6/6 ~ Coco ~ AMPS ~ >600 ~ Acro/Lev/R

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CocoButterBall

CocoButterBall

Member Since 2011
Yesterday's thread / Info
viewtopic.php?f=9&t=44838

So far today:

AMPS - >600 4u Levemir
+1 - >600
+2 - 455
+3 - 385
+4 - 285
+5 - 271
+6 -
+7 - 263
+7.5 - 280 1.5u R
+8 - 260
+9 - 221
+10 - 261 1u R
+11 - 208
PMPS - 214
+1 - 308
+2 - 318
+3 - 300
+4 - 288
+5 -
+6 -
+7 -
+8 -
+9 -
+10 -
+11 -
AMPS - 389 (6/7/11)
 
oh he will lol. always does this to me >.< lol

mainly why i need help with my R use. some of his Spikes just seem too massive lol
 
Hi Andrea, I saw you opened your condo and wanted to say hello. My Tommy throws some wicked spikes too some times.. Aren't we glad we have R to help out from time to time. It will take some time, but you are in amazing company with great people who are here to help and support in any way needed. Not to mention some excellent advisers :-D Come on down Coco, there's really nothing to see up there.
I hope you have great evening Andrea :-D
 
Hi Andrea! It will take some time but Coco will improve with the help from R, the expert dosing advice found here, and your continuous dedication. Coco just needs to find the dose that makes him the most comfortable and allows Lantus to do its job. Gus needed some R today or he would have been off the charts. One of the good points about FDMB is that there is always someone who understands exactly what you're experiencing. In fact, there are a number of us with Adorable Acros who occasionally need their R. Good luck with the plan tonight. :-D Maybe LL could have its own version of AA :lol: :lol: !!!
 
bev5477 said:
Hi Andrea! It will take some time but Coco will improve with the help from R, the expert dosing advice found here, and your continuous dedication. Coco just needs to find the dose that makes him the most comfortable and allows Lantus to do its job. Gus needed some R today or he would have been off the charts. One of the good points about FDMB is that there is always someone who understands exactly what you're experiencing. In fact, there are a number of us with Adorable Acros who occasionally need their R. Good luck with the plan tonight. :-D Maybe LL could have its own version of AA :lol: :lol: !!!
Click to expand...

Yeah i really liked looking at your ss cuz i see you use R more like i wanted to do in the first place :] Good to see its not as foreign to do as i was told..

__________________________

Tonight went really well i think. I was able to get R in soon enough to keep him yellow all evening so far. Just gave him his 2nd R dose and hoping to remain yellow! :]
 
Andrea: I just wanted to welcome you and Coco to LL!!! I hope the R will help and he'll come down. Bev and Lauren have made great strides with it. You're in the best place for great help!
 
Hi Andrea,

I just looked at Coco's ss and I was just wondering if it ever occurred to you that maybe it might be a better idea to raise Coco's basal insulin dose and maybe to try not to use R except when needed like at +10 to give Lantus a lower number to start at so it can work more effectively?

I used to use R a lot on my cat and finally found myself in a vicious cycle of highs and lows that I couldn't get my cat out of with out constant help. complete withdrawal from R, and tons of worrying about ketones...and that's what it looks like is happening to Coco. I realize that Coco is an Acro and they require higher doses of insulin than a regular diabetic but I have lots of friends with Acros that have had much better results using less R and more basal insulin. R is only supposed to be a booster. It doesn't appear to be doing anything for Coco...and I am by no means suggesting you raise the R dose...that is far to dangerous.

Just my 2 cents..no ill will intended

Good luck to you.
 
Marjorie and Gracie said:
Andrea: I just wanted to welcome you and Coco to LL!!! I hope the R will help and he'll come down. Bev and Lauren have made great strides with it. You're in the best place for great help!
Click to expand...

Thanks :]

I am already making progress with it just being in a area that has my back xD

_________________________________

Coco is at +11 now 208!!! WTG COCO!! :D this is so awesome to me you all have no idea lol
 
Caryl and Alex said:
Hi Andrea,

I just looked at Coco's ss and I was just wondering if it ever occurred to you that maybe it might be a better idea to raise Coco's basal insulin dose and maybe to try not to use R except when needed like at +10 to give Lantus a lower number to start at so it can work more effectively?

I used to use R a lot on my cat and finally found myself in a vicious cycle of highs and lows that I couldn't get my cat out of with out constant help. complete withdrawal from R, and tons of worrying about ketones...and that's what it looks like is happening to Coco. I realize that Coco is an Acro and they require higher doses of insulin than a regular diabetic but I have lots of friends with Acros that have had much better results using less R and more basal insulin. R is only supposed to be a booster. It doesn't appear to be doing anything for Coco...and I am by no means suggesting you raise the R dose...that is far to dangerous.

Just my 2 cents..no ill will intended

Good luck to you.
Click to expand...

My thing with raising lev is.. I dont want to have feed greens every day.. Maybe he can handle a raise now. but i fear i will always have the same issue with the sudden bounce from the lev dieing off early.. then i am dealing with greens and a bounce in 1 cycle.. .. I really think lev just poops out at that time.. so if he cant handle much of a higher dose, and he is still having super high bounces. what else can i do rly? except look for alternatives.. In a few days .. when i have more recent numbers. if it is thought that i should raise lev.. i will, Im willing to try things as long as it doesn't cross the one line i have.. if he is going up end cycle.. i will use R.. or he will get sick. I cant do that to him .

My goal is to somehow find a way to make these 2 insulins work together to make flatter cycles.. Im sure with the help from people here i can find a balance, if not ill have to try something else.

like split dosing to every 8 hours.. I know its widely frowned upon.. but i have the time to do it and test a lot and have read it works in a few cats quite well. and i also read it killed some.. but i think its worth a shot if all else fails, i feel like coco might be a good match for it.. and have been thinking about it even b4 coming to this site. i think i mentioned it on my first post ever xD.. i am giving this whole R set up a chance first though, sinse it seems generally safer
 
CocoButterBall said:
Caryl and Alex said:
Hi Andrea,

I just looked at Coco's ss and I was just wondering if it ever occurred to you that maybe it might be a better idea to raise Coco's basal insulin dose and maybe to try not to use R except when needed like at +10 to give Lantus a lower number to start at so it can work more effectively?

I used to use R a lot on my cat and finally found myself in a vicious cycle of highs and lows that I couldn't get my cat out of with out constant help. complete withdrawal from R, and tons of worrying about ketones...and that's what it looks like is happening to Coco. I realize that Coco is an Acro and they require higher doses of insulin than a regular diabetic but I have lots of friends with Acros that have had much better results using less R and more basal insulin. R is only supposed to be a booster. It doesn't appear to be doing anything for Coco...and I am by no means suggesting you raise the R dose...that is far to dangerous.

Just my 2 cents..no ill will intended

Good luck to you.
Click to expand...

My thing with raising lev is.. I dont want to have feed greens every day.. Maybe he can handle a raise now. but i fear i will always have the same issue with the sudden bounce from the lev dieing off early.. then i am dealing with greens and a bounce in 1 cycle.. .. I really think lev just poops out at that time.. so if he cant handle much of a higher dose, and he is still having super high bounces. what else can i do rly? except look for alternatives.. In a few days .. when i have more recent numbers. if it is thought that i should raise lev.. i will, Im willing to try things as long as it doesn't cross the one line i have.. if he is going up end cycle.. i will use R.. or he will get sick. I cant do that to him .

My goal is to somehow find a way to make these 2 insulins work together to make flatter cycles.. Im sure with the help from people here i can find a balance, if not ill have to try something else.

like split dosing to every 8 hours.. I know its widely frowned upon.. but i have the time to do it and test a lot and have read it works in a few cats quite well. and i also read it killed some.. but i think its worth a shot if all else fails, i feel like coco might be a good match for it.. and have been thinking about it even b4 coming to this site. i think i mentioned it on my first post ever xD.. i am giving this whole R set up a chance first though, sinse it seems generally safer
Click to expand...

I had the same problem with longevity for a long time. People said i was nuts that there is no longevity problem with Lev. Well, there was with Alex. I did try split dosing(split dosing is actually giving part of the dose at the regular time and the rest 2 or 3 hours later to try to make the insulin last longer) and it didn't work for me. What did work for me is tid every 8 hours like you're talking about. It's difficult and I had NO LIFE while I was doing this but...for us it worked. But I had help from someone who had done it with her cat. You really need to keep at it a little longer. My cat is back to bid now. I am a Levemir user as well and getting Alex on track with a little unorthodox method may have been slightly frowned upon but I was working from home and I could monitor often as well. The key was patience. Coco will flatten out but I can tell you from experience that giving R every 2 hours is not the way to do it. I am not chastising you and I sympathize with you, but R IS dangerous stuff. Maybe you should try raising his dose by drops so you don't see Coco plummeting and you won't get so scared. I just lowered Alex from 3.5 to 3.4 and next will be 3.3 cause he just threw me a 40 at +4 (UGH) And he will bounce and as soon as I see the bounce, if it is very high, I will give him a tiny amt of R just to give the Lev a decent place to take over...but not to regulate his numbers because that's not real. What you see from R is not "real" it's just a quick fix. You really need to let his insulin slowly flatten him and it will if you give it a chance. It won't if R keeps interfering and he keeps bouncing. I KNOW you don't want to hear this and you want to see nice numbers and nice colors(who doesn't)but that will happen. I don't hate R if it's used as a tool, but not in place of your regular insulin to bring down your kitty's numbers.In conjunction they are great and for you more so than for me.

I hope you aren't offended but I want to see the best for Coco and you.

Caryl
 
nice. :smile:

What might be happening here is that his bounce might be clearing out. You do have to be careful about how much R you give when a bounce is clearing - if the number would be dropping anyway, and you add R on top of that, you can get a pretty fast drop. A crystal ball would be very helpful in these situations. ;-) So yes, I would keep monitoring for a while tonight.

Bounces can take up to 72 hours to clear. In this case, it looks like it lasted less than 2 cycles. 1 unit of R in the 200s might be too much at the end of a bounce. You did a really good job of keeping him flat today, though. Once they flatten out, it gets easier to shift the flat range down to where you want it. You should start needing less and less R at some point.

I have to say that I am still on the fence about increasing Coco's Lev dose. I would rather see a couple more cycles worth of data. Let's see where he goes tonight. The 123 yesterday was a good nadir - did you give any R overnight on the 4th, or just the dose at AM+9? What about overnight on the 3rd?

Caryl is right, we have had some people use TID or as-needed dosing on Lantus and Lev. It can work great for the really bouncy cats, like her Alex, but it is really hard on the person so it's not used very often.
 
Caryl and Alex said:
CocoButterBall said:
Caryl and Alex said:
Hi Andrea,

I just looked at Coco's ss and I was just wondering if it ever occurred to you that maybe it might be a better idea to raise Coco's basal insulin dose and maybe to try not to use R except when needed like at +10 to give Lantus a lower number to start at so it can work more effectively?

I used to use R a lot on my cat and finally found myself in a vicious cycle of highs and lows that I couldn't get my cat out of with out constant help. complete withdrawal from R, and tons of worrying about ketones...and that's what it looks like is happening to Coco. I realize that Coco is an Acro and they require higher doses of insulin than a regular diabetic but I have lots of friends with Acros that have had much better results using less R and more basal insulin. R is only supposed to be a booster. It doesn't appear to be doing anything for Coco...and I am by no means suggesting you raise the R dose...that is far to dangerous.

Just my 2 cents..no ill will intended

Good luck to you.
Click to expand...

My thing with raising lev is.. I dont want to have feed greens every day.. Maybe he can handle a raise now. but i fear i will always have the same issue with the sudden bounce from the lev dieing off early.. then i am dealing with greens and a bounce in 1 cycle.. .. I really think lev just poops out at that time.. so if he cant handle much of a higher dose, and he is still having super high bounces. what else can i do rly? except look for alternatives.. In a few days .. when i have more recent numbers. if it is thought that i should raise lev.. i will, Im willing to try things as long as it doesn't cross the one line i have.. if he is going up end cycle.. i will use R.. or he will get sick. I cant do that to him .

My goal is to somehow find a way to make these 2 insulins work together to make flatter cycles.. Im sure with the help from people here i can find a balance, if not ill have to try something else.

like split dosing to every 8 hours.. I know its widely frowned upon.. but i have the time to do it and test a lot and have read it works in a few cats quite well. and i also read it killed some.. but i think its worth a shot if all else fails, i feel like coco might be a good match for it.. and have been thinking about it even b4 coming to this site. i think i mentioned it on my first post ever xD.. i am giving this whole R set up a chance first though, sinse it seems generally safer
Click to expand...

I had the same problem with longevity for a long time. People said i was nuts that there is no longevity problem with Lev. Well, there was with Alex. I did try split dosing(split dosing is actually giving part of the dose at the regular time and the rest 2 or 3 hours later to try to make the insulin last longer) and it didn't work for me. What did work for me is tid every 8 hours like you're talking about. It's difficult and I had NO LIFE while I was doing this but...for us it worked. But I had help from someone who had done it with her cat. You really need to keep at it a little longer. My cat is back to bid now. I am a Levemir user as well and getting Alex on track with a little unorthodox method may have been slightly frowned upon but I was working from home and I could monitor often as well. The key was patience. Coco will flatten out but I can tell you from experience that giving R every 2 hours is not the way to do it. I am not chastising you and I sympathize with you, but R IS dangerous stuff. Maybe you should try raising his dose by drops so you don't see Coco plummeting and you won't get so scared. I just lowered Alex from 3.5 to 3.4 and next will be 3.3 cause he just threw me a 40 at +4 (UGH) And he will bounce and as soon as I see the bounce, if it is very high, I will give him a tiny amt of R just to give the Lev a decent place to take over...but not to regulate his numbers because that's not real. What you see from R is not "real" it's just a quick fix. You really need to let his insulin slowly flatten him and it will if you give it a chance. It won't if R keeps interfering and he keeps bouncing. I KNOW you don't want to hear this and you want to see nice numbers and nice colors(who doesn't)but that will happen. I don't hate R if it's used as a tool, but not in place of your regular insulin to bring down your kitty's numbers.In conjunction they are great and for you more so than for me.

I hope you aren't offended but I want to see the best for Coco and you.

Caryl
Click to expand...

I know R can have bad effects on coco, i see it on his ss all the time lol. A huge reason i am here is to find the right balance of R and lev for coco .so it will be a while before i get there and i know im a bit off atm, .. but atm its safer for him to be on the R then not on the R.. so im going to slowly adjust it and lev until it works out.... im slowly lowering my dose now .. i think tmr ill be at 1u and .5u .. i do think my doses are too high and harsh on his cycle atm.. but in the end.. if it cant be balanced out. i may just go to tid dosing. or as needed :]
 
Libby and Lucy said:
nice. :smile:

What might be happening here is that his bounce might be clearing out. You do have to be careful about how much R you give when a bounce is clearing - if the number would be dropping anyway, and you add R on top of that, you can get a pretty fast drop. A crystal ball would be very helpful in these situations. ;-) So yes, I would keep monitoring for a while tonight.

Bounces can take up to 72 hours to clear. In this case, it looks like it lasted less than 2 cycles. 1 unit of R in the 200s might be too much at the end of a bounce. You did a really good job of keeping him flat today, though. Once they flatten out, it gets easier to shift the flat range down to where you want it. You should start needing less and less R at some point.

I have to say that I am still on the fence about increasing Coco's Lev dose. I would rather see a couple more cycles worth of data. Let's see where he goes tonight. The 123 yesterday was a good nadir - did you give any R overnight on the 4th, or just the dose at AM+9? What about overnight on the 3rd?

Caryl is right, we have had some people use TID or as-needed dosing on Lantus and Lev. It can work great for the really bouncy cats, like her Alex, but it is really hard on the person so it's not used very often.
Click to expand...

Yeah, after his PS. I def thought i should have went with .5 u the second time.. his bounces always clear about this fast though.. so i kinda knew inside he was clearing the bounce.. but i knew he would probably have ended this cycle at around 400 without R.. I was a little hesitent on the R today though because of the cleared bounce. Will def lower my R use next time to u or .5u to test that one out. i dont believe i gave R on those other dates.. Im not sure though D:

I know at this point im creating bounces.. hopefully ill get the hang of this soon lol
 
hi andrea! i'm up late tonight too - just reading the comments in coco's condo and thinking. you know i am not an expert, but, just thinking if you get to the point of wanting to increase the lev, perhaps a small increase (like a .25?) would avoid the drops that you're worried about while giving you the little bit longer support that you are trying to get.

anyway, just wanted to throw it in the mix there while you are considering options. now i'm off to bed - i hope you get some sleep tonight too!

btw, i was wondering is coco 100% black/dark, or does he have white anywhere? he is such a beautiful kitty.
 
He is all black! xD lol He doesnt look that good anymore.. this whole diabetes mess rly messed with him.. hes pretty mangy.. lost about 7 lbs.. :/ I guess being unregulated for 7 months will do that..

I am thinking of increasing lev.. Im thinking maybe.. i dunno if i mentally can hold myself back . but try to not give R tmr? so that you all can see an un affected cycle.. would that help any one here?
 
you'll get the hang of it. It's all about finding out what works for your cat. If only we could have hindsight in advance. LOL!
 
Libby and Lucy said:
you'll get the hang of it. It's all about finding out what works for your cat. If only we could have hindsight in advance. LOL!
Click to expand...

I just think its taking so long.. been 7 months now ._. Im starting to get a lil.. hopeless i guess you can say.. will coco ever be balanced? lol ._.
 
PMPS +1.. 308 ..

damnit lol . there goes my yellows ..

im thinking its just R wearing off tho and not another bounce. (hopefully) ._.

lev should kick in next hour.. hopefully turning into a good looking cycle >.>

I will lay off the R tmr if you wanna see a no R cycle or 2.. I will try to make him as full of fluids and everything as i can to help him not get so sick if the numbers go too high. I'm just thinking it might help you guys help me if you saw a few cycles without R. .
 
andrea - why don't you ask that question again tomorrow, if it would be helpful to see a cycle without R.

i think you'll get him regulated, andrea. did you see the patience pants that marjorie left in punkin's condo earlier today? hahahaha, if i knew how to move them to you i would. she put pink ones in punkin's condo and yellow ones in Leo's, i think. punkin was diagnosed 12/4 and it was within the past 2 weeks that i realized his hair has refluffed - so that took 6 months and a lot of dose increases. he looked like a sick kitter for quite a while - nothing like greasy hair to make you look sick. i think coco's beautiful coat will return as he gets evened out.

this is definitely a patience game - the whole bouncing thing adds a "special" dimension to trying to figure it out. i still have trouble seeing bounces, but figure eventually i'll get it. punkin is normally pretty flat, but he does bounce a little bit.
 
julie1220 said:
andrea - why don't you ask that question again tomorrow, if it would be helpful to see a cycle without R.

i think you'll get him regulated, andrea. did you see the patience pants that marjorie left in punkin's condo earlier today? hahahaha, if i knew how to move them to you i would. she put pink ones in punkin's condo and yellow ones in Leo's, i think. punkin was diagnosed 12/4 and it was within the past 2 weeks that i realized his hair has refluffed - so that took 6 months and a lot of dose increases. he looked like a sick kitter for quite a while - nothing like greasy hair to make you look sick. i think coco's beautiful coat will return as he gets evened out.

this is definitely a patience game - the whole bouncing thing adds a "special" dimension to trying to figure it out. i still have trouble seeing bounces, but figure eventually i'll get it. punkin is normally pretty flat, but he does bounce a little bit.
Click to expand...

Alright. ill ask in tmrs thread o.o

and lol. i saw them.. xD I do lack patience in general.. so its a lil rough on me. but doing my best lol xD

your ss is beautiful to me :D
 
Andrea,

You might want to take a look at some of the split dosing thoughts that were offered on this thread on Think Tank. Stefani and I put Bastian (not an Acro but a very bouncey boy) on split dosing of Levemir to extend duration and now Bastian is OTJ.

Venita
 
With those numbers, I still think Coco could use a bit of a Lev increase but that's my opinion. I think I've come to know enough in two years with a very bouncy kitty, who is NOT low dose unfortunately although I wish he was, and probably never will be, and who I have gone through every mistake in the book with and come back with a happy purry and 5 pound fatter cat than when he was dx'd..to offer this advice. The green's you see are all a part of liver training school and until Coco gets used to lower numbers he IS going to bounce. If you don't allow him to do that by giving him the insulin he needs-which his body will get used to, you will keep seeing higher numbers. It's all part of the dance. His body needs to be trained. By throwing the R in there you're just tricking his body into thinking it has enough insulin. When it wears off, he goes up again because he doesn't have enough Lev. If he did..it would take over from the good place the R took him to. Does that make any sense?

As for the less conventional methods...The one thing I beg of you is that if you do decide to go tid(I would highly suggest against 'as needed' as you are dealing with long acting insulin and have no idea with what 'as needed' is..nor would I with my cat. dangerous way of dosing IMO), which is highly highly regimented, please do not do it without the help of someone who has done this before, It has to be done with a rhyme and a reason. Sometimes when you think you need more, you really need less and the dosing is totally different from bid. tid is basically just to get your cat's body used to the lower numbers so you don't see the highs and lows that you see now.There is so much thinking involved when you just don't know whether you should shoot or not. There were days when I shot tid because I really was scared of a hypo situation and I have shot low. You really have to know your cat before attempting this. This is why I suggest that you wait on these kinds of things until you have enough data to know how Coco reacts to Levemir. I waited a year before I tried this. I had plenty of data. You have to know Coco's nadir before you can even think about this or you can end up in mucho trouble. As for 'as needed', I would not do it and I would try to stop anyone who would. I would hate to think I was giving a shot just as my cat was peaking ((((shudder))))) JMO

Good luck on the no R today...although I do believe it will prove to be what you are trying to show because of the insulin dose.
scritches to Coco :)
 
To me, it looks sort of like the 1st 3 hours and the last 3 hours of a Lev cycle are when he is highest. Something that could bridge over the 6 hours he is highest might help. What about using N, which is a bit less harsh than R or the 70% N / 30% R combo to bridge that gap?

Maybe this could work:
dose Lev, then at +9 Dose N, or the R/N combo

For example (adjust times to your need, but keeping about 3 hours between the N and the next Lev dose):
+9 (7 am), N
AMPS (10 am) Lev
+9 (7 pm) N
PMPS (10 pm) Lev
 
I'm not sure that N is the best choice. It's not considered a short-acting insulin and while I can't say this definitively, I don't think it's typically used as a bolus insulin. N is considered an intermediate duration insulin.

Also, at least according to my vet who is a feline veterinary specialist, N is not a particularly good insulin for cats. She indicated it's more successfully used with dogs.

I think Andrea's goal of collecting data so we can see how Coco is responding to Lev and R is a good plan. I'm not sure that any of us can make good interpretations until there's some additional, recent data given the gap on Coco's SS.
 
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