9/9 River PMPS 157 +2:169 +3:185

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Picknickchick

Picknickchick

Member Since 2013
Yesterday

0 6:30 146 8.1 AMPS
0 6:45 3u Lantus
+1 115 6.4
+2 85 4.7
+3 70 3.9
+3.5 68 3.8
+4 67 3.7
+4.5 77 4.3
+5: 88 4.9
+6 97 5.4
+7 128 7.1
+8 149 8.3
+10 158 8.8


Fed:
AMPS Wellness @ +0.
+1 Wellness @ 7:45 and Pepcid. Flovent @8.
+2 Wellness @ 8:45.
+2.5 1 T. Wellness + 1 T. Fancy Feast HC with gravy (MC)
+3.5 1 T. MC
+4.5 Not feeding because BG came up
 
Re: 9/9 River AMPS 146 TOO LOW? PLS ADVISE!

I don't normally give dose advice, but I've been told if the pre-shot number is too low for you to be comfortable with, and you can't stay home to test, it is okay to reduce the dose or skip the shot. Good luck with whatever you decide.
 
Re: 9/9 River AMPS 146 TOO LOW? PLS ADVISE!

Another thing to consider is do you know if he's going up or down? Were you able to get a before pre-shot test? This has helped me a lot to get a test when I first get up so I'll know if Furball is going up or down before PS time and I have to go to work.
 
Re: 9/9 River AMPS 146

Thank you x 2 Carla! You're a dear! Actually, I gave him the insulin and will stay home. This isn't really an option, but I've been hoping to get him safely lower for such a long time that this is our chance. He's definitely going lower, as he's just off a bounce.
 
Re: 9/9 River AMPS 146 TOO LOW? PLS ADVISE!

You can stall without feeding River, and test again after 30 minutes to see whether he is dropping or rising or surfing along. I always recommend what Carla said to get a +11, so you can compare that number to the PS number and determine which way he is headed.
If you stall, then your next dose of insulin will be due 12 hours after you shoot this morning.
Besides skipping, you can also give a BCS (token) dose which would be whatever you feel comfortable with, like maybe 1.50, just so the depot doesn't drain too much. Skipping and BCSing will have an effect on the next couple of cycles.
 
Re: 9/9 River AMPS 146

Oh, I see we cross posted, and that you shot. If you don't have supplie, I would run out and get them now.
Have a good day, and maybe some nice greens :mrgreen:
 
Re: 9/9 River AMPS 146

Thank you, Dyana, this will be helpful for the next time this happens, and I can't be at home.
Not that I can today, actually! I have all my hypo gear loaded up.
 
Re: 9/9 River AMPS 146 +1:115 +2:85

Morning, Lara! It sounds like River changed your plans for the day. Good job on shooting the 146, it takes time to get comfortable with those lower shots. He is dropping fairly quickly - what is your usual feeding schedule with him? Have you fed him a bit more now? You might want to slow down that drop a bit. 85 is still a safe number but it's pretty early in the cycle. I'm just off to work but I'll check in later (an hour or so) to see how things are going.
 
Re: 9/9 River AMPS 146 +1:115 +2:85

Thanks for the advice, Amy. I'm not sure how much to slow him down. The last time he dropped, on Friday evening, I gave him HC too early. Afterwards, Liz remarked that this is only for when a cat goes below 49. So I have been feeding him LC Wellness every hour. He's had some at 6:45, his usual breakfast time, 7:45 and 8:45. I'm wondering if I should give him a bit of Orijen kibble or wait until 9:45. It would be great if you can check back in a bit. I'm not quite nail-biting yet :? I'd like to keep him in blues and greens as much as possible, and not overly carb him so he doesn't bounce too much. (Wouldn't we all...)
 
Re: 9/9 River AMPS 146 +1:115 +2:85

It's hard for me to know what to say on that one since Papaya is very NOT carb sensitive - the only way I've started to get decent numbers out of her in the last couple months is actually switching her to 8 or 9% carb all the time, with 14% and higher to feed her at the lower numbers to keep her surfing. So I reach for higher carb a lot sooner than everybody else.

Do you have a feel yet for how various carbs affect River in the short term? I wouldn't do the kibbles, dry seems to take longer to kick in and stays around longer, so gravy stuff gives you a bit more fine-tuned control. You might try mixing your high carb (not sure what % carb that is for you??) with the low carb Wellness to make medium carb, and feeding him a small portion of that, then testing in half an hour to see how much it bumped up his numbers? Also since it's early in the cycle it's still clear what you mean, but from here out you might want to also refer to feeding times as +1, +2 etc so it doesn't get confusing to different time zones (it's just my 8:00!).

OK I have to check Papaya who is off to a good start this morning too, and finish getting ready for work, but I'll be back online in about an hour.
 
Re: 9/9 River AMPS 146 +1:115 +2:85

I'll do a mix of LC+HC at 2.5; that sounds like a good idea.
That would be a teaspoon of Wellness with a teaspoon of Fancy Feast with gravy. Yum yum!

I hope Papaya has a great day today!
 
Re: 9/9 River AMPS 146 +1:115 +2:85

You're doing great, Amy, and so is River! HC + LC = MC, so I will be interested to see if that will level him off instead of sending him back up. :mrgreen: :mrgreen: :mrgreen:
Liz
 
Re: 9/9 River AMPS 146 +1:115 +2:85 +3:70

Thank you, Liz. It's now +3 and he's gone a bit lower, to 70. Still safe.
MC, I've never heard that before, perfect. I am hoping it makes him coast.
 
Re: 9/9 River AMPS 146 +1:115 +2:85 +3:70

I'll see how he's doing at +3.5, and give him some more MC if needed.
70 is a very nice compromise on his part: low enough for him to heal, and high enough for me not to stress out.
Should I let him get lower to see if he needs a dose reduction, or engineer him to stay around 70?
 
Re: 9/9 River AMPS 146 +1:115 +2:85 +3:70

Well, that's a good question, how to steer the numbers. If you give him a little MC and he stays pretty flat, then he's not ready for a reduction. On the other hand, if you're having to work pretty hard to keep him above 50, by giving HC, then it's better to let him get the reduction or even take a reduction if he's in the low 50s and getting HC. It's a fine line you have to walk.
Liz
 
Re: 9/9 River AMPS 146 +1:115 +2:85 +3:70

That's helpful, thank you. I want to be able to know if he's angling for a reduction.
 
Re: 9/9 River AMPS 146 +1:115 +2:85 +3:70

Good morning Lara,
Good job, and great numbers for River!
I hope he'll surf nicely from now.
 
Re: 9/9 River AMPS 146 +1:115 +2:85 +3:70

Looks like you're doing well! The MC slowed the drop nicely. I think your plan to check at +3.5 is a good one. If he's still really dropping, a bit more MC, if level maybe hold off on the food and check at +4 to see if he's decided to surf.

As to reductions - again I'm coming from a bit different perspective since Papaya is so erratic. With her, I want to see between 40 and 50 on three different days before I reduce to make sure the reduction sticks. Looking at River's spreadsheet, he's been quite high a lot lately. You haven't had many PS, at least in the AM, this low, so it's hard to know what he will do.

Even if you keep him a bit higher this time just to get information on how the food affects him, it won't be a forever-lost opportunity to get a reduction. I think it's Carl that often says when a cat wants a reduction they will make it pretty clear! See how it goes today but don't feel like you have to just stand by and watch so that you can score a reduction. Give him a bit of leeway, but look at today's cycle as a good way to gather some data on how his lower cycles go. If you keep him above 50 today, if he's really done with this dose he'll give you another lower cycle until you get the message.

You're doing great!
 
Re: 9/9 River AMPS 146 +1:115 +2:85 +3:70 +3.5:68

Looking good! No need to panic, Mr. Liver, Lara has everything under control. :mrgreen:
Liz
 
Re: 9/9 River AMPS 146 +1:115 +2:85 +3:70 +3.5:68 +4:67

Mariko, thank you for your kind wishes, and a very good day to you and Lucy and Ginger. I'll be visiting Lucy's condo to say hi.

Amy, thanks for this wisdom. At +4 he's gone down a tad, from 3.8 to 3.7, and we're not at the nadir yet. I'll see what's up at 4.5 and if I should give more MC.

I'm guessing that he'll bounce after this, so that gives me a day or so of not worrying. But then I go back to the office, and will fret if I think he's having another day like this and I'm not around to do food engineering. I'm assuming that if I weren't here, he would have already earned that reduction, so I'm wondering if I should shave the dose.

Liz, thank you for the encouragement. I am able to do this well this time only because of what I've learned from you the first two times. Now I do feel a sense of some control.
 
Re: 9/9 River AMPS 146 +1:115 +2:85 +3:70 +3.5:68 +4:67

That 70, 68 and 67 are all essentially the same number. Looking good! :mrgreen:
Liz
 
Re: 9/9 River AMPS 146 +1:115 +2:85 +3:70 +3.5:68 +4:67

Okey dokey, artichokey :lol:
So what do you think of a dose reduction?
 
Re: 9/9 River AMPS 146 +1:115 +2:85 +3:70 +3.5:68 +4:67

He's coasting along nicely now! On a usual work day, how much before you leave is shot time? I ask because if your feeding MC at (I think) +3 kept him surfing along this well, if you're usually home long enough to be there for the +3 before you leave, then you wouldn't have to worry as much when you go to the office. And you can leave food out for extra insurance (I always do that, and just decide whether it's LC or MC based on the numbers before I leave).

These are really good numbers; the kind of numbers you'd actually like to see every cycle, so don't feel like you should reduce even if it isn't earned just because you want to keep him higher than this. Like Anne Liz (sorry!) said, if the MC can keep him pretty flat then he's not needing a reduction yet. See what the rest of the cycle does!
 
Re: 9/9 River AMPS 146 +1:115 +2:85 +3:70 +3.5:68 +4:67

Thank you for taking the time for this, Amy. I really appreciate it.

His schedule is that his AMPS is at 6:30 AM, and he gets fed and his insulin. I test and feed a second breakfast at +2 and go to work.
I have a buncha other Hoover cats who would eat anything that isn't nailed down, so leaving food out for later wouldn't work.

So I am wondering if he should have a reduction, because I won't be around to prevent him from going lower, and I am pretty confident that he would have gone too low if I hadn't been here to feed.
 
Re: 9/9 River AMPS 146 +1:115 +2:85 +3:70 +3.5:68 +4:67

I really think it's a bit too early to talk reduction. Just see where the rest of the cycle goes for now.

Just for comparison - I test/feed/shoot Papaya at 4:30 AM so I can be home until +4 to know where the cycle's going, but that works because I get home at 4:30 as well and can shoot again then. Not good for sleeping, but I do less worrying when I leave because I already have a reasonable idea of how the day will go. It's definitely trickier with the other "Hoovers" roaming the ranch ;-) If you have to, on a lower cycle if you can't stay to monitor, is there a room where you could separate River and his food from the rest of the critters? I mean I know how much cats are offended by closed doors, but it might be one more way to keep him safe and still get to work.
 
Re: 9/9 River PMPS 157

Beautiful PMPS! It looks like you "surfed" him perfectly and avoided the bounce! Ha ha ha and you thought you'd have a couple cycles to relax ;-)
 
Re: 9/9 River PMPS 157

It looks like River had a great surf today. I'm glad you were able to stay home with him and see how it all went. You did great.
 
Re: 9/9 River PMPS 157

Thank you so much Carla, and I really appreciated you being there this morning. I'm glad I could stay home today too, but tomorrow I can't. So I hope there's a bit of a bounce coming.
 
Re: 9/9 River PMPS 157 +2:169

Awesome! :-D :-D :-D You might want to consider whether you want to follow Tight Regulation or Start Low Go Slow. In SLGS, you take reductions if BG goes under 90. In TR, it's a reduction if BG goes under 50. Here is the SLGS protocol. The TR protocol is in the sticky at the top of the Lantus forum. You are perfectly welcome to post here, even if following the SLGS protocol (like Carla does). The main thing is to keep River safe and for you to find a way to manage the testing and feeding and working. That darn work! :-x People here have lots of experience and ideas, I am always amazed at what great suggestions we get.
Liz
 
Re: 9/9 River PMPS 157 +2:169

I'll take a look at that, Liz, and consider it, thanks.
I know that Donaleen had similar concerns about her Ozy, so I'm going to pass this on.

From what you've seen here, does SLGS also have a good chance for remission? Because that's what I'd like to aim for.

This was a very good, flat (comparatively) day. If you look at the SS since I've been keeping records, it's always been pink and red. Today was a huge change.
 
Hi Lara

Very nice day for River today! Good job!!

One thing I want to clarify: if you get a number at PS that you don't feel safe shooting but is above 50, then you wouldn't normally reduce the dose. However, if you get a number below 50 at PS and you haven't just taken a reduction, then you would reduce the dose. That's for newly dx cats. Long term dx cats would be different.

However, at any time you feel the numbers are too worrisome for you and you want to keep home safe, you can reduce the dose.

SLGS used to be the only approach here and cats did go OTJ.
 
I'm getting a feeling I'm being urged to go to this other approach. Is this what's going on? Am I asking too many questions, or taking too long to learn?

I've been here for less than one month. I'm pretty new. Can I get used to things first?
 
You don't have to rush into switching to SLGS. I think people are just offering that to you to consider in case it fits better with your schedule. I chose the SLGS because I can't come home at lunch when I have to work to check on Furball. I have modified it some as to what number I take reductions with because Furball didn't hold reductions if they were below 90. You can make adjustments to either protocol so that it works with your schedule and you cat. As you learn more, you'll get an idea of what works best for River. Just keep asking questions and then you can make the best decision for you and River.
 
Thanks, Carla.

I joined here on August 20, so I have not been doing this for very long. I do test multiple times a day. It's true that Monday to Friday it's unlikely I will be able to be at home to test River's nadirs, however I see that this is the case for other people here who are following TR and go to work.

My cat is now starting to improve after many months of being very sick. I thought he was going to die. Now he is remarkably getting better.

Since August 20, I am seeing what he does with insulin if it is dosed correctly for him. He isn't yet regulated. People keep saying, "You know your cat", but actually I don't. I don't know him in these circumstances. That's why I keep asking for the advice of more experienced people, and I understand that they give me their best wisdom, but it still might not be applicable to my cat. However, it is better than what I was getting from my vet, which was not making him well.

I ask questions because I want to learn from his last bounce, last good day, last increase. If I understand I worry less. I analyze whether he would have gone under 50 and thus earned a reduction if I didn't feed him yesterday, and whether then after he gets off his bounce if he will indeed go under 50 because I won't be able to be here to feed him. This seems logical to me. I like to have a plan and some understanding rather than just be reactive.

I see people working with Donaleen to help her get the best from TR. I am assuming I'm being annoying or demanding by asking too many question here. I am really trying to be friendly to people who are friendly to me. I hope this isn't annoying, but I can certainly stop. Ultimately I am here to try to help my cat.
 
Lara, you are doing GREAT! I love it that you ask questions, never too many. We just want you to make the best choice for you and River. We all think that TR is best and sometimes (often?) get criticized for being to rigid about that. I do think TR is better for going into remission but it's really hard, lots of testing, being super careful about eating, meds, whatever. Whatever choice you make, we are behind you 100%. If you want TR, then TR it is. It's fabulous to read that River is feeling better and better. :-D :-D :-D That totally makes my day.
Liz
 
I've totally been with the program since Day 1. Go look at that ss, eh? :-D
My question yesterday was about a reduction, not that I'm questioning TR or thinking it isn't for River, etc.
 
Hi Lara! Don't EVER worry about asking all the questions. We all read other people's threads, and there are people who may be reading the board who aren't posting and haven't actually joined the board, so when you are discussing all the details a lot of people are learning from it. There's one member who doesn't always post every day now, Kelly and Tomcat, who was pretty new when she kept getting hit with crazy lows all the time. She had to ask a lot of detailed questions as she got used to shooting lower and lower, and her thread was amazing as everyone chipped in with their experience. I learned a lot from reading everyone's answers there.

I think SLGS just got mentioned yesterday, not because it seemed like you weren't doing what you need to for TR, but because sometimes when people get stressed about low numbers they need some reassurance that there are other options they can choose if they don't feel they can handle this. It's kind of like how vets don't suggest home testing even if they know it would be good, they're just afraid people will freak out and run! But you're right, a lot of people are doing TR without the luxury of being home all day - and the more you ask, the more you can learn their tips and tricks!

PS usually we try to start a condo every day, and only post in the one for today's date, otherwise it gets a bit confusing and some of the today's condos might get hard to find. Since there were already comments in this one for today I added to it . . . but it would be best if you could start one for 9/10 and continue the discussion there. And KEEP ASKING QUESTIONS :-D
 
Lara

Let me be clear....you asked about SLGS and whether it had a chance for remission. I was just responding to that.

I think the best chance for remission is TR and I'm not pushing you towards SLGS. I'm just trying to support you in what you feel is the best approach for you and River.

You are not being annoying by asking questions. We are here to help. I just got some feel from your post that you were interested in SLGS.

The advice I gave you to not reduce is based on TR. if you want to continue TR, I am thrilled! But we also want you to be comfortable and what I didn't want to happen is that you felt pressured into TR if you really wanted to do SLGS.

Sorry for the misunderstanding. ;-).
 
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