7April2020/Maxi/AMPS346/Increase R?

Maxi is a challenge isn't he. Hope it all kicks in soon.

Is he's losing weight? 1.5 pounds in 6 days is that correct?
 
Olive & Paula said:
Maxi is a challenge isn't he. Hope it all kicks in soon.

Is he's losing weight? 1.5 pounds in 6 days is that correct?
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Thank you. His weight is 14.5 again today. Evidently the scale is not very accurate. Or maybe something is going on in Maxi's belly.
 
Olive & Paula said:
If you have a 5 lb weight or bag of sugar/flour you can use that to reset scale. Maybe worth a try.
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Good idea! I just did it with a 5-pound bag of rice, and it was accurate. I weighed Maxi again. Once it came out as 14, and once it came out as 14.5. This morning it was 14.5. So, the scale is more-or-less accurate; the measurement varies depending on its mood.
 
I wouldn't increase the R just yet. Yesterday AM the 1.5 units of R took Maxi down almost 100 points by +2. You only want to go down 100 points over 4 hours. Since we don't have a R+4 test, not sure what the total was. The R mid cycle seems to work nicely. He had a really long stretch of yellows yesterday. That's good progress. Today might either be a bounce from those yellows, or a bit of New Dose Wonkiness.
 
Wendy&Neko said:
I wouldn't increase the R just yet. Yesterday AM the 1.5 units of R took Maxi down almost 100 points by +2. You only want to go down 100 points over 4 hours. Since we don't have a R+4 test, not sure what the total was. The R mid cycle seems to work nicely. He had a really long stretch of yellows yesterday. That's good progress. Today might either be a bounce from those yellows, or a bit of New Dose Wonkiness.
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OK, thank you, Wendy. I won't increase the R.

I don't get why we don't want Maxi's glucose level to go down more than 100 points since more than 100 points below his usual level is the goal.

There are several R+4 tests: March 23-31 and April 4.
 
The reason we don't want just the R portion of the cycle to drop the glucose more than 100 points, is because it can set up another bounce. What you do want to do is have the BG go down lower with R, then hand the baton over to Lantus that (hopefully) continues to lower it.
 
Wendy&Neko said:
The reason we don't want just the R portion of the cycle to drop the glucose more than 100 points, is because it can set up another bounce. What you do want to do is have the BG go down lower with R, then hand the baton over to Lantus that (hopefully) continues to lower it.
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Wendy, there are 2 more R+4 numbers from last night. Don't they suggest an increase in R?

Thanks
 
Wendy&Neko said:
The reason we don't want just the R portion of the cycle to drop the glucose more than 100 points, is because it can set up another bounce. What you do want to do is have the BG go down lower with R, then hand the baton over to Lantus that (hopefully) continues to lower it.
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...and today's R+4
 
Those +4 were's all during bounce cycles, were R is doing the job of preventing the numbers from getting too high.
 
Wendy&Neko said:
Those +4 were's all during bounce cycles, were R is doing the job of preventing the numbers from getting too high.
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I don't see how you see R doing its job of preventing numbers from getting too high.

Aren't 200's and 300s too high?

His numbers have gone down without R, and they have gone up with R.

And since starting R, his numbers in general are no lower than before R.
 
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bambinaki said:
I don't see how you see R doing its job of preventing numbers from getting too high.

Aren't 200's and 300s too high?

His numbers have gone down without R, and they have gone up with R.

And since starting R, his numbers in general are no lower than before R.
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I recommend an R free 24 hours (2 cycles). This will allow you to see how Lantus alone is doing. It will also allow you to get some sleep. The monitoring required when shooting R every 6 hours around the clock will burn you out. I know that firsthand.
 
Sandy and Black Kitty said:
I recommend an R free 24 hours (2 cycles). This will allow you to see how Lantus alone is doing. It will also allow you to get some sleep. The monitoring required when shooting R every 6 hours around the clock will burn you out. I know that firsthand.
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I am supposed to increase Lantus by 0.5 unit more than every 6 cycles now, aren't I?
 
Sandy and Black Kitty said:
I recommend an R free 24 hours (2 cycles). This will allow you to see how Lantus alone is doing. It will also allow you to get some sleep. The monitoring required when shooting R every 6 hours around the clock will burn you out. I know that firsthand.
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OK, so I won't give R for 24 hours. But aren't I still supposed to test to see how he's doing without R?

(I would love to sleep a night without interruption. It's been so long. I'm tired.)
 
Wendy&Neko said:
Yes, you can test to see how he's doing without R, but you don't need to test as often. Get a before bed test tonight, and as long as it's not a lot lower than PMPS, catch up on sleep.
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Should I increase Maxi's Lantus to 7.5 tomorrow morning?
 
Wendy&Neko said:
No, you wait six cycles between increases, that would be tomorrow night.
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I thought at this point, since we escalated the increases from 0.25 to 0.5, it might be right to also escalate the frequency of increases:

"Alternatively, if the cat is continuously producing moderately elevated BGs (nadir always >=200 mg/dl), increase the dose every 2-3 days by 0.25 IU ( if the cat is getting a low dose) or 0.5 IU (if the cat is getting a higher dose). From this point onward test for ketones once per week, or more often if the nadirs are still >=200 mg/dl." http://www.tillydiabetes.net/en_6_protocol2.htm
 
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But your using R. That could be the reason for not doing every 2 days. I would think for safety reasons, one or the other but not both.

It just takes time and increases until you hit that dose. It doesn't happen overnight and you can't force it safely. In the beginning, I did every 2 days with Olive and it still took months to keep her in yellow with a pop of blue.

But look where we are now, back in pink. She had some nice greens and blues for awhile. But she turned around again. It's the nature of the beast.
 
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