1/22 Yum: AMPS 84 +2 49 +2.5 53 +3 131+4 253 +10.5 74 PMPS 75+2.5 85+3.5 76+4.5 89+6.5 123 (AT2)

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by MJW, Feb 22, 2018.

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  1. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    When I saw the AMPS 84, I gave her a 1 unit reduction.
    I guess that was too ambitious, because of the depot.
    At AMPS+2 she was 49.
    I'm feeding her a half a can of FF chicken gravy.
    I will retest in 30 minutes.
     
  2. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    Dec 28, 2009
    Just an observation...

    Looking at Yum's numbers from your last test in the PM cycle vs the AMPS, numbers were dropping. You may need to be aggressive with the HC. I like your plan to re-test in 30 min. Depending on what the numbers tell you, you may want to add some syrup to the HC.
     
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  3. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    I gave her more syrup and ff gravy at AMPS+2.5, when I saw the 53. I will test again at +3.
    What should I have done differently this morning?
    Should I have given her a 2/3 shot?
    What dose will I give her this evening?
     
  4. Doodles & Karen

    Doodles & Karen Well-Known Member

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    The last test at 118 to the AMPS this morning while dropping would not have set a big alarm off for me. I would've given the full dose and have had mornings like you are having currently. Maybe next time you can stall 30 min. and see if she's flat, rising or still dropping.

    See what Yum does today and how hard it takes to keep her up before deciding on tonight's dose. She did earn that reduction you gave this morning but you may want to think about a BCS tonight or possibly and/or a larger reduction because of the cabergoline .
     
    Last edited: Feb 22, 2018
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  5. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    You did just fine! I wouldn't have done anything differently.

    It looks like Yum may be bouncing. There's no way to know whether to give a reduced dose. The only time I see that as viable is if numbers were even lower and you weren't going to be able to monitor. However, due to the way the depot acts, reducing the dose may not have an effect during the current cycle. It's always a bit of a guessing game.

    I would not try to second guess how the rest of the cycle will go and what the PM dose will need to be. If you're following TR, given that Yum is a long term diabetic, you wouldn't reduce. The acro diagnosis always adds a dimension to those decisions, though. I'd like @Wendy&Neko to weigh in. It's looking like Yum may be wanting a dose reduction to my eyes but Wendy is much more experienced with acro kitties than I.

     
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  6. MJW

    MJW Well-Known Member

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    @Wendy&Neko did advise a few days ago (on Yum's first reduction) that I follow standard TR and not long term diabetic TR because she is a high dose acro.
    She also recommended BCS shots to begin a reduction, to drain the depot.
    This morning I took a reduction going into what would likely be a bright green, but it wasn't enough.
    Perhaps I should have (a) stalled (as recommended by @Doodles & Karen) or (b) just done a BCS low dose.
    I don't want to start her bouncing, but maybe I did that anyways with all the FF gravy and Karo.

    Thanks everyone for your advice.
     
  7. Doodles & Karen

    Doodles & Karen Well-Known Member

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    See where she is at PMPS. 49 on AT is way to low. At the very least if she's high the new dose would be the 13.75u you shot this morning. If it were me I'd try 13.5 even just to get me back on the line. If she comes back down by PMPS shooting a BCS is an option. The cabagoline in the mix also creates the need for additional caution IMHO.

    Sure Wendy will chime in . My 2 cents is only worth a half a penny.
     
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  8. Wendy&Neko

    Wendy&Neko Well-Known Member

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    My Canadian $.02 isn't worth much either if you look at the exchange rate. :p I agree with Karen, I might try 13.5 to get back on the line. The larger depot is likely a bit in play, but it's a little past 3 weeks since starting Cabergoline and 2-3 weeks seems to be the time frame when I've seen action starting from it. With the larger depots and cabergoline in the mix, I'm more cautious. Try the reduction, and you can go back up if it dosen't hold. I said that many times to Nat when Marvin started working the cabergoline. She never went back up.:cool:

    If Yum drops back down for PMPS, you might want to do that one time BCS where you take 1/2 or 1/3 off the dose (so do 7-9 units) to try to drain the depot some more. Bonus, it's night time so might get more sleep.
     
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  9. MJW

    MJW Well-Known Member

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    AMPS+10.5 74
    I don't want to jinx it, but WOOHOO YUM!
    Hope I didn't jinx it.
    Maybe tonight I will give her a BCS shot of 10 units, just to be a little aggressive.
    Then, in the morning, assuming she rises, I will give her what? 13?

    I might need to give her some carbs at PMPS. Or before. We have 1.5 hours to go.
    Maybe the BCS will be 9u or 8u.

    I like having these problems for a change, although they are high stress.
     
  10. Doodles & Karen

    Doodles & Karen Well-Known Member

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    She certainly came back down:):nailbiting: . IDK, being aggressive at this point is not what I would do personally. You want to get to a dose where you can hold for 6-8 cycles otherwise you're constantly guessing where the depot is with a chance of it getting ahead of you. I'd likely go with a BCS of 7 or 8 units tonight (help drain the depot a bit) which doesn't guarantee there still won't be some action tonight. Then try the 13.5u tomorrow morning. Hopefully @Wendy&Neko is around to weigh in.
     
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  11. Doodles & Karen

    Doodles & Karen Well-Known Member

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    BTW, hope you gave her a little snack at that 74 and that she's even at a shootable number for PMPS!
     
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  12. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    I tried feeding her. Unfortunately, she is now refusing everything but fancy feast gravy. She nibbled some mixed with raw at PMPS. She is hungry but stubborn, I think. I will wait her out or try canned salmon. Or I could dig out LC fancy feast pate. Fancy Feast is really bad for her kidneys. Cats!

    I did open a new vial of Lantus on 2/17. I hope that didn't have anything to do with her lower numbers. I hope there are other more positive reasons.
     
  13. Doodles & Karen

    Doodles & Karen Well-Known Member

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    Cats and their food drive me insane :arghh: It’s not food if they don’t eat it though, Hope it’s an uneventful night for you both.

    Might want to update your title so people scanning can check in if needed.
     
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  14. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    Paws crossed for a nice surf tonight. BTW, that 85 on the SS should be green. :D

    Hard to say if the new vial made a difference. She was seeing blues before you started it.

    Eat the good stuff Yum!
     
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  15. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    No sleep for me. If she keeps this going another hour, I guess I will give her Fancy Feast gravy again.
     
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