6/17 Max AMPS 328 +6.5=81+PMPS134+1.25=198+2.5=215+4=210

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tiffmaxee

Member Since 2013
YESTERDAY'S CONDO:
viewtopic.php?f=9&t=120370

YESTERDAY'S #S:
AMPS 359
+3=290
+5=193
+5.5=147/154
+6=139
+10=114
PMPS 135
+1=158
+2=117
+3.5=96
+4.5=92
+6.5=112

Either Max is bouncing this morning or feeding him prevented the lantus from lasting the duration or who knows? confused_cat

I just don't know any more how to get Max into good numbers. Maybe he is one that just can't regulate. :YMSIGH:

Vines for JD and Sasha and those in need.
 
Re: 6/17 Max AMPS 328 FAILED EXPERIMENT

Hi guys .. I don't know if max will ever be regulated or not, but yesterdays numbers look pretty nice to me! Lots of blues and some dashes of green .. have a great day guys!
 
Re: 6/17 Max AMPS 328 FAILED EXPERIMENT

Max may very well be a bouncy kitty. We do have a few here who have always bounced...Gabby, J.D., Zener, even Gracie. I don't have any ideas about the preventing the bouncing, and I know Marje has given you lots of suggestion based on her very thorough bouncing research and experience!

But, even if Max never stops bouncing, he is SOOOOOO much better off now than he was before he was on insulin. Numbers are really only part of the FD dance. How Max is doing overall is the main factor. If he didn't insulin, he would a very sick kitty. So even though his liver has a tendency to panic, you are doing a great job taking care of him. And who knows...he may surprise you one day and suddenly decide he's had enough with the bounces. We have our fingers and paws crossed that that happens!!

I replied about Trix and the appy stimulants in her condo. Long story short, though, she can't have them - they react badly with her BP meds.

I hope you have a great day, Elise, and don't worry about the bounces!!!
 
Re: 6/17 Max AMPS 328 FAILED EXPERIMENT

Oh, my dear!!! :-D :-D One cycle does not mean a failed experiment! I actually think Max is possibly bouncing off that big drop between +3 and +5 yesterday morning. I think last night was perfect and exactly what you want to see!!!

Amy is right. Some cats are just bouncers. We are trying to minimize the bounce in Max. I know you look at SSs. Please feel free to go through Gracie's tabs and you can see how much time and effort it has taken and she still will bounce. But it's so much better than it was. So it is what it is. There have been some cats here that bounced up until 2-3 weeks before they went into remission. Yes, the goal is to get him tightly regulated first.

Bouncing is stressful on the CG. No doubt. But Amy is also correct that Max is so much better and he is spending a lot of time in normal numbers. Take a look at Mocha's SS since Devon posted today on your condo. Mocha bounced and bounced ...almost two years. And then stopped.

We can keep trying to minimize the bounces. But I also want you to try and step back and not get upset by them. It's difficult....believe me I've walked 100 miles in those shoes. But at some point, you have to let it go. When we get bouncy days, like yesterday, we are outta here! We go do something really fun knowing she is safe and everyone is benefitting from a pokey break.

Love your old license plate. :lol: I'll be around today and check in to see how the bounce is clearing. Then we can talk more about holding the dose and continuing to flatten the curve or to edge it up a bit. But I think I'd go to the gym if I were you ;-)
 
Re: 6/17 Max AMPS 328 FAILED EXPERIMENT

:YMHUG: :YMHUG: Amy and Marje are right, some cats just bounce! Tess is another. You get to know their patterns and take advantage of the bounces when you can. Yeah, and I feel guilty every time I'm relieved to see her bouncing, so I can go to bed at night too! :roll: :lol: :lol:
 
Re: 6/17 Max AMPS 328 +3.5=204/224

Thanks as always for the support. It is so appreciated!!!

Well he dropped again. My cleaning lady is here and so he was under the bed until now. I dragged him out and tested using the Relion Micro and the Arkray which I inaugurated just now. He was 204 on the Relion and 224 on the Ark. Pretty similar. I decided I should check in case my battery goes out and I need to know right away. For someone who was NEVER going to test i now would be lost without a meter knowing about bouncy Max and how he likes to slide at night more than during the day. It is so weird as he doesn't even want food from +4-PMPS time yet wakes me at +9-10 begging. He did again today but I ignored him. Of course guess who didn't get to go back to sleep. He eventually gave up on the other hand. When I have tested him at that point he has had various numbers so that doesn't explain it to me.

Since it was already +3.5 and he hadn't eaten since I put the food out, he just ate some lc 4%. I guess I'll try the experiment again with tonight's cycle.

Question, at what point does glucose stop invading the urine? I'm guessing that is what is meant by the renal threshold? When Max tested for his labs at my vet's office the last time his blood was 144 but his urine was +3. My vet said that is to be expected because he is diabetic. I know that one can't be right! He is a diplomat of internal medicine and knows a lot about so many things, but not as much I'm guessing about diabetes.

Again, thanks for getting my head back on track.
 
Re: 6/17 Max AMPS 328 +3.5=204/224

the renal threshold is the point where the kidneys can't process out the glucose and it "spills over" into the urine. The standard response that you'll see published is somewhere around 250. I have heard people do experiments on their own cats and reported that some cats seem to spill glucose as low as 150ish.

One important factor in the urine test, however, is that urine accumulates for hours in the bladder, so a urine glucose test is measuring an event that occurred hours ago. The blood test is measuring what is there right now. It is more accurate, and between the two, i'd care a lot more about the blood glucose measurement.

i've been thinking of another possibility to help with Max and the bouncing. I'll get back to you later today on it.
 
Re: 6/17 Max AMPS 328 +3.5=204/224

Thank you Julie. You guys are moving me to tears!!! I'm so lucky to have found the FDMB.
 
Re: 6/17 Max AMPS 328 +3.5=204/224

Julie's explanation is why we discourage using urine glucose testing to monitor cats' diabetes. When Gracie was first dx, our vet at the time did not recommend home testing but did support urine glucose testing. I did both and then I sat down with her over lunch and showed her that Gracie could be in green but still have glucose in her urine because hours before, she had been bouncing high enough to spill glucose. I think it was a real AHA! moment for her. If you want to try and figure out where Max's renal threshold might be, you can buy the diastix that measure ketones and glucose in urine. You have to be able to catch them in the LB as they are rising from normal numbers. It took me several days, but I figured Gracie's renal threshold was low 200s. I don't know if it can change over time.

I'm happy to see Max clearing his bounces so fast. That's a good sign!
 
Re: 6/17 Max AMPS 328 +3.5=204/224

i think all of us that stick around to help do so because we get how much it matters to have our cats healthy. our cats are family members, with personality and quirks and we love them like children.

on sunday night we were with my in-laws for Father's Day dinner. My ever-insensitive mother-in-law said to me "isn't it great that you don't have to be home by 7pm to give an insulin shot anymore?" :shock: She would be a person who doesn't get it. She has said that to me, verbatim, at least 6 times since punkin died. i'm afraid the next time she says it i will have to throw my glass of ice water in her face and i might even scream something along with it. :lol: Six times of not-reacting hasn't made it go away yet, so it's probably going to take me saying something to get her to shut up. :-x
 
Re: 6/17 Max AMPS 328 +3.5=204/224

Of course Mr. Max is not an easy one to get urine. He is a very private guy. I have the strips and need to check the expiration. They are probably done as I opened them on 11/12/13 which is how I diagnosed him. My vet confirmed the next day and the rest is history. I have special litter but am saving it for an emergency as it is so expensive. I bought gravel at the pet store to try as well. Just haven't gotten the motivation for it yet.
 
Re: 6/17 Max AMPS 328 +3.5=204/224+5.5=93+6.5=81+7.5=94

Poor Max got extra pokes because I wanted to catch his nadir. Surfing now so I will leave him alone until PMPS.
 
Re: 6/17 Max AMPS 328 +3.5=204/224+5.5=93+6.5=81+7.5=94

There are a few strategies that you haven't tried yet. Each one has to be tried for a decent amount of time, so i'll just lay some ideas out. You can ask questions and think it over. Hopefully others will comment with their suggestions and experiences.

One technique is to shoot early. If Max is on his way up at +10, you could try shooting then. The plus of this is that you're increasing the time that the last shot and the current shot are overlapping, which can flatten out a kitty's BGs. The new shot will onset a couple of hours after you give it, and that can help prevent a rise, while the first shot is still lingering. The downside is that you still would be thinking of the next shot as being 12 hrs later, unless the second cycle replayed like the first one. Ideally, shooting early would create a different cycle, ie, flatter and lower, so you wouldn't have a repeat of the original cycle, and you would be shooting 12 hrs later. Does that make any sense? Let me give a concrete example.

Say today's day cycle - Max is surfing along at 90ish but at +9 suppose he goes to 250 and +10 he's at 300. Let's say you shot him this morning at his regular time at 7am, for example. You could shoot then at +10 (5pm) before he got higher. Supposing it brought him back down in the pm cycle to 90's again, but he surfed along - you probably wouldn't choose to shoot at +10 if he was at 90. Then his next shot would be due at +12, and yikes, that might be at 5am. The downside of that becomes obvious. However, if you have some flexibility, even doing this a few times might help reduce his bouncing.

Another option is to try Lev. I know you've got more Lantus left, so that might not be an ideal solution. Some cats do have flatter cycles on Lev, but not all. Some cats that are bouncy on Lantus still bounce on Lev. It's not a guaranteed solution, but it does help some cats flatten out.

A third option is to try using R on his bounce cycles. You've seen enough people use R that i suspect you have a good idea how it works. One major downside of R is that one has to be careful to not use too much, and it needs to be timed carefully so that you don't set up R bounce cycles, where the R brings the cat down quickly and the cat bounces from the fast drop. You would want to give it as a bounce cycle began rather than after one was in full force and certainly not use it when a bounce is clearing. The good thing is that Max is really clearing his bounces fairly quickly right now, so it might be easy to identify when he's on his way up and shoot a tiny amount then. If you want to start that, you'd need to identify times, probably in the second half of the cycle, where you could test once an hour for 4ish hours. And we'd want to use it when he was on his way up, so not every cycle would work - you'd need to watch and shout out for someone to give you a hand when you saw Max was starting a bounce.

And perhaps the easiest option is to give more time to what you are already doing, trying to manipulate his cycles with food. If you increase the nadir with carbs, then increase the dose slightly, you can reduce the range the numbers are moving in any given cycle. The image in my head is of a hand holding up the nadir from underneath, while the slightly increased Lantus becomes a hand pressing down from above to reduce the distance between your two hands. Your goal with this is to bring down the upper numbers, and flatten out the cycle.

I'll add for lurkers that these suggestions are specific to Max - Elise tests frequently, listens to directions, asks questions and makes sure she understands what's being suggested, understands how Lantus works in Max, and has tried diligently using traditional methods to get him tightly regulated. Those factors are important before you step out into other strategies. If anyone wants suggestions for their cat's specific circumstance, please ask rather than just trying these without guidance.
 
Re: 6/17 Max AMPS 328 +6.5=81+7.5=94PMPS 134

Hi Everyone,

Julie, you and Marje have given me lots to think about. Thank you both for that. I need to read everything over a few more times but at the moment I am leaning toward possibly shooting early. I didn't want to test him again until his PMPS and it is a good one. So now let's see where he takes himself. R I assume would require a prescription from my vet, right? I'm not sure if he has ever used it or would think it is necessary since he told the cardiologist Max is regulated. If we exhaust all other options I will have a chat over his ss and ask for it. Do you buy it at the pharmacy or is it a pet med?

The list vet suggested I try Cell Advance 440 and better quality food. Have any of you used it? It's a combo of antioxidants in a pill. As for the food, I add fd human chicken to his food and as treats and Stella & Chewy's. He only gets one or two pieces with most meals unless I use the powdered part of the fd. The only thing I don't like about the Honeyville is there are lots of powder and crumbs but it's okay because that part becomes a topper for his food. He likes the Trader Joe's and is okay with the turkey Special Diet Friskies but that one of course isn't higher quality. It's a good addition because of the lower phosphorus.

I didn't do my homework last night so I still can't get the air bubble out of the terumo. I'll try with water after dinner tonight. So I wonder what is in store for tonight. :roll:
 
Re: 6/17 Max AMPS 328 +6.5=81+7.5=94PMPS 134

R is an over-the-counter insulin so, no, you don't need a prescription for it. I have no idea why some require prescriptions and some don't. i probably never even told the vet i was using it. You can buy Humulin R or Novolin R - i want to say that whatever Walmart sells is cheap - like i think i heard someone say it was $25. I bought Humulin R locally (we don't have a walmart) and it was $65ish a couple of years ago. It's not fragile like the L insulins - i kept it in the fridge, but you don't have to, and one vial lasted the rest of punkin's life and then i passed it on to Carolyn/Jesse/Spock for her kitties. The stuff is tough.

i'm not familiar with that supplement.

did you trying drawing more insulin than you need, then holding it with the needle pointed to the ceiling, then tapping it to move the bubble up to the top? Sometimes it helps if you then draw in some air - it gives the air something to grab onto and it helps make it coalesce. then you can "squirt" out the bubble.

i think the extra insulin in the syringe helps - say to draw up about 3 units to start with.

good luck - sometimes syringes are just very aggravating. i rarely got bubbles in my terumos - i wonder if you have a bad box.
 
Re: 6/17 Max AMPS 328 +6.5=81+7.5=94PMPS 134+1.25=198

That's good about the R. I have had a bubble in every syringe I've used so far. I did tap it to the top but I didn't draw in enough insulin. I was just a little over. I'll try what you suggested tomorrow morning. It didn't happen with the monojects for some reason. Could it be because of the hub? If I try the R it will be our secret, LOL. Thanks, Julie.
 
Re: 6/17 Max AMPS 328 +6.5=81+7.5=94PMPS 134+1.25=198

heehee well no one here is going to call your vet to tattle on you! :lol:

he's on a small enough dose that you can probably stand to waste some insulin. i'd pull up a little extra, then try drawing in some air as well. liquid has a property that makes it want to stick together (hehe that's what i learn being in an elementary school!) and it *should* pull together and allow the air to escape if you have enough insulin in the syringe. Give it a shot (no pun intended) and see if it helps.

i had a lot worse problems with bubbles in the Monojects than with the terumos.
 
Re: 6/17 Max AMPS 328 +6.5=81+7.5=94PMPS 134+1.25=198

Hi Elise! :YMHUG: :YMHUG: :YMHUG:

Looks like Max gave you some greens today. I hope he decides he doesn't need to blast up tonight. I "lurked" through Julie's suggestions and will definitely be watching with interest if you decide to try a different approach.

Max and Eddie sort of seem to be on a similar tack lately - decent nadirs, and lots of aggravating bouncing. Of course our kitties are more than their numbers, but it's hard not to let our emotions get tied to the rollercoaster numbers, too. I know you look at lots of spreadsheets, as do I. There are two in particular that I actually keep open in tabs to look at from time to time. One is Mocha's - OTJ after almost two years, and the others is Leo's - bouncy, bouncy boy who went OTJ after 8 months, bouncing all the way there. When I'm feeling down about our progress, I study these two spreadsheets (and I'm not afraid to admit that I totally have FD crushes on these kitties :lol: ), and I feel hopeful that even bouncy kitties CAN go OTJ.
 
Re: 6/17 Max AMPS 328 +6.5=81+7.5=94PMPS 134+1.25=198+2.5=21

Hi Jen. I agree with everything you wrote. I haven't looked at Leo's ss but have looked at Mocha's a lot. Eight months is just around the corner. It's too early to know what Max will do tonight but he so far is heading up so I fed him his lc food. I just ate a late dinner and am going to check out Eddie's ss now.
 
Well, so far surfing low yellow. Not sure which approach to take. I guess I will sleep on it. If I don't fall asleep I'll test once more in 1 1/2-2 hours.
 
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