11/10 Ming PMPS=344, +2=274, +4 = 239

Discussion in 'Lantus / Levemir / Biosimilars' started by Crista & Ming, Nov 10, 2018.

  1. Crista & Ming

    Crista & Ming Well-Known Member

    Joined:
    Jun 10, 2018
    http://www.felinediabetes.com/FDMB/...-do-i-still-increase-or-hold-the-dose.206231/

    AMPS = 376. I haven't checked ketones in 2 days. I really should get on top of that!!!

    I decided to hold 6 units again because his AMPS is "low" and historically, he'll drop with this PS number. But an increase is probably due sometime this weekend before I go to work on Monday.

    Should I increase by 0.5 u or 0.25 u considering he was able to drop to 76 yesterday? He's just always bouncing.
     
  2. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    Technically you start the count again from the 76. So you should hold the dose another 6 cycles if doing TR and human meter unless he earns a reduction. If using Pet specific meter it's possible a reduction was earned, I'd have to go back and look It up.

    It would help if you can put in your signature what meter your using and if you are following TR or SLGS method.

    The bouncing will become less over time.
     
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  3. Crista & Ming

    Crista & Ming Well-Known Member

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    Jun 10, 2018
    Oh I see! Time to go back to reading about TR again.

    And okay, I added it to my signature :)
     
  4. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    Ok. You have to wait for the bounce to clear also. Usually that would be 6 cycles too (for now). If he hits a blue bounce is breaking. They break quicker as they start getting better.I

    So hold for 6 cycles after that 76. When ever in doubt post for advice with ? in the title.
     
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  5. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

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    Jun 16, 2017
    Ugh, bounces. My buddy Lou likes to bounce too so I feel your pain. Congratulations on the green! Exciting times! I hope Ming breaks this bounce soon and gets back into better numbers!
     
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  6. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    I don't see anything that says that in TR. The only thing that restarts the cycle count is a skip, reduced dose or long stall. Here is a post on Counting Cycles. TR does let you hold the dose up to 10 cycles if you are seeing nadirs (note the plural) in green. Ming had exactly one green. He's had 11 cycles at this dose with one reduced dose after the first 6 cycles.
    Also not true and a common myth floating around here. Bouncing is not involved in cycle counts as far increasing goes. You just want to avoid increasing on the cycle where they clear the bounce. Bounce clearing plus increase can cause some extra downward momentum. You are fine to increase on any of the other cycles of a bounce.

    Libby did an excellent post on the urban myths that seem to float around TR. It's a good read. The one on increasing during bounces is post 17.

    As for increase, you could try a 0.25 unit increase and see if it does anything. Some cats are sensitive to smaller changes in insulin. The down side if it doesn't is then you aren't dosing on the line anymore. ;) Also mentioning that because there was some confustion with the other people giving insulin to Ming on what the dose should be. Let's see what he does this cycle. You could wait and see what the sixth cycle does after the reduced dose a couple nights ago and increase tomorrow. But if you see him still in the rafters today, I'd increase tonight to take advantage of the fact that you are around and able to monitor more for a couple days.
     
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  7. Crista & Ming

    Crista & Ming Well-Known Member

    Joined:
    Jun 10, 2018
    +4 = 351

    When I get the same number I did two hours ago, it makes me doubt the meter but I'm not going to bother doing another test since it's just a high number.

    Alright! I'm excited to increase tonight if this cycle continues to hold. I think he had some diarrhea an hour ago since his litter stunk like crazy and I didn't see solid poops. I gave him his "snack" (his snack is now a full can because I'm going out for errands later) with about a half a cap of florastor or whatever was left when I used it last week.

    Thanks for the links @Wendy&Neko! I read the post Libby made about shooting a dropping number too and I really liked the reminder that it'll keep them flat if we shoot before they rise.
     
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  8. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    Geez sorry for miss information. Many times I was told to start count over from a green. Think I'll just stick to emojis from now on.
     
  9. Crista & Ming

    Crista & Ming Well-Known Member

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    Jun 10, 2018
    It's okay :) I appreciated the advice and your time! It made me go re-read the TR protocol and I think it would've made sense if Ming was having multiple green nadirs but he's only had one... darn cat hahah! At least that's my interpretation!
     
  10. Crista & Ming

    Crista & Ming Well-Known Member

    Joined:
    Jun 10, 2018
    PMPS=344

    Increased to 6.25 u. It sure is hard to draw 0.25 u! My mom and I did it together so we’re all on the same page :)
     
  11. Crista & Ming

    Crista & Ming Well-Known Member

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    Jun 10, 2018
    It’s gonna be an exciting cycle!

    +2 = 274
     
  12. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Glad you are home tonight!
     
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  13. Crista & Ming

    Crista & Ming Well-Known Member

    Joined:
    Jun 10, 2018
    +4 = 239.

    Good boy, Ming. Nice and easy :)

    I think I'll test in another 2-3 hours since he's not dropping like he has historically.

    Also I think his blood is bright pink again. o_O He DID have gravy a few nights ago and yesterday...
     

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