9/27 Apollo PMPS 216, +2 197, +4 125, +5 114, +6 131

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Re: 9/27 Apollo AMPS 448

Good morning John! I watched your condo last night and was glad that you went with the full dose. Apollo's body is just getting used to going into the lower numbers and his liver is over reacting. That is completely normal and will even out as he gets used to being lower again and his liver chills out. It is very gut wrenching and nerve wracking the first few times but it will get easier. You did a great job and handled it all really well.

Come on Apollo! Come on down to the pinks and yellows. You know those are soooo much better now! Hope he doesn't sky dive on you today and just slowly comes down into more reasonable numbers.

Hang in there! You are doing great!
 
Re: 9/27 Apollo AMPS 448

This is the time that requires patience. It can take up to 72 hours for the bounce to clear. Just stick with your current dose no matter how much you think you should increase.
 
Re: 9/27 Apollo AMPS 448

I was watching you guys yesterday with excitement! You handled yourself and Apollo very well!

Here is my two cents: ENJOY your rest while this bounce clears - it will take time and the numbers will be higher than you'd like to see. Apollo reacted very quickly to this insulin, which as Jill referenced last night, means you will very likely have some very active days ahead.
 
Re: 9/27 Apollo AMPS 448

Thanks for all the encouragement. I'm pretty tired this morning, but hanging in there. Yesterday was an emotional roller coaster that's for sure.
 
Re: 9/27 Apollo AMPS 448

Yes, I will second what Melissa and Jessica said. You and Apollo can get a break from the poke fest (still testing to make sure he's not on the express train) but it could take up to 3 days for him to see lower numbers again. Gives you a chance to recover too. :smile: Good work!
Liz
 
Re: 9/27 Apollo AMPS 448, +6 190

Apollo's +6 was 190.

I may need some help. Do these numbers look to be expected? Just want to be sure. :smile:
 
Re: 9/27 Apollo AMPS 448, +6 190

Very nice! I would keep my eye on him. It looks like he is doing what he did yesterday. Hopefully Jill, Sienne, or Libby will be along, but if not it will be the same as yesterday if he goes lower (100 or so). Test, Feed, Repeat (Wash, Rinse, Repeat). Of course you are an old pro by now right? :lol: He is really responding to the insulin. His liver just needs to calm down so he doesn't bounce high, but that will come in time as well.
 
Re: 9/27 Apollo AMPS 448, +6 190, +7 180

After the +7 test, I gave him a little food with a few drops of syrup in just to help keep him from going low too fast. Hope this was the right move?
 
Re: 9/27 Apollo AMPS 448, +6 190, +7 180

You didn't need to give him any syrup. He didn't drop that drastically and was pretty even from +6 to +7. You really want him in those numbers or even a little lower. When Jill had you use syrup yesterday, it was because it was a big drop down to 96 I believe. She didn't want him going down any more than that since you didn't have a lot of data. We only pull out the syrup when they are dropping fast. No harm no foul. Expect his numbers to come up a little. In the future, just let him do his thing if it stays that even and above about 100.
 
Re: 9/27 Apollo AMPS 448, +6 190, +7 180

Melissa & Tarragon said:
You didn't need to give him any syrup. He didn't drop that drastically and was pretty even from +6 to +7. You really want him in those numbers or even a little lower. When Jill had you use syrup yesterday, it was because it was a big drop down to 96 I believe. She didn't want him going down any more than that since you didn't have a lot of data. We only pull out the syrup when they are dropping fast. No harm no foul. Expect his numbers to come up a little. In the future, just let him do his thing if it stays that even and above about 100.
Click to expand...

Woops. I wasn't sure since he was at AMPS 448 this morning and now at +7 180, so a 268 point drop, and yesterday he was at AMPS 401 and down to +7.5 95 or a 306 point drop. I thought we wanted to avoid such big quick drops to avoid a rebound?
 
Re: 9/27 Apollo AMPS 448, +6 190, +7 180

It wasn't necessarily the large drop that was the issue yesterday. It was the below 100 number. Since you are pretty new to Lantus, I think Jill just didn't want him going much lower because there wasn't enough data to know how Apollo was going to react to the lower numbers and keep dropping rapidly. The AMPS number yesterday and today was probably rebound numbers based off of the lower numbers the day before. So, today's AMPS of 448 was due to the greens yesterday. When BG numbers drop down into a range that the cat is not used to, the liver reacts by dumping glucose and hormones into the blood which spikes the BG back up. Apollo's body (mainly liver) needs to get used to those lower numbers and then he will stop bouncing so much. It just takes time. You will see the bouncing for awhile.

We have been doing this for 7 months and still bounce anytime Tarragon gets lower than what is "normal" for him right now. The "normal" for Apollo has been HI so his body needs to adjust and find a new "normal" with the insulin. Does that make sense? It is very confusing, but it will suddenly click all at once. I had no clue what any of it meant and then one day had an ah-hah moment.
 
Re: 9/27 Apollo AMPS 448, +6 190, +7 180, PMPS 216

Just did PMPS and he is at 216. Note that PMPS is about 30 mins early as we want to move his shot time to a more convenient time. Is it ok to do his 2.5 even though he is at 216? Just wanted to be sure.

Also I have noticed last few days Apollo seems be feeling better, coming out more, more expressive, etc. :smile:
 
Re: 9/27 Apollo AMPS 448, +6 190, +7 180, PMPS 216

2.5 should be fine. How about a test at +2, just to be sure you catch it if Apollo has anything interesting planned for tonight.

I love hearing that he feels good!
 
Re: 9/27 Apollo AMPS 448, +6 190, +7 180, PMPS 216

Ok will do. Thanks!

Btw what's the minimum AMPS or PMPS number I should watch out for to NOT give him his full dose? Like if he is below such and such number then don't give him his full dose? I'm trying to learn more so I don't have to run here for advice every time I see a lower AMPS or PMPS number then before.

Thanks.
 
Re: 9/27 Apollo AMPS 448, +6 190, +7 180, PMPS 216

Hi John,

I don't have advice for you, just wanted to say how awesome it is to Apollo doing so well :-D
And you too :-D

Hope you both have a good night.
 
Re: 9/27 Apollo AMPS 448, +6 190, +7 180, PMPS 216

Hurray Apollo! You're already seeing some great numbers!!' :mrgreen:
 
Re: 9/27 Apollo AMPS 448, +6 190, +7 180, PMPS 216, +2 197

Good job thru ALL this John! I KNOW how scary that ride is when they start getting lower than WE are used to - scarz us beanz....
 
Re: 9/27 Apollo AMPS 448, +6 190, +7 180, PMPS 216, +2 197

Nice numbers Apollo...great start on your sugar dance. Kudos to you and John! :mrgreen:
 
Re: 9/27 Apollo AMPS 448, +6 190, +7 180, PMPS 216, +2 197

John, I have no dosing advice and just want to say YAY! You and Apollo are amazing and doing a fine job. You are on a fast track to better control and scary as it seems, it is a very good thing. I am sure someone will be along to advise you about PS numbers. I do know that the more data you have the better it will be for those who do the advising.

Believe me, these lower numbers are very important and I believe you are seeing the fruits of that now. So glad he is feeling better. I can attest to how crappy it feels to have high BS. I can't imagine what a little kitty must feel like but I know it is not good for them.

You are a fast learner so this will be much easier in a few weeks when you have the patterns down and know how Apollo responds to his dose. Eventually you will see regulation and a much happier kitty and bean.
 
Re: 9/27 Apollo AMPS 448, +6 190, +7 180, PMPS 216, +2 197

Thanks to everyone for all your support and kind words. Apollo and I greatly appreciate it.

Dumb question: If a cat's blood sugar goes down too low are they able to "sense" that and go eat on their own if food was available to bring it up? Sort of like how diabetic people feel when they are low and needing to eat. Now I realize cats can only do so much for themselves, but I was just wondering if they had a natural sense to eat when low? Anyone know? I was just curious.
 
Re: 9/27 Apollo AMPS 448, +6 190, +7 180, PMPS 216, +2 197

My sense of it is that some cats do, but some cats don't. You may learn over time whether Apollo tends to "feed" his lows.

The caveat is that if numbers are dropping too quickly, the dive needs to be managed actively, with testing and feeding.

But others jump in!

So glad to see you and Apollo do so well!
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125

Just did his PMPS +4 and he is at 125. Can I feel safe going to bed now? I'm just still trying to get comfortable seeing these low numbers and don't quite know what numbers are safe at which point in the curve yet.
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125

Hi John, I'm a bit of a newbie so I don't feel comfortable giving advice. Maybe you could edit the subject line to put "help" so someone with more experience will take a look. That is a pretty good drop so you will want to pay attention.
Liz
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125, help

I agree with Anne. You don't have quite enough data yet, and that IS a big drop. Ideally, you'd like to see him start to surf. Can you test again now? Has he eaten?
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125, help

Yes I can test again. Yes he ate earlier before PMPS about 75% of 3oz of Fancy Feast Classic Chicken. He has also been grazing since then.

Should I give him some food with syrup or not just yet?
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125, help

No, you don't need to give him gravy. 125 is a nice number in itself, not dangerous. It's where he's headed that we're looking at.

I asked whether he had eaten because we want to know how much food there is fueling that +4. Test first, no food.
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125, +5 114 help

Ok his +5 has him at 114.

Like I said he usually eats a his biggest meal before shot and then grazes for next several hours.
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125, +5 114 help

My computer just crashed. I'm back.

Can you stay up a bit longer? Looks like the drop is slowing, which is great. He hasn't reached nadir yet. Usually that's around +6. I would probably want to get one more test. What do you think?
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125, +5 114 help

Sure I can do that. Why do the scary drops always happen during the night? Not fun.
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125, +5 114 help

Also thinking that you gave the shot half an hour early. That does have an impact, almost like a little increase, because the insulin stays in the system. I would get the +6. If he is still above 100, I think you could feed him and go to bed.

Sometimes I used to drizzle a little gravy on Kitty's low-carb food. It makes it "medium carb."
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125, +5 114 help

They have a sense for when we want to go to bed, don't they?! When you have more data, and his liver is more used to lower numbers, it will get easier.
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125, +5 114 help

About 45 minutes, 2:15am EST. Actually I only ended up giving him his shot 15 minutes early. I fed him, then waited a bit longer as I thought maybe 30 minutes was too much time to change at once.
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125, +5 114 help

That was smart not to move it up more than 15 minutes, which is considered not significant.

I think you could test him now.

I don't want to leave you, but I don't think I'll make it. How do you feel about handling this? The plus 5 seems to say he has stopped a rapid decline.
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125, +5 114 help

I think if I were you, I'd get the +5 1/2. If he's above 100, feed him - put the plate in front of his face if necessary, with maybe a drizzle of gravy. Medium carb should be okay.

How does that sound to you?
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125, +5 114 help

15 minutes early or late is just fine. shouldn't affect his numbers. i think you're just seeing apollo doing better overall on the lantus.

you're doing great john! it gets easier. after you've gathered a little more data you'll know what to expect from apollo and when it's safe to go to bed and when you have to stay up and test. often people will set a cell phone alarm and sleep in between tests.

one of the things i've learned is that just because they'll drop from 400 to 200 on a dose doesn't mean they'll drop from 300 to 100 on the same dose. as their bodies get used to the lantus, it flattens out the curve, so the same dose on a lower number won't drop it as much.

hope you get some sleep tonight!
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125, +5 114 help

kathy, do you mean if he's below 100 to feed him gravy & med carb? you don't mean above, do you?
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125, +5 114 help

I did mean that, but I should have continued.

If he's above 100, then I think he's surfing. I would give him a snack, and I probably would add a drizzle just for my comfort. It isn't necessary. But I think a snack helps ensure the surf.

If Apollo were BELOW 100, I would say lather rinse repeat, and do another test to make sure he isn't still dropping.

This may be an excess of caution on my part. I'm The Worrier. I think Apollo will be fine, and John, you could probably give him a snack now and go to bed, after that +5. For my own comfort, I'd want one more test to be sure.
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125, +5 114 help

I will do a +6 just to feel more comfortable. I am mentally and physically exhausted. Thank god I work from home.
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125, +5 114 help

I do think he is doing better on the Lantus too. He just seems to be feeling better. How will I know when he needs a dose reduction? Just curious.
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125, +5 114 help

While you're waiting :-D you can read this sticky. There are specific guidelines for holding and changing the dose.

I am signing out. I think you are doing a fantastic job. Apollo is responding so well, even though these early days are hard on you.

You can test again any time, and if he's not really dropping (and I think he will be fine), give him a snack and get some sleep. The snack is for comfort, just to support the surf.

Good night. Well done!
 
Re: 9/27 Apollo PMPS 216, +2 197, +4 125, +5 114 help

here's the link to the protocol. Tight Regulation Protocol

You're going to hold this dose for 5-7 days unless apollo goes below 50. every time he goes below 50 that's going to trigger a dose reduction. you're likely not going to be doing a dose reduction real soon, but you never know.

"General" Guidelines:
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Click to expand...
 
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