11-11 Moey 18 hour cycle +12=51 +12.5=50 +14=82 +16=124 +18=154(shot) +3=191 +5=174

Discussion in 'Lantus / Levemir / Biosimilars' started by Briere Fur Mom, Nov 11, 2019.

  1. Briere Fur Mom

    Briere Fur Mom Well-Known Member

    Joined:
    Sep 19, 2019
    11-10 (Yesterday) Good morning. I hope everyone has a wonderful day!

    I figured I'd try to get some advice before AMPS. So far Moey is approaching his lowest PS # ever. He dropped at some point last night. I thought he was in a slightly non active cycle by his #'s leading to PMPS +4. Well I slept through my alarm so, I don't know exactly when the drop occurred. He is either dropping slightly now or staying "flat" leading up to AMPS. I'm prepared to stall w/no food to see if I'm getting a rising number. If I don't get that rising number what are my options besides reducing his dose slightly. I can shoot the lower # if appropriate and monitor. I was thinking this increase was a little much but, I'm trying to follow the TR dosing guidelines(which I didn't in the past). Thoughts?

    K, enough drama Moey!
    Happy veterans day. Your service to this country is the ultimate gift. Who knows what this country would be like without you!!!!!
    Prayers for all the kitties and beans! Sweet ones be good for your beans today..
     
    Last edited: Nov 11, 2019
  2. Tina Marie (GA) and Jan

    Tina Marie (GA) and Jan Well-Known Member

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    Jul 24, 2019
    Thoughts? Well the 1.25U sure put him in nice numbers quickly. Even if he is rising, it looks like he would/might go low with another dose of 1.25.
    Same thoughts you were having, so that didn't help much!
    First, is he rising?
     
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  3. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    Sep 19, 2019
    K I'm going to stall for now. He's still dropping. BG=51
     
  4. Sandra And Buddy (GA)

    Sandra And Buddy (GA) Well-Known Member

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    Oct 4, 2019
    And Moey say's, "Hold my beer, Watch this!"
     
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  5. Christie & Maverick

    Christie & Maverick Well-Known Member

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    I'm sorry, I am at work and can't see your SS, are we at about 20-30 minutes now since you started stalling? If yes, can you please test? He may be coming up now.

    ETA: you mentioned that he was dropping to the 51, what was the number before, and when?
     
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  6. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    I guess I'm going to use my experience with Ittle on this. If he doesn't give me a rising # then possibly try an 18 hour cycle. He should def have a higher # by then. The question at that point is going to be the dose. Assuming he has a higher than normal #(blues/yellows) the 1.25u should be appropriate to rein him back in. But, the following dose(AMPS) should that dose be reduced to the fat 1u instead of the full reduction back to 1u. Hmmmm. I don't like trying to predict the future:banghead:
     
  7. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    Sep 19, 2019
    +12.5 Bg=50
     
  8. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    Sep 19, 2019
    PMPS +9=69(7:30am) +11=60(9:30am) Eastern standard time
     
    Last edited: Nov 11, 2019
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  9. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Well arguably within meter variance from +11 to now...so flattish, but you are right on that no shoot number, and it's a little too close for my comfort. Depending on how off schedule you can be, you can continue to stall another 30 minutes. Or maybe not a bad idea to do your 18 hour cycle, I've never done that. No previous issues with diabetic ketoacidosis? That would be a consideration if you skip altogether.
     
  10. Christie & Maverick

    Christie & Maverick Well-Known Member

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    As far as dose, he hasn't earned a reduction...yet.
     
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  11. Tina Marie (GA) and Jan

    Tina Marie (GA) and Jan Well-Known Member

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    Jul 24, 2019
    This sounds like a good plan to me - especially if he's still dropping - then wait until the next preshot to decide dose (?)
     
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  12. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    No hx of DKA. Always neg on ketone urine strip. I can be off schedule(work from home). I can continue to stall but, Moey is going to kill me and eat me alive next time I test and he doesn't get fed. He's starving! LOL:p
     
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  13. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Since he’s not going up from my experience it’s best to feed as he might continue to drop. I’d do an 18 hour.
     
  14. Christie & Maverick

    Christie & Maverick Well-Known Member

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    So here's some food for thought (and future consideration). Again, I'm not overly familiar with Moey and can't see the SS (at work, not anything you've done), but depending on how much data you have collected, and how familiar you are with how the insulin is working for him (onsets, nadirs, duration, carryover), shooting lower numbers won't be so scary. This time around, his nadir was basically +12. I remember being told a few times that stalling is mostly for the caregiver's benefit! That said, I would be very nervous shooting a 50 if you don't have enough data to support that.
     
  15. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    I think if it were me, I'd go for the 18 hour cycle at this point, best to be on the safe side. I need to sign off now, but hope Moey enjoys his breakfast :)
     
  16. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    Does this help?

    moey.jpg
     
  17. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    I don't have data shooting low #'s with him. Last night was my first green shot with him and it was basically a blue(98). Last night PMPS was 98, +1=113, +2=111, +4=116 +9=69 +11=60. I have tons of data just not with the lower numbers. He was a typical cycle cat(+2 higher than PS...food bump +3 onset, nadir around +4 - +6 with the occasional +9). With this increase he's dropping at +1 - +2 with little to no food bump and nadir around +3. I just increased him yesterday AMPS. I think he's trying to tell me the dose is a bit much:oops:
     
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  18. Sonia & Leo

    Sonia & Leo Well-Known Member

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    May 24, 2018
    Good luck Briere!! You did and 18 hour with Ittle and look where he is now!!! Moey is following in Ittle's footsteps!! :D:D:D
     
  19. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Thanks @Red & Rover (GA) is does! Since these lower preshots (last night's) and the doozy this morning are not Moey's normal pattern, I think we are right to be a bit more conservative... the 18 hour cycle seems the best choice :)
     
  20. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    a.m. cycles on November 5th and November 6th with lower preshots were interesting. Those may have both been late nadirs as well.

    ETA:
    Maybe...those nice greens on those days would have made me hold for a little longer, but my Mav is a bit of a slow starter, and a bouncer.
     
    Last edited: Nov 11, 2019
    Reason for edit: self-expanatory
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  21. carfurby (GA)

    carfurby (GA) Well-Known Member

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    Feb 19, 2012
    Moey is looking great. I think the 18 hour cycle is a good idea. I hope he keeps surfing safely.
     
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  22. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    Sep 19, 2019
    I'm thinking I should have waited too. Ittle started to show a downward trend on day 9 of his fattened dose.
    I didn't follow either dosing guideline to a T with Ittle....kinda blended them.
    With Moey I started trying to follow TR closely. When he began to give me higher nadirs I increased his dose. Really though his nadirs weren't terribly high. It just seemed he was trending up little by little. When I was threatening the dosecrease, Marje recommended the full .25u increase according to TR(instead of fattening). So, now here we are contemplating if I should have held the 1u or just fattened his dose.:confused:
     
  23. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Sorry, this popping and out from work is making me less than thorough in my answers :rolleyes:. Absolutely correct with TR to have increased as you did. My situation with Maverick is different, for a lot of reasons; and I have been known to linger too long over a dose :). It is likely that 1u wasn't cutting it for Moey, and the 0.25u increase gave Moey enough of a kick in the pants to get back into nicer numbers. He really is looking good with this dose.
     
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  24. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    I think the .25 increase was just what he needed. Some would have shot on time this morning but I wasn’t that brave for a long time. I did the 18 hour once because of personal reasons making it impossible for me to stay home to monitor. It took Max a few cycles to get back to green nadirs so don’t be surprised if that happens.
     
  25. Crista & Ming

    Crista & Ming Well-Known Member

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    Jun 10, 2018
    Glad you got help this morning, Briere! I hope Moey behaves for you.

    I would have increased too, just judging by his numbers. Sometimes they do need that kick like everyone’s said but it’s also important to Know Thy Cat. For now, 1.25u is working great and it’s good you’re able to monitor closely.
     
  26. Sue and Luci

    Sue and Luci Well-Known Member

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    Nov 3, 2017
    Great that @Christie & Maverick were there to help you this morning!

    Looks like Moey is going to follow along his brother's footsteps! Those kids of yours - are something else!!! Great that you can monitor closely too!
     
  27. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    Sep 19, 2019
    Marje should withdraw the honorary BOS "award" she so cutely bestowed upon me last night. After all, it was only a 98 that I shot. I def. didn't have BOS this morning! Doesn't that sound like a broken record when saying, "I'll get the courage to shoot the low greens soon." I'm sure Moey will give me another opportunity to truly earn the BOS "award". :p
     
  28. AmandaE

    AmandaE Well-Known Member

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    Mar 18, 2019
    Good idea today with the 18hr cycle, I had heard of this strategy before but I had never seen it actually implemented... throwing that one in the ol' data bank :)

    Moey! you're looking great bud!!
     
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  29. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    Oh no...those BOS are yours! Once bestowed, and taken out of their original packaging, they are non-returnable and non-refundable :p. Put them up on a shelf until you get your next pair, and it will be a matching set. You'll be shooting green again :D
     
  30. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    You crack me up!!!
    Thank for your help and support today Christie! Your awesome:)
     
  31. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Hehe, finally someone who gets my sense of humour:woot:! Glad to help, but it was me and a few others, it was a team effort, and you already had a plan, we just all pitched in and said it was a good one ;)
     
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  32. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Welllllllllllll............

    If you notice, he started up after AMBG. Because of the depot, he’d likely have done the same thing. He was basically flat from +11 on. I know the thought of shooting that 50 made you nervous but shooting and feeding him even some MC if you felt you needed to would have been the best option provided you had supplies and were available to test. That’s what TR is all about!

    Shooting 18 hour cycles is a good tactic if you can’t be home by shot time or, perhaps, for a high dose cat. But in this instance, it wasn’t an option I would have ever suggested. Just as others in LL have, in the past, thought that skipping a shot to “drain the depot” was an option, it’s usually best reserved for high dose cats or caregivers who are not able or available to monitor.

    With a few exceptions, shooting the full dose, on time, is the best option for the cat as long as the BG is 50 or higher.
     
  33. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    Sep 19, 2019
    I knew you were going to scold me:eek:. I'll do better next time promise. You can have the BOS back:oops:
    He started rising at +2(12:30pm) because he finally chewed my leg off and got something to eat around noon:p. That +12 of 50 really scared me, obviously. It's like c'mon Moey give me a mid 60's or 70 smthg for my first lower green shot...NOT a 50 for goodness sake. Next time, I'll just shoot and steer:):nailbiting:;)
     
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  34. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Oh, my dear! Not a scold at all! It was meant as teaching so you’d know the options you weren’t given. You didn’t do bad so you don’t need to say you’ll “do better” next time.

    My “job” is to give you the best advice to help you get Moey well-regulated. You still hold the syringe so it’s your decision...there’s no judgement here. Promise.:)

    You earned the BOS! No taking back.;):woot:
     
  35. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    Sep 19, 2019
    I was just kidding around with you about the scolding and giving the BOS back(they're mine forever!). I know you're not judging, too.:) I look forward to you posting on Moey's / Ittle's threads. Your advice holds a lot of weight. I was serious about doing better on my next opportunity to shoot a lower green. Learning, through doing, is improvement...for me at least.;)
    I should have posted in the original reply to you that I was joking around, as not to bump this thread back to the top. I just wanted to make sure you knew that you haven't hurt my feelings or anything of the sort.:cool:
     
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  36. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Thank you for a great post. And for clarifying. I appreciate your concern and letting me know all is :cool::cool:
     
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  37. Crista & Ming

    Crista & Ming Well-Known Member

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    Jun 10, 2018
    What a great thread to read :D This is why I love this board! There’s so much to learn and every situation has its own little nuances to understand.
     
  38. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    I knew you were kidding ;). Here are some observations., FWIW. It was really slow yesterday, so by the time a few of us joined you, you had already started stalling. Part of what I try to take into consideration is how comfortable the caregiver is right then and there and that affects my response. To me, you had already decided what you wanted to do, and at that point it was the right decision for you. You had never shot that low, of course there are emotions! If I had suggested feeding and shooting, would you have done it? If a more senior member had come by and suggested it, would that have changed anything? I don't think so. And even more critical for me, I would have never suggested you shoot and leave you hanging! I wasn't able to stay and help you if you needed it. Who knows what that cycle would have looked like if you shot. I've seen some stay flat, I've also seen active cycles, with lots of testing and intervention.

    It is very easy to look back and assess, and certainly now you might have a different view when you get a low preshot, armed with a few more options to weigh when you make your decision :).
     
  39. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    Sep 19, 2019
    You are correct. I had a plan in place. Wasn't the smartest one. ECID and what works for one may not work for another.
    Probably not. I would have held to the 18 hour because I had success with Ittle.
    Again, probably not. Seniority has nothing to do with it. What it boils down to is my comfort level. I respect everyone's opinion on this board. Each individual has something unique to offer the "collective" mind. It's beneficial to have different views to present a variety of options.
    I know you wouldn't have left us. You were at work and couldn't fully support us. That's one of the golden rules of this board that I love and appreciate so much. You never leave someone hanging. The board was slow yesterday morning. I'm sure if someone else was on that could assist you would have suggested I shoot. You stayed within my comfort level and the support available at the time. You did everything purrfectly!!!! And I truly thank you for it!!!:smuggrin:
    You're absolutely right. It could have been a, " Gotta have some shots of liquor after this is over" type of cycle for sure! I experienced something less severe with Ittle(#'s stayed flat even with HC and Karo). I just have to remember that I'm in control and hold the reins. I own the cycle, it doesn't own me! We have all the tools necessary to steer the cycle or abort it all together.
    It's very easy to reassess things when it's all over. That's knowledge. Looking at every angle, trying to constantly improve. I see things a little more clearly now.
    I hope you will continue to weigh in with Moey's journey. He has a long way to go and needs all the friends he can get!!!!:bighug:
     
  40. Gill & George

    Gill & George Well-Known Member

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    Oct 27, 2015
    Look at Moey!!!
    Congrats on the BOS, I chickened out on my first 50 (it was like the third of 4th green PS), I ended up stalling almost 4 hrs. I learnt a lot from that experience, that was the last time I stalled, and I never did get the opportunity to shoot a 50 again LOL

    Looks like you were able to gather some data that will give you the confidence to shoot low.
     
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