Asia 12/10 AMPS 55, +3.5 43, +4 55, PMPS 216

http://www.felinediabetes.com/FDMB/threads/12-9-asia-amps-243-pmps-157-2-96-3-74.187772/

I guess I was exhausted, I fell asleep on accident last night, woke up to Asia burgling at me 2 minutes before the am alarm and she's at 57

So yeah, I'm stalling right now to see what Meatbeard the Pirate is up to!

 

Just when you think you know......good luck

 

I fully admit I don't think I know, and when it comes to predictions, I win about 50% of the time...if I'm lucky (and that's when it's a this or that prediction)!

 

Beautiful numbers last night and this morning Asia! But no need to go any lower!

 

Asia, be a good girl and let momma bean give you your insulin today. Don't go any lower!

 

I stalled for 30 and she's testing 55. Without food, I would expect her to keep dropping. Her last meal was +8 pm cycle. I don't want to skip a shot because I have a pretty good idea where that will get me. I don't think a BCS dose will do much to prevent the impending downward drop if I shoot, so that doesn't seem helpful to mess with the depot. If I shoot, can I load her up with carbs right after the shot to try to get a higher number for the insulin to work with?

 

Paula and I play the guessing game. One of us guesses the BG number and the other has to say over or under. If the number guesser gets within 5 points of the actual it's an automatic win. Are we sick or what?

 

Not a lot of experience but I would feed first to ensure carbs etc are onboard b4 shot.

 

We do it all the time here as well. Guess the BG, but it's price is right style, closest without going over is the winner. Hey, you have to take the levity where it presents itself!

 

She's still above 50, she has proved her point holding 57-55. If you can monitor feed and shoot. It's scary shooting low numbers

 

Just fed tsp of FF gravy and regular food, I think I'm going to go through some FF today. I feel like she would drop in the first 1-2 hours which is why I'm concerned. Having a higher number to drop from is my preference.

 

I'm curious why you didn't reduce Asia's dose after the 48 on 12/6? That's dose reduction territory unless Asia has been diabetic for more than a year.

If you're following TR, shooting numbers in the 50s is feasible if you'll be home to monitor, have strips, and HC food on hand. The rationale is that onset takes roughly 2 hours, you're at the end of the cycle when numbers typically rise, and you'll giving Asia her morning meal -- which also causes numbers to rise. You've shot green before albeit, not quite this low.

 

Come on Asia, no reason to go any lower!

 

Thanks, Sienne. I discussed the reduction with Marje. I decided to do 3 under 50 or 1 under 40 because she already had a failed reduction from this dose and both times her low number was off of a really wonky cycle. She has dropped before onset, even from green, more than once.

 

Not the time I'd chose to use a new pen, but the old one is done so c'est la vie. Carbs on board, shot the dose, now the freak out begins.

 

She gave me a 43 after FF gravy (guess not long enough after) and I "fed" her some honey (tapped it on her mouth so she had to lick it off) and now she's at 65. It's going to be a long day.

So to recap: lowest AMPS to date and reduction earned in first 15 minutes of the cycle.

 

Stacy --

That's a reasonable strategy. I would put the info in your signature, though. I know I won't remember and there will be others who will keep raising the question unless we can find information on your strategy.

Just as an FYI, I'm not a big fan of using HC to bump up the numbers at AMPS in order to shoot. When I was nervous about shooting low, I would get a test at +0.5 or at +1 and then give HC if necessary. Gabby had an early nadir so dives into low numbers was pretty common for us.

 

I call the meter the one arm bandit (like slots) - I often asking him if he is going to give me winning numbers.

Good luck. Hopefully she will come up a bit and surf for you. As hard as it is I have to give Gizmo at least 30 min for any amount of carbs to influence his numbers.

 

Ok Asia you've made your point now get away from the shark nets please!

 

Asia! Those finned toothy dudes are not your friends.

Hoping she continues to stay in darker green territory Stacy.

 

Just was not sure what to do, I was almost positive she would drop before onset as she has a good habit of doing that and the thought is much more jarring and dramatic when the preshot is this low. I wanted her to drop from something better than a 55. As is, she gave me a 43 fifteen minutes after shot and high carbs. So you would just shoot and see where the cards fall? Even if you had a good hunch they would go lower?

I'm still figuring out which way is up with this cat. My prediction is she continues fighting to stay over 50 for a good several hours. I hope I'm wrong.

 

Oh, but she's already named them. She's making them reindeer headbands as we speak!

 

Just gave more honey and I'm bringing her to the bowl to encourage eating a few bites of Rad cat every 30 mins. +1 59

 

Good luck with trying to figure your cat out! They tend be deliberately unpredictable.

Usually, when you shoot low, the cycle is flatter. A "typical" Lantus cycle is flat -- at least as a cat is becoming better regulated. It's why a cat that's on the road to remission sees a flat cycle despite getting whatever the full dose of insulin is.

I would use the HC sparingly unless it's absolutely necessary to intervene. Again, MY strategy with Gabby would be to try LC first to see if it bumped up the numbers but I was also testing early and often. This may or may not be a good approach with Asia.

If you think it would be helpful, take a look at Gabby's SS. She would double dip (numbers drop a second time closer to shot time) which was crazy making. I was pretty compulsive about leaving comments about what I was doing in response to her numbers.

 

Oh no Asia! Don't do it.

 

Oh, Asia, you naughty girl, you! Always coming up with new tricks to stress out your bean!

Just popping in to say "hi", will be keeping an eye on this thread to see how it goes today. You got this!

 

Asia just wants to be sure she is the center of your attention today.

 

Thank you so much for your insight, Sienne!

It looks like Gabby responded well to LC and got a food spike when you shot low, even in the 50s. My experience with Asia is that her (no carb) food keeps her surfing, but I typically don't see food spikes like that. Asia is also a nibbler, and doesn't eat much at one time, so surely that contributes. I treated this morning's preshot like it was already below 50, proactively, because given her history, regular food wouldn't do much to slow her roll. Although she's still not very consistent, her am nadir is more often +4/+5. She's got a lot more room to drop if she's so inclined. I don't want to intervene unnecessarily, but I also don't trust her at these lower numbers and I didn't want her to earn a reduction (too late there) as 2 units didn't work out so well the last time. I know the cycles should be flat, but I guess I'm not seeing enough consistency with her to feel comfortable that it would be flat from such a low number so early in the cycle. Regardless of her early dropping, she's usually lowest +4/+5. Had this been a+3 number and there was no big drop before onset, I would have let her be with her regular food.

It's a new adventure every day. At least I'm learning something.

 

But that is every day already!

 

Thanks, Nan. I'll be glued to this cat and this board for hours it appears.

 

+2 52, I'm going to just give her regular food and see where she is in 30 minutes. I feel like more honey is imminent, but it's worth a shot seeing if she might surf this I suppose.

 

Asia go easy and show us your surfing skills

 

In my stress brain, I thought she earned a reduction (because I was thinking this is the 3rd time below green on this dose), but the first one was when she was on this dose and I took the reduction. So it's 3 under 50 since this current dose, yes? Of course, that could change today anyway if she goes lower.

 

So far your surfing well, paws crossed

 

Surf, Asia, surf!

Yeah, best not to plan too far in advance where Asia is concerned!

 

You've got this Stacy!

 

Mini surf experiment not going well. +3.5 43, well maybe she is surfing...in the 40s but we can't have that. Gave tsp of FF, a drop of honey and some regular RadCat.

 

Asia is giving you a hard time today.

If you struggle to bring her up or to keep her in safe numbers, you may want to consider taking the reduction. But I'm not a pro like @Sienne and Gabby (GA) or @Marje and Gracie.

I'll keep an eye on you.

 

You know, some cats do actually like the 40's! Of course, that doesn't change the take action cutoff of 50 and you still have to treat them as you are doing now (no complacency!), but if it helps reduce the stress a bit to think of this...

 

It is definitely a consideration, we will see how it plays out. This is another one off cycle that she went below 50 on though, and that was my trouble with not wanting to reduce to begin with. I really waffled with skipping her shot this morning, but it's never done well when I have.

 

Well she's in the 40s a lot today and she's not bothered; she does seem to enjoy the 50s, but yeah, can't let that be a thing! When she gave me a 30, she was ravenously hungry and today I'm having to pick her up and pop her over to the bowl for bites in between her hourly visit to it.

 

Heh. Sounds like you're on top of things-- Asia is getting the royal treatment today!

 

Everything crossed so it goes smoother/smoothly for you and Asia!

 

Hello I am farely new here and a struggling tryng to get my kitty's right dosage. I am looking at your spreadsheet and find it very interesting. Based on the info on this website in the Lantus section, they say not to give insulin with numbers under 100 and under 200, to just give a small percentage of regular dose. I've tried that before doesn't work. However this kitty has gone into remission once before (last year for about 9 months) and when that happened I didn't give under 100 and it was fine. I see that you stick consistently with your dose regardless. I have been advised by Dr Pierson to do this and i guess I am afraid of his GL going too low. So I am confused as to what to do when numbers start going down. Yesterday decreased the dose to.5 from 4 because it was 57. Maybe I just can't understand how this insulin works but I need to keep him from bouncing. So confused and would love some advice. Thank you

 

+4 55, another tsp of FF. I'm glad I figured out I could dab her on the mouth with honey and she licks it off. It annoys her for sure, but it's better (for me) than going in the back side. She'd be less annoyed if I went in the backside than tried to touch her mouth, however.

 

He's surfing beautifully Stacy! Good job!

 

Hi Connie, I encourage you to open your own thread on this forum and copy what you wrote into that. You'll get many more eyes and help that way. I'd love to answer some of your questions on your own thread, that way you can keep all of Junior's info in one place. As far as Asia's dose is concerned, I'm following the TR protocol to the letter, with the exception of reduction after 3 drops below 50 and one below 40, which is a modification for my cat and situation only.

 

She's staying in safe territory, which is great! The FF is low-carb, correct? I'm confused-- are you also giving her honey right now, or was the reference to before when she was in the 40s? She shouldn't need honey now, but if you are giving it, that's good to know (so we can see how much effort it's taking to keep her here in the 50's!).

 

No, I didn't give her honey just now, but at +3.5 when she was at 43. it's just a new way to get her to eat honey I discovered today. The FF gravy is 15 carb. She's definitely not staying over 50 without these interventions.

 

Good morning
Wow!

 

Hi Tanya!

Well she never has been subtle!

 

No...no she wasn't... I know how nerve wrecking it is and what kind of effort it takes but how lovely it is to see the preponderance of Greens! Well done both of you! I hope she'll surf nicely and safely for the rest of the day!

 

+5.5 61, no honey or FF 15 carb gravy since +3.5, I hope I'm not speaking too soon, I think she might be holding this on her own now, finally...but I'm sure she has more surprises in store, because: cat!

 

great, looking good!
if she doesn't bounce by PM I'd reconsider keeping the dose - the depot looks a bit overfull to me.
But hopefully someone with greater knowledge can weigh in on that.

 

I'm glad Asia finally came up for you. I hope she keeps surfing safely. You're doing a great job handling things.

 

Yes, I'm thinking about a reduction and if that doesn't work, something in between 2 & 2.25 because clearly, we can't be simple about this.

 

I think today's numbers are partly because she was coming back down from the big bounce on the 8th.

 

Thanks, Carla. I'm so glad she saved her most thrilling cycle for the daytime and I'm not working off sleepy brain for this one!

 

I too thought so, plus the new pen is in use - always more potent in the begging. It probably added muscle to the already clearing cycle.

 

That would be in tune with the last time she went below 50, and that is my frustration with taking the reduction. If it's a reaction to a bounce vs what's normal for her on this dose, it's baffling where you go from there.

 

Perhaps that, but I would have guessed the cycle to play out similarly without the new pen in the mix. I was worried the second I saw that AMPS because I knew she was 99% likely to drop in the first two hours, then it's an uphill battle, no matter old insulin or new.

 

It is hard to know what to do sometimes. Sometimes you just have to go back and forth between two doses before a reduction holds. Some cats are just bouncy. I think the waiting for three numbers below 50 is a good strategy for Asia, unless you have a hard time getting her to come back up or she gets into the 30s. Numbers in the 30s are an automatic reduction.

 

similarly - yes but when those Lime Greens keep popping up time and again despite HC or honey I'd back down. But hey, Asia's over all numbers are better than Ducia's - I'd probably be better off by listening to you and do as you do

 

+6 66

 

I'm constantly asking questions and trying to figure things out, but I doubt I'm doing anything all that much different from you, we just have different cats!

Do you dose with calipers, by chance? Ducia is very capable of being in greens for a good duration, she looks a little bouncy, Asia is too,but I also wonder if she's sensitive to tiny changes in dose which calipers could help control. It made a world of difference for Asia when I started using them.

 

If the cat is making you work to keep her above 50, that is another sign she wants a reduction. Remember if doing the 3 times under 50 (or once under 40), the three times are on separate days. I'd count the 3 under 50 today as "making you work". Remember that what dose a cat needs at one time, is different a while later. There could be some beta cell healing going on with all that green Asia has been seeing. You don't know whether she'll be fine with the reduction until you try it.

Great job today Stacy!

 

I do use calipers (rather DH does ).
I do something different with Ducia's feeding but need more time doing that to make any meaningful assessment. I am worried about Pinks making itself so comfortable in her SS and on the other hand I see her bouncing shortens
Marje is not available for a while to see her SS so I just do that - feed differently and collect the data. Tricky Ducia!

But I absolutely love how Asia is holding now on LC alone!

 

Thanks, Wendy! I know the reduction might stick this time even if it didn't before. I sure hope it does because I am going to try it out. Healing beta cells in an ancient cat, that would be something!

 

Never say "never"!

 

I'm glad Asia seems to be over the hump, for now.

Oh good, I think I'm the resident caliper pusher, maybe I'll get a commission on that some day! Your husband? Lucky you! Mine is squeamish with needles and blood.

The feeding the curve stuff really makes my head spin. I'm just now starting to work with that and it just adds such a level of complexity to an already tricky dance. I wish you all the luck in the world with your food wizarding skills! I've read some cat's are just born to bounce, and even some of the bouncy ones go in to remission, so that gives me hope.

 

+7 86, exactly 20 points higher than an hour ago and what she likes to do when she's being normal and predictable!

 

Just peeking in again. Holy cow. Great job Stacy!!
Go Asia

 

Thank you all so very, very much for your support and guidance today! I know I would have rather spent my Sunday differently, I didn't have a choice in the matter, but all of you did and I am so appreciative!

Asia insists she had this all handled and didn't need any minding, but she says thanks for the extra love and attention anyway because it's always welcome!

 

I'm sorry I missed all the excitement this morning! Looks like you did a terrific job, and while I like Miss Asia hanging out with Maverick, my original plan was for the shallow end of the lagoon...their shark tag teaming in the deep end may be heaps of fun for them, but a whole lotta stress on the beans

 

I think it was some sort of underwater sport happening, Furs vs Fins! ...let's stick to Marco Polo in the shallow side, mmmkay, Asia and Maverick?

 

PMPS 216, a bounce happening, perhaps? Took the reduction and shot 2 units, wish her luck sticking with it this time!

 

I agree with Wendy’s comment above. Only you know how hard you had to work to get her to stay above 50. I had days, once Gracie was no longer newly diagnosed, where the whole cycle was a struggle keeping her in the 40s/50s. Even though she hadn’t dropped below 40, I reduced.

 

I wouldn't say it was hard, it just required repeated interventions (4). She seemed like she might have surfed the 40s today if I let her, it didn't seem like she was trying to drop much lower than that, it just seemed like she wanted to hover in the 40s. It was pretty in line with her other cycles, the outlier was just the very low start. She drops a decent amount in the +1 and +2 more times than not and doesn't show a good food spike. Now I'll be on the lookout for a failed reduction. I really hope it sticks, though.

 

I hope this reduction holds for you!

 

The LagoonMeister is impressed with today's cycle. Now Asia can haul herself out onto the beach and play a little beach volleyball!

Nice job today, Stacy. Good luck with the reducie.

 

Me, too. You’ll at least have some data that will help you define whether she was signaling you for a reduction!

That was something that developed a year or two after we came here; even if one was struggling a bit to keep numbers up, we didn’t give the reduction unless the kitty went below the reduction point. But then it really became a common sense thing and i found out the hard way one night that it was a smart thing to do.

 

Stick to it Asia!!!