6/1 Poe

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Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

Deb, you meant to type 0.25, right?

Shoot and feed.
 
Re: Poe AMPS +4 560 AMPS +6 292 AMPS +8 267

Sorry, typo on the amount. That 0.2u should have said 0.25U.

I would suggest a +2 and then somewhere around the +5 to +7 timeframe.

It depends on how the +2 looks, we may want some tests before that +5.

If the +2 is similar to pre-shot, more tests.
If the +2 is much less than the pre-shot, more tests.
 
Re: 6/2 Poe AMPS 335

I changed the heading in the first post with the date and the amps.

I went back and looked at the pictures of the tiny doses on my thread in the main board, so I made sure I gave him the .25.

Test again in +2 and +6?
 
Re: 6/2 Poe AMPS 335

Yes, test again in +2 and +6 sounds like a good plan.

Unless the +2 is much less than the pre-shot. Then I might ask for more tests.
 
Re: 6/2 Poe AMPS 335

Am I safe to think that the testing is to determine how the Lantus works for him? Does it give some idea of predictability? I was just wondering the significance between say the +2 or a +5 or a +11 in the cycle

Thanks
 
Re: 6/2 Poe AMPS 335

KarensPoe said:
Am I safe to think that the testing is to determine how the Lantus works for him? Does it give some idea of predictability? I was just wondering the significance between say the +2 or a +5 or a +11 in the cycle

Thanks
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Yes, the testing is to help determine how the Lantus is working for Poe. ECID (every cat is different) so we need to test to see how Poe reacts.

We ask for the +2 tests to help us determine if this is going to be an active cycle or not. If it does look like it will be active (similar to PS or much less than PS), we will have you get more tests if you are home or we will suggest you leave out some extra food if you will be away at work.

We ask for the +5 to +7 tests to find Poe's nadir, or low in the cycle. The low is used to base dosing changes on. The nadir can also give us an indication if those later numbers we see in a cycle are "bounces" from the body "panicking" and dumping hormones to raise the BG's back to what it has gotten used to as normal ranges. Without those mid-cycle tests, we can only guess how low he went and guess how much or even if a bounce is occurring.

We ask for the +11 test to find out if the PS (pre-shot) tests are a rising or falling number. If the number is still falling between +11 and PS, then you may need to wait on the shot and food for 30 minutes to an hour and retest at 30 minute intervals to determine if you want to shoot, if it is safe to shoot and leave for work for the day. If the number is rising between +11 and PS, then it is usually safe to shoot if you're at or near your shoot/no shoot threshold.

For example, say your +11 this morning had been 140 and your AMPS had been 175. This is a rising number so I would have suggested you go ahead and shoot. The number will rise a bit more with food and the Lantus insulin doesn't onset or take effect for a couple of hours after a shot, usually onset is not until +2, closer to +3.

Over here in lantus land, we have a shoot/no shoot threshold of 150. You do not have a lot of data yet on Poe, so we may have that threshold a little higher for now, more around 200. As you gather more data and learn how your cat reacts to insulin and food, we drop that shoot/no shoot number down. Another of our mottos is 'Shoot low to stay low' BUT you need the data first to shoot low.

Hope that helps to give you a little bit of understanding why we ask for the various tests. Please, keep asking all the questions you want. That is how we learn.
 
Re: 6/2 Poe AMPS 335

I understand a bit better now. It's making sense now as to why I needed to test at certain PS + and how to read the numbers especially on the days I have to leave for work. That is comforting because I worry myself sick leaving him alone whether I was shooting or not.

I'll keep reading that to lock it into my head so I begin to learn how to respond to those different numbers too.

Thanks...I was reading all the stickys and the simpler the explanation, the better for me right now.
 
Re: 6/2 Poe AMPS 335

That is comforting because I worry myself sick leaving him alone whether I was shooting or not.
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If you haven't given any insulin, it will not be possible for your cat to hypo, and go too low. So if you are not shooting, no need to worry. It is still a good idea to do a few tests to see how high Poe will bounce, or to see when the insulin stops working.

We like to see the momentum keep going, but sometimes a shot is skipped. Sometimes we give a fur shot, where we have missed giving some or all of the insulin. It happens to all of us, even those giving insulin for years.

Worst case, the numbers are too low before you need to leave for work, so you skip or give a reduced shot and leave out some extra food.

Tomorrow is another day. Or more accurately, the evening is another cycle.
 
Re: 6/2 Poe AMPS 335

His AMPS +2 is 359...so he's going up..now I'll go back and read again to see what that means :-D

What does "active cycle" mean?
 
Re: 6/2 Poe AMPS 335 +2 359

An active cycle is one in which there will be a lot of variance in the numbers. Maybe some steeper drops. We think of any change in the numbers more than 30-50 points an hour to be a fast or steep drop.

A flat cycle is one in which the BG numbers are all clustered in the same general range, say within 20-30 percent of each other.

His AMPS +2 is 359...so he's going up..now I'll go back and read again to see what that means :-D
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I'm not going to tell you anything about that +2 and what it means until you have some time to go back and try to figure it out yourself. Think of this as a mini-lesson.

Here is some more information for you on a typical 12 hour lantus cycle:
Example of a typical Lantus curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.
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Don't let the word 'curve' throw you. We do not mean a testing curve in this instance. Here the use of the word "curve" means the shape of the numbers if plotted on a graph. We want to see a nice smile shape. That is our goal.
 
Re: 6/2 Poe AMPS 335 +2 359

After reading the last few posts about the cycle, and seeing how his +2 number is not much different than his PS, I am thinking that a +5 would be a good next test since the numbers are so close and not looking like an active cycle?
 
Re: 6/2 Poe AMPS 335 +2 359

Yes, only a 24 point difference. Some of the difference could be from food or even meter variance.

Pre-shot and +2 are similar. So probably not an active cycle. That +5 sounds like a good next test to do.
 
Re: 6/2 Poe AMPS 335 +2 359

Good morning, Karen!

I'd suggest your start a new thread (we call them them "condos") each day. If you keep posting to the same thread, it will get impossibly long. I'd suggest switching your Subject line back to 6/1 and opening the new condo with the subject line you have for this one.

Just a word about shot times. Much of when you test depends on your cat and the insulin you're using. What Deb posted makes sense for Lantus (vs. Levemir) and if your cat has a nadir (i.e., lowest point in the cycle) that's somewhere in the neighborhood of +6. Right now, what's important about testing is becoming data ready. This is important because as you accumulate testing data and you see Poe's numbers improving, you'll want to start shooting progressively lower numbers. There's a section in the Shooting & Handling Low Numbers sticky that addresses becoming data ready.
BECOMING DATA READY

Let's talk specifically for Lantus and Levemir. This is about fine tuning your curves.
Are you data ready to handle a lower preshot number?

This is where the very early cycle spot checks (those +1's, +2's) and those very late cycle spot checks (the +10's, +11's) come into play. Call them the "neglected" spot checks. Everyone gets those +6 spot checks, but there is a reason to collect data in the very early and very late part of the cycle.

Say you get a preshot of 150. Well if you've collected the data on the average time it takes the insulin to start having any effect for your cat and what happens after +12, then you might see that shooting a 150 is actually very safe in your cat. Kitty will be in the 200's before the insulin starts working. You are then using the lag time (aka overlap and carryover) between shooting and effect time to your advantage.

So why the +10's and +11's? Well say you are on day 5 of a dose increase change and your storage shed is now not only full, it is overflowing... and your +10 or +11 was way higher than your preshot. Good way to stay out of trouble cause now you know you would have shot a still dropping number, not a good idea. so what is the plan then?.... keep testing, and not 2 hours later, every 20-30 minutes would be better, so you can catch the minute it turns and do not loose all your overlap. If you miss the rise and cat is way up there BG wise before you shoot, remember the number is just going to continue to rise in those hours before the insulin has a chance to kick in, and you have a roller coaster curve going rather than the flat curve that is ideal.

Also some Lantus and Levemir users notice a dip at the end of the cycle, meaning that their preshot is always a bit lower than their +10 or +11. It is important to know if your cat is one of those because if you are not raising your dose because your PS doesn't seem to call for it, yet your nadir is not so hot... this could be the reason why.

If you want to choose less important times to test, really the +8's and +9's and the +4's and +5's are the numbers that yield the least amount of important data once you have well established the nadir in your cat. Yes, get them here or there on spot checks, but do not forget to get the "neglected" spot checks... the very early and very late parts of cycle. They are more useful than most realize.

Know thy cat. Be data ready to handle the situation.

~ written by jojo and bunny(GA) and Y
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Hopefully, this puts testing into perspective.
 
I started a new thread with the Subject as you suggested. I have copied the Lantus and Shooting Low info into word so its easier to access.

My next test is a +5, but I'm also going to do a +11 and see if I can start understanding this all as it applies to Poe. Switching and skipping doses confused me quit a bit, but hopefully sticking with the .25 for 3 days and testing at the most "data important" times will give me what I need to know what to do in Poe's best interest.

Thanks again :-D
 
Sorry for jumping in, but WalMart can not ask for a prescription for syringes,anyone can buy them. Just tell them you need the 3/10's 31 gauge 8mm needles they have to give them to you or you call the main office. My sister works for them said they have to give to you or report them. Linda
 
Interesting...twice they told me I had to have a prescription because my vet did not authorize a refill. I will stop tomorrow after work again and tell them this, although yesterday I had gone again, with them telling me the same thing, and they faxed the vet asking for authorization. I imagine they have what I need now, but I have not gotten a phone call from WalMart confirming this.

Thank you for the info
 
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