litter pan and feeder in a closed room. I have yet had to do this, I like to be overly prepared.

One of my dilemmas is that my crazy Mr. Kikibell can open all our doors! LOL! Love this cat, he makes me laugh every day with his crazy antics! I'm wondering if a 2 compartment feeder might hold enough that all 6 would get a chance at the food if I set them both to open at +3 or so. Might be worth a go.