? 16 Oct | Girlie | AMPS 454; +2=547; +6=563; PMPS 635; +2=682; +4=581 Concerned re still hi numbers

Condo: http://www.felinediabetes.com/FDMB/...-confused-re-dose-increase-tr-bounces.185435/

Increased dose last night to 0.5

Would still love to get some feedback, if possible, on the following that I asked yesterday:

Was reading another post and came across this link re: Myths debunked, so now I'm even more confused and wondering whether I should have already increased Girlie's dose earlier. Should you follow the "Nadirs over 200: who cares if there is bouncing, cat needs more insulin, increase after 2-3 days" or are there exceptions to this, such as, perhaps, the vet visit/enema possibly spiking Girlie, or even then, might it have been better if I'd increased her dose earlier given her solid climb up the ladder and refusal to budge from those super high numbers for 6+ cycles? I'm just trying to get my head around this so I can be more confident in future.

Further on, at post #17, I just read this:

"One other note:

Every high number is not a bounce! Numbers go down, numbers go up. Often I see people comment that their cat is bouncing, when really they are just seeing the natural rise at the end of the cycle or a food spike. Other times I see people whose cats are stuck (really stuck) in a high pattern who think it's a bounce. If your cat has been in pretty good numbers for a while, then suddenly loses regulation, don't hold the dose, get the regulation back! If they are used to good numbers, it is much, much easier to get the good numbers back if you do it quickly."

 

Good questions. Unfortunately, I don't know the answers. Hope Girlie come back down for you soon.

 

I'm in a similar boat, stressful and confusing. I'm learning more each day but have more questions as well. I hope we figure our kitties out soon and Girlie gets away from those blacks quickly.

 

Thanks so much! I know I'm doing TR, but for some reason I feel like I end up holding doses too long, but maybe I'm wrong... I also prefer to get advice before I increase a dose, and sometimes that's not possible, especially given the time difference for Australia/US. Are you both confident about making those dosing decisions on your own now? Maybe I'm just too confused, but it seems like so many different things can come into play (unless I'm wrong); I'm also not a really confident SS reader yet...

Girlie is doing the "dose increase bounce" today: 511 @+4, but at least she's coming down, slowly. And that means I can go in to work this afternoon without worrying today, at least!

I've been reading and re-reading Tilly's Diabetes page (written by Dr Roomp or Room and Rand from Management of Diabetic Cats, if I'm not mistaken), and there's some interesting stuff on there. Are either of you - or is anyone else - giving Taurine supplements?

 

I am starting to be more confident in making dosing decisions on my own. But I still hold the dose to long when I am worried about something. For example, I held the dose at 7 units for to long, but no one was around to monitor and that scared me. I'm lucky because my husband and I work different shifts most of the time, so someone is almost always around with Gizmo. And I struggle with "if you don't see it, it didn't happen." I'm always playing the what if he went lower when I couldn't monitor ... so I hold the dose another few days. I'm getting better, but it takes time to just trust the numbers you see and base your dose on those numbers. Another thing I do is post that I am thinking about an increase a day in advance. That way people can respond if they see a reason why I shouldn't. I am not giving taurine supplements.

 

I'm absolutely not confident in any of my dosing decisions yet, getting there, but no. In theory or on paper, a lot of it is making sense to me (like shooting low numbers), but I know when it actually happens to me, it won't be so easy. The only thing I am 100% confident about is that finding this group and trying this protocol is way better than following my vets advice of blind dosing twice a day! I'm expecting bumps in the road and not every day to be great, but no matter what, she's better off now than she would have been getting guess doses based on her weight only.

I totally agree with what @Chubba said, if I can anticipate something a day or more in advance (like a dose change), I will post it so that when I really need the info I'm not desperately waiting for a reply.

As far as taurine and supplements in general, I'm very conservative with the lotions and potions side of things. For Asia's needs and her very advanced age, one false placed block can topple the tower, so to speak, and I try not to have too many variables at play so that if an issue arises, I don't have to guess as much what could be causing it. I learned this the hard way with her. If she eats a food and she vomits, it's easy to target the food, but if it's new food, this drug, that supplement, new litter, etc. there's too much at play and it's much harder to work out. That's just my approach. Until insulin, Asia has never been on any drug daily or long term, and when she has had them for crisis situations, we always dealt with side effects that perhaps were not worth the good the drugs were doing in the first place. I want to introduce green lipped muscles for her arthritis, but I'm holding off until/if the diabetes gets more regulated. For now, she's just getting acupuncture and it's working.

 

Sorry I wish I had answers on dosing.

Girlie's SS is hard to "read". Not sure what she has in mind. Sorry I couldn't be more help. I would just increase after 6 cycles and would increase .5 if she's still in blacks/reds. lots of these

 

I think you are right where you need to be. The increase you gave was warranted This is the second cycle on this increase and it could take another 1-2 cycles for the depot to fill. I would hold this dose for 6 cycles unless of course if she goes under 68 on the AT 2 meter then you would decrease.

.

 

PS, when confused, and it happened to me a lot, post a ? mark on your thread so more eyes will be on it and peeps can weigh in to help you .

 

Thanks so much, all...

It's interesting that you find Girlie hard to "read" as well - I thought, perhaps, it was just me, although I do feel like I'm getting better at reading her SS in combination with her attitude towards food and behavioural attitudes in general: she usually gives pretty good "tells" about how she's feeling and what her body is doing, often a while before it even shows up on the BG monitor.

This is cycle 2 on the increase to 0.5 (last night and this morning), and she's still determinedly black.

 

Thanks so much, Bobbie: I'll see where she is at Cycle 6. I'm surprised that she hasn't already started responding to this dose increase, but she was in black a long time there...maybe after tonight's dose. Probably on the day when I can't be home to monitor, of course, and have an appointment I can't miss!

I think one of my problems might be the time difference, as I do use the ? in my title, but sometimes no one responds. I'll have to bump it up when I get up to get a drink of water, I guess!

 

It's hard when your're in a different time zone than most. Keep bumping your thread up and hopefully someone will be online to answer.

 

Boy, she doesn't want to leave those high numbers, even with the dose increase to 0.5 last night!

AMPS 454
+2=547
+4=511
+6=563

 

Come on, Girlie! How about you try on something in pink next?

 

She says "no": +11 = 623

 

Girlie please come down from waaaayy up there.

 

Wow: PM+4= 581

Even after the dose increase last night, now on cycle 3, she's still solid black, after about 5 1/2 days in solid black, and I'm really starting to get a bit concerned at her utter lack of movement despite the dose increases. I wonder if she might need another increase to 0.75 if she doesn't show any progress tomorrow? I'm really starting to get anxious here, so any dosing advice would be much appreciated. I thought I'd start asking now due to the time difference with Australia....

This is a bad week for me, unfortunately, as I have appointments every afternoon for the rest of the week, though, and have to be out of the house from her AM+6 on. She saves her shark swims for the daytime, usually before her AM+4. What to do...?

 

I hear ya. I'm not sure what you should do. She definitely needs to get out of those high numbers, I look back at her SS and she has done this before back in August, been a stretch of blacks and then eventually comes back down. If you follow TR you would increase in 3 more cycles. I don't know if increasing sooner is a good idea especially if you're not around to monitor. TR method is already aggressive. Hopefully someone with more experience can offer something else. I would be more worried if Girlie never saw blacks. This is not that unusual for her when looking at her SS from day one. My point is her body seems to handle it better than others. Not that we want her in those high numbers but for some reason she skyrockets. If she didn't see these numbers once in a while and all of sudden she was running this high I would be much more concerned...like something was so out of place and wrong. I think she will get through this and back to planet earth in no time. Just keep doing what you're doing and grab ketone tests whenever you can.

 

On the taurine, I saw it mentioned in the same article and started it right away. But I had too many supplements going, it was too early in the game, and I didn't know what was affecting what. So I stopped all supplements and let Maggie stabilize. Then I've added some supps back in the mix. When I saw your question about taurine I added it back in. So that's a long way to say, I've used it, but can't tell you if it does anything!

 

Wish I could help but I still struggle with dosing myself. I can offer good thoughts though, and pray that Girlie starts seeing some better numbers soon. I know how hard it is to see those high numbers. My heart sinks everytime Molly throws out a pink or red.

 

It can take up to 4 cycles for the depot to fill in. Hopefully by tomorrow's AM cycle you will see some movement.

As far you being out of the house this week from AM +6 on, you should be able to get a good idea by then how the cycle is going. In the event that she is dropping you can steer and leave the appropriate carb count food for her if she should need it. Her lowest number 6 days ago was 83 so she does have some wiggle room before she goes below 68 on the AT 2. But, I think you will have a good idea by +6 since she does drop earlier in the cycle.

 

She's 544 @ +11 before her amps: good grief!

I hear you, @Beenie , but she's definitely dug her heels in here. I can try a fresh bottle of insulin this morning as current cartridge is almost done.

This morning is cycle 4: clearly there's no change as still solid, high black. She doesn't usually take this long to get over a dose increase bounce.

Torn between increasing now or suffering another day of high blacks...

 

Put on those tight patience pants, and wait the full six cycles.

How is Girlie doing otherwise? How are the 5 P's?