Cinco AMPS 81, +3 46 - Reduction Again?

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Tricia Cinco(GA) & Harvey

Tricia Cinco(GA) & Harvey

Member Since 2011
We shaved a few drops off Cinco's AM shot due to PSBG being so low. I checked him at +3 because is nadir is usually around +3 to +4. He was at 46 so I fed him a couple teaspoons of HC FF in gravy and another slice of turkey (Very hungry). Tested him again 20 minutes after he finished eating that and he was up to 53. Will test again at +4. Soooo, has he earned another reduction already? Things are moving so fast!

- Tricia & Cinco
DX 06/23/11

https://spreadsheets.google.com/spr...gVSWwdEp4OWZpVXZCd05WV0taYmJRb1JmVXc&hl=en_US
 
newly diagnosed kitties can get a reduction if they go below 50 . . . as long as they are holding the reductions. you don't want to reduce if it's 2 cycles in a row because that can have to do with the shed still being full of the last dose. does that make sense? if your reduction was more than a shot ago (i confess to not looking at cinco's ss) then you reduce from today.
 
looks like this would have been Cinco's eighth cycle at .75u but you say you shaved it? I think it would help on your SS if you showed you shot a sk.75 this morning if you shaved a drop or so off the .75u.

You have shot a very similar number (83) so I'm not sure why you shaved him this morning. However, IMHO, you should not shave again. If you shot a sk.75u this morning, the 46 is probably shed from the .75u. I think I'd shoot the sk.75u tonight and monitor.

Good luck with this morning's reduction!
 
Actually, Julie, I think you confused me more! When you say
newly diagnosed kitties can get a reduction if they go below 50 . . . as long as they are holding the reductions. you don't want to reduce if it's 2 cycles in a row because that can have to do with the shed still being full of the last dose.
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does that mean that if he goes below 50 once you can reduce the dose, but if he goes below again with the next dose, you shouldn't reduce again right away?

He's been at this dose for 8 cycles, and this was his first drop below 50, athough he's been close a couple of times. His pre-shot numbers are getting pretty low, too. We have been shaving a couple drops off the dose when the PS is below 100. I would appreciate anyone else's thoughts on this, please!

- Tricia & Cinco
DX 06/23/11

https://spreadsheets.google.com/spr...gVSWwdEp4OWZpVXZCd05WV0taYmJRb1JmVXc&hl=en_US
 
Thanks, Marjorie. BTW, I grew up, met my husband and was married in Tucson!

Actually, if you read the notes on my SS, we shaved a couple drops off when we had the similar PS number a couple days ago, too. I did put it in the notes this morning, too. Since it is a spreadsheet, I didn't know I could mix letters with numbers in the cells. I'll change that. So you're saying we should shoot .75 but shave a couple drops off tonight, too, to keep it consistent?

- Tricia & Cinco
DX 06/23/11

https://spreadsheets.google.com/spr...gVSWwdEp4OWZpVXZCd05WV0taYmJRb1JmVXc&hl=en_US
 
yes, you understood what i was saying. for example, if last night punkin got down to 45, on a dose of 1unit, i would reduce him to .75 this morning. then if he got down to 45 today, i would wait to reduce it until it happened again in a future cycle. tonight i would shoot .75 again. if he got to 45 tonight, in the morning i would shoot .5.

the reason is because of the "shed" with lantus. there is an actual physical deposit of lantus in their body that corresponds in size to the size of the dose. here's the link that explains how it works: http://www.diabetesclinic.ca/en/diab/2treat/lantus_vs_levemir.htm

when you decrease the dose the shed needs a cycle to reduce also. so back to back cycles with a BG of less than 50 you only reduce on the first one and then wait at least 1 cycle for the shed to reduce. if you get a less-than-50 on the subsequent cycle, reduce again.
 
Tricia:

Julie and I are saying the same thing: the shed usually carries over anywhere from 1-3 cycles so the 46 today is probably from the .75u last night and is not influenced by what you shot this morning. That's why I, personally, am not a big fan of skinnying a dose when I get a low PS. But that's me and my cat...ECID and Know Thy Cat. I think it is helpful if you get a low PS that you are nervous about, you could shoot a .25u reduced dose or stall until the number comes up and shoot your regular dose but if you are skinnying a dose every few cycles, then I wonder if the dose is too much.

There are two options:
1. the 46 he got today earned him a reduction from .75u since that's probably the shed talking. So you could reduce him to .5u tonight per the protocol since newly diagnosed cats earn a reduction of .25u when they go under 50.

2. you already skinnied his dose this morning to sk.75u so you could assume that is his reduction that he earned with the 46 (remember the 46 is the .75u shed talking); so you could shoot the sk.75u tonight and as your new dose until he earns another reduction. This is more what someone would do who has been at this longer and their cat doesn't hold reductions and that's why I made that earlier comment.

I think what Julie is telling you is in the case where there are back to back numbers below 50.....which is not what is happening here. I'm confused by his SS because you've been changing his dose alot. On the morning cycle of 8/8, he earned a .25u reduction which you gave him that night. I'm not sure why you went back up to 1.25u the next morning...you should have held the 1u because he went low again that morning cycle on 8/9 and you had to reduce him again to 1u. Then the morning of 8/10, he went below 50 again and you rightly gave him a .25u reduction to .75u.

After studying his SS a little more, I actually think I'd probably go with Option 1 above and see if he'll hold it; if he doesn't, you can take him back up. It's your decision. The other thing is to wait and see if Sienne pops in (I believe she's been helping you alot) and see what she thinks......and I'd go with what she suggests; she is very, very astute with this stuff.

Cool on the Tucson connection. How long since you've lived here and do you still have fam here?
 
Marjorie:

Thanks for clarifying. I am still a little overwhelmed by the whole thing, and Cinco seems to be progressing so fast it's hard to keep up. I know the SS is a little confusing. The day we went back up to 1.25 was because my DH didn't listen to me about holding the dose and thought the higher AMPS number meant he needed more. I have since explained to him, ad nauseum, why that was not the thing to do. The quick reduction to .75 was per Sienne's advice. I will keep watching to see if Sienne weighs in. If she doesn't, I think we'll go with option 1.

I moved away from Tucson 25 years ago, after I got married because my husband was in the AF and we were sent to Mississippi. My parents lived there till their deaths and I still have a sister there. My husband has an aunt and uncle there, too, so we visit at least once a year. Loved Tucson but don't miss the heat!

Thanks!

- Tricia & Cinco
DX 06/23/11

https://spreadsheets.google.com/spr...gVSWwdEp4OWZpVXZCd05WV0taYmJRb1JmVXc&hl=en_US
 
Tricia:

I think you could go either way -- either stick with the skinny 0.75u or reduce to 0.5u. Cinco has been moving quickly. You may need to screw up your courage and shoot a number like the 81 without reducing the dose at some point. I think this is entirely your call and what you're comfortable with. I think Marje gave you a solid explanation.

My initial reaction was much the same as Marje's -- reduce the dose to 0.5u and if it doesn't seem to be holding, bring the dose back up to a skinny 0.75.
 
Thanks, Sienne. We think we will go with the .5, as it's easier to be sure you're giving the right amount. .25 incremements are so hard to measure accurately. We'll check him several times and see how he does with that. I really look forward to a time when I don't have to keep checking him several times a day - it would be nice to give his ears a break and just check pre-shot. Does that ever happen?

I love all the help I get. Thank you, everyone!!
 
Tricia:

wow....my husband was in the military, too, and we retired here. You'll have to let me know when you get here next time.

it would be nice to give his ears a break and just check pre-shot. Does that ever happen?
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:lol: :lol: :lol: :lol: :lol: Sienne and I are definitely the wrong ones to be asking that question as we are both testaholics. But both our girls are unpredictable.

You are right that it is easier to dose the .5u than the sk .75u. I think you made a good choice; Cinco is doing great.
 
Thanks, Marjorie. We will probably be down there in November. We go to Phx for the NASCAR races and pop down to visit. Christmas is also a possibility. Appreciate your help!
 
sorry i was gone all day - but you got good advice by 2 people who both know more than me.

i wasn't speaking about tonight's dose, i was speaking in general about 2 cycles in a row where the cat goes below 50. sorry about muddying the waters!
 
That's okay, Julie. We shot .5 after getting a PMPS of 99. I feel like we're on the right track. I'm so lucky my friend hooked me up with the board. Don't know where we'd be without all of you!
 
it is great to have online tutors and support, isn't it? especially from people who "get it." the whole thing is so confusing when you're starting, but it does get easier fairly quickly.
 
You said it. I don't mind admitting I had serious doubts when we started out about whether we could pull this off. I am not a very coordinated person, nor am I calm under fire. Cinco was so very, very ill that the vet had told us to consider euthanization. He wasn't even really my cat - he's a stray I started to feed and I was hoping to find him a home. Little did I know it would be mine! He's a fighter, so he inspires us to keep going. I still feel inept, but I have more confidence knowing I have a whole team behind me!
 
:YMHUG: we all get it. i know i felt the same way! it's a lot easier to ask a question here than to call your vet - not to mention that my vet, while i love him, doesn't know much about feline diabetes and gave me all kinds of wrong information. here people do feline diabetes 24/7 on a lot of different cats and have a ton of experience to share. it's a great place.
 
Yeah, my vet thought Cinco only needed to be tested a couple times a week! At first she seemed very knowledgeable, but after I started reading all the info on the board, I realized she only knew enough to help the simple cases - cats that respond right away to the treatment she prescribes. No offense to her, because she's a great vet, but this requires a specialist, and there aren't many of them around. The board is the next best thing.
 
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