who's here NOW?

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Hi Lori,
Your doses are all over the place. Tom is probably a good candidate for OTJ at this point, but dose hopping won't get you there.

Dropping the dose considerably from 1.4U to only 1U will probably cause some yellow numbers, but I can't recommend giving more than that. Are you using a modified sliding scale? Why are your doses so erratic?

Sorry to be so critical. You've made a lot of progress with Tom and his numbers aren't too bad, I simply think they could be even better. Jumping around with dose amounts is going to cause preshot lows like this.
 
vicky thanks for stopping by. it does'nt seem to me that i've dose hopped...if i ever did switch dose it was for a valid reason i think. i've been as you might know off board for a while and somewhat doing my own thing with help from pheobe and jojo...intermiitently.
 
oh i know..i just mean reading the ss together..no advice giving or anything like that. just to read and understand. it's hard this way.
 
I know I am coming in a little late for you here, but I would have shot the 1.25u dose too. You shot an 89 the other day and it turned out just fine. I see reasons for your dose changes up until the last few days. You keep reducing the dose to 1.25u because of low numbers, but you bump it back up to 1.4u a cycle or two later. (ex - the increase on 3/26 even though the previous numbers seemed just fine). I personally would keep with the 1.25u dose for a few days and let that settle in. You might get a smidge higher number for a cycle, but I'd be curious if that number is a fluke or would be a continuous one.
 
hi kelly, guess what? i did shoot 1.25 and +2 after that is 100! so i caught him on the rise. Yes, i do know how he goes...still unnerving for me to shoot those lows....suppose one day i'll do it easily without fear.
thanx,
lori
and tomtom too!
 
Lev doesn't work on a sliding scale. Are there times when you can't stop yourself from reducing the dose because a PS is really low? Yes. I did it just last week with Jeddie, but for the most part holding the dose that is giving you nice numbers works best. It is not a good idea to respond to one high PS number by raising the dose. Not when you have 6 days before that on one dose and great numbers (Mar 6-11).

For the past 3 weeks, I'd say that the best dose for him right now is 1u. The 1.25u is making him bounce, and then you are skipping/delaying shots and he heads upwards only to zoom back down again.

That's my two cents, anyway.
 
thank you sheila...i am not seeing 'bounce' in the equation. and i do need to stick to one dose but the 1u is kind of high blues and low yellows. 1.25 it seems is the middle ground from the 1.4 he was getting.
 
lori and tom said:
thank you sheila...i am not seeing 'bounce' in the equation. and i do need to stick to one dose but the 1u is kind of high blues and low yellows. 1.25 it seems is the middle ground from the 1.4 he was getting.
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You need to go back and look at his SS then. The week I mentioned (Mar 6-11) he was on 1u and getting great numbers, then you started increase to a fat 1u and so on and his numbers started swinging - lower AND higher. Bouncing.

1.25u isn't working if it gives you PS's you can't shoot.
 
Oh Sheila I can shoot them! Look at yesterday...loverly. see, but now he is doing what he always does on this reduced dose which is that slow climb back up to upper blues and eventually a low yellow. i will hold it of course. but watch as we go. we've seen this pattern before.
 
and now 3, 4 hours later i stand corrected. this does not appear to be a climb...not yet anyway. amps 170, +2.5 91 and now +4 is 68.
let's at least understand that tom dropped hizzelf to the +2.5 91. and now...lookin good.
 
I do not agree that he dropped himself. That is the insulin doing it.

Try to let the evidence lead you to the answers instead of making the evidence fit a preconceived theory. When you started lev I looked over his SS and posted that I thought he had been getting too much insulin for a long time. THAT is what is causing the steep drops in the first two hours.

I'm not seeing a slow climb, I'm seeing one slightly higher number that you then raise the dose on (PZI thinking). You really can't raise the dose based on the PS and not on one number.
 
sheila tomtom has been self dropping furever. 90% of the time. here would be some of the example from both pzi days and now.

+11 230 fed amps 111
+105 198 amps 87

those were the extreme's and please note the extremes were even more extreme in his pzi 600+ days. dropping 300 points or so in an hour.

ok now

during the pm cyce pmps 198 +6 109 +11 172 fed amps 136
and on and on and on

with this data are you really gonna debate this is NOT a food drop?
 
most who have studied the charts now agree...tomtom is a food dropper.
it's kind of a mute point now that we are this far in.
however it is important to note he ONLY DROPS AT AMPS NEVER PMPS.
 
To me, there is no way a cat can have time selective pancreatic response (what "food dropper" actually means, the pancreas is contributing insulin in response to food) unless the rest of the day he is fed horrible, carb laden foods. Pancreatic response would happen after any meal and is the normal process for a cat headed to remission. It means that the care giver has to factor that into the process and REDUCE the exogenous insulin. It is not the other way around that the pancreas has to factor in the dosed insulin - so that means the drop is from the SHOT insulin, not the pancreatic insulin. In other words, the dose is too high.

You have to first rule out that he is a +12 - or later - nadir kitty though.

those were the extreme's and please note the extremes were even more extreme in his pzi 600+ days. dropping 300 points or so in an hour.
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Those responses are what I meant when I said he had been rebounding for quite a while.


+105 198 amps 87
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And I am not sure why you would have a +105 number followed by a drop and then a shot? That's just crazy.
 
well as to your second point of why i would shoot the 80 after dropping since +10.5,,,,a cat does not drop 100 points at that hour in the cycle following a meal. and yes it is possible to have a morning pancreatic response after no food or excercise for 10+ hours. the data speaks for itself. his + 6 is lower than his pmps...his + 10 is higher and he is fed and suddenly his amps is lower...can you do the math on that?
as i said sheila, this is to me a mute point. it is what it is...i take my que's from the cat not the protocol.
can you understand that and work with it?
 
Just for the record -- (removed), we temporarily set up a special GROUP on Facebook with SEVERAL members from FDMB - not just Jojo and me.

So there was public discussion and sharing of ideas on how to help Lori and Tom Tom.

(removed), the facebook group is now inactive. We are not having dueling discussions.

(removed). While I don't post here every day, I have been using levemir for 2 years successfully with Tiggy and Rusty (and now Rusty is living with Ella - posting in Lantus land but still on Lev). They are well regulated on a tiny BID dose.

(removed)
 
As I said Phoebe, 'doing my own thing, with input from jojo and phoebe' is'nt that how we should ALL operate? just sayin.
 
My personal opinion, for what it is worth ---- is that Tom's pancreas is working some and that he does get "food drops" from some "home-made" pancreas-created insulin.

I believe this is consistent with a cat that is trying to go OTJ

I consider gradually lowering the dose - maybe over weeks - will help Tom go OTJ. That said - none of my diabetic cats has gone OTJ, so I hand over the reins to those with experience in this area.

Tiggy and Rusty got down to 0.5u BID with a tease of 0.25 -- but when we skip a shot, BGs are over 200. and my DH refuses to try reducing to odd doses like skinny or fat or 0.1 or ???? things he can't measure (he is the primary shooter)
 
sorry about that. 105 198 amps 87. that line does'nt even make sense period! :o but Sheila you see my point.
 
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