dosing advice - the Murphy experiment

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Carol & Murphy (GA)

Carol & Murphy (GA)

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@Rachel I decided to start a new thread - Murphy's amps was 452 - now I need help deciding between 1.25 and 1.5 - this is probably a bounce but 452 is a rather big number -
 
I think you are seeing a bounce, Carol. Some kitties don't bounce in the next cycle, but the next day. This could be a bounce from yesterday's daytime numbers or he could have gone lower last night (ya just never know). Given that, I'd stick with 1.25 if he was mine. My reasoning is that if he is bouncing, raising the dose really won't help. You know how it is...kitties bounce until they don't. That lower dose might help you get gentler cycles so he can gradually come lower..that's my thoughts anyway. What do you think?
 
Rachel said:
I think you are seeing a bounce, Carol. Some kitties don't bounce in the next cycle, but the next day. This could be a bounce from yesterday's daytime numbers or he could have gone lower last night (ya just never know). Given that, I'd stick with 1.25 if he was mine. My reasoning is that if he is bouncing, raising the dose really won't help. You know how it is...kitties bounce until they don't. That lower dose might help you get gentler cycles so he can gradually come lower..that's my thoughts anyway. What do you think?
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yes, that was my original plan but seeing red made me hesitate. Until my new half unit syringes come in (thanks @Sharon14) it will have to be a fat one. I think I'm set - thanks Rachel.
 
I get it! It would have made me hesitate too. It's good to think over your plans when Murphy throws a curveball because sometimes they need to change! We can always go up in a cycle or 2 if we need.

BTW, I love how you named this thread the Murphy Experiment. I feel that would be a good band name!
 
@Rachel Murphy had an interesting cycle today - steep drop from reds to greens by +5 coming off a bounce. Also, the insulin didn't last very long today and I anticipate a probable high pmps today. -- More than likely a bounce. So I am faced with my least favorite activity - trying to figure out a dose. Judging by today - not sure a 1.25 is an appropriate dose. I'm thinking of a 1 or even a skinny one tonight. Thoughts welcome
 
Wow Carol! I love this experiment! I hope Rachel will weigh in but, my instincts are saying hold the dose, you got a nice result from it. Here will bounce back up but as Rachel has said to me in the past, you want to shoot the same dose for that bounce. I am going to link her exact quote to me :
"When you shoot the same dose into a bounce you may have a higher nadir. You want that really because going as low or lower will cause more bouncing. The goal is to get them to have a smile curve that's gentle...no steep drops. Once the bounce has cleared the dose will depend on the numbers you're getting...could be changed or stay the same" . (Rachel) I hope this helps! Good going Murphy!!!!!
 
Hi Bobbie - actually I hate getting into the greens - to me, it's cutting it too close - if I have to worry about a hypo starting at 80 on an Alphatrak, I don't want anything in the greens. I was actually thinking that maybe he needed less insulin if he went from reds to greens within 5 hours - I can't wait for the day all of our kitties are stable and every day isn't this constant roller coaster
 
Carol C said:
Hi Bobbie - actually I hate getting into the greens - to me, it's cutting it too close - if I have to worry about a hypo starting at 80 on an Alphatrak, I don't want anything in the greens. I was actually thinking that maybe he needed less insulin if he went from reds to greens within 5 hours - I can't wait for the day all of our kitties are stable and every day isn't this constant roller coaster
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Carol I understand. Yesterday was a little too close for comfort for me too. But, you can always steer with some LC food, re-test in 20 minutes and if he doesn't come up, give about .75 oz of medium carb food and 20 mins. later if numbers don't come up, give some high carb food (15-20 %). Only you know what your comfort zone is. Personally, I wanted to see how fast he would drop yesterday. Remember, you can always pull out the karo if all else fails but personally, I wait on that after Low carb, medium carb, and then high carb. He is improving. Lower numbers make all us newbies uncomfortable but, it is progress. :bighug::bighug:
 
Bobbie - yes, it is progress - last week at this time, I was giving 3 units still, I can't imagine stressing about the doses and hypos day in and day out for years
 
Carol C said:
Bobbie - yes, it is progress - last week at this time, I was giving 3 units still, I can't imagine stressing about the doses and hypos day in and day out for years
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You won't, it has got to level out sooner or later. I think as time goes on, we get more comfortable with it all. It's like any new thing, a learning curve. As long as the time spent in under the renal threshold is greater than the preshots. we are doing good. Hang tight. We are all right there with you and Murphy. :bighug:
 
Hi Rachel yes, that is correct
I'm so glad you are here - I am puzzled by the numbers today - I should have tested earlier, but by +5, he was already in the greens but the insulin didn't seem to last very long today - I was actually expecting a larger pmps number - expecting a bounce I really don't want greens - it's too stressful for me
 
I think in your case, I might have dropped to 1 instead of doing 1.25. So, I like your dose! Bobbie is right that generally speaking you want to stick with the same dose when you have a bounce because the preshots you are getting aren't "real"...they're reactions to low numbers. Generally, people want to increase the dose when they see a bounce, which is why I said to stay the same dose. If you increase based on that preshot number, you're going to probably push the cat into lower numbers, which will cause more bouncing...etc. Does that make sense?

HOWEVER...you are also correct that you were getting dangerously close to the low numbers there. Since 80 is what you watch for on an AT, I would reduce slightly because you don't want to end up with an even lower number. I generally don't suggest a decrease for a bounce since the point is you want your cat in lower numbers. But you don't want those numbers to be SO low...

So to recap my thoughts on bouncing: If you have a bounce, increasing the dose isn't the answer. If you increase, it's exactly as Bobbie said. The nadir might go lower, causing more bouncing...never ending cycle. Shooting the same dose will hopefully help pull the kitty out of the bounce without making the numbers high. However, if you found that you got close to hypo numbers, you earned a reduction I believe. I like the tiny dose change down to 1. As Robin said, those small dose changes might be what Murphy needs.
 
Just now reading the thread here and you got some excellent advice! I was wondering the same about a bounce and kept Ruperts dose the same, but he did not get into the greens, only blues, so I didn't have to worry about the dose being to high. I think Rachael is right and a small reduction was called for, which is what you did! I understand completely about "going too low", especially when they are first throwing those greens at us, it makes me nervous too! You did a great job! Congrats to Murphy, maybe this is his break through!
 
You're doing great, Carol. Your instincts are right on. If it turns out that 1 is too little, we can go back up. But for your peace of mind, I think it's best to stick the lower dose tonight...let you get some rest.

I don't think the issue today was insulin not lasting long (though I could be wrong!). I think it was a bounce. I think he just hit those greens and his body panicked a bit and the bounce started a bit early perhaps. I'll make sure to check in tomorrow to see how he goes. I'd suggest holding the 1 unit tomorrow unless he's too low to shoot (which I don't anticipate but you never know!). My guess is he'll be high, but let's see what 1 unit does for that if you think that sounds good?
 
Carol C said:
:) thanks BTW, how is Bubba's eye doing?
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Monday, I take Bubba to see a new vet who saw him on Facebook and gifted a much lower rate to remove his eye. It is all so very scary and I awaken most early mornings with anxiety over it yet, I know if we have a chance of the cancer not metastasizing, we have to have his eye removed. Imagine his sweet face but just winking at you!
 
Awww Bobbie, Bubba will be just as sweet with one eye gone. I'm sure of this. Keep us posted on how it goes Monday. I know it's scary but we're here for ya!
 
thanks Rachel I read today that the too low to shoot number for AlphaTrak was 230- is that the case? I am not someone who wants to see the greens ever - I am much more comfortable with a nadir in the mid blues. So a 1 unit tomorrow is my maximum. If amps is in the 300s, I may do a skinny 1. I feel like Murphy's insulin requirement are quite fluid at the moment -
Bobbie - Bubba is so gorgeous one eye or two - doesn't matter. So glad you found a new vet for that
 
I think that's correct, Carol. Though if he's close, I'd stall and if he was close to 230 and rising, I'd probably shoot. Maybe a skinny 1? You test enough that I know you can keep an eye out and that way, we can get some data on that. If he throws some yellow preshots that we feel safe shooting...even a reduced dose if you feel more comfortable...that will help us see how he reacts, telling us what Murphy's no shoot number needs to be. Don't worry! We'll figure this out!
 
Aww, Bobbie, that would be scary, but Bubba is a tough little guy and he will be beautiful with one eye or two! He could wear a little patch and be a pirate, the mice will be terrified! How nice that a vet is willing to give you a reduced price, he must have a good heart. Fingers and paws crossed for a successful surgery and speedy recovery! :bighug:
 
CatX4 said:
Aww, Bobbie, that would be scary, but Bubba is a tough little guy and he will be beautiful with one eye or two! He could wear a little patch and be a pirate, the mice will be terrified! How nice that a vet is willing to give you a reduced price, he must have a good heart. Fingers and paws crossed for a successful surgery and speedy recovery! :bighug:
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Had to laugh at the pirate patch, arrrrhhhhh, Funny, my birthday is on National Pirate Day. Maybe that's why I cuss like a sailor (sorry Lynn's mom!)
 
I wonder if Murphy is having a bounce today, if he is having a high, flat cycle=too much insulin, or if I gave him a fur shot this morning - i remember wondering if I did- but I didn't feel any wetness at the injection site I should have smelled for insulin If it is #1) I should give him the same dose for pm shot, but not if his cycle this morning is due to #2
 
There really isn't a way to know for sure, Carol. It could be a fur shot...but even if you knew that, you couldn't give more insulin this AM, so it's kind of a moot point.

Honestly, I feel there is another possibility. I think Murphy might take a few cycles to settle into a dose. On 10/13, you gave 1.5 in the evening. He stayed pretty flat. The next day, we don't know what the mid cycles were, but the numbers for preshots were hight. But then on 10/15 he suddenly threw some blues. Low blues too.

So we switched to 1/fat 1. He gave a small drop, but not much that night. 10/16, he gave a drop, but not real low in AM cycle, and stayed fairly flat in the PM cycle. Then yesterday, he threw some greens.

What I get from all this is that first, the lower amounts of insulin do work better for him. Even when he didn't go real low, the lower amounts gave him more of a drop than the higher ones. Second, it might take a few cycles for a dose to really settle in for him. And if I remember, that's basically what Robin was saying. That he might need smaller increments of change for his body to get used to it...he might just be a kitty who requires tiny changes and a few cycles to get used to it.

For this reason, I'd stick with 1 unit tonight. Yeah, he'll probably be high. But I'd like to test this theory out a little more (if you agree!). I'm wondering if you'll see a drop tomorrow AM cycle if you stick with this dose.

In the end, Carol, you hold the syringe. I know this isn't going as fast as we'd all like, but if you look just at the colors on your SS, since we started this lower dose experiment, the preshots have been better. Since you're getting ketone tests, you know he's safe there. I know this is frustrating, but what do you think about my plan? We're doing a lot of experimenting with Murphy, but if he was mine, that's what I'd go with. If this ends up not working, we can change at any point.
 
Hi Rachel I'm not that frustrated - I'm pleased his insulin requirement seems to be decreasing - I think it's because he is now up to 1/4 can of venison a day and less Royal Canin dry food. having learned my lesson about what a consistently high cycle, without much drop, can mean (too much insulin) I was concerned that 1 unit was too much insulin for him I'll keep him @ 1 unit tonight and get a +4.5 BG reading. Thanks for the help in interpreting his (lack of) curve today. Quite a mystery, these felines.
 
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