9/27 Max AMPS 203 +3 242 +5 85 +6 63 + 7 87 +9 110 PMPS 244 +3 416 +5 429

Max & Lori

Member Since 2021
Yesterday https://felinediabetes.com/FDMB/thr...-180-pmps-222-2-173-3-137-4-110-5-100.268902/
We increased Max’s dose this morning to 5.75 units. Maybe he saw green last night but not tested. He had an early onset so we fed small amounts of LC until he flattened out. If he did get to green, I’d like to think he surfed in some safe numbers since he was flattening out right before bedtime. Now we wait for whatever comes next.
 
First day on this dose increase and it took him to 63. He came back up with some MC. Does that mean we have to go back to 5.5 units or should he stick with 5.75 a little longer? His reduction point is below 70, but he’s not having any SRT action lately that I know of. I wish! He sure had a nice day.
 
Glad to see you shot the 5.75U ;)

I think before we had discussed two different reduction points? 70 being the reduction point when it looks like you're getting SRT/IAA action, but 50 otherwise?
 
I hate these high bounces so much!!! I’ve been reading other condos still trying to learn. I’ve been in this over a year and trying to absorb as much knowledge as I can. Sometimes I get it and other times, I feel so inadequate. I don’t think I’m doing all that I can because I still don’t know the answers to so many things. I feel that I should by now. I’m sorry but this is upsetting me so much. My poor boy. Why is it that some cats use R in addition to their long acting insulin? Is that appropriate to use with bouncing into these high numbers like Max does? I don’t see how he will ever get used to green numbers. He just continues on this same cycle even this far out in his diagnosis. I cannot understand it.
 
Truthfully there's not much more you can do, that's what makes it so frustrating. He takes quite the dives sometimes, and it's not always predictable enough to stay ahead of. The bounce after that dive today is expected, just sucks there's nothing you can do really once it hits. I'm sure @Lisa & Oberon feels your pain as well, and @Jodey&Eddie&Blue lately too

R tends to be used in ketone/DKA prone cats, it's really a better question for @Wendy&Neko . Im not sure it's the answer for you and Max though... I don't mean this any particular way, but it's a whole 'nother insulin to learn with different rules, different trends. With as dramatic as he can be, one wrong decision can get you into deep water, fast.

Does he act any differently during these dives? Like after +3, he didn't seek out food or anything?
 
Truthfully there's not much more you can do, that's what makes it so frustrating. He takes quite the dives sometimes, and it's not always predictable enough to stay ahead of. The bounce after that dive today is expected, just sucks there's nothing you can do really once it hits. I'm sure @Lisa & Oberon feels your pain as well, and @Jodey&Eddie&Blue lately too

R tends to be used in ketone/DKA prone cats, it's really a better question for @Wendy&Neko . Im not sure it's the answer for you and Max though... I don't mean this any particular way, but it's a whole 'nother insulin to learn with different rules, different trends. With as dramatic as he can be, one wrong decision can get you into deep water, fast.

Does he act any differently during these dives? Like after +3, he didn't seek out food or anything?

He does act differently sometimes by looking for food, but not always. I’m on it as far as testing him often and feeding when needed him trying him flat. I’ve never considered R before but he has had DKA and I nearly lost him the summer after he was diagnosed. I think that’s why I get so darn upset when he spikes so high. He looks awful when he’s that high too. I know you guys have told me several times that I’m doing everything I can. It’s incredibly difficult for me to be in a situation where I cannot to anything to make it better. I am having a really hard time right now. I saw that someone else is using R for their cat. I realize because Max has had SRT that he is different and I am definitely not experienced enough to add R. I would be willing to learn if we thought it would help him though. I certainly wouldn’t want to cause him any harm. Thanks for your comments.
 
Truthfully there's not much more you can do, that's what makes it so frustrating. He takes quite the dives sometimes, and it's not always predictable enough to stay ahead of. The bounce after that dive today is expected, just sucks there's nothing you can do really once it hits. I'm sure @Lisa & Oberon feels your pain as well, and @Jodey&Eddie&Blue lately too

R tends to be used in ketone/DKA prone cats, it's really a better question for @Wendy&Neko . Im not sure it's the answer for you and Max though... I don't mean this any particular way, but it's a whole 'nother insulin to learn with different rules, different trends. With as dramatic as he can be, one wrong decision can get you into deep water, fast.

Does he act any differently during these dives? Like after +3, he didn't seek out food or anything?

I definitely agree; these bouncy cats are really frustrating! It's been over two years for us with no sign of the bounces settling down. The only thing that helped was switching from Lantus to Levemir- the bounces are still there, but everything happens a little more slowly, so we don't seem to have to worry about him going from 350 to 50 in the space of six hours. But he definitely still bounces. I initially used R early on when Oberon was dealing with ketones (no DKA, luckily) and we were still working towards an effective Lantus dose. I've just started using it again for the first time in about 9 months to try to keep him from getting stuck in high numbers. Seems like when he's up for a while resistance builds up and we have to ramp the Lev dose up to a breakthrough dose, then go right back down again. So we're toggling back and forth between about 5 and 7 U. R might help us with that so we can get through the resistance without upping the Lev as much. We'll see how that works out. I don't know whether R would be helpful for your situation, though. Hang in there!
 
I'd be mulling over R if he were my cat as well, you just have to balance what makes sense for you guys. No judgement from me, ever!

You have the ketone meter, I take a lot of comfort in having one as well. He's well past the DKA, he's had low (basically no existent) ketones, try not to worry to much :bighug: I know it sucks when they don't feel well and there's not much else we can do
 
Why is it that some cats use R in addition to their long acting insulin? Is that appropriate to use with bouncing into these high numbers like Max does?
The main reasons we suggest R initially are two. One is for ketone prone cats that need to get as much insulin into them as quickly as safely possible. The other is for cats with high dose conditions. Similar reason, also a way to get more insulin into the cat before they get to a good dose. Also some caregivers or high dose cats max out on how much L insulin they can afford, so R is a cheaper way to supplement and get a higher dose. The other bonus for higher dose cats is that if their insulin needs suddenly drop, and you are giving R, the depot from the L will be lower so less of a pain when the dose goes down. I started using R a couple years after Neko's first SRT, when her insulin needs were shooting up. With Oberon, he had a pretty high IAA number, so the resistance can be strong!

We don't suggest R for helping with bounces, though once you become skilled at R, you can use it for that as well. The other side benefit for a skilled R user is if you skip/fur shot, you can ease the damage. The down side to using R for helping with bounces, is that if not used correctly, you can cause even more bouncing and make it worse.
 
I definitely agree; these bouncy cats are really frustrating! It's been over two years for us with no sign of the bounces settling down. The only thing that helped was switching from Lantus to Levemir- the bounces are still there, but everything happens a little more slowly, so we don't seem to have to worry about him going from 350 to 50 in the space of six hours. But he definitely still bounces. I initially used R early on when Oberon was dealing with ketones (no DKA, luckily) and we were still working towards an effective Lantus dose. I've just started using it again for the first time in about 9 months to try to keep him from getting stuck in high numbers. Seems like when he's up for a while resistance builds up and we have to ramp the Lev dose up to a breakthrough dose, then go right back down again. So we're toggling back and forth between about 5 and 7 U. R might help us with that so we can get through the resistance without upping the Lev as much. We'll see how that works out. I don't know whether R would be helpful for your situation, though. Hang in there!

Thanks Lisa. I’ve been following you and Oberon’s journey and think you’re doing a fantastic job. I’ve learned a lot from reading your condos. It’s so hard with unpredictable cats. Good luck with everything, and thank you.
 
By the way, I meant to add that your decision to hold the dose is probably going to help his bouncing. There may be some short term pain as he sees green, but hopefully he'll start to see them more often. And then bounce less.
 
The main reasons we suggest R initially are two. One is for ketone prone cats that need to get as much insulin into them as quickly as safely possible. The other is for cats with high dose conditions. Similar reason, also a way to get more insulin into the cat before they get to a good dose. Also some caregivers or high dose cats max out on how much L insulin they can afford, so R is a cheaper way to supplement and get a higher dose. The other bonus for higher dose cats is that if their insulin needs suddenly drop, and you are giving R, the depot from the L will be lower so less of a pain when the dose goes down. I started using R a couple years after Neko's first SRT, when her insulin needs were shooting up. With Oberon, he had a pretty high IAA number, so the resistance can be strong!

We don't suggest R for helping with bounces, though once you become skilled at R, you can use it for that as well. The other side benefit for a skilled R user is if you skip/fur shot, you can ease the damage. The down side to using R for helping with bounces, is that if not used correctly, you can cause even more bouncing and make it worse.

So with Max, would using R be a good idea to implement? I have zero experience with it and would have to have a lot of help, but I am willing to learn. I have no idea if we should just keep waiting to see if we get more action from SRT before doing something like that or not. He’s not quite one year out but close.
 
By the way, I meant to add that your decision to hold the dose is probably going to help his bouncing. There may be some short term pain as he sees green, but hopefully he'll start to see them more often. And then bounce less.
I thought about that too and decided he just has to keep going until he sees more green. It just kills me to see him with these bounces though.
 
I hate these high bounces so much!!! I’ve been reading other condos still trying to learn. I’ve been in this over a year and trying to absorb as much knowledge as I can. Sometimes I get it and other times, I feel so inadequate. I don’t think I’m doing all that I can because I still don’t know the answers to so many things. I feel that I should by now. I’m sorry but this is upsetting me so much. My poor boy. Why is it that some cats use R in addition to their long acting insulin? Is that appropriate to use with bouncing into these high numbers like Max does? I don’t see how he will ever get used to green numbers. He just continues on this same cycle even this far out in his diagnosis. I cannot understand it.
OMG, do I ever hear you. We've yet to be in the blue zone for any significant time. At times I think, yes, we're on it and then, other times, I just don't know. It's acromegaly. I hate it. I live with Eddie and Blue, brothers. They both have it. I know what you're going through. Right now Eddie's at 20u Levemir. 20u.
 
OMG, do I ever hear you. We've yet to be in the blue zone for any significant time. At times I think, yes, we're on it and then, other times, I just don't know. It's acromegaly. I hate it. I live with Eddie and Blue, brothers. They both have it. I know what you're going through. Right now Eddie's at 20u Levemir. 20u.

I don’t know how you do it with both having acromegaly. I’ve followed your posts too. I know you’ve been through a lot with them. I hate acromegaly too. It really takes its toll on these precious, sweet cats, which leads to our own emotional pain. I understand when you say at times you have it under control and others not. It’s very frustrating. After a while, it really gets to us. Sometimes I feel like I’m losing my mind! I hope Eddie gets to a good dose soon and that Blue continues improving too. They have to be tougher than we think to go through all that they have. At least we can come here to be educated and get emotional support, right? Hugs to you Jodey.
 
I don’t know how you do it with both having acromegaly. I’ve followed your posts too. I know you’ve been through a lot with them. I hate acromegaly too. It really takes its toll on these precious, sweet cats, which leads to our own emotional pain. I understand when you say at times you have it under control and others not. It’s very frustrating. After a while, it really gets to us. Sometimes I feel like I’m losing my mind! I hope Eddie gets to a good dose soon and that Blue continues improving too. They have to be tougher than we think to go through all that they have. At least we can come here to be educated and get emotional support, right? Hugs to you Jodey.

Lori, it's such a balancing act when there's the kind of attention that's needed for their care and other obligations, like work, groceries, you name it....I so understand that feeling of becoming a bit unhinged and it usually is associated with interrupted sleep and alarm setting especially when that's followed by high, high numbers. Some days I feel like Ok, we can do this. Other days I worry about losing them to this awful condition. These days I get excited for Eddie when I see an AMPS in the 200s. Still trying to get a handle on Blue's numbers but his situation is not as challenging as Eddie's, at least not now.
Hugs right back to you and Max, Lori. Thanks for your message. :bighug::bighug::bighug:
 
Lori, it's such a balancing act when there's the kind of attention that's needed for their care and other obligations, like work, groceries, you name it....I so understand that feeling of becoming a bit unhinged and it usually is associated with interrupted sleep and alarm setting especially when that's followed by high, high numbers. Some days I feel like Ok, we can do this. Other days I worry about losing them to this awful condition. These days I get excited for Eddie when I see an AMPS in the 200s. Still trying to get a handle on Blue's numbers but his situation is not as challenging as Eddie's, at least not now.
Hugs right back to you and Max, Lori. Thanks for your message. :bighug::bighug::bighug:

Same here. I completely understand.:bighug:
 
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