8/26 Boo Radley AMPS 267 +2/249 +6/318 +10/218

[Jessica & Boo Radley]

We had our 5th dose increase this week. Boo sure seems "steady" to me - I'd love anyone's thoughts on our choices and numbers. We religiously feed and shoot at 630AM/PM +-15 mins, feed only FF Classic or Special Kitty, lunch snack of FF after +6 test, and treats are chicken breast, boiled pork, or raw liver

I've been off for several weeks which has worked out so well with his new diagnosis (for both Boo and I)....but am unfortunately heading back today and leaving my capable husband with detailed instructions on testing.

We appreciate your thoughts!

 

[PeterDevonMocha]

Re: 8/26 Boo Radley AMPS 267

hi guys .. I unfortunately don't have any advice on Boo's numbers or dose amounts .. but you know others will be along soon .. Sorry to hear you are off to work but I am sure your husband will do just fine .. have a great weekend!

 

[Mary and Stella]

Re: 8/26 Boo Radley AMPS 267

Hey Jessica! Since we can hold each increase for 3-5 days...why don't you hold this one for 5 to see what you've got? My guess is you will end up with a higher dose, but really these little furry friends can be unpredictable and we just have to wait and gather the info. Boo Radley may take longer than 3 days to clear a bounce...so we don't really know if he is getting bounce on top of bounce with each dose increase.

I am sure your husband will do great! Have fun at work (if that is possible :lol: ) I look forward to seeing what you both decide to do. I am sure many other more experienced people will be along shortly. :smile:

 

[Jessica & Boo Radley]

Re: 8/26 Boo Radley AMPS 267

Hey Jessica! Since we can hold each increase for 3-5 days...why don't you hold this one for 5 to see what you've got? My guess is you will end up with a higher dose, but really these little furry friends can be unpredictable and we just have to wait and gather the info. Boo Radley may take longer than 3 days to clear a bounce...so we don't really know if he is getting bounce on top of bounce with each dose increase.

I am sure your husband will do great! Have fun at work (if that is possible :lol: ) I look forward to seeing what you both decide to do. I am sure many other more experienced people will be along shortly. :smile:

I'm thinking of taking the 0.25 increase on Sunday to get to 2.5, which is a much easier number to pull than the 0.25s fractions. I'm home Sunday and Monday, so could watch him closely with that increase and then maybe hold the 2.5 through the end of the week (as I have long hours Thursday and Friday and would prefer not to up any doses near that time).

I just think it's interesting that he's so flat...I guess in some ways it's great not to have him bouncing everywhere, but a little....I'd be OK with.

 

[Mary and Stella]

Re: 8/26 Boo Radley AMPS 267

Boo Radley might be 'flat' because he is just filling up the shed. Apparently it is a bottomless pit. ;-) That is why I suggested holding for longer than 3days/6cycles. To give Boo that chance to fill up the empty tank. The .25 usually has such a BIG affect on most cats, and Boo is not really responding...so I wouldn't want you to pass up the perfect dose if filling up the shed is all that is happening right now. Since every cat is different, maybe Boo is just a heavy drinker. Ha! :lol: Sounds like you have a solid plan. I can't wait to see Boo go Blue! Again, what do I know... in the end I really just know Stella.

 

[julie & punkin (ga)]

hmmm, jessica i see what you mean. solid yellows with just a blue here and there. it doesn't look like bouncing to me. bouncing occurs after a kitty hits a lower BG number than it's used to sending the subsequent BG higher than normal for up to 3 days. i'm not seeing any particular lower than usual numbers, just pretty flat. but i've only got 6 months experience at it - others may see more.

i'd suggest that you edit the subject line of your first post and ask for some eyes on boo's spreadsheet.

my guess is that you're going to just keep following the protocol, but it would be best if someone with more experience took a look though, and gave you advice.

 

[Ann & Maggie11 (GA)]

Hi Jessica,
I don't think I've ever visited your condo, so wanted to stop and say hello. Which flavors of FF Classic do you feed Boo? Maggie likes the Super Supper Special Kitty. Hope you get some answers on the dosing.

 

[Jessica & Boo Radley]

Hi Jessica,
I don't think I've ever visited your condo, so wanted to stop and say hello. Which flavors of FF Classic do you feed Boo? Maggie likes the Super Supper Special Kitty. Hope you get some answers on the dosing.

Hi there and thanks for stopping by. We feed him all Classic flavors...Salmon, Ocean Feast, Chicken and Giblets...truthfully..I'm not sure he knows the difference. Boo has ALWAYS had a ferocious appetite and I think he would eat just about anything I put down!

 

[Ann & Maggie11 (GA)]

Re: 8/26 Eyes Please...Boo Radley AMPS 267 +2/249 +6/318 +10

Boo has ALWAYS had a ferocious appetite and I think he would eat just about anything I put down!

Hi Jessica, you are so lucky that Boo is a good eater. Maggie is picky, picky! The reason I asked about the flavors of FF is that there is one FF Classic -- Turkey & Giblets that causes a spike in a few of our kitties. It may not affect Boo Radley, but thought I'd mention it. Have a nice evening.

P.S. It will help, too, if you edit your subject line and add the ? mark icon in your subject line. It will stand out for more experienced ones to see your condo and help with the dosing.

 

[Sienne and Gabby (GA)]

Re: 8/26 Eyes Please...Boo Radley AMPS 267 +2/249 +6/318 +10

Just so you are aware, you can increase as soon as 4 cycles/2 days. Since you're schedule has changed, I don't know if this would be preferable so you have more time to monitor.

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).

(FYI for those reading: The dose is held for 5 days if the nadirs are consistently below 200. Otherwise, doses are increased every 2 - 3 days.)

 

[Patty & Champ]

Re: 8/26 Eyes Please...Boo Radley AMPS 267 +2/249 +6/318 +10

Sienne is definitely the one you want to listen to for dosing advice. She has a ton of experience and has never steered me wrong!!

 

[Jessica & Boo Radley]

Re: 8/26 Eyes Please...Boo Radley AMPS 267 +2/249 +6/318 +10

Just so you are aware, you can increase as soon as 4 cycles/2 days. Since you're schedule has changed, I don't know if this would be preferable so you have more time to monitor.

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).

(FYI for those reading: The dose is held for 5 days if the nadirs are consistently below 200. Otherwise, doses are increased every 2 - 3 days.)

Sienna,

What would you do based on these numbers. I appreciate your frankness and would like your opinion.

 

[Marje and Gracie]

Re: 8/26 Eyes Please...Boo Radley AMPS 267 +2/249 +6/318 +10

If someone can monitor him closely, I would increase by .25u tomorrow morning as Sienne pointed out the Tilly Protocol indicates you can increase every 2 days (4 cycles) with BG >200. His fourth cycle is tonight so if he stays flat yellow, I'd take hiim up .25u tomorrow morning.....if "someone" (DH?) can closely watch him. I'd be sure he knows how to post in LL in case he needs any help.

Also, just in case, it's always good to be sure your hypo kit is ready and you have lots of strips, lancets, HC food, karo, etc. Not trying to scare you but you never know if that .25u will take a bit to get him started or if it will kick right in.

 

[SmokeyD]

Re: 8/26 Eyes Please...Boo Radley AMPS 267 +2/249 +6/318 +10

Good luck with the dose increase!!! I'm just about to increase Smokey's (this is our third increase!). Looks like you and I are both "new" at this- good luck!

 

[Sienne and Gabby (GA)]

Re: 8/26 Eyes Please...Boo Radley AMPS 267 +2/249 +6/318 +10

Jessica --

There's not a "right" answer here. I wanted you to be clear with respect to your options given the parameters of the protocol. Boo Radley already has a shed and there was no reason to hold the dose for 10 cycles. Some beans prefer to be more aggressive, others -- not so much. Then, of course, there are those pesky life issues like your schedule, what's easier to measure, etc. I've certainly held a dose for an extra day because the weekend was coming up and I would be able to monitor more closely.

If you want to split the difference, increase tomorrow PM -- that will be after 5 cycles. If it will work better for your schedule to increase on Sunday, that's absolutely fine. Sometimes, it's a matter of what you're most comfortable with. And sometimes, you just have a feel for how your cat is handling a dose and your sixth sense tells you to hold for another cycle or two because numbers will drop. (It's even better when you're right!)

 

[Jill & Alex (GA)]

Re: 8/26 Eyes Please...Boo Radley AMPS 267 +2/249 +6/318 +10

responding to jessica's PM here asking me to take a look at Boo Radley's ss...

did you happen to see my Reminder: Counting Cycles post today? after reading it, go back and review boo's ss. count the consecutive cycles before each increase was made while giving consideration to the guidelines suggested for specific nadirs.

what i'm seeing on boo's ss...
he dropped to 71 on the 12th cycle @ 1u bid. looked good! unfortunately, the dose was increased before the bounce could clear (takes up to 72 hours). additionally, when we're seeing nadirs in greens or blues, we hold the dose for at least 6 - 10 cycles. add not holding doses for six consecutive cycles to the mix. this is not a criticism, but rather a explanation as to a possible/probable reason for what you're seeing.

so, what now? if you're available to monitor, i would go onward and upward until you see a nice break in the numbers. if it were me, i would hold the current dose for 6 full cycles before making another dose adjustment.

 

[Jessica & Boo Radley]

Re: 8/26 Eyes Please...Boo Radley AMPS 267 +2/249 +6/318 +10

Jessica --

There's not a "right" answer here. I wanted you to be clear with respect to your options given the parameters of the protocol. Boo Radley already has a shed and there was no reason to hold the dose for 10 cycles. Some beans prefer to be more aggressive, others -- not so much. Then, of course, there are those pesky life issues like your schedule, what's easier to measure, etc. I've certainly held a dose for an extra day because the weekend was coming up and I would be able to monitor more closely.

If you want to split the difference, increase tomorrow PM -- that will be after 5 cycles. If it will work better for your schedule to increase on Sunday, that's absolutely fine. Sometimes, it's a matter of what you're most comfortable with. And sometimes, you just have a feel for how your cat is handling a dose and your sixth sense tells you to hold for another cycle or two because numbers will drop. (It's even better when you're right!)

If I could figure out how to quote both you and Jill at the same time without spending the extra time...I would.

I want to be clear and want to make sure I am both conveying my " curiousness" and understanding your experience.

Jill - I see on cycle 12 we hit 71. I counted those cycles in the 1.0 dose, which also was my initial dose...as 15 cycles -thus the increase. What I think you're saying....is that when we see a "low number" we start counting the cycle then to hold? You're saying that when he hit that 71...I should have held for 6 cycles to know what was happening? Just want to clarify this is the point you were making so I can reference in future occasions. I definitely read the reminder today and as FYI...interpreted something different (being that if your nadirs were less than 200, you held for the 10 cycles vs. the 3, if they were over 200, you increased at 6....I didn't read into when the count started).

Sienna and Jill.... and I think ultimately what my request for "Eyes Please" was....Boo has been very "steady". It was suggested that maybe he hasn't filled his shed yet and I need to slow down on my increases. I fully understand how important it is in monitoring, and if I look at others SS as examples....I don't see much of the steady that I'm seeing with Boo, nor do I see the consistent 6 cycle increases. Jill's response may have very well answered why that is. I stress again...I'm OK with steady if it's an acceptable response for our place and time, but if I did miss the count, or if there is a chance that I'm moving too fast - I want to make sure I'm considering your opinions.

 

[Jessica & Boo Radley]

Re: 8/26 Eyes Please...Boo Radley AMPS 267 +2/249 +6/318 +10

Boo has ALWAYS had a ferocious appetite and I think he would eat just about anything I put down!

Hi Jessica, you are so lucky that Boo is a good eater. Maggie is picky, picky! The reason I asked about the flavors of FF is that there is one FF Classic -- Turkey & Giblets that causes a spike in a few of our kitties. It may not affect Boo Radley, but thought I'd mention it. Have a nice evening.

P.S. It will help, too, if you edit your subject line and add the ? mark icon in your subject line. It will stand out for more experienced ones to see your condo and help with the dosing.

Thanks for the info on the Turkey and Giblets - had no idea and since he'll eat anything...I'll avoid that one without any tears!! Thanks again ;-)

 

[Libby and Lucy]

Re: 8/26 Eyes Please...Boo Radley AMPS 267 +2/249 +6/318 +10

Jill - I see on cycle 12 we hit 71. I counted those cycles in the 1.0 dose, which also was my initial dose...as 15 cycles -thus the increase. What I think you're saying....is that when we see a "low number" we start counting the cycle then to hold? You're saying that when he hit that 71...I should have held for 6 cycles to know what was happening?

Almost. ;-) When the cat starts getting lower numbers, you have to play things by ear a little more, rather than just counting cycles. The cycle counts we give are basically minimums once you start seeing movement in the numbers - you don't want to increase sooner than suggested, but you might hold doses longer. It depends on what you are seeing on your spreadsheet at any given time.

When Boo hit the 71, she bounced back up from there. That's a normal response to a cat's first green number. The counterregulatory hormones that cause the bounce can take up to 72 hours to clear out. When the cat is bouncing, it is important to wait at least 6 cycles before making another dose increase. When the bounce clears, they might get back down to green on their own (meaning the dose is ok for now) or they might not (meaning you need to increase). Wait and see, then decide what to do. Once you have more data on your cat, you might see that he consistently clears bounces faster (or slower) than 6 cycles. Once you're sure of his patterns, you can consider changing your strategy.

Regardless of WHY the numbers are what they are, usually the best strategy for getting rid of flat yellow/pink is to keep increasing the dose to cause a breakthrough. Using the tight regulation protocol, we're not generally interested in letting a cat "settle" into a dose that is keeping them high. We want to work as quickly as we can (safely) to move them into a dose that will get them into flat blue/green. Usually, the longer a cat sits in higher numbers, the more insulin is eventually needed to bring the numbers back down.

 

[Jill & Alex (GA)]

Re: 8/26 Eyes Please...Boo Radley AMPS 267 +2/249 +6/318 +10

in addition to libby's comments...

Jill - I see on cycle 12 we hit 71. I counted those cycles in the 1.0 dose, which also was my initial dose...as 15 cycles -thus the increase. What I think you're saying....is that when we see a "low number" we start counting the cycle then to hold? You're saying that when he hit that 71...I should have held for 6 cycles to know what was happening? Just want to clarify this is the point you were making so I can reference in future occasions.

i think some of the confusion lies in we're talking about two different subjects, but they affect each other.
cycle 12 on 1u -- kitty drops to 71 and then bounces. at this stage of the dance, the dose should be held until the bounce had cleared (up to 72 hours) before thinking about increasing the dose. instead, the dose was increased by 0.5u only four cycles later... to soon, not to mention when an increase was needed, it should have been a 0.25u increase. for some reason, the next cycle was decreased by a 0.25 unit to 1.25u which was held for 6 cycles before a reduced shot of 0.75u was shot. the cycle count for 1.25u should have started over and held for 6 consecutive cycles. instead, 1.25u was held for only 2 cycles before increasing to 1.5 units. the 1.5u dose was held for 6 consecutive cycles before increasing to 1.75 units. the cycle count when on 1.75u should have started over after the fur shot.

I definitely read the reminder today and as FYI...interpreted something different (being that if your nadirs were less than 200, you held for the 10 cycles vs. the 3, if they were over 200, you increased at 6....I didn't read into when the count started).

after reading the above, go back and read it again. lol! it's all about counting CONSECUTIVE cycles:

"Because of the cumulative nature of Lantus and Levemir... stalling, shooting a reduced dose, shooting a BCS dose, skipping a shot, and fur shots can alter the effect on the insulin/depot on any given dose. If you have to do any of these things, the cycle count starts over. If you don't start over, you run the risk of kitty becoming over dose."

Sienna and Jill.... and I think ultimately what my request for "Eyes Please" was....Boo has been very "steady". It was suggested that maybe he hasn't filled his shed yet and I need to slow down on my increases. I fully understand how important it is in monitoring, and if I look at others SS as examples....I don't see much of the steady that I'm seeing with Boo, nor do I see the consistent 6 cycle increases. Jill's response may have very well answered why that is. I stress again...I'm OK with steady if it's an acceptable response for our place and time, but if I did miss the count, or if there is a chance that I'm moving too fast - I want to make sure I'm considering your opinions.

my intention was to give you an explanation for what you're seeing. increases were not made according to the protocol. the "counting cycles" post underscores the importance of things like skipped, reduced, fur shots, and stalled shots.

i hope i'm explaining this well.

 

[Jessica & Boo Radley]

Re: 8/26 Eyes Please...Boo Radley AMPS 267 +2/249 +6/318 +10

in addition to libby's comments...
i think some of the confusion lies in we're talking about two different subjects, but they affect each other.
cycle 12 on 1u -- kitty drops to 71 and then bounces. at this stage of the dance, the dose should be held until the bounce had cleared (up to 72 hours) before thinking about increasing the dose. instead, the dose was increased by 0.5u only four cycles later... to soon, not to mention when an increase was needed, it should have been a 0.25u increase. for some reason, the next cycle was decreased by a 0.25 unit to 1.25u which was held for 6 cycles before a reduced shot of 0.75u was shot. the cycle count for 1.25u should have started over and held for 6 consecutive cycles. instead, 1.25u was held for only 2 cycles before increasing to 1.5 units. the 1.5u dose was held for 6 consecutive cycles before increasing to 1.75 units. the cycle count when on 1.75u should have started over after the fur shot.

i hope i'm explaining this well.

Makes perfect sense. At the beginning, when you saw that increase to 1.5 vs.the 1.25.....I was only a few days inn and following Vet advice. I think I posted that day here and was advised that 1.25 was the right choice. I have subsequently been on the bandwagon of 0.25 increases.

The .5/.75 day was one in the past few weeks when we were flat going to be out of our house 3 hrs before and 3 hours after his normal schedule. Boo's an FIV kitty too, so I am equally concerned with high numbers and UTI's, thus I made the call to split his shot....how'd that work out for me???!!!... :lol: live and learn.

For the 71 bs we had at cycle 12....I am now crystal clear in how a low number should be handled in the future until I am more clear on his reaction - thanks to both you and Libby for laying this out again. I think this is the point I was missing most.

Any how, all of your responses were just what I needed and some points I though were clear to me have been thoroughly clarified, so thanks much to you all. Onward we march and will head for that "break"....in which we will now know what to do.

Thanks again...I sure am keen on learning!