11/17 Gizmo PMPS 241, +1=320, +2=312, +3=250, +4=185 , +5=158 -

Discussion in 'Lantus / Levemir / Biosimilars' started by LizzieInTexas, Nov 17, 2016.

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  1. LizzieInTexas

    LizzieInTexas Well-Known Member

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    11/16 thread

    Not as high a start. Stay off the trampoline today Gizmo.

    AMPS 290
     
  2. carfurby (GA)

    carfurby (GA) Well-Known Member

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    Nice blues last night. I hope Gizmo heads down today and doesn't bounce.
     
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  3. LizzieInTexas

    LizzieInTexas Well-Known Member

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    +1 254 tested a little late - got busy and forgot to set my reminder timer.
     
  4. carfurby (GA)

    carfurby (GA) Well-Known Member

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    Yay he's heading down.
     
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  5. LizzieInTexas

    LizzieInTexas Well-Known Member

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    I have a food/feeding question. I am sorting through all Gizmo's food this morning. I have about 2 1/2 cases (24/3oz) various FF foods. All are on the "approved" low calorie list here:
    http://catinfo.org/docs/FoodChartPhosphorus9-22-12.pdf

    How important is it to stay with the exact food while going through getting them regulated.

    I am currently feeding 2-3.2oz Weruva Cats in the Kitchen Fowl Ball and 1-3oz can FF Turkey & Giblets classic mixed together - this is for a 24hr period.

    Can I substitute the other variety of foods in with the Fowl Ball to use them up? Or should I stick with just the FF T&G? I would probably use 2-3 times/week until they were used up with T&G being the primary mixer.

    Tender Beef Feast Classic (a few cans)
    Fish & Shrimp Feast Flaked (little more than a case)
    Chicken Feast in Gravy Grilled (a few cans)

    I am ordering more of the Fowl Ball today - and I want to make sure I have enough of the mixers to add with it.

    I am trying to get everything I need to last through end of year ordered early - especially the food so I don't run out and am not stressing getting it here with the holiday shipping mess.

    Right now I am not too concerned with his phosphorous as he has always been normal (last labs on 10/18), but it is the primary reason I am transitioning to Fowl Ball - this is due to his ckd.
     
    Last edited: Nov 17, 2016
  6. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Yay!! I did a happy dance and made me smile - it still seems that the dose may not be quite enough though. I really thought I would be seeing a little green and maybe blue PS' - trying to be patient.
     
  7. LizzieInTexas

    LizzieInTexas Well-Known Member

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  8. carfurby (GA)

    carfurby (GA) Well-Known Member

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    I think it's okay to change food, but you may want to make a note on your SS when you feed something new in case it affects Gizmo's numbers. It does look like he will need an increase, but with SLGS, you need to wait a week. Hopefully he's getting used to the blues now and then when you increase he'll head to greens. He's doing good working his way down right now.
     
  9. LizzieInTexas

    LizzieInTexas Well-Known Member

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    So 14 cycles? I get confused because it hasn't always been the full time before recommending a dose increase here.

    I am ok with waiting - not an issue just checking. I would rather do this slowly and not get too much bouncy - bouncy I don't like.
     
  10. Doodles & Karen

    Doodles & Karen Well-Known Member

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    Even with TR when you see blue we hold the dose for at least 10 cycles. Since you're home on vacation if you don't see green I think you can increase on the 10th cycle. Even those following SLGS sometimes increase a little sooner than the 7 days if you have enough spot checks and are able to monitor.

    Today is the 6th cycle for the current increase and he's off to a good start! Lets see what you can do Gizmo.

    I also agree you can change his food up. It's better to have a few flavors in rotation so they don't get tired of one and stop eating it. They are cats and love to do that from time to time! Keeping notes on your SS in the comment section as Carla mentioned helps.
     
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  11. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Thanks Carla and Karen.

    How do I "tag"? @Doodles & Karen & @carfurby is there a way to do it automatically - or do you just type it out? Still learning how to operate here.

    This is Gizmo - lol. He doesn't care as long as it is food. :)
     
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  12. Doodles & Karen

    Doodles & Karen Well-Known Member

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    The tag came through! It's great Gizmo loves food. It makes this dance a whole lot easier when they are good eaters ;)
     
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  13. LizzieInTexas

    LizzieInTexas Well-Known Member

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    +3 162

    Blue!! :cool: +3 snack in about 20 min.
     
  14. Doodles & Karen

    Doodles & Karen Well-Known Member

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    I see green real soon...nice and easy buddy.
     
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  15. carfurby (GA)

    carfurby (GA) Well-Known Member

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    :cool::cool::cool:
    When you type a tag, after you start typing @ and the name a dropdown list pops up.

    One day is two cycles, so a week (7 days) is 14 cycles. I agree with Karen that you could increase after 5 days since you test so much. However, if Gizmo hits green today, you won't have to worry about an increase.
     
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  16. Gill & George

    Gill & George Well-Known Member

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    Morning Lizzie and Gizmo,
    not a bad start, hope he slides back into blue. (oooo just saw he did!)
    Being a good eater makes life a lot easier, like Carla and Karen said, you can mix it up and making notes of what you are feeding and when on the ss is useful, just in case you see odd patterns it can help you figure out if its food related.

    I think that you should be holding the dose for a little longer too. On TR it would be a minimum of 10 cycles. (a week/14cycles on SLGS)

    Now that you switched from the high carb renal diet ( I think it's been 5 weeks) and given that you monitor him so well there shouldn't be a problem following TR if you wished to. TR will allow you to make dose changes sooner, and you 'push' the BG down into that healthy range more proactively, that will see him get into a healthy range of BG quicker, the more he is in the healthy range the better it is for his kidneys, high BG's put a lot of strain on the kidneys.

    I seem to remember you talking about making the switch to TR once things had settled with him after making the food switch.

    :cool::cool::cool:
     
  17. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Nice +3 Gizmo! And nice job learning to tag. I had so much to learn when I first got here. Being a tech mo mo and never being on a forum before made an old gal learn new tricks!
     
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  18. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Ya'll are so kind and helpful. It really relieves a lot of stress. :bighug:

    +4 132

    I will just wait on the increase until advised. Maybe I won't need one :rolleyes::cool:. I did put a note on the SS to at the 10 cycle time - just as a reminder to myself.
     
    Last edited: Nov 17, 2016
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  19. Gill & George

    Gill & George Well-Known Member

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    Don't tease us Gizmo, we'd like to see you in your green trunks.:cool::cool::cool:
     
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  20. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Maybe. I am not sure right now. I am ok pushing it when I can test but to shoot low numbers and then leave for work - even with the autofeeder - scares the **** out of me! I don't know if I could handle it if something happened while he was alone and I was the cause. I almost can't even think about it.

    I am really pleased with the slow trend down right now though!
     
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  21. LizzieInTexas

    LizzieInTexas Well-Known Member

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  22. LizzieInTexas

    LizzieInTexas Well-Known Member

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    +6 125

    Pretty flat - but I will take it! Maybe tonight will be a green night. Maybe still a chance this afternoon.
     
  23. LizzieInTexas

    LizzieInTexas Well-Known Member

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    +7 173

    +6 snack was 40 min ago - # may be partially food bump.
     
  24. Gill & George

    Gill & George Well-Known Member

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    Gizmo you are such a tease LOL:cool::cool::cool:
    Stop eyeing up the lagoon and take a dip;)
     
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  25. Gill & George

    Gill & George Well-Known Member

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    Possibly, time will tell.
     
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  26. LizzieInTexas

    LizzieInTexas Well-Known Member

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    +8 185

    And it's done. Giving testing a rest until +11 unless someone sees a reason to continue?
     
    Last edited: Nov 17, 2016
  27. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    I do think you could easily do TR, but you have to be comfortable with how you're handling Gizmo's FD, so if you want to stick with SLGS for now, that's fine, too. Some people have switched back and forth, if they have a long stretch of being home - like teachers on a summer break - but I wouldn't do it if the breaks are fairly short (a couple of weeks). That's just my two cents' worth.
     
  28. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Is the primary difference the dosage changes? I just read through the sticky's this morning was wondering at the time.
     
  29. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Pretty much. With SLGS you wait 7 days to change the dose, unless a decrease is earned, and the threshold is 90 (on a human meter), as opposed to 3-5 days and 50 (40 for long term diabetics) with TR. With SLGS, you get your preshot tests daily and do a curve once a week to determine if a dose change is needed (although you can test more and we encourage that). With TR you need to get a minimum of the preshot tests and at least one mid-cycle test daily (although we encourage at least one mid-cycle test per cycle) and adjust dose accordingly. TR is more aggressive, as you don't leave the kitty sitting in high numbers for a week, as can happen with SLGS, but you do need to monitor a bit more and be ready to make changes. Also, SLGS allows dry food (although it's discouraged), and TR absolutely does not allow it. TR is based on documented research, while SLGS was developed by lay people looking to find a more schedule-friendly, less intensive method.

    If you haven't already read it, the post about doing TR with a full time job has some good info.
     
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  30. LizzieInTexas

    LizzieInTexas Well-Known Member

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    +11 114
     
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  31. Gill & George

    Gill & George Well-Known Member

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  32. LizzieInTexas

    LizzieInTexas Well-Known Member

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    For historical purposes
    AMPS 290, +1=254, +2=230, +3=162, +4=132, +5=131, +6=125, +7=173, +8=185, +11=114

    PMPS 241
     
  33. LizzieInTexas

    LizzieInTexas Well-Known Member

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    This is where I have the issue - I can't get any mid-cycle during the week when working. Best I can do is maybe +5 one-two days a week. I just can't stay up that late and get up at 3:45am.
     
  34. Doodles & Karen

    Doodles & Karen Well-Known Member

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    It's OK to be cautious. Personally if I had your schedule TR would not be my choice until much later with a lot more data but that's me. You can always switch back and forth and "modify" the SLGS depending on how much testing you are able to get. :bighug::bighug:

    What's with that huge jump from +11 to PMPS Gizmo?
     
  35. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Right? It may have been a bit of stress as daddy did the test/shot tonight. I tagged him when he got home so I could run to the grocery store. He (daddy) stresses when he has to do it and I think it transfers. Gizmo has done this before - I forget what it's called... (went and looked it up) the number dip around +10 or +11.

    It is like the insulin doesn't last quite long enough to get him blue for PS. Maybe tomorrow morning, but it seems he is closer in the evenings than in the AM.
     
  36. Doodles & Karen

    Doodles & Karen Well-Known Member

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    He did the "double dip" as we call it toward the end of the cycle :) Doodles was notorious for doing that.

    There is something called Dawn Phenomenon that can affect the AMPS numbers. Sometimes they are the last to come down. Unless that +11 was a bad test he had a good size drop from +8 to +11 and may have triggered another mini bounce. Hopefully he'll slide back to blue tonight.
     
  37. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Interesting.

    +1 320

    Dangit.
     
  38. Doodles & Karen

    Doodles & Karen Well-Known Member

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    Technically you can increase him tomorrow morning. It's ok to increase during a bounce we just avoid increasing when the bounce might be breaking. See post 17 in
    Myths Debunked . I'm only mentioning it because you are home on vacation so it's a good time to take advantage of being a bit more aggressive with TR. Just something for you to think about.

    Hope you get some rest tonight.
     
  39. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Just so you know, "mid-cycle" test doesn't always mean a +5, +6 or +7, although those are the ideal times. A +3 works fine, or a +8 once in awhile. Where do your test times fit in with your work schedule? Do you shoot then leave? Do you just get home in time for PMPS? When do you usually go to bed in relation to shot time? A "before bed" test counts as "mid-cycle" (unless you go to bed one hour after shooting). There are ways to work it out. Not trying to change your mind - just wanted to clarify.
     
  40. LizzieInTexas

    LizzieInTexas Well-Known Member

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  41. LizzieInTexas

    LizzieInTexas Well-Known Member

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    I think I am going to give it one more day.

    Do you give Doodles potassium? This is the only concern of mine with Gizmo right now. I think he may be low. He was barely in the "normal" range at last labs and has been a fight to keep him up. Vet didn't think he needed it after last labs. He was on the potassium gel - but we think that may contain sugar and was elevating his BS - so she just discontinued it with no replacement.

    @Tricia Cinco(GA) & Harvey
    Wake: 3:45a
    Shower/get ready for work
    4:30-4:40a - test, feed, shoot
    6:00-6:15a - leave for work (+1.25 - +1.5 test)

    4:20-4:30p arrive home
    4:30-4:40p test, feed, shoot

    9:30p-10:30p (+4 or +5) got to bed

    I can't test, feed, shoot any earlier in the a.m. because I can't get home any sooner. As it is this is a very tight schedule for me. Especially getting straight home after work.
     
  42. Doodles & Karen

    Doodles & Karen Well-Known Member

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    I don't. His levels are holding steady right in the middle of normal. It's very surprising considering Lasix is a potassium robbing medication and he's on a huge dose. Did they ever give you an indication as to why Gizmo's levels run on the low side? FWIW my cardiologist mentioned that usually a kitty will have low potassium from not eating enough. Doesn't sound like that's Gizmo's issue at all!

    I'd get one more test before bed an call it a night. Get some rest...you both could probably use it.
     
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  43. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Thanks. I am going to call and talk with the Tech tomorrow. I thought I had a potassium powder "saved" in my Amazon list (it was from someone here) but I don't I will go back and try and find it tomorrow. Gizmo just seems lethargic and a bit wobbly upon waking - I would rather not wait for three weeks to find out. Even once a day won't hurt him for that long.

    I don't know what is causing it and I didn't think to ask the vet. My suspicion is he was already low when he got so, so sick. Wasn't eating, drinking a ton, peeing a ton and a half and he got depleted. I don't know how fast they can replenish their "reserves" but the vet just said to keep an eye out for the symptoms.

    I didn't get your message about testing tonight as I was making burnt sugar and nuts (Peanut Brittle) - first batch of the year. I make lots of this during the holidays. It is requested by everyone.

    +3 = 250

    PB.jpg
     
  44. LizzieInTexas

    LizzieInTexas Well-Known Member

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    +4 185

    Still think he is ok for the night?
     
  45. LizzieInTexas

    LizzieInTexas Well-Known Member

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  46. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Lizzie, you're probably in bed by now, but I do think he is okay for the night. His drop was slowing down and probably close to levelling off.

    Getting a +4 or +5 at night is enough to qualify you for TR. The +1.5 in the morning is good, too, as it may tell you whether you need to leave some HC or MC out for him. Ultimately, it's your decision, but I think you could do it, based on what you told me. The benefit is being able to adjust the dose more often, as needed.
     
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