7/31 Max Amps~149+2~92+4~61PMPS~100+1~76+2~74

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max&emmasmommie

max&emmasmommie

Member Since 2012
Hello everyone. Ugh, what a night.

Link to yesterday: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=76059

So, I'm assuming he is going to surf right into AMPS. If so, what is his dose? He earned a reduction during the day yesterday to 2.25u, when he dropped to 49 once and then 47 the next time. Last night during the night cycle, he dropped to 49 once (within the first 2 hours!). Is his dose now 2.0 or still 2.25?

(I was hoping to go out by 9 a.m., and let my husband give Max his dose at 10:30. However, I don't want to miss another dose, and if I'm not back until 12:30 or 1:00, Max might really drop; I'll have to wait until 10 to decide whether to go.)
 
Re: 8/1 Max +10 (102)

Hi again Dale! Just one quick thing: On your SS, you've noted the 102 as (+9) but here in your subject line it's listed as (+10) ;-)

max&emmasmommie said:
So, I'm assuming he is going to surf right into AMPS. If so, what is his dose? He earned a reduction during the day yesterday to 2.25u, when he dropped to 49 once and then 47 the next time. Last night during the night cycle, he dropped to 49 once (within the first 2 hours!). Is his dose now 2.0 or still 2.25? (I was hoping to go out by 9 a.m., and let my husband give Max his dose at 10:30. However, I don't want to miss another dose, and if I'm not back until 12:30 or 1:00, Max might really drop; I'll have to wait until 10 to decide whether to go.)
Click to expand...

You say you'd like to go out by 9am - what time is for you now?

I want to have another look at your SS regarding the dose query...
Jane
 
Re: 8/1 Max +10 (102)

Ok then. According to protocol, here's what the rules are:

Quoting from the TR Protocol Sticky:
"General" Guidelines:
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles). Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...). Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Reducing the dose:
If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further. If an attempted reduction fails, go right back up to the last good dose.

There are circumstances such as ketones present, an unusually low preshot number, a caregiver leaving the cat with a sitter, relatively high flat curves, loss of appetite, infection, a schedule change, ability to monitor, etc. which may call for adjustments to these guidelines." (END OF QUOTE)

Generally, back-to-back full reductions are not advised (unless there are exceptional circumstances). As you can see from the protocol, we're at a point with Max where the one rule (dropping below 40/50 earns reduction - since Max was diagnosed in March, only a few months ago, I believe he would still count as newly diagnosed - long-term consideration begins from 1 year after DX) meets another rule (reductions are close together, so shave dose rather than fully reduce by 0.25u).

I would say that this means you ought to shave the dose - which we also call "fine-tuning the dose" ;-) - rather than reduce by a full 0.25u. BUT I would consider how closely you and/or your DH can monitor this cycle. Can your husband keep a close eye on this cycle? Are you still ok with enough test strips? Food, supplies, etc.? Will your husband get the (+11) and/or (+11.5) (depending on +11), to see where Max is headed for the pre-shot?

Jane
 
Re: 8/1 Max +10 (102) +11 (150)

He's headed up! I think I'll try a skinny 2.25. My husband will test, and as long as he's rising I think that dose will be fine. Thank you for pointing out that part of the protocol.
 
Re: 8/1 Max +10 (102)

Yes, he knows, but he probably won't. He'll call me, and I'll do it from my phone. I'll get the +11.5 before I leave, and maybe only give 2.0 if I don't like the number. Thank you!!!!!
 
Re: 8/1 Max +10 (102)

Oh, well, I couldn't get it together to go today. I'll be here.

EDITED: Uggh! He's such a diva!!!! He didn't want his food because it was too old. Then he walked away before the new food was put down, but my husband said he has to see me put the new food down or he won't eat it. So, I picked him up from his water bowl, and put him back over by the food bowl before my husband put the food in his bowl.

I gave him a SK2.25U
 
Re: 8/1 Max +10 (102)

Hey Dale, I know yesterday seemed like two full days rolled into one, but today is only 7/31/12...it's not August yet. ;)
 
Re: 7/31 Max AMPS~138+2~92

Suze wrote:
Hey Dale, I know yesterday seemed like two full days rolled into one, but today is only 7/31/12...it's not August yet. ;)
Click to expand...

Oh, my Goodness. I'm too old for all nighters!

He was at 149 for AMPS, I gave him a little less than 2.25u, and at +2 he was at 92. I didn't get a plus one. I went out to breakfast. It was the only way I was going to stay awake. Emma fell asleep in the car on the way home, and didn't even wake up when she was carried in the house (unusual). She's starting to have more "normal" nap periods. She'll be 15 months old tomorrow. I need her to nap! I think I'll try to catnap for a little while.
 
Re: Amps (149) +2 (92) +3 (75) +4 (61)

Beautiful!

Don't you wish we could just put spigots on our cat's ears so we wouldn't have to poke them all the time? *LOL*
 
Re: Amps (149) +2 (92) +3 (75) +4 (61)

Terrific numbers! I'm pretty sure that there are a lot of folks on the board who would gladly take the numbers you've seen for about the past 10 days.

Carl
 
Re: Amps (149) +2 (92) +3 (75) +4 (61)

I know, Carl. I used to be one of those people! I can't believe this is happening.

Suze, yep. I hate poking him.
 
Re: 7/31 Max Amps~149+2~92+3~75+4~61+5~71+6~78

What's with that double dip at +10?
Carl
 
Re: 7/31 Max Amps~149+2~92+3~75+4~61+6~78+9~124+10~78

He's on his second dip. I suppose this may be a permanent oddity. He dropped really fast coming out of the gate, and his nadir was at +4 or +5. Now, we'll just have to see how high he goes. He ate at +10.

Hope you are all well tonight.
 
Re: 7/31 Max Amps~149+2~92+3~75+4~61+6~78+9~124+10~78

Dale, I didn't know about that Lantus double dip until a few days ago, either!

But Max has had an awesome day of numbers! No matter how much you had to test to make sure he wasn't dropping too low, it does seem like the Lantus and his pancreas are now working in synch. That is so beautiful!!!! And such a far cry from where you were with him just a month ago!

Major hugs for getting Max to this point!

Suze
 
Re: 7/31 Max Amps~149+2~92+3~75+4~61+6~78+9~124+10~78

Thanks, Suze. I know! This is incredible. I was so distraught at the end of June and even on July 20th.

The double dip thing is awfully strange, but apparently it's something that can happen with Lantus. Don't know much more about it than that. It really makes for an odd "curve," and if I wasn't testing so much I probably wouldn't even know about it.
 
Re: 7/31 Max Amps~149+2~92+4~61+6~78+10~78+11~97PMPS~100

Well, despite the +9 of 124, he finished at 100. I gave him 2.25SK. I hope I don't have a long night. Now, I want you to bounce, Max, just not too high!
 
Re: 7/31 Max Amps~149+2~92+4~61+6~78+10~78+11~97PMPS~100

I totally understand when we pray for a bounce so we can sleep!

(((HUGS))) to you, Dale!

I'll be napping on the sofa tonight so that I can test Pumbaa regularly and make sure he doesn't dive.
 
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