Any comments on Alex?

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Ginny & Alex

Ginny & Alex

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I haven't posted in a few days, so thought I would ask for some of you to take a look. I kind of sailed through the 1.8 dosage, since my middle-aged eyes can't accurately differentiate between 1.7 and 1.8. We're dosing at 2.0 units now and I guess I think I should stay here for a few days, but where are the blue numbers? confused_cat
 
I know we can be real nags, but any way you can get a number close to nadir in the day or night cycle? You have okay pre shot numbers in the 200s. If he is going down to the 100s at nadir, he is doing pretty well. I think I would find out how low he is going and if he is in the 100 range, stay with it a few more cycles before you increase. If he is flat in the 200s the whole cycle, then you could increase by .25?
 
Sue, I would hardly call any of you nags, especially not when you're giving me valuable advice :smile:

I will certainly try to get a +6--maybe day and night--in the next day or so.
 
Mid cycle tests would be good to see if he is getting a good nadir or is running flat.

It looks like he likes the 2u with those yellow AMPS's.
 
Yay, lovely to see better #s! I agree you need at least a nadir-ish spot check before you can decide if a dose change is in order. You can't judge by the 1st cycle or 2nd cycle on a dose in many cases. If you can get in a +6 or so spot check at the nadir is above 120, I would go up another .2 on the dose.
 
Well, I got some mid-cycle numbers today, but apparently, Alex doesn't like curves. I am inclined to stay with this dose a bit longer though, as it seems it sometimes takes a while for him to settle in.
 
Interesting almost no rise to the PMPS. That's a good sign I think! I'd still raise the dose. When they sit in higher #s they adjust to the dose and then you often need more insulin to get anywhere. I'd capitalize on the progress and go ahead up to 2.2. Just my 2c :-D
 
We had discussed increasing Alex's dosage to 2.2, and since I work from home on Fridays, I decided to wait until today to give the increased dose. But can anybody give a reasonable explanation for this? Yesterday, at PMPS, he was 222 (the second lowest ever at that time) and this morning he was 388. His appetite was a little off yesterday, but other than that, everything else was the same.

I went ahead and shot 2.2 this morning, but wonder if that was the right thing to do.
 
I am in no way an expert and hate to give advice
but it sounds like he had a little bounce yesterday
If you shot the same dosage into his 222 he might ahve gone to low and bounced back up
(I know this cause I did this to Shakes yesterday!!)

Since he was at 388 this morning I think its ok to shoot the 2.2 but if he has anouther222
I dont think I would shoot the same

BUT please wait for someone more experienced to answer!
HAve a great day and keep us posted!

Denise and Shakes
 
Could have been a bit of a bounce. Keep hoping we will see some lower numbers mid cycle - maybe today. I think your 2.2 should be fine. We would really like him to move down a little in numbers.
 
Good you'll be able to get some mid cycle tests today. It will be nice to see what Alex is doing during the day.

This morning could be a bit of a bounce.
 
There's a lot that's just unpredictable. Some cats get more predictable #s than others, a lot of times you just never know for sure what the reasons are for #s being different day to day. Like others said it's always useful to have mid-cycle #s, otherwise it's just a guess. There are bounces from the #s going too low or the drop being too steep, in which case you need to reduce the dose, and bounces from liver training (#s not too low & drop not too steep, but #s they aren't used to so they freak out), in which case you want to hold the dose steady through the bounce, and then after that evaluate whether you are at the right dose, or need an increase. Without mid-cycle data, it's just guesswork what happened. And of course there are explanations other than bounces too - snuck some dry food, cat fight outside got them riled up, etc.
 
Also, looking at your SS, it's not really that much higher than the AMPSs you have been seeing lately. Bounce should be more dramatic than that, like red or black #s. Could just be meter variation, or test was 5 minutes later than normal, etc. Also if he ate less, that can affect the #s too. I wouldn't worry about it too much.
 
It's just one number, but the +4 this morning, is BLUE--139. I'll try to get a couple of more numbers before PMPS.

But in trying to plan ahead, if at PMPS, he is below 150 (vet's no-shoot number), what do I do? Skip the shot, delay the shot, decrease the dosage?

As always, thanks for your help!
 
WOW! Now that's a nice #.

As for a lower PS you don't want to skip a shot at this point, I would not feed and test again in 15 minutes to check for a rising # and then reduce the dose depending on what that number is.

You're doing great.
 
Yay for blue...go Alex! I'm guessing you'll probably be fine for PMPS but ECID. For PMPS's lower than you're no shoot, the standard is to wait 15 - 20 min and retest. If still low, repeat wait and test. Not always but for most kitties their #'s will eventually creep back up into a shootable range.
 
So unless he got into some food he shouldn't - he is probably bouncing a little from the blue number. He hasn't seen those in a while. I would go with that 2.2 tonight and see if he will decide he likes it down in the blues.....
 
Yah, they shouldn't be too much on the rise typically by +7.5, that seems bouncy to me too. [ETA I guess that's not entirely true, as some cats do well on TID, so they would almost have to be rising by +7.5. So... hmmm] That's the beauty of getting in some spot test - w/o that +4 we would probably think it was a flat pink cycle based on the +7.5. (or at least I would have jumped to that conclusion! :oops: )

It's possible that the drop is too steep - that looks like about 250 points in 2 hours give or take. I would consider trying maybe 2.1 or a skinny 2.2 and seeing what happens. See what others think though, it's just a thought. I don't want you to lose progress.

I just saw your note too about the storm and hiding (awwww...). Could be stress bumped his #s up midday rather than a bounce. It's hard to say for sure, but I think those 3 things (liver training, real bounce from an overly steep drop, or stress) are all possible explanations for the jump mid-cycle.

It will get clearer as you go along and get more data.
 
I did back off the dose just a bit--tried to shoot 2.1 this morning. I got a +3 and a +9, but was out and about and was uanble to get a +6. That could have been very revealing.
 
I agree-- it would have been interesting to see where Alex was between +3 and +9.

It does appear you have had a good day today!
 
Wow, interesting. When the next +12 is lower than the mid-cycles like that it can be a sign the dose is too high, but I'm not sure that it is in this case - that's more like if you had a +9 that is pretty high and then it drops down. This is more flattish, so doesn't quite count for that I don't think.

Cool though that this is the opposite of bouncy - could just be random wonkiness, but could also be confirmation that 2.2 was indeed too high a dose. Time will tell! I agree stick with this dose for now & get more data and see how it shakes out.
 
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