2/13 Jan and Buddy PMPS +23.45 390 +2 458

Should I not shoot anything, or should I shoot 1/2.
Shot time is now.

 

Re: 2/13 Jan and Buddy +11.5 111 +11.45 102 AMPS 93

bumpity bump

did you shoot?

 

Re: 2/13 Jan and Buddy +11.5 111 +11.45 102 AMPS 93

no I'm 5 min after shot time

He seems to just keep going lower
Have not fed anything

 

Re: 2/13 Jan and Buddy +11.5 111 +11.45 102 AMPS 93

hey Jan

will u be able to retest?
are u home to monitor?
how much longer do u think u can stall?

do u have any notes from Carolyn/Spot on these situations?

 

Re: 2/13 Jan and Buddy +11.5 111 +11.45 102 AMPS 93

That's a tough one!
I don't think that not shooting is an option. You mess up the shed.
But don't know what you should shoot.
911-time?

 

Re: 2/13 Jan and Buddy +11.5 111 +11.45 102 AMPS 93

Jan can u retest? it's been 30 min since the 93

are u home to monitor?

 

Re: 2/13 Jan and Buddy +11.5 111 +11.45 102 AMPS 93

Yes I just retested @ +12.5 he is @76. I am not going to shoot. Going to go feed.
Thanks
Bye

 

Re: 2/13 Jan and Buddy +11.5 111 +11.45 102 AMPS 93

Jan that's fine, he is still dropping. What would be really helpful is to keep getting some tests in to see what's going on with him. We need to know when he starts rising and how fast (I know he just ate so we will see a rise from that) Seems like If he were a human and on once per day dosing the 6.5U would be just right. Maybe we need 6.5U per day and should split it into 2 doses. I think it's typical on a larger dose to have a later nadir and longer duration (bigger shed) so maybe the antibodies have backed off. It is important that we have a dose that we can shoot on a regular schedule without skipping, so maybe we have to start lower and work up again as needed. I know you worked up to this dose, but with IAA the needs can change, and skipping a shot every other day isn't going to be helpful in the long run. The good news is every hour Buddy spends in these lower numbers is healing time for his pancreas.

 

Re: 2/13 Jan and Buddy +11.5 111 +11.45 102 AMPS 93

Jan, this is a dropping number..
Options: Wait another 1/2 hr & retest-see if it is safe to shoot.
Call it a fur shot & dont shoot
If number is rising, shoot a BCS dose to keep the shed from depleting.
As Buddy is on a high dose, I see why you made that decision, but he may have a high number at PMPS, so you maybe able to shoot full dose then.

 

Re: 2/13 Jan and Buddy AMPS 93 + 12.15 83 +12.5 76

Thanks Guys,
I chose not to shoot. Went ahead and fed, will test again in 1/2 hour.

 

Re: 2/13 Jan and Buddy AMPS 93 + 12.15 83 +12.5 76

I'm lining up behind Ronnie. You have a window of up to 2 hours before you're completely on shed action. Could you re-test and let's see where Buddy's numbers are. I'd hate to see you lose momentum by skipping. Monique's point about this being a time to do some data collection in case the IAA is backing off is a good one, as well. Can you get a +1?

 

Re: 2/13 Jan and Buddy AMPS 93 +1 65

He is still dropping after feeding LC
Should I go ahead and give some HC or wait a little longer??

 

Re: 2/13 Jan and Buddy AMPS 93 + 12.15 83 +12.5 76

Why do you want to feed HC, If you have decided to skip the shot or shoot a BCS dose when he starts rising then you don't want to artificially send him higher. Just test and see where he goes on his own. 65 is not too low (it's not +1 if you didn't shoot it's +13!) we want to see when he starts rising without any artificial manipulation (just his normal meals)

 

Re: 2/13 Jan and Buddy AMPS 93 + 12.15 83 +12.5 76

Monique,
Thanks, changed SS.

What if he gets in the 50's, 40's?? Don't feed HC??

Just tested again + +13.45 60

He is still going down slowly, shouldn't he have gone up a little just from feeding the LC @ +12.5??

 

Re: 2/13 Jan and Buddy AMPS 93 +12.5 76 +13 65

If he goes into the 40's you can feed a bite of some HC, but after 14 hours with no insulin I think the risk of hypo is pretty unlikely. Spooky is not on insulin and I have measured as low as 28 on him after eating you can't truly have a low BG with no artificial insulin (rare exception of some tumors that produce insulin) so there is no need to treat anything. Also the human meter underestimates so even though he measured 28 he was likely at 60 something which is ok. In a few hours Buddy won't have much insulin left in his shed so he can't go to low. IF....he does stay lower for the next 12 hours that means his own pancreas is producing insulin!

 

Re: 2/13 Jan and Buddy AMPS 93 +12.5 76 +13 65

One would think Buddy would have gone up in response to food. Buddy clearly has different intentions!

I agree with Monique - this is not a HC situation. At this point, even if he were to drop below 50, Buddy hasn't had any insulin that would be causing his numbers to drop. This is shed action that's influencing the numbers -- or Buddy's pancreas kicking in. If his numbers drop below 50, it might be a time to consider a bit of MC but for now, hold off and see what's happening.

 

Re: 2/13 Jan and Buddy AMPS 93 +12.5 76 +13 65

OK Thanks Guys!!

 

Re: 2/13 Jan and Buddy +11.5 111 +11.45 102 AMPS 93

Please stop dose advising. This cat has IAA. Do you know what IAA is? You don't know what can happen if you shoot and he drops.

 

Re: 2/13 Jan and Buddy AMPS 93 +12.5 76 +13 65

Well well well little Buddy Man.

He's trying to kill us Jan! :lol:

Cawfee #1 here, and I see I have some time to think about it, so I'm gonna think. Late night last night and I sure didn't expect all this excitement from a cat with a recently skipped shot!

 

Re: 2/13 Jan and Buddy AMPS 93 +12.5 76 +13 65

Ok I thought about it.

Until he starts rising, we don't have a plan. I'm thinking shoot BCS on the rise, but that all depends on when he starts rising and how fast he's rising. I would not normally call for a dose redux, but I think this dropping 40 pts past +12 means his shed is on overtime and we really don't want that. On the other hand, we don't want to lose progress. Safety wins and I recommend dose redux to 6u, we can always go back up if we go too far down. I'm also gonna say I think you're doing a frickin awesome job Jan. I am sure every hair on your head is standing on end right now LOL

 

Re: 2/13 Jan and Buddy AMPS 93 +12.5 76 +13 65

Yes it is! :lol: :lol:

So do you have a number in mind to shoot at??
Do I need to feed anything right now, he had his brefst @+12.5

 

Re: 2/13 Jan and Buddy AMPS 93 +12.5 76 +13 65

On the rise and I'm gonna wanna see him at least at 80, did you update your SS and condo with that 54 you just got?

 

Re: 2/13 Jan and Buddy AMPS 93 +15 47

I'm getting VERY nervous!!! nailbite_smile nailbite_smile nailbite_smile

 

Re: 2/13 Jan and Buddy AMPS 93 +15 47

This is good news I think .. if he drops below 40, give him a tsp of HC and test 15 mins later. Not sure what exactly is happening though so make sure you can find your Karo ok?

 

Re: 2/13 Jan and Buddy AMPS 93 +15 47

OK Now I'm really getting nervous!! :lol: nailbite_smile

 

Re: 2/13 Jan and Buddy AMPS 93 +15 47

This isn't scary it's exciting! Did you feed him anything other than breakfast at +12.5? There can't be much insulin left in him since his shed must have been pretty depleted after skipping a shot yesterday. Maybe his own insulin is working some here? I would say as long as he is acting fine just feed him bites of food and see how long he surfs like this, I can't imagine he could go very low without having a shot. Maybe Buddy has learned to shoot himself :lol:

 

Re: 2/13 Jan and Buddy AMPS 93 +15 47

How can you be nervous. You've got Carolyn backing you up!!!

 

Re: 2/13 Jan and Buddy AMPS 93 +15 47

Don't worry.. we got your back

To be perfectly honest, I am not sure I am willing to make the call to even shoot a BCS since he's still dropping this late in cycle. Wondering if we need to drain the shed, and wondering even more why that last skipped dose didn't drain his shed.. so is this pancreatic action we're seeing?


Edit: LOL I see Monique and I said the same thing!

 

Re: 2/13 Jan and Buddy AMPS 93 +15 47

wow Buddy, whacha doing today?


Jan, no need to be scared, like Monique said, maybe offer a few bites of food and see what he does next.

Exciting day in here!

 

Re: 2/13 Jan and Buddy AMPS 93 +15 47

I think at this point if you shoot even when he starts rising your going to be so off schedule that it will be a nightmare to get back. It seems like a good oppotunity to watch and see what happens until evening. If he is still yellow or lower at night then ( the shed MUST be empty by then) perhaps we need to take the dose way down (like 3U) and test what happens for a few cycles you can always go back up if he gets high or suppliment with a TOR (which he responds very well to).

 

Re: 2/13 Jan and Buddy AMPS 93 +15 47

I agree with this assessment, for at least today and tonight since you are going out. I think this is a wash cycle, and I think tonight you shoot on time, on schedule, but a reduced, and 3u sounds good to me. We need to be cautious, it's been clear for a few days that you're getting ahead of the antibodies and I see them fighting back but less and less. I suspect as well we might have to be extremely flexible with dosing and go off protocol. I know that's out of the norm, but we're reacting instead of acting at this point and that's all we can do. I never thought, studying Sandy's SS, that we would get ahead of them this quickly. I figured we had weeks or months of beating them down.

 

Re: 2/13 Jan and Buddy AMPS 93 +15 47

Does this have you a little stumped? Would you say this is unusual, or you don't really know cause there isn't much info on IAA kitty's??

I always new "My Buddy" is special. With your guidance, hopefully we can help any other IAA kitty's.

 

Re: 2/13 Jan and Buddy AMPS 93 +15.5 45 +16.15 58

I would say it's unusual but not unheard of. As a matter of fact i have seen this or simular in other diabetic cats (non IAA) that suddenly go low and stay low for quite a while (even into remission) on a normal dose of insulin (like 2U or something) without going through the usual stepping down doses. Sometimes the pancreas just wakes up and starts sputtering. Remeber that the antibodies are not part of the program when it's Buddy's own insulin, he doesn't make antibodies to his own natrural insulin, only to "foreign" insulin. The question is if his pancreas is "waking" up and working sometimes how well is it working and for how long. It is weak and still fragile so it may work well for a day or a few hours then it can't keep up anymore and he goes back into diabetic numbers. In a typical cat we would treat with continue insulin and slowly working down the scale until the pancreas was well healed and strong, but in Buddy's case every time we have to inject foreign insulin there is the chance he will rebell with antibodies, so finding the dose is a challenge. It's going to be a matter of just trying to get as many hours each day as possible in a good range to allow maximum pancreas healing, the more of his own insulin he generates the less Lantus he needs and the less antibodies he will create.

 

Re: 2/13 Jan and Buddy AMPS 93 +15.5 45 +16.15 58

OK I think I got most of that, but I'm going to reread it, to make sure.

Thanks for your support!!!!!!!! :YMHUG:

 

Re: 2/13 Jan and Buddy AMPS 93 +15.5 45 +16.15 58

Here's hoping maybe Mr. P is sputtering

Your doing an awesome job Jan!

 

Re: 2/13 Jan and Buddy PMPS +23.45 390

It's been a very interesting day, to say the least!! :shock:

 

Re: 2/13 Jan and Buddy PMPS +23.45 390

In fact it was. Nice job there Jan (and Buddy!).

 

Not sure if I wrote that right?? Would it be +2 or +26. Since I shot at PMPS wouldn't I start a 12 hour count again???

So the 458 would be the +2? :?:
Thanks

 

Re: 2/13 Jan and Buddy PMPS +23.45 390 +26 458

If you shot at PMPS, the 12-hour cycle starts all over again. So what you have labeled as +26 would really be PMPS +2. (If you call it +26, it implies you didn't shoot your AM or your PM dose.)

 

Re: 2/13 Jan and Buddy +11.5 111 +11.45 102 AMPS 93

Maybe you should come down from your high horse and learn to read (again).
The only advice I gave was the 911.

 

Re: 2/13 Jan and Buddy +11.5 111 +11.45 102 AMPS 93

I beg your pardon? You advised her to shoot. This is the 3rd time I have found you advising people to shoot without reading their spreadsheets. When you refer to my high horse, I hope you are recognizing that I happen to know what I am talking about, where you are completely unaware of what IAA is, let alone when someone should shoot.

"Spacey & Ella wrote:That's a tough one!
I don't think that not shooting is an option. You mess up the shed.
But don't know what you should shoot.
911-time?"

Not shooting was her only option. Look at her spreadsheet again.