9/17 Reuben PMPS 496

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Alexa and Reuben

Alexa and Reuben

Member Since 2012
9/16 Condo

Reuben earned a reduction yesterday and we shot the first 1.75u last night.

Sienne - Thank you so much for your observations and suggestions yesterday. I am now administering the bupe consistently (whether he 'lets' me or not) and the improvement is marked. I am taking care to administer the Pecid at least 30 minutes before shot meals, and giving the Potencil before the Pepcid. If you have any more comments or observations about our situation I am all ears.

Jane - Thank you a million times over for working with me yesterday, it changed things for us in a hugely positive way. I look forward to our weekly check-ins!

Marje - I didn`t 'see' you this weekend, and I would be most grateful to know any observations/suggestions you have about our case :-)

Measuring 1.75u is going to require either a caliper or some other solution to create consistency.

cat_pet_icon To All




Potencil 50mg bid
pepcid 2.5mgbid
bupe - 0.07-0.10ml/8 hours
miralax - suspended
 
Re: 9/17 Reuben AMPS 433 +1/371 +2/235

You're so welcome, Alexa! I look forward to it too - I'll post a bit of an impression from each week here in your condo, and then others can weigh in and hopefully, thay way, you'll feel safe knowing there are lots of eyes on you and your darling kitty :smile: You guys are doing great! I can't wait to see what Reuben does with this dose!

Hugs,
Jane
 
Re: 9/17 Reuben AMPS 433 +1/371 +2/235

Jane said:
.....I can't wait to see what Reuben does with this dose!

Hugs,
Jane
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Whoa... Jane, what do you make of this +3/82? Makes me wonder what he did last night after I bean-failed and fell asleep!

- Alexa
 
Re: 9/17 Reuben AMPS 433 +1/371 +2/235 +3/82

That is one big ole drop, there. Over 150 points in one hour. I would feed him, to get him to slow it down some.
 
Re: 9/17 Reuben AMPS 433 +1/371 +2/235 +3/82

Dyana said:
That is one big ole drop, there. Over 150 points in one hour. I would feed him, to get him to slow it down some.
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Pretty crazy, isn`t it!! Makes me wonder what he did last night while the bean slept.... !
 
Re: 9/17 Reuben AMPS 433 +1/371 +2/235 +3/82

Hi guys .. congrats on the reduction! That +3 is looking awesome! I hope reuben decides to surf around here for awhile .. have a great day guys!
 
Re: 9/17 Reuben AMPS 433 +2/235 +3/82 +3.5/56 +3.75/48

That's good. I'd feed him just a little LC to try to get him back into the 50s.
 
Re: 9/17 Reuben AMPS 433 +2/235 +3/82 +3.5/56 +3.75/48

+4/49

He's on his way up.

So, any opinions on this reaction on second cycle of .25u reduction to 1.75U ?

Fascinating.

Like I said, I really wonder what went on last night while I slept. (which I realllly didn`t mean to!)

I just gave him little dabs of LC along the way. Bigger dab to keep him from going through the floor of course. :lol:
 
Re: 9/17 Reuben AMPS 433 +2/235 +3/82 +3.5/56 +3.75/48

I don't think he went down last night. He seems to have fairly early nadirs. I think the reds were just a bounce from yesterday's green. And some of the greens you are seeing today are carryover from the depot from the 2.00 dose.
 
Re: 9/17 Reuben AMPS 433 +3/82 +3.5/56 +3.75/48 +4/49 +4.25/

+4.25 48

Thank you Dyana!

It makes sense what you say about what`s going on right now. Much appreciated, and I am glad not to be worrying about last night now.

He`s hanging at just below 50 right now even though I`m feeding it, because of nadir, it feels like. I don't want to feed too much and put a wrench in the rest of the day. He'll ease up now I think.

He showed his ability to be very stable last week for a couple of days, so we know it's there.

Dyana, did I read that you are from Mt. Diablo? Was that you? If it was, then this will mean something to you... I`m from Mt Tamalpais!
 
Re: 9/17 Reuben AMPS 433 +3/82 +3.5/56 +3.75/48 +4/49 +4.25/

Wow! Small world. That's Marin County, right? What a beautiful place to be from. Of course I loved growing up on Mt. Diablo, too :-D Did you have horses to ride?

Yes, he should be reaching around nadir, and since he's so steady, you could probably start testing every 30 minutes.
I think I might still feed just a bit though if you're going to wait 30 minutes for his next test.
 
Re: 9/17 Reuben AMPS 433 +1/371 +2/235 +3/82

PeterDevonMocha said:
Hi guys .. congrats on the reduction! That +3 is looking awesome! I hope reuben decides to surf around here for awhile .. have a great day guys!
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Thanks so much Devon :razz: I got him to hang around a bit lower than that +3, but I`ll take it! You guys have a great day too!
 
Re: 9/17 Reuben AMPS 433 +3/82 +3.5/56 +3.75/48 +4/49 +4.25/

Dyana said:
Wow! Small world. That's Marin County, right? What a beautiful place to be from. Of course I loved growing up on Mt. Diablo, too :-D Did you have horses to ride?

Yes, he should be reaching around nadir, and since he's so steady, you could probably start testing every 30 minutes.
I think I might still feed just a bit though if you're going to wait 30 minutes for his next test.
Click to expand...

We must have cross-posted, I just saw your post now... Yeah, it`s Marin county. No horses though, did you have horses? We used to drive by your mountain on the way up the delta when we had our boat up there.

Yeah, I got him up to 51 and he fell asleep so I think he feels good. I think he`s past nadir now, we'll find out right now ooops, I guess it`s been 45 minutes!!
 
Re: 9/17 Reuben AMPS 433 +3/82 +3.5/56 +3.75/48 +4/49 4.5/51

Wow.
That's a lot of change again.
Whatya up to Reuben?
His cycles are fascinating to watch.

You are getting to be an old pro at this, Alexa!
 
Re: 9/17 Reuben AMPS 433 +3/82 +3.5/56 +3.75/48 +4/49 4.5/51

rhiannon and shadow said:
Wow.
That's a lot of change again.
Whatya up to Reuben?
His cycles are fascinating to watch.

You are getting to be an old pro at this, Alexa!
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Yeah, big change again, what do you make of what's going on right now Rhiannon? I'd love to have your take on this...
 
Re: 9/17 Reuben AMPS 433 +3/82 +3.5/56 +3.75/48 +4/49 4.5/51

I'm not Rhiannon but what I think you're seeing is that Reuben's depot hasn't had a chance to catch up with your last dose reduction. Couple this with the bounce breaking and you see lower numbers. I'd like to see how the rest of the cycle plays out. If you're not having to really work hard to keep Reuben's numbers up, I'd suggest sticking with this dose.
 
Re: 9/17 Reuben AMPS 433 +3/82 +3.5/56 +3.75/48 +4/49 4.5/51

Sienne and Gabby said:
I'm not Rhiannon but what I think you're seeing is that Reuben's depot hasn't had a chance to catch up with your last dose reduction. Couple this with the bounce breaking and you see lower numbers. I'd like to see how the rest of the cycle plays out. If you're not having to really work hard to keep Reuben's numbers up, I'd suggest sticking with this dose.
Click to expand...

Sienne - Thank you! This is what I wanted to know. No, I am not having to work to keep his numbers up... I suspect he will hang out here for a while before heading back up to 'comfort' zone, whatever that will be for him now. I`ll check in with you towards the end of the cycle to confirm staying on this dose, okay? And, I always want to know what you think. -Alexa
 
Re: 9/17 Reuben AMPS 433 +3/82 +3.5/56 +3.75/48 +4/49 4.5/51

Hi Alexa, wow on Reuben's numbers. Congrats on the reducie! Reuben is looking amazing! Have a great day.
 
Re: 9/17 Reuben AMPS 433 +3/82 +3.5/56 +3.75/48 +4/49 4.5/51

Hi Alexa! Wow, look at Reuben go! Once he got a taste of the green lagoon, he decided he liked it and wants to keep going back.
Keep going Reuben!

Melanie & Racci
 
Re: 9/17 Reuben AMPS 433 +3/82 +3.5/56 +3.75/48 +4/49 4.5/51

MelanieAndRacci said:
Hi Alexa! Wow, look at Reuben go! Once he got a taste of the green lagoon, he decided he liked it and wants to keep going back.
Keep going Reuben!

Melanie & Racci
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Haha, Yeah Melanie, looks like he thinks he`s a Christmas Cat now, all dressed up in red and green :lol:

Ann & Maggie11 said:
Hi Alexa, wow on Reuben's numbers. Congrats on the reducie! Reuben is looking amazing! Have a great day.
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I`m glad to know you think he looks amazing Ann, I`m getting dizzy following him around!! Thanks for stopping by!

Anne&Muffin said:
Congrats on the reduction!
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Thanks Anne - :razz:
 
Hi Alexa

Sorry I missed you over the weekend. I often just stalk at night ;-) and sometimes I end up spending slot of time with just a couple people who need help and don't make it to all the condos.
reuben'smom said:
Anyway, yes, I understand the basic concept, but I think I am starting to wonder about the more specific data regarding time frames... how long does it take to fill on an increase and shed on a decrease? What are the factors that affect it?; what percent is going to the depot and what percent to mimic the missing natural pancreatic release of insulin? and where is this insulin depot anyway?
Click to expand...

Carl did a good job of explaining how lantus and levemir work. Let me answer your other questions. The time it takes to fill the depot on an increase depends on the cat and the dose. Some cats have new dose wonkiness, others kick in gear fairly fast and then might settle down a little more, and some cats take 10 or more cycles to fill the depot from a new dose and start having nice numbers. The depot doesn't fill on a decrease..it drains. Again, the length of time depends on the cat. The depot from a higher dose can affect a lower dose for at least six cycles. Some cats, it's only a few but it does seem the higher the dose, the larger the depot, and the longer one would see it affecting numbers after a decrease. Factors: the cat, the rate of absorption which can vary from day to day by as much as 25-50%, the amount of the dose, the size of the depot, etc. we don't usually talk in terms of the percent which goes into the depot as we don't know and it can change from day to day.

Lantus and Levemir work differently. Lantus is stored in subcutaneous fat as a precipitate and releases slowly. Levemir sticks to itself subcutaneously and the disassociates and attaches to albumin where it slowly disassociates releasing insulin into the bloodstream.

Carl made a great observation that using these long term insulins is an exercise in patience. Think of a large cruise ship. The captain can turn the wheel but it takes a long time to actually change course.

I'm currently working on the patience thing with Gracie and you can see it in her SS. She was regulated and doing well but got an infection. The antibiotic kicked in and all of a sudden, she had too much insulin which caused her to start diving down onto the 30s and 40s. The fast dives caused her to start bouncing again. She was not overdose because of the dosing we had done because we go up and down in small increments but the antibiotic decreased her insulin needs. I reduced her and now I am waiting...first for six cycles to be sure any bounce from low numbers has cleared and then a few more cycles to give her a chance to change course on a lower dose. I am not used to her being in high numbers and it's really, really tough. But I need to be sure she is flat again and not overdosed otherwise I risk her starting the dive/bounce again. Odds are 50/50 that this dose will work or it won't and I'll have to take her up. But it's a good example of patience....which I've had difficulty with :-D :-D

How does it apply to Reuben? We always want to be careful about reductions taken too close together especially when kitty pops right back up from low numbers. We don't want to stop his progress by giving too many back to back reductions resulting in you having to take him back up if he stalls. It's a fine line....and we look at a lot of factors on his SS and how he is doing because missing a reduction can also be dangerous as it allows the depot to get ahead of you. If that happens, you could end up fighting low numbers over a long period of time.

Lots to learn, I know. Please lt me know if this helps, makes sense, or if I've left you :shock: :shock: :-D
 
Hi Marje - Thank you so much for taking the time to help me understand what is going on with Reuben, and no I am not :shock: haha ....your explanations were very helpful. I`m sewing up a new pair of patience pants right now, and making them a little too big even so there`s room to grow into :lol: And now... I`m wondering if the high/low/high/low boinging can take on a life of its own... and also wondering if I should be trying not to let him go too low in order to help with that? I am now also thinking that he probably came down the night of the 16th, based on what he did the 2 subsequent cycles.

Thanks again Marge, I appreciate your help so much.

Alexa
 
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