2/11 - Sami -PMPS 408; +2 368

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Tina & Sammy

Tina & Sammy

Member Since 2010
Good morning all,

Yesterday's Condo

julie & punkin (ga) said:
My quick look through your earlier part of the spreadsheet seems like she got to 1.5u the first time around. Most cats coming back out of remission end up going over their previously high dose (from the first time round) before they begin to have dose decreases. It's also good if you know what brough her out of remission (i'm thinking you'd said it was pancreatitis) and that concerns gets resolved.

I don't think she's gotten too low at any point and I don't think this dose is too high. you've done a good job of being methodical about the increases. I noticed she skipped from 1.5u to 2.0u, but even that - if the dose is too high she'll tell us. I think you're just now hitting a good dose - she saw green on 2.0 and I suspect once things settle down that will happen again.
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@julie & punkin (ga) , I just don't get it, I gave Sami 1.5 units on 2/9 and she stayed in the blue longer and didn't spike as high, but last night I gave the full two units and she lost her blue streak earlier and she spiked even higher.

I still agree that she isn't going too low, but is there a possibility that her body is reacting and anticipating a drop? Or could it be the location of the shot? The last few days, I have been given her the shot in her flank, where as before I was giving it in the scruff. Maybe I need to always give in the scruff unless I am going to give fluids.

Also, I haven't given fluids since Saturday morning, so I will probably do that this morning before going to work, which means she will probably drop quick and hard.

I want to stick with the two units because we have seen the most progress there, but I am still really concerned that she is getting too much. Is it possible for her to get too much be never go into the GREEN?

I am going to try to hold it together today, if I give fluids this morning on a 2 unit dose, and based on what she has done in the past, I will expect to see some green by PMPS. Then I will be Freaking Out again.
 
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Sami is coming down nicely from her highs this morning. So far it has been a steady slide unlike some of the other slides after fluids. I will try to get a +6 and a +7 just to keep monitoring to see how she reacts to the fluids today.
 
Tina & Sami said:
I just don't get it, I gave Sami 1.5 units on 2/9 and she stayed in the blue longer and didn't spike as high, but last night I gave the full two units and she lost her blue streak earlier and she spiked even higher.
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Remember that each cycle depends not just on the dose you just gave, but the depot that was created leading up to that dose. Any time you skip or reduce the dose, you impact the depot. And can get wonky action. You've followed the protocol on increasing, I don't think she's overdosed. Especially with the amount you test. As Julie said yesterday, give her 6 consecutive cycles on 2.0 to see if she finds her green back. If not, she'll need an increase.
 
Okay, I am trying to be strong. It is just so frustrating that she keeps bouncing like this.

I am happy that she didn't plummet with the fluids this morning it makes me a lot more comfortable giving them to her now. I think I will give her the insulin shot in the scruff when I am not going to give fluids and in the flank when I am going to give fluids. Is that okay?

As I mentioned yesterday, I have been reading some of the old threads from 2010 when Sami was on insulin before and someone told me that it isn't a good idea to jump back and forth at different injections sites. For instance, Right Flank in the morning, scruff for the PM, then the next day doing Left Flank and then Scruff, and so forth. Are there any thoughts on this?
 
The main problem with changing the injection sites is there's some information out there that says that different injection sites can cause different absorption rates...some say the scruff doesn't absorb as quickly as other places

I think the only way to really know would be to try it on Sami...but there may not be any clear answer since so many other factors can effect absorption, action and duration
 
@Chris & China So other than how a specific injection site might affect Sami there is no reason why I can't jump from site to site at every injection?

I will probably stick with the scruff unless I am planning on giving fluids, that seems to be the area where she does best with the injection. Although the last few days I have been given her the shot in the flank and she seems to have done quite well in the morning, but the even she seems to fizzle out a bit. Could time of day and injection site affect absorption?

I am also wondering about this bounce, why is this one lasting so much longer than the past few day? Is this common?
 
I don't know any reason why you couldn't change sites at every injection other than IF the absorption rate is going to be different for different sites on Sami, it's going to add yet another variable in trying to figure out her patterns.

I've never seen anything about "Time of day" being important, other than just needing to be as close to 12 hours apart as possible.

In the last 9 cycles you've skipped once and giving a reduced shot once, so that's going to effect how she does as far as clearing bounces too. Another frustrating thing about bounces is that just because the last time they cleared a bounce in "X" cycles doesn't mean the next time they're going to do it in "X" cycles. It's not something that's really predictable.

The only thing we can say is that as she spends more and more time in better numbers, her bounces shouldn't be so high, and should clear quicker
 
Chris & China said:
The only thing we can say is that as she spends more and more time in better numbers, her bounces shouldn't be so high, and should clear quicker
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@Chris & China That is what I thought which makes me wonder why the last two bounces cleared so quickly and this one is taking longer. I will try to remember that it could be a layover effect of the skipped and reduced shots from the past few days. I shot 2 units again tonight and I am really hoping that we make it back down to at least YELLOW tonight.

As I already mentioned, I am happy to see that the fluids this morning didn't take her all wonky, it makes me much more comfortable about giving her the fluids. So right now I am am looking at that as my positive for the day.
 
Marje/Gracie rotates every single shot. There are others that do that as well. I always shot in the scruff, there are others that always shoot in the same location.

One thing we know is that even if you hold every factor the same, the absorption rate can vary by as much as 50% from one shot to the next. My lightbulb moment of understanding this came when I really GOT IT that insulin is a hormone. It's not like say, blood pressure med, where you take the same dose every day for years on end and the equation is x meds + your body = perfect blood pressure.

It's more like "one teenage girl x 30 days = wildly unpredictable behavior." I have 2 daughters - think happy one moment and slamming doors and tears the next. And all because of hormones.

I think you're thinking, as I was, like it's blood pressure meds. Take one Sami and add insulin = regulated cat. But this is a hormone. Absorption varies. Her body may be putting out some insulin as well. You just have to roll with the flow on this and not make yourself too insane trying to figure out how to outsmart her body. As people here say, she is leading the dance and your job is to follow her lead. The thing I like a lot about the protocol is that you're looking at 3 day units, most of the time, to see what the overall trend is. One day, one test is pretty unimportant - but the overall look is really important. Not sure if that makes sense, but ask questions if it's muddy.

I would say that the fluids really had minimal impact on her BGs today.
 
I'm a compulsive spreadsheet studier and I shot Vyktor in flank and scruff and in the overall scheme of things didn't notice any difference between the two.
 
@julie & punkin (ga) I will try to keep that in mind. It is all so confusing and I do think of insulin that way, where if a 2 unit dose does something one day I expect it do do exactly the same thing on another day. I am really trying to relax a bit about this whole thing and just stick to TR and hopefully everything will fall into place and we can get Sami back to the falls.
 
I just tested Sami at +2 and she is at 368 from 408 at PMPS. Do you think it would be okay if I only got a +6 and a +10 check tonight.
 
I might get a +5....she still has a ways to drop before she'd be in any kind of trouble, but when they drop at +2, it's a sign that they may be having a more active cycle.

If she starts acting like she's hungry, test sooner

If she's still doing well then, you could probably plan on sleeping the rest of the night!
 
@Chris & China

Okay, thanks I will set the alarm for +5. I have the feeder set for +4, +6, +8 and +9, all with about a tablespoon to a tablespoon and a half of food, May be up to 2 tablespoons on one or two of them.
 
I like Chris's plan. If she's high blues or above at +5, I'd set the next alarm for AMPS. Also, I wouldn't put as much food as that in the feeder for after +6. The insulin is waning then and feeding food after mid cycle can slam the brakes on the insulin and cause her to zoom up to preshot. Unless she's really low, I'd cancel the +8 and +9 feeds.
 
Wendy&Neko said:
I like Chris's plan. If she's high blues or above at +5, I'd set the next alarm for AMPS. Also, I wouldn't put as much food as that in the feeder for after +6. The insulin is waning then and feeding food after mid cycle can slam the brakes on the insulin and cause her to zoom up to preshot. Unless she's really low, I'd cancel the +8 and +9 feeds.
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I never knew that about the food. Guess our 230 am feeding is gone. :)

Hope Sami has good numbers for you Tina!
 
Tina & Sami said:
I do think of insulin that way, where if a 2 unit dose does something one day I expect it do do exactly the same thing on another day.
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Most of us start out thinking that same way - I know I did. But it's not as predictable as that - although wouldn't that be awesome and convenient?!

Just plow ahead - you're doing fine and it's great to be asking questions and trying to figure things out.
 
Okay, just did a +4 and she was 324, I will probably try to get a +7, and I will reduce the food in the feeder or eliminate it for +8 and +9.

Thanks everyone.
 
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