9/15 Morgaine AMPS 163,+6 130,PMPS 147

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skybar22

skybar22

Member Since 2010
yesterday

Morgaine is starting to creep up again, 163 this AMPS. I am noticing a pattern of good numbers and then a creeping up and coming back down to good numbers but at this point I am thinking of increasing just a bit to 3.25 again. I didn't do it today because I am going out for the afternoon but may try it again tomorrow. Meanwhile any advice would be welcome.

Hope all are having a good day!
 
Re: 9/15 Morgaine AMPS 163 Advice welcome

hi rosalie! if she were mine i'd take her back up to the 3.25. when you gave her that dose on 9/1 she didn't drop below 50, so technically didn't "earn" a reduction back to the 3.0 that evening. she probably would've gone below 50 that day if you hadn't given her med/high carb foods. it's a mixed bag with slowing them down by using med/higher carb foods - several people do that successfully. i think most of the people who do that have cats that "dive" with their numbers and they are wanting to slow down the dive. i haven't done it because under real circumstances, i want to see what a particular dose of insulin does to punkin without me intervening or steering punkin's numbers with food. he also never dives. or at least hasn't yet. i shoot and watch, and if he goes under 50 then i adjust the dose. if i had to leave or go to bed, that would be different, but that's the general tactic i use.

you can, of course, do whatever you want! these are just different options that work better for different cats.

here's the part of the protocol that would apply to morgaine. it basically would indicate that every 6-10 cycles you would want to increase the dose by .25u, unless she drops below 50.
Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...
 
Re: 9/15 Morgaine AMPS 163 Advice welcome

Hmmmmm......I'm not sure I understand the increased dose on 9/1 for just one cycle nor am I certain if that was the cause for the green...it could have been but sometimes you don't see the effects right away.

The thing is that Morgaine often has green on f3.00u. I can understand with these numbers why you don't want to do a lot of testing....she's pretty consistent. But you really have no idea how long she is staying in green and her exact nadir....which can shift cycle to cycle anyway.

The other important thing is not to dose based on PSs. I think if you want to bring her nadir down a bit more, you can add a drop or so and see what it does. I think you need to be prepared to test a little more. She's only had that dose one cycle and no one really knows if it was that cycle that caused the lower greens or you were just testing more and so you picked up some lower numbers. But I always feel vigilance is important on a new dose.

Good luck!!!
 
Re: 9/15 Morgaine AMPS 163 Advice welcome

I do want to discuss all of this further but I have a Dr. appt and have to go soon so it may have to wait until later.

I do base my decisions on nadir and not PS #.

Marjorie, are you saying you might test more before increasing the dose? I can do that. How often would you test? I am also a prudent person based on my years of dealing with D and I know it is different for a cat but my guidelines are so clear for me and I think I am slowly learning to move them for Morgaine. When i see numbers going down and heading into possible hypo ranges I immediately use carbs to increase. I do think I need to see where she goes whe her numbers are moving down in the green but it takes a bit of courage on my part. I would love some step by step instructions on how often you would test if things are in the green and going down. My big fear is based on my own physical limits and my inability to drive anymore so I couldn't just hop in a car and get her to an ER if something should go terribly wrong. That said, I DO know how to handle things, just my silly fears.

So, I would like to see her with more green and a little lower on the nadir.

I also have the issue of not trusting that my meter is accurate so I am waiting for new meter and strips. As mentioned yesterday, I got a One Touch Ultra mini on ebay. Then I can determine how off my Freestyle really is and adjust from there.

My feeling is that Morgaine is in a decent range now and could be better for healing purposes. I notice a big difference in drinking more and peeing more when her numbers are a little elevated. She has days of complete normalcy when her numbers stay down. More later. Excuse typos I have to go.
 
Re: 9/15 Morgaine AMPS 163 Advice welcome

i'll be curious to see what you find out with the new meter compared to the Freestyle Lite. I think i might have mentioned before that's what i use.

i guess i got inaugurated into low numbers kinda cold turkey. in the first few days of hometesting, punkin registered a 34 - no visible symptoms at all, but marjorie and others led me through giving the high carb foods and testing punkin til he was safely up. so i didn't have the "one toe in the water" experience that you're having with lots of blues/greens, that's kinda given you opportunities to really think about getting into the mid-greens.

cats that don't have diabetes register somewhere 50-120ish - although i tested a non-diabetic cat a couple of weeks ago that was 46. so that range is a totally safe range. i've seen cats on here in the 30's without visible symptoms. there have also been cats that went in the 20's and began having symptoms - in my limited experience i've heard people report seems to be mental confusion for the cat - not to minimize that either - because you don't want their little brains without glucose!

i guess what i'm saying is you have a bit of a safety cushion if you begin treating at 49, which is what the protocol calls for. the important thing is for you to know morgaine, how she responds to carbs, how long it takes to register increases in BG, how much food you have to give her to pull her up, that kind of thing. as you learn how she responds perhaps that will increase your comfort level with the whole process.

not sure if that's helpful, but i know the more information i have for myself, the better able i feel to cope with everything. we could call me a control freak, which would be accurate, but not terribly nice! :lol:
 
Re: 9/15 Morgaine AMPS 163 Advice welcome

Marjorie, are you saying you might test more before increasing the dose?
Click to expand...

Rosalie...I'm sorry. I didn't mean to confuse you. I think my comment (that was not very well stated) is that on the current dose, we have an "idea" of what she is doing but not fully because of only having spot checks. BUT she hasn't gone really low on the f3.00 and so there really is no need to poke her just for the sake of poking unless you wanted to do a mini curve some time and see if this dose is getting her any lower. I'm not sure that is necessary.

I can understand you wanting to increase her to get some more green in and yes, with that comes the possibility that she will go much lower. Remember...you have to shoot low to stay low and that is the goal in TR. I understand your concern about her dropping but you control that with testing and you'll have to see how much and how fast she drops and test accordingly. Some cats here drop down but bring themselves up. Some, like Gracie, don't. But you are in control and you can bring Morgaine up if you see her coming down too fast or too low.

I know you have limitations and that plays a big role here. Tight regulation may or may not be your goal because of that. So by going slowly on the increases, perhaps you can find a nice dose that will keep her safe but allow her to get into the 70s. I know you are amazingly diligent.

I wish I could give you step by step instructions but I think you'll have to find out how Morgaine reacts and remember....there's usually someone around in LL if you need some support on what to do when. Julie and I are often up late our time. Consider at what BG she starts, how fast she is coming down, where she is in the cycle and test accordingly. I find that, normally, testing every 30 mins works for us especially if I have fed her....the food needs a little time to work. But you might feel more comfortable testing every 20 mins the first time she comes down more.

I have been using a OT Ultra Mini since we started....and have one as my backup. I have a Contour as my second backup. I bought a Freestyle lite and sent it back. I didn't like it....it read much lower than my OT Ultra Mini and Contour and it was inconsistent. But the strips are a lot more expensive for the OT.
 
Re: 9/15 Morgaine AMPS 163 Advice welcome

I don't have any advice but it looks like you have gotten a lot of great advice. Hope the increase gives you back some green! Have a great evening!
 
Re: 9/15 Morgaine AMPS 163 Advice welcome

Thanks for all this great advice.

Marje, I get free strips, in abundance, for the Freestyle. I really can not afford to purchase strips on a regular basis so I want to get a better idea about how "off" the Freestyle is. I also plan to discuss that with my endo since he knows all of these meters well and probably can answer some questions for me on accuracy.

Julie, I will definitely share my results both with you personally and on the board. The few tests I have run have shown the Freestyle to run a bit lower than the variance at times and within the variance so I want to see what using a different meter consistently, on Morgaine, not me, will result in.

I am also quite a control freak and having this disease and having tight control for years makes me more so. So, if I can tweak Morgaine's numbers for TR I want to do that. I also need to consider her willingness. I can't nor do i want to restrain her for a BG test. She is not easy to hold onto and she is very strong, stronger than i am. So far she is tolerating it all and gets her rewards but if I tried to test her every 20 minutes she may decide to bolt and hide. So I will do my best and I really appreicate all this advice. I do not think Morgaine is dropping too much lower than the greens we are seeing on her chart. I can do a curve one day but that can change the next day as well and because of her flat curve, I am not sure testing so often is needed either.

I will be around for several days after next Monday so i will do a curve then and decide what to do from there.

I think when Morgaine is 150 on the Freestyle she might be closer to 200 on another meter. That is when she starts to reach her renal threshold and the polyuria kicks in. Also, at one vet visit he drew blood and I had him test it on the Freestyle. It was 132. The lab test on the same blood sample came back 181. She was also spilling glucose that day.

Knowing that cats are different doesn't help me get over the serious warnings I have had about hypos for humans. Therefore I am a little hesitant to allow Morgaine to get too low, especially because she is an older cat, 13+, and so I have all that in my head when I see her numbers coming down. I know cats run lower on these meters we use than humans and she is perfectly safe in the 50's and probably 40's. A human being can die if their BG goes into the 20's. Cats are differnet but do we know what is considered REALLY dangerous and can we know for sure that these meters are accurate enough? Those are my real concerns.

I have had readings on myself in the 30's and it is very difficult to maintain my ability to think straight at those numbers so i know low BG feels really strange and causes serious harm if not dealt with immediately. All this is in my head when I think about my girl.
 
Re: 9/15 Morgaine AMPS 163 Advice welcome

Rosalie:

What you might want to do is take a look at the SSs of some of the people who have been around here a while. It will give you a feel for how we test. With Gabby, when I see her dropping, I test every 30 min. Some of how I test has changed over time. The better I understand her individual pattern, the better sense I now have of surfs, drops, etc. and how and when to intervene.
 
Re: 9/15 Morgaine AMPS 163 Advice welcome

I have a short list of SS that I look at. I have chosen them because the insulin doses are close to Morgaine's and so are the numbers though they get more green than we do. I am thinking she needs a bit more insulin and i need to test more on days where she is lower than normal. I thought i had been doing that but I also can see where I stop the drop and give food to bring her back up before I allow the insulin to take her lower. This has been a really good discussion for me.

I am going to wait until I get the new meter and strips and then increase the dose to 3.25. I will probably wait until after next Monday since i am not going to be home much until then. Although I see why some of you test so frequently Morgaine is relatively consistent and flat. She has not gone very high and she doesn't dive into the lows. I have been watching her and she might drop by 70 within 3 hours of a shot. It's always the increases that require me to do more testing and I have no problem with that if i am going to be home with her.

Thanks so much for all the input and feel free to offer any further advice whenever you think it might help us reach our goal of TR. I'll feel much better when I know how accurate her meter is and what adjustments I need to make.
 
Re: 9/15 Morgaine AMPS 163 Advice welcome,+6 130

Great discussion today. You are ahead of the game just because of your extensive knowledge of diabetes. It's always a pleasure to read your condo.

Have a great evening.
 
Thanks everyone. I just started a new vial of Lantus. It is almost 3 months since I opened it and it is nearing the end. I also dropped it on the floor and it rolled around and got a bit foamy. I am interested to see if a fresh vial will make a difference. Will watch her closely for a few more hours.
 
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