11/1 Blaze AMPS 279 +1 228 +2 235 +3 168 +7 129 +9 170 +11 126 PMPS 137 +2 253

Sweet Blaze Boy:cat: Be good to your momma this weekend by working the juice and providing life giving cuddles and purrs so she feels all better :bighug::bighug::bighug: So glad you have these 3 days to lounge, heal and recharge ,Sarah :bighug:
 
Time will tell! I do think that the high numbers the last couple days were probably due to the pretty greens the other night, and he's breaking it now, but I don't think the 0.25 increase this morning will make much difference in how it plays out. It'll mostly be the depot working today.

Where it will get interesting is if he drops into lime greens and requests a reduction, but for now, he's looking good in blue!
 
Nan & Amber (GA) said:
Time will tell! I do think that the high numbers the last couple days were probably due to the pretty greens the other night, and he's breaking it now, but I don't think the 0.25 increase this morning will make much difference in how it plays out. It'll mostly be the depot working today.

Where it will get interesting is if he drops into lime greens and requests a reduction, but for now, he's looking good in blue!
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I’m afraid this new dose is going to drop him into lime greens, earn a reduction and take us right back to 1.5U and then bounce for days :woot:
 
Hah! Wouldn't that be a trip.

Do you have any tests past the +3?

My opinion: if he were to drop into lime greens today, I'd call that the 1.5U depot, and reduce from there, not 1.75.

Not that you were, or would have wanted to be, awake for most of it, but last night and this morning he was pretty flat in yellows. Sometimes, a cycle like that (assuming that's what he did in the middle, too) can precede a bounce-breaking cycle. Looks like he might have done something similar on 10/20, too. I don't know that that is enough data to call it a pattern with him, but just something to watch out for!
 
Nan & Amber (GA) said:
Hah! Wouldn't that be a trip.

Do you have any tests past the +3?

My opinion: if he were to drop into lime greens today, I'd call that the 1.5U depot, and reduce from there, not 1.75.

Not that you were, or would have wanted to be, awake for most of it, but last night and this morning he was pretty flat in yellows. Sometimes, a cycle like that (assuming that's what he did in the middle, too) can precede a bounce-breaking cycle. Looks like he might have done something similar on 10/20, too. I don't know that that is enough data to call it a pattern with him, but just something to watch out for!
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I had to run some errands so had to leave the house and was gone after +3 and just got home and got a +7 test. I’m home for the rest of the day and night too.
So if he were to earn an deduction today/tonight, you are saying I should reduce from the 1.5U then? So reduce to 1.25U? Who knows if that will even happen! I never know what to expect with this guy!
 
http://www.felinediabetes.com/FDMB/...ps-359-1-335-2-228-3-214.221115/#post-2469640

Link to yesterdays condo for continuity.

It does look like the bounce is breaking this cycle. You may find he continues to drop through to pmps.
Get another test sooner rather than later if you can (I think you should be around +8 now)

If he earns a reduction I would take him back down to 1.5u.
Shooting an increase as they clear a bounce can create more downward movement than you would have otherwise had.

I'm sorry no one got back to you when you asked about a dose increase yesterday, it was late at night for me here and I wasn't on line, I didn't get notification of the tag, and I checked back to see if I'd missed it, but it wasn't in my alerts, I don't know why but this can sometimes happen, sorry.
A little tip for the future, when you have a dose question (or any other question) ask it on the title and use the ? prefix from the drop down list. So, for example, yesterday 10/31 Blaze AMPS *** +3*** dosecrease??

About the dose increase, if you don't get a response, I remember a member (Wendy) advising me as a newbie, to look back at the guidelines and see what part of the guidelines on increasing the dose applied. That was very good advice and stood me in good stead.

So from the sticky on SLGS/TR
Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.

Because the cycle count restarted after the 0.75u, you've only held the dose 7 cycles I would have waited for 10 at least but would have probably liked to see if he landed back in green after the bounce. You were right in your condo yesterday, the high numbers you were seeing yesterday were a bounce, and ideally you would have waited for the bounce to clear before taking the dose up.

It's late for me, and I'm just about to hit the sack. Good luck with the rest of the cycle.

 
I've got to go to bed, but I've sent a message to a number of experienced members, across timezones.

Going to give you a plan of action
1) monitor BG, if you find she's continuing to drop monitor regularly. If rate of drop is fast you may need to do this at 30min intervals, and you may need to intervene with food, try to not feed after +10 (unless you have to because she is below 50) you don't want pmps to be food influenced
2) do get a +11 today and then a pmps, if she is flat blue or still dropping, you may want to consider skipping and resetting the dose if you have no one experienced to guide you.
3) If she is high at pmps, I might go back to 1.5u , I don't like flip flopping with dose but I am concerned that the 1.75u may prove too much for Blaze. So safety first.

ETA I would take the dose back to 1.5u even if she hasn't earned reduction to be safe.

Hopefully some of the folk I've messaged will get back to you.
 
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Gill & George said:
http://www.felinediabetes.com/FDMB/...ps-359-1-335-2-228-3-214.221115/#post-2469640

Link to yesterdays condo for continuity.

It does look like the bounce is breaking this cycle. You may find he continues to drop through to pmps.
Get another test sooner rather than later if you can (I think you should be around +8 now)

If he earns a reduction I would take him back down to 1.5u.
Shooting an increase as they clear a bounce can create more downward movement than you would have otherwise had.

I'm sorry no one got back to you when you asked about a dose increase yesterday, it was late at night for me here and I wasn't on line, I didn't get notification of the tag, and I checked back to see if I'd missed it, but it wasn't in my alerts, I don't know why but this can sometimes happen, sorry.
A little tip for the future, when you have a dose question (or any other question) ask it on the title and use the ? prefix from the drop down list. So, for example, yesterday 10/31 Blaze AMPS *** +3*** dosecrease??

About the dose increase, if you don't get a response, I remember a member (Wendy) advising me as a newbie, to look back at the guidelines and see what part of the guidelines on increasing the dose applied. That was very good advice and stood me in good stead.

So from the sticky on SLGS/TR
Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.

Because the cycle count restarted after the 0.75u, you've only held the dose 7 cycles I would have waited for 10 at least but would have probably liked to see if he landed back in green after the bounce. You were right in your condo yesterday, the high numbers you were seeing yesterday were a bounce, and ideally you would have waited for the bounce to clear before taking the dose up.

It's late for me, and I'm just about to hit the sack. Good luck with the rest of the cycle.
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This is all so hard for me because I have people telling me he’s due for an increase and so I give him an increase and then I have others telling me I shouldn’t have increased. It’s all so confusing and makes it really hard for me to know if I’m making the right decisions or not. I try to use the ? Prefix and questions in my thread title when needing advice about a dose increase and I still barely get any responses. I did that yesterday and the response I got was that he was due for an increase.

I go back and read the guidelines often because I’m new to TR and I think of holding the dose for 10 cycles, due to Blaze being pretty bouncy after he hits low numbers, and then others tell me I’m holding a dose too long and need to increase the dose. I just feel like no matter what I do, I’m wrong:(
I was afraid 1.75U was going to be too much for Blaze too, I should have seen that yellow amps as a bounce clearing and held the 1.5U.

I’m going to get a +9 now and a +11 like you said, and of course the PMPS. His last snack was at +7 so he’s not food influenced at this point. If +11 and PMPS are flat blue, I might skip the pm shot like you suggested and start back at 1.5U tomorrow.

Unless someone else can offer some more advice, I’m not sure what else to do if he’s clearing a bounce today. I don’t want to shoot 1.75U at pm shot and have to work really hard to feed and test and keep him from dropping too quickly.
 
+9 is 170. If +11 and PMPS are flat blues, I’m thinking I might skip the shot tonight and let the depot drain a bit. If he’s clearing a bounce today/tonight, I don’t want him dropping dangerously low. I’m still not feeling well, taking lots of cold medicine and have been trying to rest at home, I’m not sure I’m “healthy” enough for fast dropping numbers tonight.
 
If you think it's best to go back to 1.5 units tonight so you can keep Blaze safe, I'd do that. You need to have time to rest too so you can get over your cold. Sometimes there are circumstances where you may want to wait to increase the dose, like you being sick, that don't exactly follow the guidelines. You have to take care of yourself so you can take care of Blaze. Sending prayers.
 
carfurby said:
If you think it's best to go back to 1.5 units tonight so you can keep Blaze safe, I'd do that. You need to have time to rest too so you can get over your cold. Sometimes there are circumstances where you may want to wait to increase the dose, like you being sick, that don't exactly follow the guidelines. You have to take care of yourself so you can take care of Blaze. Sending prayers.
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Thank you Carla! @Gill & George suggested skipping the shot tonight if Blaze’s +11 and PMPS are flat blues, indicating a possible active cycle with the bounce breaking. I guess I’ll see where he’s at with +11 and PMPS before I decide. But Gill also suggested going back to 1.5U either way, whether it be tonight or tomorrow morning.
 
Hi Sarah--

I'm sorry this is so confusing, and I'm sorry no one got back to you about the dose change. I agree with the cautious approach here, maybe going back to 1.5U tonight [ETA: or a skip, as suggested]. Why push things when you're feeling sick? Blaze will be fine, he's certainly not in any danger here, and you didn't do anything wrong by increasing this morning. It's just that the situation changed a little when he hit that green the other night, making the increase less obviously necessary today, and waiting for the full 10 cycles a more attractive option. The two wild cards here are your schedule and your current illness, with the first pushing more in the "increase when you can do the testing" direction and the second in the opposite direction, because while you can do the testing this weekend, you'd probably much prefer taking the opportunity to take care of yourself with some extra sleep! And that would probably be better for Blaze in the end, too-- you have to take care of yourself first so you can take care of him.

Anyway, I'll be interested to hear what the experienced people have to say about this, but my vote is for backing off while you get better. Blaze is in lovely blue numbers today largely because of the 1.5U depot and he had that nice run of greens the other night, so that dose is capable of getting him to a decent level.
 
Nan & Amber (GA) said:
Hi Sarah--

I'm sorry this is so confusing, and I'm sorry no one got back to you about the dose change. I agree with the cautious approach here, maybe going back to 1.5U tonight [ETA: or a skip, as suggested]. Why push things when you're feeling sick? Blaze will be fine, he's certainly not in any danger here, and you didn't do anything wrong by increasing this morning. It's just that the situation changed a little when he hit that green the other night, making the increase less obviously necessary today, and waiting for the full 10 cycles a more attractive option. The two wild cards here are your schedule and your current illness, with the first pushing more in the "increase when you can do the testing" direction and the second in the opposite direction, because while you can do the testing this weekend, you'd probably much prefer taking the opportunity to take care of yourself with some extra sleep! And that would probably be better for Blaze in the end, too-- you have to take care of yourself first so you can take care of him.

Anyway, I'll be interested to hear what the experienced people have to say about this, but my vote is for backing off while you get better. Blaze is in lovely blue numbers today largely because of the 1.5U depot and he had that nice run of greens the other night, so that dose is capable of getting him to a decent level.
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Thank you Nan, you really have been so helpful and I appreciate it! I should have held off on the dose increase, because to me, it looks like the 1.5U is doing pretty well for Blaze, at the moment. The yellows and pinks and occasional reds are bounces from the lower numbers, and with that yellow Amps this morning, I should have held the 1.5U and am kicking myself now for taking the dose up instead of waiting.

How should I decide whether to shoot tonight or skip? Any suggestions?
 
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Sarah and Blaze said:
I’m afraid this new dose is going to drop him into lime greens,
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IF you suspect he's getting too low - start feeding him some medium carb food to steer him away from the lime greens. You don't want him losing out on a good dose too soon...those blues are looking good...now if he can just get to the lagoon...and stay in the safe areas.

I'm on the road for the next two days so will not be on the forum much - I can read some on my phone but it's pretty challenging to type on it in the car.

I hope you and Blaze have a good evening and a wonderful weekend! I hope he works this dose and hits some nice greens soon. And that your cold is better!

Take care Sarah!
 
I suspect what also wasn't clear is that whenever you adjust a dose, like the 0.75u on 10/28, the dose count starts over. So, if you do end up skipping or reducing the dose tonight, you either start the clock tomorrow AM if you skip or tonight if you reduce.

Right now, the big question, at least for me, is whether numbers numbers will be dropping at PMPS.
 
Sienne and Gabby (GA) said:
I suspect what also wasn't clear is that whenever you adjust a dose, like the 0.75u on 10/28, the dose count starts over. So, if you do end up skipping or reducing the dose tonight, you either start the clock tomorrow AM if you skip or tonight if you reduce.

Right now, the big question, at least for me, is whether numbers numbers will be dropping at PMPS.
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So after the dose reduction on 10/28 in the am and then going back to 1.5U at the pm, I should have waited ten cycles before I thought about an increase, right? I increased too soon when I increased today?
 
Right, the fact that he saw green the night of the 29th puts you in this zone:

Gill & George said:
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
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but it was only cycle 8 this morning.

Going a bit early wasn't a harmful move by any means, the risk was that it might have led to him breaking the bounce with a bit more gusto and ending up in the limes, but you were monitoring and he was safe (and as Gill mentioned, he still might have some more moves in him tonight, but you are on your guard for that, too).

And the good news is, all of this has as its backdrop the fact that Blaze is (slowly) getting more stable and spending more time in good numbers! Dose decisions are easy when he's just up high all the time the way he used to be, the fact that it's a bit more complicated now is a good sign, as frustrating as it is for you!
 
Sorry, another one who did not get your tag yesterday for some reason. Plus I has at a party last night so only briefly peaked at the board.

Cats often give you hints on the first cycle of a new dose, as to how that dose will do. I would not call today’s action strictly from 1.5 units. As for timing of increase, I always made it a practise to wait at least six cycles after a green, especially if rare and lower than used to.

+11 could be a Lantus double dip. A good number to have to compare against preshot.
 
Nan & Amber (GA) said:
Right, the fact that he saw green the night of the 29th puts you in this zone:



but it was only cycle 8 this morning.

Going a bit early wasn't a harmful move by any means, the risk was that it might have led to him breaking the bounce with a bit more gusto and ending up in the limes, but you were monitoring and he was safe (and as Gill mentioned, he still might have some more moves in him tonight, but you are on your guard for that, too).

And the good news is, all of this has as its backdrop the fact that Blaze is (slowly) getting more stable and spending more time in good numbers! Dose decisions are easy when he's just up high all the time the way he used to be, the fact that it's a bit more complicated now is a good sign, as frustrating as it is for you!
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Okay, got it, that makes sense. So for future reference, hold the dose for 10 cycles when he’s seeing nadirs under 100.
I’m glad I didn’t make a harmful move by giving the 1.75U, BUT I wish I would have held the 1.5U for the full 10 cycles.
I’m glad that he’s slowly seeing better numbers though, this is all great! I just want to make sure I’m doing things right and keeping him safe. It’s definitely harder decisions when he’s in these lower numbers though!
 
With these numbers tonight, should I be skipping the shot to maybe let the depot drain since he has been slowly dropping all day?

I’m sick and am not sure if I can stay up all night to test and feed and steer him.. not sure what to do.
 
Also, I’m starting to move shot times 15 minutes starting tonight, so that on Sunday I am shooting at “6:30 am” when daylight savings starts.

But thinking it might be best to skip the shot tonight.
 
Ooh, that +11 sure makes skipping look like a good option! Although I'd still wait for PMPS to make the decision-- he may be heading back up again by then if that 126 is part of a double-dip.

If you end up skipping, you'll still want to get a +2, just to make sure he's not up to something anyway. But hopefully he'll behave himself and let you get a full, restful night's sleep!
 
Nan & Amber (GA) said:
Ooh, that +11 sure makes skipping look like a good option! Although I'd still wait for PMPS to make the decision-- he may be heading back up again by then if that 126 is part of a double-dip.

If you end up skipping, you'll still want to get a +2, just to make sure he's not up to something anyway. But hopefully he'll behave himself and let you get a full, restful night's sleep!
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PMPS is 137, so I think I will skip tonight and start back at 1.5U tomorrow and give him a full ten cycles on the 1.5U before I decide on an increase again. I will definitely get a +1 and 2 tonight also.
 
Sarah and Blaze said:
With these numbers tonight, should I be skipping the shot to maybe let the depot drain since he has been slowly dropping all day?
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There wasn’t really a depot to drain, just the depot of the 1.5 unit dose, which you are going back to. One cycle of the higher dose wouldn’t have made enough 1.75 unit depot to worry about. For future reference, and just for this weekend, you could have delayed an hour to see if he was continuing to rise and still stayed on schedule. Since the shot is moving back an hour anyway with the time change. A delayed shot can act a bit like a dose reduction, so might have been an acceptable option.

Sleep well.
 
Wendy&Neko said:
There wasn’t really a depot to drain, just the depot of the 1.5 unit dose, which you are going back to. One cycle of the higher dose wouldn’t have made enough 1.75 unit depot to worry about. For future reference, and just for this weekend, you could have delayed an hour to see if he was continuing to rise and still stayed on schedule. Since the shot is moving back an hour anyway with the time change. A delayed shot can act a bit like a dose reduction, so might have been an acceptable option.

Sleep well.
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I’m just trying to be cautious tonight. I should have held the 1.5U for ten cycles so the increase this morning was too early. By advisement from others, I’m skipping tonight, because it’s what I’m comfortable with, and going back to 1.5U tomorrow morning and holding that dose for 10 cycles this time. I will reassess the dose after 10 cycles. I may have been able to stall the shot for an hour tonight but that would mean, if I did shoot, I would be staying up even later to test and with the severe cold I have right now, that’s not something I want to do tonight. I want to get over this cold, not prolong it. So skipping tonight was the best option for me and Blaze. Back to business tomorrow.
 
Gill & George said:
I've got to go to bed, but I've sent a message to a number of experienced members, across timezones.

Going to give you a plan of action
1) monitor BG, if you find she's continuing to drop monitor regularly. If rate of drop is fast you may need to do this at 30min intervals, and you may need to intervene with food, try to not feed after +10 (unless you have to because she is below 50) you don't want pmps to be food influenced
2) do get a +11 today and then a pmps, if she is flat blue or still dropping, you may want to consider skipping and resetting the dose if you have no one experienced to guide you.
3) If she is high at pmps, I might go back to 1.5u , I don't like flip flopping with dose but I am concerned that the 1.75u may prove too much for Blaze. So safety first.

ETA I would take the dose back to 1.5u even if she hasn't earned reduction to be safe.

Hopefully some of the folk I've messaged will get back to you.
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Thank you for helping me with a plan of action before you went to bed, I appreciate it! Like I told Nan, due to Blaze’s flat blues pretty much all day and at +11 and PMPS, I decided to skip the shot tonight to be safe and will start back at 1.5U tomorrow morning and will be holding that dose for ten cycles. He’s already coming back up at the +2 but I feel better skipping tonight and getting back on track tomorrow, with being sick and all. Just wanted to say thank you for your help!
 
Sarah and Blaze said:
1.5U tomorrow morning and will be holding that dose for ten cycles.
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That depends, you net to let the numbers be your guide.
You start the count again.
So you hold 6cycles, see where his nadir is and then decide whether you need to hold or not.
Their insulin requirements can and do change, what seemed to be working well this last week, may leave him in high numbers in the days to come, or not...
If he was in say pinks and yellows for 6cycles on this dose, you might want to take him up. If he is seeing blue or green, you'd hold longer.
 
Gill & George said:
That depends, you net to let the numbers be your guide.
You start the count again.
So you hold 6cycles, see where his nadir is and then decide whether you need to hold or not.
Their insulin requirements can and do change, what seemed to be working well this last week, may leave him in high numbers in the days to come, or not...
If he was in say pinks and yellows for 6cycles on this dose, you might want to take him up. If he is seeing blue or green, you'd hold longer.
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Okay got it! Thank you Gill!
 
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