8/12 8/12 Poe PMPS 310 +2 328

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KarensPoe

Member Since 2013
Yesterday/last night viewtopic.php?f=9&t=102048

Well...between the HC and the bounce, he's up there...

He earned a reducie last night to a 2.75. I worked hard keeping him floating with HC and it was pretty scarey after I saw that 2nd number in the 40's.

Thanks to Carl and Jill for being there with me. Now I have to make it through the day without falling asleep at my desk...think I feel a sick day coming on :-D

It does seem that Poe nadirs late, and I do keep food for him out all day while I'm at work through an auto feeder and at night also, but make sure I take it 2 hours prior to the PS. Those 2 hours can be really rough because I can tell he is hungry and really wants to eat. I need some help on figuring this out so I'm not seeing him drop so much in those 2 hours and end up worrying about the next cycle before it even starts.

Vines and purrs to all the kitties....especially to Jupe on the onco appt. Have a good Monday, beans. :-D
 
Re: 8/12 Poe AMPS 323....? on late nadir

Hi guys .. yay for a reducie poe!! No advice from me unfortunately but I'm sure someone on here will have some ideas! have a great day guys!
 
Re: 8/12 Poe AMPS 323....? on late nadir

I'd almost call that the result of a failed increase last night - you upped him, based on the TR protocol, to the 3 units, but even though the nadirs suggested he needed that, he didn't. You got lows after 3 days on the prior dose, too. If you look back at late July, it seems like something similar happened - you tried to increase based on TR, then had to decrease twice, because he went low. It may have taken more than 3 days to drain the shed.

Unless, for some reason, he was having appetite or GI issues? I don't see any noted on the spreadsheet, though.

Maybe he needs a bit more time than 3 days to settle on a dose, perhaps another day or two. I know that isn't exactly the TR protocol, however each cat is different and sometimes a standard protocol needs to be adjusted to the individual when you have evidence it may not be optimal if followed rigidly.
 
Re: 8/12 Poe AMPS 323....? on late nadir

I think it helps to keep in mind that the nadir isn't a fixed point -- it can move around. It looks like Poe is one of those kitties where you can't always know if his nadir will be in the middle of the cycle or late.

I'm not sure I would refer to yesterday as a "failed increase." There are definitely times when you need to increase the dose back to a previous level and the increase kick starts the numbers. You may see someone mention that you need to bring the dose up in order to come down. It's not an unusual situation.

When are you setting your timer for? It may be you need to be sure there's food out at around +8. The challenge may be that if Poe's pancreas is producing insulin, if you feed him, it may cause his pancreas to pull the numbers down.
 
Re: 8/12 Poe AMPS 323....? on late nadir

I do have food out for him up until +10 during the day when I'm at work. I do know that those 2 hours prior to shot he is hungry, and sits there waiting for me to test him because he knows at the +11 he will get treats and of course at +12 he gets his meal.

At night, it's a bit different because I know i won't get up to pull the food 2 hours prior to dose time, but I make sure he has food after the before bed test, and since that is usually around 10 pm for me, which is about +4.5, I don't think he eats quite as much as during the day.

I have looked at his spread sheet and I don't see a fixed nadir point...even surfing him last night, he was flat until the HC finally kicked in and bumped him. His +10 was 307 and by AMPS he was higher...at +2 he was even higher. I know at the +10 its a combo of HC and insulin wearing off, the other 2 are bounces for sure, but I kept the reducie and shot the 2.75.

I'm going to hold this dose I think longer than the 6 cycles because it seems near the end of the run is when I start to see something significant. I am thinking his metabolism might be slower than average too...but ppffttt I don't know really. All I know is that those 2 under 50 numbers within one cycle made me panic.

No GI issues or anything out of the ordinary. Normal BM's, and everything else was in place, except for the asthma issues that came about during the surf.
 
Re: 8/12 Poe AMPS 323....? on late nadir

I agree with Sienne. I don't think this was a failed increase. I also think Poe could possibly have gotten into some other green numbers (maybe p.m. cycle 8/9). And the other thing that strikes me is that he was clearing a bounce last night.

I don't think it is uncommon for a kitty to start a bounce as he did the p.m. cycle 8/10, look like its clearing but then numbers go back up a bit before it really clears. Then when all those counterregulatory hormones clear out and the Lantus can do it's job, numbers come down really fast as they did last night.

You could have shot through the bounce this morning with 3u and taken the reduction tonight but, because they can come back down when you shoot through the bounce and you were tired, it was probably a good decision to shoot the new dose.

Good luck with the reduction! Hope you get some sleep today.
 
Re: 8/12 Poe AMPS 323....? on late nadir

Hi Karen,
Well, I was expecting a high yellow or low pink AMPS this morning. ;-) after last night's antics. And glad you didn't try to shoot through it since the "plan"was to go to work today. But if you had to use a sick day, Monday is a good day to use one :-D

You and Poe did great last night!
 
Re: 8/12 Poe AMPS 323....? on late nadir

Hi Karen,

I'm glad Poe didn't tank again after your 6.5 last ni ght & you were able to get a (very) little sleep!

It seems Tigger shadows some of the things Poe's experiencing, so I'm really learning from the posts you're getting, too! This is such a big learning curve, isn't it?

You're doing an excellent job, I hope you make it through the work day with both eyes open :lol: & Poe has a nice gentle ride today - no extremes!
 
Re: 8/12 Poe AMPS 323....? on late nadir

KarensPoe said:
...I'm going to hold this dose I think longer than the 6 cycles ...
Click to expand...

Holding a dose longer was my main point, whatever you want to call it. You have to find what works for the cat. It'd be nice if it fit the protocol exactly; sometimes, it doesn't and you have to adapt, rather than being rigid.
 
Re: 8/12 Poe AMPS 323....? on late nadir

I was able to get up for a +10 and that one was at 307 and he just went up from there. I forgot to note the AMPS +2 on his ss, but it was higher than AMPS.

I got home for lunch today...yes I went to work...but will be draggin through the afternoon...and got a 325 at AMPS +6. His feeder had opened, but he still had a little bit left from breakfast.

He has been clearing bounces pretty quick, which helps me see what a new dose is really doing for him.

Shooting through the bounce was just not an option for me at this point. It might not have affected this daytime cycle, but if it affected the PM cycle, I would be in big trouble. I can't do 2 week nights in a row like that. Normally, on the last times I surfed him, I was just tired...last night I was very very concerned because what worked before was not working.

The most frightening part is the fact that I'm alone, and there is no way I could drive to the emergency vet and get karo on his gums at the same time if things had turned for the worst.

I'm thinking if maybe using a combination of the TR and SLSG would be a better fit since I'm going to hold his dose changes longer.

Thanks again Carl for staying up with me so late :-D
 
Re: 8/12 Poe AMPS 323....? on late nadir

hi karen. just wanted to follow up after all you went through last night... you did an awesome job keeping poe safe. last night it was too late and i was too tired to study poe's spreadsheet to try to figure out why you had such a hard time pulling his numbers up (with all that hc on board), but more on that later.

KarensPoe said:
It does seem that Poe nadirs late, and I do keep food for him out all day while I'm at work through an auto feeder and at night also, but make sure I take it 2 hours prior to the PS. Those 2 hours can be really rough because I can tell he is hungry and really wants to eat. I need some help on figuring this out so I'm not seeing him drop so much in those 2 hours and end up worrying about the next cycle before it even starts.
Click to expand...
some kitties are insistent on being fed in the 2 hours prior to the next shot. sometimes a small lc snack fed at +9 or even +10 will solve the problem. other times giving something as simple as some boiled or freeze dried chicken at +10 or +11 will do the trick. experiment a little to see what it takes to take the edge off his hunger. we don't want any starving kitties!

as far as the difficulty in bringing up poe's numbers last night...

i have a different take on how long it takes for poe to clear a bounce. i think poe is a tease! he'll bobble around and throw some blues at ya to make you think the bounce has cleared, but it appears to me poe can take up to 4 or 5 days to truly clear a bounce. clearly, he hasn't read the rule book! the idea to hang onto a dose a bit longer than 3 days before increasing is a good one... for now anyway. as time goes on, we may see things change or he'll just get with the program and adjustments will have to be made accordingly.

i'd also resist the temptation and/or advice given to increase the dose in as little as 24 hours after seeing green... even though it was a high green... at this point in poe's treatment. last night's night fight to maintain his numbers tells me he was over dose because typically, that amount of hc should have resulted in a quick rise... without a whole lot of effort... and there was nothing "typical" about last night. BJM said the dose almost looked like a "failed increase". i wouldn't, but only because it's not a term i use. i would call it an increase that shouldn't have happened after seeing green 24 hours earlier. hindsight is great, isn't it? the important thing is poe is safe and we learned something here. :mrgreen:


just my thoughts. hope they haven't added to your confusion...
 
Re: 8/12 Poe AMPS 323....? on late nadir

I agree completely, Jill, and thank you for last night also.

My gut was telling me that an increase on a dose when a cycle hasn't seen almost all yellows and higher should have been held off a bit longer. Normally, when I began to increase, I was comfortable and secure because Poe's ss was almost solid yellow/pink. Looking back at it, I'm starting to see more and more greens/blues now as I kept up the momentum with the TR.

I am more comfortable holding his dose up to 5 days, instead of 3, because I think he's just a "late bloomer" in showing how well or not that dose is working for him. At least for now anyway.

When I saw 2 numbers under 50, I knew he was over dose...and I knew going into the cycle it was going to be a long night...and honestly at PMPS, I thought about a BCS or even skipping because that 64 was just way too far from my comfort level.

I am very thankful I was able to help him steer a little bit... and only because of learning from here and looking at the last few times I had done this...although this one did not follow ANY protocol. I thought by +5 last night that he'd be way up from all the HC, because normally I can surf with a combo of LC and MC...he dropped so fast and so early which is why I started with HC.

And I am rambling...the lack of sleep is catching up now ohmygod_smile I'm hoping to sneak out of work here very soon and catch a nap before that PM cycle hits again.

Thank you all again so very very much ...all you advice and guidance is sooooo greatly appreciated. :-D
 
Re: 8/12 Poe AMPS 323....? on late nadir

I got that nap...and dreamt of HC, LC, MC, nadirs, meters, and schedules ugh

Anyway...at least ALL that was just a dream.

The PM cycle is coming fast....we'll see what the AMPS +11 is...although I bet tonight will be quiet. :-D
 
Re: 8/12 Poe AMPS 323 +2 349 + 6 325 +11 295

Already dropping at +11...not by much...but he's back in the high yellows. His lowest number of the cycle now.
 
Re: 8/12 8/12 Poe AMPS +6 325 +11 295 PMPS 310

Hi Karen,
I just want to stop by and give you bunches of pats on the back for last night. :thumbup :YMHUG: :YMHUG: I've got paws and fingers crossed for a calm night tonight for you and Poe. Those nailbite_smile nailbite_smile nights really take it out of a bean. Hope you get some good rest.
hugs and scritches from me and ollie
 
Re: 8/12 8/12 Poe AMPS +6 325 +11 295 PMPS 310

Sorry, I'm just catching up now. Wow, you did good last night :thumbup
I'm still tired from my night up on Saturday. I hope you get lots of deep sleep, tonight.
But, get a +2 if you can, please :smile:
 
His +2 is 328 so he came up some...probably a similar cycle to today's.

Thanks for all the visits...it was a pretty rough night...and I kept thinking I had 2 below 50's but there were 3 ohmygod_smile

Sure dont want another night like that...
 
You did great! I understand what you mean as I had a night like that one night.

I took a snapshot of it and put it in this post about Reductions. It was a hairy night like yours!

Hope you get some rest tonight.
 
karen, hope you're getting some sleep tonight!

let's see what this dose can do. the 2.75u dose dropped poe into the the upper 90s. tell him to do it again!

going forward (for now anyway)... don't try increasing the dose until you give the bounce a chance to clear...
and certainly not within 24 hours of seeing green. :mrgreen:
 
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