? 9/6 Chloe AMPS 322, +4 328

MaryB

MaryB

Member Since 2022
It’s been a while since I posted… Chloe’s numbers were coming down pretty well over the last month, less pink… mostly yellow and even several high blues. We are up to 3 units now and I’m still not seeing her numbers get significantly better. Her spreadsheet is up to date. her diet hasn’t changed: she eats 2-3 can of pate FF daily with some freeze dried chicken or beef for snacks. Her weight is pretty stable 13-13.5 lbs.

Please does anyone have any suggestion or advice to offer? Is this normal and I’m just overthinking?
 
Hi Mary
Are you still following TR ? (That's what it says on the ss)

On TR you would normally be reassessing rhe dose every 6 cycles, looking at the SS you've maybe been holding onto doses that are not getting Chloe down I to those green nadirs.

It does look as though when needs more insulin, but having said that, for about the last week you've not got any tests in the earlier half of the pm cycle, so that always leaves me wondering if you may have missed something.

On balance it doesn't look like you have, she looks pretty flat and high in those yellows and pinks today.

Secondly, you do need to be more aggressive with the dosing to get her back into regulation, the best way to do that isafely s to follow TR closely and take those increases if those nadirs aren't in that 50to 80 range.

So yes I would take the dose up to 3.25u maybe tomorrow morning if thats better for you to monitor.
I would also encourage you, if at all possible, to grab a just before bed test, so you can take the dose up more confidently from now on.
Keep those +10 and +12 they're super useful too.
 
Gill & George said:
Hi Mary
Are you still following TR ? (That's what it says on the ss)

On TR you would normally be reassessing rhe dose every 6 cycles, looking at the SS you've maybe been holding onto doses that are not getting Chloe down I to those green nadirs.

It does look as though when needs more insulin, but having said that, for about the last week you've not got any tests in the earlier half of the pm cycle, so that always leaves me wondering if you may have missed something.

On balance it doesn't look like you have, she looks pretty flat and high in those yellows and pinks today.

Secondly, you do need to be more aggressive with the dosing to get her back into regulation, the best way to do that isafely s to follow TR closely and take those increases if those nadirs aren't in that 50to 80 range.

So yes I would take the dose up to 3.25u maybe tomorrow morning if thats better for you to monitor.
I would also encourage you, if at all possible, to grab a just before bed test, so you can take the dose up more confidently from now on.
Keep those +10 and +12 they're super useful too.
Click to expand...

Hi hello! Thank you for the advice. Yes I’m still trying to do TR. I started school the last week of august in the evening so I think that’s why I have been missing the previously PM +3 check. I’ll set an alarm for myself to stop and do it.

when you say increase “ if those nadirs aren't in that 50to 80 range “ … can you possibly explain that further, as far as what it means? I understand nadir means the lowest of the cycle right? So do you mean if it hasn’t dropped 50-80 points from the last check then to increase the dose? o_O

sorry for confusion! Thanks again for your help.:bighug:
 
MaryB said:
Hi hello! Thank you for the advice. Yes I’m still trying to do TR. I started school the last week of august in the evening so I think that’s why I have been missing the previously PM +3 check. I’ll set an alarm for myself to stop and do it.

when you say increase “ if those nadirs aren't in that 50to 80 range “ … can you possibly explain that further, as far as what it means? I understand nadir means the lowest of the cycle right? So do you mean if it hasn’t dropped 50-80 points from the last check then to increase the dose? o_O

sorry for confusion! Thanks again for your help.:bighug:
Click to expand...

Let me tag @Gill & George for you, she can prib probably explain it better than I can
Thank you Gill
 
MaryB said:
Thanks @Diane Tyler's Mom ;)
I am trying my best to do that. I just don’t understand why it’s not better with 3 units. Seems like so much :nailbiting:
I appreciate your help!!
Click to expand...
I suspect that a little glucose toxicity has set it in, you may need to gone bit higher before you start to see a breakthrough.

Holding onto a dose that isn't getting the bg where it needs to be is counter productive and allows this to happen.
From the sticky on tr
Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
MaryB said:
when you say increase “ if those nadirs aren't in that 50to 80 range “ … can you possibly explain that further, as far as what it means? I understand nadir means the lowest of the cycle right? So do you mean if it hasn’t dropped 50-80 points from the last check then to increase the dose? o_O
Click to expand...
With TR we add aiming g to get kitty into the BG range of a healthy cat that's 50-80, so we are aiming to have them go that low on a regular basis. Everything we change a dose we ask ourselves, is this dose getting my cat into that range?

The answer to that question guides us on our dosing decision. If the dose is getting to green some cycles we will hold onto that dose. If it isn't we will take the dose up.

Chloe is above 200 for some time and hasn't seen green since 8/6. So that probably answers your question.

You also took her down with a 53? Was that an AT or the relion?

If it was a human meter she didn't earn that reduction either. As a relapse kitty you do need to be strict about those reductions, if you want to get back to regulation.

Don't get hung up about a dose, she needs what she needs.:bighug:
 
When following TR, the reduction point for a pet meter is 68 vs 40 ( because Chloe is a long term diabetic) with a human meter.
@Gill & George
Sorry to tag you again I just want to be sure this is correct
Thank you Gill
 
Gill & George said:
I suspect that a little glucose toxicity has set it in, you may need to gone bit higher before you start to see a breakthrough.

Holding onto a dose that isn't getting the bg where it needs to be is counter productive and allows this to happen.
From the sticky on tr
Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.

With TR we add aiming g to get kitty into the BG range of a healthy cat that's 50-80, so we are aiming to have them go that low on a regular basis. Everything we change a dose we ask ourselves, is this dose getting my cat into that range?

The answer to that question guides us on our dosing decision. If the dose is getting to green some cycles we will hold onto that dose. If it isn't we will take the dose up.

Chloe is above 200 for some time and hasn't seen green since 8/6. So that probably answers your question.

You also took her down with a 53? Was that an AT or the relion?

If it was a human meter she didn't earn that reduction either. As a relapse kitty you do need to be strict about those reductions, if you want to get back to regulation.

Don't get hung up about a dose, she needs what she needs.:bighug:
Click to expand...

Thanks so very much for this detailed explanation! I understand! No idea that 53 wasn’t considered low, that’s my fault. I decreased it bc I was scared it was low. I only use the Relion meter.
I saved these instructions to my phone and also writing them down on a post it note for the kitchen. I appreciate you taking time to explain and we will be increasing tonight!
 
tiffmaxee said:
You want to see lots of blue and green on your ss. You are t getting that on 3 units. That’s why an increase is needed.
Click to expand...
Thanks so much. I thought 3 units was so high, but if it’s not working, it’s time to increase. I have high hopes of a 2nd remission so I have to get better about the strict control.
 
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