8/22 Clare AMPS 278;+10-265;PMPS-277;+2.5-280;+4.5-35

[Georgette and Clare]

Yesterday's Condo

Today's News:

AMPS: 278
+2.5: 383
+4: 350
+6: 282
+10: 265

PMPS: 277
+2.5: 280
+4.5: 351

Good morning everyone! Sending lots of healing wishes to those who need them today, kitties and beans.

Some things that have been happening since we reduced the dose, that may be contributing to Clare's higher numbers since then: (1) Bouncing; (2) Experimenting with giving HC at the beginning of cycles to smooth out her lows; (3) Hairballs.

Thanks to Julie, Wendy and Amy, we have a plan. If I've got it right: We'll stop feeding HC to Clare at +2 when we get lower numbers and just wait to see the 40's to do that. And we'll change Clare's AM+9 (3 PM) feeding from a snack to a treat only, and not feed her at all after that so that her PMPS test isn't at all influenced by the food. If Clare doesn't go into the greens tonight, we'll be back at the 0.25 dose for tomorrow's AM shot.

Greens, here we come! :razz:



Have a good day, everyone!

 

[julie & punkin (ga)]

Re: 8/22 Clare AMPS 278;+2.5-383 Increase dose?

Last night Wendy suggested:

As for dose, since you did skip the shot 3 nights ago, you depleted the depot. You could wait a couple more cycles to fill the depot and see what .1U dose does, but if you don't see green by tomorrow night, I'd increase.

It's reasonable to wait til tonight - especially since you already shot this morning. ;-) but i wouldn't wait any longer. The fact that you skipped a shot does mean that she got the equivalent of an extra reduction immediately after the 40's, which is why Wendy suggested waiting - skipped shots impact the picture. From the New Dose Wonkiness, Failed Reductions & Bouncing post found at the bottom of the "New to the Group" sticky:

There is no "NDW" following a dose reduction nor do we hold a reduced dose 6 cycles (as done with dose increases) to "fill the insulin depot".
"Settling time" does not apply to dose reductions. We don't wait for a reduction to "settle".

When you see numbers trending higher after a dose reduction we immediately return to the last "good" dose as described in the The Tight Regulation Protocol with Lantus or Levemir:

"If the cat will not stay in the normal range after a reduction, immediately increase the dose again to the last good dose."

The only role bouncing plays in the decision is that you want to see how low a dose takes a cat in between the bounce - so you wait until you can see that before deciding the reduction has failed. In Clare's case, you can see she cleared the bounce from the 40's by the next day and only got to a 113.

By the way, have you seen spreadsheets of cats after people who are shooting low? Maybe that would help you feel more comfortable with the green numbers. Here's a post discussing shooting low and it includes ss of cats that have been shot with everything over 50 and an explanation of why it's helpful. http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=121668&p=1266813#p1266813

 

[Georgette and Clare]

Re: 8/22 Clare AMPS 278;+2.5-383 Increase dose?

Hi Julie,

That helps a LOT -- reading your explanation and looking at the others' spreadsheets. I didn't realize that shooting low would actually stabilize her numbers!

I'm ready. We've been only feeding her LC today. I won't try any +2 feedings of HC. If she doesn't go back to the greens by tonight, we'll go back to the 0.25 for tomorrow's AM shot. We'll be around all day over the weekend days, so we'll be able to monitor the change.

Thank you so much!

 

[julie & punkin (ga)]

Re: 8/22 Clare AMPS 278;+2.5-383 Increase dose?

yeah - it's really counterintuitive. people typically think it's safer to shoot a high number than a low one, but lantus works best on the low ones. for whatever reason, it's hard (impossible?) to get flat cycles except in normal numbers. well, you can have flat high 300's, but no one wants that. when you shoot a higher number, then you can get a dive. shoot a normal number, you might see a cycle that only moves 10 points in the whole day. a person needs to work up to it and initially monitor a lot to learn what their cat is going to do when they've got the normal dose into a normal number.

i meant to add this morning - i think the first strategy i'd use with clare's food is to eliminate the significant meal in the second half of the cycle. if she isn't as high at preshot, you may not have the dives after preshot.

 

[Georgette and Clare]

Re: 8/22 Clare AMPS 278;+2.5-383;+4-350

HI Julie,

I put this in today's first post, so I can easily refer to it. Does it summarize what we've talked about?

Thanks to Julie, Wendy and Amy, we have a plan. If I've got it right: We'll stop feeding HC to Clare at +2 when we get lower numbers and just wait to see the 40's to do that [No HC yet today]. And we'll change Clare's AM+9 (3 PM) feeding from a snack to a treat only, and not feed her at all after that so that her PMPS test isn't at all influenced by the food. If Clare doesn't go into the greens tonight, we'll be back at the 0.25 dose for tomorrow's AM shot.

Is there anything else we should do?

Thanks again!

 

[Georgette and Clare]

Re: 8/22 Clare AMPS 278;+4-350;+6-282;+10-265;PMPS-277;+2.5-

Doesn't look like tonight will be the night that Clare goes back down to the greens. We'll test again before bed and maybe we'll see something different then.

Clare, sweetie, you have been such a trooper. So patient with us while we're learning. May you be happy! cat_pet_icon

 

[Georgette and Clare]

What causes a bounce 4 hours into a cycle? It's happened to Clare in both her AM and PM cycles today. confused_cat

Well, back to 0.25 in the morning. :?

 

[julie & punkin (ga)]

this isn't a new bounce - this is still from yesterday's 147, or it could be just not enough insulin. i'd lean toward bouncing from yesterday's blues.

sometimes with a bounce, a cat will bobble around high and there will still be some movement up and down in numbers. you know a bounce has resolved when they get back somewhere in the range that caused the initial bounce.

doesn't really matter if it's a bounce or the numbers have trended up because she isn't getting quite enough insulin. either way, i'd go back to 0.25u tomorrow morning.