8/21 Max +11.25~113PMPS~118+1~123+11.5~87

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max&emmasmommie

max&emmasmommie

Member Since 2012
Oh, Phooey!!!! Phooey! Phooey! Phooey!

I ran out of coffee. I've been drinking tea for a few days, and waiting for Max to start making progress again. You know how if you leave the house without an umbrella . . . It rains!?!

Well, I took Emma out to breakfast, and left DH to test and shoot Max at AMPS. What does Max do? Tests at 77, that's what! DH calls me, and I had left my phone in the car, and he didn't shoot. It was a dropping number, technically, but I would have shot it.

So, I get home, and give him the shot 45 minutes late. Better than an hour late -- (British accent: Olways look own the brwite side of liofe! Do do, do do, di doo di doo di doooo!)

Yesterday: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=77513
 
Re: 8/21 Max 86 NEVER run out of coffee!!!!

But most importantly, it was GREEN:-)
You did pick up coffee while you were out, right?
America runs on Dunkin'....
Carl
 
Re: 8/21 Max 86 NEVER run out of coffee!!!!

Oh no, Dale, did you ever get the coffee, most important thing in my house. I hope you and Emma made it thru breakfast, too. Nice green, too, almost forgot about it thinking about the coffee. Have a nice day.
 
Re: 8/21 Max AMPS~86+2.25~85+3.25~63

He's still not earned a reduction and this is pretty much the usual nadir. I so wish I had been able to shoot on time! Damn!
 
Re: 8/21 Max AMPS~86+2.25~85+3.25~63

Ann and Carl, Yeah, maybe. I'm going to test him every 15 minutes now that I have this 58 in the hopes that I will catch a below 50!
 
Re: 8/21 Max AMPS~86+2.25~85+3.25~63+4.25~58+4.75~63

No dice! I hope I didn't miss, but I doubt I did. Sigh. I may have to raise the dose.

I have a question though: Has anyone ever tried to just stop the juice when the cat is at 0.5 or 0.25 units instead of microdosing? What are the risks meaning I suppose you might have to take the dose back up if the cat doesn't stay in normal numbers and you would lose time, but has anyone ever tried this and it worked?

My husband's theory -- based on not much that has to do with Roomp Rand, but on some logic and probably highly influenced by a hope that Max will suddenly go OTJ and stop causing me so much grief, is that different cats might go OTJ for different reasons. He thinks cats get diabetes for different reasons, and perhaps those causes having been withdrawn, the need for this slow decrease of insulin would be obviated. If the only reason for the diabetes was that an infection caused the high numbers and that infection resolved completely, the cat might go from using 0.75 of Lantus just because it is there one day, and then needing nothing the next if the Lantus isn't given. My husband thinks this is possible. He wonders if the infection in the mouth was a major reason for the diabetes and there being no actual disease of the pancreas present right now, the pancreas might produce enough immediately upon the withdrawal of all insulin. He thinks that that when I use insulin, Max's pancreas is putting out only a part of what it is capable of putting out, and if I were to stop giving him insulin suddenly, the pancreas would step up production to the level needed with no ill effects. He says he'd like me to test his theory by dropping the Lantus to 0.5 without getting a below 50 reading. What are the reasons for NOT doing this anyone?
 
Re: 8/21 Max AMPS~86+2.25~85+3.25~63+4.25~58+4.75~63 Questio

Of course, I have been intending to raise the dose soon. Max has had 22 doses of 0.75 with no below 50s that I caught. Both my husband and I think he's probably been below 50, but I'm having a terrible time at night getting up at the right time to test him. This problem is now exacerbated by the fact that we missed his shot by 45 minutes this morning. Ugh! And I just put Emma on an earlier schedule -- 7 to 7.

Sigh . . . So many times it's 2 steps forward and at least 1 step back. I'm waiting to increase the dose because I feel so overwhelmed.

My husband put the LB outside the other day while his family was here, and it got left out long enough that Max peed on my laundry. Now I have to treat that, and hang it up, and treat it again, and hang it up, and on and on until it doesn't smell. (My husband says to throw it out and buy new which I just can't do. It's not me.)

I'm behind or close to behind on 2 or 3 things pretty much all the time. I wish it didn't bother me, but it causes stress because things are pretty difficult around here anyway for various reasons. I keep doing things for me though because I really do feel so good afterward. I had a lovely lunch with Marje and Ann, and I do not regret it; I was walking on air the rest of the day; we simply cannot go without doing those things for ourselves. However, the "accidents" and interruptions never stop happening to normal life such that I can get ahead. I refuse to stop going to Mommie group meetups or taking naps either. I just have to keep a normal life on some days at least. (To me, naps are a normal part of life!)
 
Re: 8/21 Max AMPS~86+2.25~85+3.25~63+4.25~58+4.75~63 Questio

Max is doing Fantastic here!!!!! Look at this, an absolutely great day!!!
Life is too short to get upset, try to enjoy things..Max is doing great!
Hugs & Love from us...
 
Re: 8/21 Max AMPS~86+2.25~85+3.25~63+4.25~58+4.75~63 Questio

I'm behind or close to behind on 2 or 3 things pretty much all the time. I wish it didn't bother me, but it causes stress because things are pretty difficult around here anyway for various reasons. I keep doing things for me though because I really do feel so good afterward. I had a lovely lunch with Marje and Ann, and I do not regret it; I was walking on air the rest of the day; we simply cannot go without doing those things for ourselves. However, the "accidents" and interruptions never stop happening to normal life such that I can get ahead. I refuse to stop going to Mommie group meetups or taking naps either. I just have to keep a normal life on some days at least. (To me, naps are a normal part of life!)
Click to expand...

Dale, life would probably be that way even if Max had never gotten diabetes. ;-) You "get it" though, and that's the important thing - you have to do stuff "for you" no matter what goes on or how stressful life gets. The fact that it makes you feel good afterwards? Well, that's the point, right? Emma is only going to be this age once. Trust me, 25 years from now you'll look back and say "no way it's been 25 years, I'm not that old, how can she be?".


My husband's theory -- based on not much that has to do with Roomp Rand, but on some logic and probably highly influenced by a hope that Max will suddenly go OTJ and stop causing me so much grief, is that different cats might go OTJ for different reasons. He thinks cats get diabetes for different reasons, and perhaps those causes having been withdrawn, the need for this slow decrease of insulin would be obviated. If the only reason for the diabetes was that an infection caused the high numbers and that infection resolved completely, the cat might go from using 0.75 of Lantus just because it is there one day, and then needing nothing the next if the Lantus isn't given. My husband thinks this is possible. He wonders if the infection in the mouth was a major reason for the diabetes and there being no actual disease of the pancreas present right now, the pancreas might produce enough immediately upon the withdrawal of all insulin. He thinks that that when I use insulin, Max's pancreas is putting out only a part of what it is capable of putting out, and if I were to stop giving him insulin suddenly, the pancreas would step up production to the level needed with no ill effects. He says he'd like me to test his theory by dropping the Lantus to 0.5 without getting a below 50 reading. What are the reasons for NOT doing this anyone?
Click to expand...
I think I agree with some of his logic. I think one reason for not doing it is - if it fails to work (going from .75u top zero), then the shed is gone, and you have to repeat days of build-up and getting back to the numbers you're at today. It would be more than "2 steps forward and 1 step backwards". I realize it's against protocol to reduce when you don't see a number under 50, but it's still always your choice if you wanted to try something like that (reducing without the sub-50 number).

I didn't use Lantus, and I know the steps "down the dose ladder" are pretty clear cut, and there's the suggestion that before stopping completely, you should go to .1 for a few cycles. The awesome thing is that there is a set of guidelines for you to follow, and they've been shown to work for many cats.
It was much different for Bob, being on PZI, and having a bean that was pretty much just winging it. I never dosed less than .25u, mostly because with U40 syringes and my eyesight, anything less than whole units on the syringe was pure guesswork on my part. In his last three days on PZI, he got 2 skips, two .25u doses, one .5 dose and one 1u dose. I'd have to find his logbook (in a box that hasn't been unpacked yet since I moved) to tell you the exact sequence of shots, doses, and skips. I know his last shot was .25u on like a 98 PMPS, and I know that all 4 of those shots were given on PS numbers in the "normal BG range". But Bob never got a dose in less than .25u increments, and even that degree of adjustment seemed to have little effect on him. He was a "gulper" for the most part. So the morning after his last shot, I just looked at him and said "OK, dude, you're on your own, let's see what you can do with that". And he looked at me and said "OK, where's my shrimp though....?" 14 days later, he told me he was over it, and I took his word for it. (after I tested him of course) :lol:

ECID IS true, and Max is Max, and he's going to do whatever it is that Max does. I think the risk is like I said above. If it doesn't work, you have to backtrack in order to get back to how well he's doing at this moment.

Carl
 
Re: 8/21 Max AMPS~86+2.25~85+3.25~63+4.25~58+4.75~63 Questio

With regard to your husband's logic, it doesn't make sense to me. There are cats here who have steroid induced diabetes. For whatever reason, steroids need to be given and the cat ends up with diabetes. The cat's pancreas is still not producing sufficient insulin regardless of what triggered the problem. Whether it's an infection or steroids, the bottom line is that the beta cells in the pancreas are not working the way they should and the pancreas needs exogenous insulin. Once the initial problem is resolved, if your husband's theory was correct, everything would snap back into place. Instead, what we typically see is that insulin needs may decrease but the pancreas is still healing. Further, if your DH was correct, once the cat was OTJ, you could feed your cat anything because the pancreas is now working. Wrong. Once a diabetic always a diabetic it's just that if OTJ, the cat is now a diet-controlled diabetic.
 
Re: 8/21 Max AMPS~86+2.25~85+3.25~63+4.25~58+4.75~63 Questio

I have to agree with Sienne. And one other little piece of info that might help. Another member had her kitty, Shadow to 1u and Shadow was doing great....pretty much all normal numbers. They went on vacation and the petsitter quit shooting. Shadow stayed normal. So Kim put her on an OTJ trial. Shadow did ok for a while...a few months. And then Kim quit testing her regularly. When she did start testing her regularly again because of neuropathy that developed, she had to put her back on insulin. She had to go up over 4.5u. I have no idea what happened....the SS just stops.

Shadow's SS

You can take him down to .5u and see how he does. The worse that can happen is you'll have to increase back up. The best....he can like it!! :-D :-D

Ok....time for time with Mike since I just got back.

I'm glad you had a good time....I had a GREAT time!!!!
 
Re: 8/21 Max AMPS~86+2.25~85+3.25~63+4.25~58+4.75~63 Questio

Thank you Carl, Sienne and Marje. The shed, of course, the shed. I would not want to take my cat up to 4.5 units, that's for sure. My husband will support whatever I want to do, but he does think hard about these sort of things that are causing me stress. I think it's best to just keep going as we are or raise the dose. We did finally, this morning have a Green AMPS! I'm shooting at 9:10 tonight, and hopefully, the 45 minute late shot this morning will be almost cancelled out with that. I've done it before with no harm that I know of. If anyone thinks that's a horrible idea, please let me know within the next 15 minutes? Thank you!!!
 
Re: 8/21 Max +11.25~113 ANOTHER Question

Having a hard time with the timing....how many hours between this morning's late shot and tonight's?
Carl
 
Re: 8/21 Max +11.25~113 ANOTHER Question

OK, so it's about a 20 minute adjustment? I think that's fine. :smile:
 
Re: 8/21 Max +11.25~113 ANOTHER Question

Yes, I think so. I know I can do 1/2 hour adjustments, but I don't want the spreadsheet to be all crazy just in case I have to use it to find out something I'm not expecting to need to know.
 
Re: 8/21 Max AMPS~86+2.25~85+3.25~63+4.25~58+4.75~63

i have a little different spin on the answer to your question only because i was around when things were done much differently in the lantus ISG. :mrgreen:

max&emmasmommie said:
I have a question though: Has anyone ever tried to just stop the juice when the cat is at 0.5 or 0.25 units instead of microdosing? What are the risks meaning I suppose you might have to take the dose back up if the cat doesn't stay in normal numbers and you would lose time, but has anyone ever tried this and it worked?
Click to expand...
yes, before the tight regulation protocol was widely accepted on the fdmb many people withheld insulin once kitty was dropping too low on 0.5u or 0.25 unit. and yes, it worked for many "newly diagnosed" kitties... not all. in 2006, alex basically went from 0.5u to 4 doses at 0.1u before i started her first OTJ trial. she wasn't dropping too low, but too much insulin was causing inverted curves... even at 0.1 unit. she remained in remission for almost 3 years.

max&emmasmommie said:
My husband's theory -- based on not much that has to do with Roomp Rand, but on some logic and probably highly influenced by a hope that Max will suddenly go OTJ and stop causing me so much grief, is that different cats might go OTJ for different reasons. He thinks cats get diabetes for different reasons, and perhaps those causes having been withdrawn, the need for this slow decrease of insulin would be obviated. If the only reason for the diabetes was that an infection caused the high numbers and that infection resolved completely, the cat might go from using 0.75 of Lantus just because it is there one day, and then needing nothing the next if the Lantus isn't given. My husband thinks this is possible. He wonders if the infection in the mouth was a major reason for the diabetes and there being no actual disease of the pancreas present right now, the pancreas might produce enough immediately upon the withdrawal of all insulin. He thinks that that when I use insulin, Max's pancreas is putting out only a part of what it is capable of putting out, and if I were to stop giving him insulin suddenly, the pancreas would step up production to the level needed with no ill effects. He says he'd like me to test his theory by dropping the Lantus to 0.5 without getting a below 50 reading. What are the reasons for NOT doing this anyone?
Click to expand...
imho, going OTJ after a stint on insulin has less to do with the reason kitty developed diabetes and more to do with what kind of shape the pancreas is in. if minor damage has been done (less beta cells damaged/destroyed) chances are recovery will take less time and effort than with a kitty whose pancreas has suffered more damage. the problem is we have no idea how many cells have been damaged nor do we know how quickly the body is healing... or if the body is healing.

fast forward to today (6+ years later)...
experience has shown us the best chance of a strong remission is to take the dose down to a drop of insulin before attempting an OTJ trial. to withhold insulin at 0.5u or 0.25u is taking a bigger risk and when you're so darn close to kitty going OTJ... why take the risk?


just a few thoughts...
 
Re: 8/21 Max +11.25~113 ANOTHER Question

Thank you, Jill. I don't want to take any risk of messing up his chance of going off the juice, of course.

He's very safe at this dose it appears, but I'm going to have to raise it if I don't see some action soon. Maybe I should just pick a day that works for me, and get it over with EDITED to add: AFTER I get 6 shots on time! Arggh! I can't believe how many have been late lately. I was excited to see the Green AMPS this morning, but this evening is clearly a result of a late shot a few days ago. END EDIT.

I'd love to read the Roomp Rand paper, but I don't have the time to fully understand it, I'm afraid. The theory, I think, is that giving him insulin at the proper dose is essentially allowing the pancreas to remain nearly dormant and thus heal. My husband was surprised to hear today that Max had probably had glucose toxicity/insulin resistance, and hadn't considered that in his analysis of the situation. He thought that was very interesting.
 
Re: 8/21 Max +11.25~113PMPS~118+1~123

Hang in there, Dale! Many hugs coming your way.

I agree with Sienne, Marje and Jill. Why take the risk, when you're so close. Max is doing beautifully. You guys have a very real shot at remission. If you can hang in there a little longer, your chances are *better*! Why deny him and you that improved chance. You'll make it through.

I'm so jealous you got to have lunch with Marje and Ann :mrgreen: Dratted entire continent and ocean in the way, for me to come over for a salad and a spritzer!
Jane
 
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