7/30 Charlie AMPS 194 +1 247 +5 374 PMPS 418

[charliesmom]

Seems to be clearing her bounce. Gave her .5 and hope it doesn't come down drastically further as I don't know if there will be a lot of tests today. Pray for us that it goes well!

 

[Jane & Jack & Karre the Emperor]

Re: 7/30 Charlie AMPS 194

Good morning Jill!

First of all, here is Charlie's 29th July Condo

After going over your SS, here's a bit of feedback on the questions you had yesterday at the end of your thread:

You Wrote: "just read that now after getting her AMPS 10.8 (194 US numbers) and giving her .5 I hope by "let her clear the bounce" you didn't mean that I should not shoot because I already shot. AGH! Let's hope that since previously she had days where she also started around the same range, she'll be fine like she was on those days."

I believe what Marje meant was to shoot the regular dose (0.5u) until Charlie has cleared her bounce. Since bounce-related numbers are *outside* of Charlie's "regular" responding-to-Lantus numbers, it's best to let them clear out of Charlie's system. Once the bounce has cleared, her more "regular" numbers (i.e. numbers that are not influenced by an overreaction from the liver) will give us a better idea about how Charlie is settling into Lantus overall and the dose in particular.

You wrote: We may not have a lot of tests this week (will try to do a couple each evening but not so many in the days probably). If you have thoughts on what times we should test each evening (to get a scattering of data), let us know. Probably we'll do 1 PMPS and 1 test after that each night.

Yes, do keep getting the PMPS ;-) Pre-shots are non-negotiable. Since we only have 1 week of data for Charlie on Lantus, and some of those cycles are influenced by bounces and that one notable drop into the greens, it's difficult to glean a great deal about Charlie's "Lantus Personality," as it were. Tentatively, I would say that when nothing out of the norm (low drop, high bounce, etc.) is going on, Charlie's Lantus nadir seems to have happened around (+3)/(+4) so far. Because Lantus, unlike some other insulins (like PZI), requires its dosing to rely greatly on nadirs rather than on pre-shots, it would be useful to get a sense of Charlie's "regular" nadir (though bear in mind that it's very early days yet, and it may take some time before it's possible to tell). If you can get one or two tests after the PMPS, I would try for (+3)/(+4) for a couple of days, and then shift forwards/backwards. Nadir-hunting, sort of :mrgreen:

Also, please remember to set up your profile, so we can have the relevant information on Charlie all in one place: Creating your FDMB Profile You gave some good info on Charlie diet switch etc. yesterday, but in a few days it would take longer to look for that condo than it will for us to just be able to click on your profile.

I hope that's useful to you. Wishing you a stress-free cycle today!
Jane

 

[Marje and Gracie]

Re: 7/30 Charlie AMPS 194

Jill

Jane explained it correctly and I apologize that I assumed you knew what "clear the bounce" means. When BG levels come down into blue/green after highs, then the kitty is clearing the excess glucagon/counterregulatory hormones from their system. What you don't want to do is raise the dose as the bounce is clearing. You need to see how far she'll come down. If you increase the dose
as the bounce is clearing and numbers are coming down, you could be in for a long day or night. So the basic rule of thumb is to not increase the dose as the bounce is actually clearing.

I'm glad you shot! Hope Charlie feels better today.

 

[Jane & Jack & Karre the Emperor]

Re: 7/30 Charlie AMPS 194

Jill, Jane explained it correctly and I apologize that I assumed you knew what "clear the bounce" means. When BG levels come down into blue/green after highs, then the kitty is clearing the excess glucagon/counterregulatory hormones from their system.

Jill, here's the Link about Counterregulatory Hormones we were given when we first showed up here in 2008 asking about bounces, just in case it's useful to you. Happy cycling, Charlie!

Jane

 

[charliesmom]

Thank you SO MUCH for the quick responses. We tested a few hours after this morning's AMPS.
Charlie was at BG 20.8 (374 in US metrics) and she was, of course, VERY STRESSED during blood test time as she has been for the last few tests.
Think she really hates us at the moment (even with the treats, etc), but we press on.

How many days can this bounce continue for? Is this normal that she's bouncing AGAIN today? Or could that just be a stress increase?

@-)

 

[Vyktors Mum]

Re: 7/30 Charlie AMPS 194, +5? 375

Oops posted this in yesterday:

@ Marge/Mike/Gracie: Thanks for the information. Better late than never. I thought that's what bounce meant but I'm not sure exactly how to deal with it yet. You said:

If her number starts to come down again tonight so you get another blue AMPS, let her clear the bounce​

I just read that now after getting her AMPS 10.8 (194 US numbers) and giving her .5
I hope by "let her clear the bounce" you didn't mean that I should not shoot because I already shot. AGH! We may not have a lot of tests this week (will try to do a couple each evening but not so many in the days probably). If you have thoughts on what times we should test each evening (to get a scattering of data), let us know. Probably we'll do 1 PMPS and 1 test after that each night.

What was meant by let her clear the bounce is that you don't increase the insulin dose while kitty is in a bounce. This can be dangerous because the bounce may clear and kitty may end up going lower than hoped.

Please ensure you do test at AMPS as well, you need to test before you shoot everytime. You probably didn't mean that would be one of the tests you'd be missing but I thought I'd better mention it just in case - saftely first!

The most important time to get another test in is around nadir. I'll have a peek at Charlie's ss in a minute and see if I can tell you when that might be for Charlie.

I agree with Jane re test times, not to much to go on with Charlie's ss yet :smile:

Bounces can last for up to 3 days/6 cycles :evil: But it is a good sign that her liver is functioning well :smile:

 

[PeterDevonMocha]

Re: 7/30 Charlie AMPS 194, +5? 375

Hi guys .. well, no advice from me on whether charlie is still bouncing or not .. but I just want to reassure you charlie does not hate you, she will soon understand all these tests and pokes are what will make her feel better .. give lots of treats, lots of cuddles, lots of reassurance .. you guys will be ok!

 

[Sienne and Gabby (GA)]

Re: 7/30 Charlie AMPS 194, +5? 375

It looks like Charlie bounced off of the blue AMPS. Alternatively, is it possible that you had a bad strip or inaccurate test at AMPS? It's hard to know since yesterday, Charlie started in the blues and some cats do experience lower numbers overnight. It is, however, entirely possible for numbers to spike they way you're seeing them.

I just want to reiterate, barring anything unforeseen, I think it's fine if you want to hold until the end of the week before increasing Charlie's dose.

@ Sienne/Gabby/Gizmo - We pretty much made a dramatic switch with Charlie's food (hills dry a/d as of June 22 when she was diagnosed and then very shortly after moving to wet food 100%... with only a few days in between of both). See comments in her SS for details.

If Charlie's GI problems continue, you may want to back off of the canned food and instead, transition. For some cats, a fast switch from dry to canned can throw their system off. I saw the same thing when I switched from canned to raw. We had poop problems!! It can take a couple of weeks for a cat's system to adjust. Of course, that's providing there's nothing medical going on.

Sienne & Marjorie: Think we will keep her at .5 until we know from the vet if she has a urinary tract infection (and needs an antibiotic) or not. If the bladder comp (holistic urinary tract infection stuff) worked, then her #'s in her urine should be stabilized. If not, we'll ask for a full urine culture & sensitivity test and the antibiotics. Then ... after that drama is over ... we can think again about her numbers.

To be honest, I'm thinking less in terms of a UTI than I am a GI bug. If Charlie is prone to UTIs, it's certainly a possibility. Some diabetic cats get UTIs rather easily.

 

[charliesmom]

7/30 Charlie AMPS 194 +1 247 +5 374 PMPS 418 +3 336

@ JANE, JACK & KARRE THE EMPEROR:
- We will follow your advice on getting a scattering of data. Got another one at +3 tonight and will try to do another at +4 if we can make it. There's a thunderstorm here tonight so Charlie is again a bit agitated.
- Thanks for the link on counterregulatory hormones.
- We'll do the profile ASAP.

@ MARJORIE & GRACIE:
- Agree. We will not raise the dose at least until a few days pass on the antibiotics when things hopefully begin to normalize. By the weekend, we'll also have a bit more data to make the right call.
- Thanks for the links on how to deal with low #'s (in your signature). We will bookmark those for the future.

@ VYKTOR'S MUM:
- We'll keep collecting data. We've been told this is a marathon and not a sprint, so we'll keep working on it.
- You said bounces can last 3 days (6 cycles). In a way, Charlie's PMPS looks like a bounce each day for the past 6 days! Am I correct in this or are some of these "normal rises" and others "bounces"?

@ PETER, DEVON & MOCHA:
Thanks for the encouragement and congrats on being off the juice yourselves. Lead us that way please. Beautiful colors, that Mocha!

@ SIENNE & GABBY:
- There's always a possibility that something could go wrong with our meter or test strips, but all are new.
- Thanks for your advice on the food change. I think to the extent possible, we want to try very hard to stay with the wet food. I suspect there is something else going on that's causing the diarrhea/vomiting, but we shall see as the weeks progress.
- I think GI bug is more likely than UTI as well.

Thanks for your continued feedback everyone.

 

[Anne & Zener GA]

Charlie has a LOT of promise as an Olympian! Maybe she could get some training tips from Marianne Vos. You are getting excellent FD advice from everyone here. Sending healing energy to Charlie and some calming energy too. Your beans are doing their very best to help you feel better.
Liz