2/15 Zoot! AMPS=280; +1=303; +2=283; +9=238; PMPS=223; +2=221; +4.5=119; +4.75=143; +5.25=133

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Cinnie Cole, Feb 15, 2020 at 6:01 AM.

  1. Cinnie Cole

    Cinnie Cole Member

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    Jun 1, 2019
    Last edited: Feb 15, 2020 at 7:08 AM
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  2. Bandit's Mom

    Bandit's Mom Member

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    Oct 18, 2019
    i believe bounces can take up to 3 days (6 cycles) to clear.

    i wonder if there is some link between time taken to clear a bounce and how low the kitty went as well as how high the current insulin dose is. that is, bounces from much lower numbers (than the cat is used to) take longer to clear.
     
  3. Cinnie Cole

    Cinnie Cole Member

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    Jun 1, 2019
    I know ECID but it seems odd that the highest reading (280, then 303) is this morning and almost three cycles after the last green (96). Yet the two days in between seemed pretty "normal". It will be interesting to see what his evening cycle numbers are tonight, too.
     
  4. Bandit's Mom

    Bandit's Mom Member

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    Oct 18, 2019
    I remember an experienced member (don't remember who - Wendy?) saying that her cat used to bounce in the third cycle after the low! Who is to understand bounces??!!
     
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  5. Cinnie Cole

    Cinnie Cole Member

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    LOL - not me in this lifetime! :rolleyes:
     
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  6. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    It's possible that it's a bounce. I'd also consider contraband.

    Since you're following TR, I'm curious why you haven't increased the dose. You could have increased on 2/11 (5 days after you increased to 1.25u). I really think you are holding Zoot's doses too long.
     
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  7. Cinnie Cole

    Cinnie Cole Member

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    Jun 1, 2019
    I though I asked the question about when to restart the cycle count sometime in the last week. I was under the impression I was to restart the count after the greens on the 9th; then there were more greens a few days later, I restarted the count again. Did I misunderstand? Clearly, I am having a hard time understanding the TR protocol. Am I supposed to move him to 1.5 now - won't that even further risk a hypo in the PM, given that he has the greens popping up now (as recently as two days ago)?

    Here is the link about dosing - perhaps I just misunderstood. http://www.felinediabetes.com/FDMB/...11-2-78-3-67-4-68-5-5-90.225568/#post-2525482

    Contraband is extremely unlikely - we only give our cats LC wet food.
     
    Last edited: Feb 15, 2020 at 8:57 AM
  8. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    The cycle count starts any time there is a disruption in the dose. In other words you start counting after an increase, decrease, skipped shot, fur shot, giving a slightly reduced dose, etc.

    When you increased the dose from 1.0u to 1.25u your cycle count started over due to a change in dose. As of today, you are at 17 cycles at your current dose. The cycle count did not restart at any time after 2/7.

    I think the point that Wendy was trying to make is that when a cat starts to see an improvement in nadirs -- nadirs are in the <200 range, you hold the dose for 8 - 10 cycles. You don't restart the cycle count -- you tack on the extra days to what is usually a 3 day cycle count. However, Zoot is not new to blues and greens so that point doesn't apply.

    The basic rule of thumb is that if nadirs are > 200, hold the dose for 3 days/6 cycles before increasing. If nadirs are < 100, hold the dose for 5 days/10 cycles. This doesn't mean only one nadir -- most of the nadirs need to be in the range noted.

    Ultimately, with TR, you will want to shoot any number above 50. I realize that it's counterintuitive that shooting a number in the 50s won't cause a hypoglycemic episode. A Lantus curve is flat. Take a look at Pax's spreadsheet. You'll see what happens with shooting low numbers -- the curve flattens out and ideally, the kitty stays in really good numbers.

    Does this help?
     
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  9. Cinnie Cole

    Cinnie Cole Member

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    OMG I am going to FRAME this response. Thank you so much. I feel a bit nervous about increasing at night (because I cannot check tonight) but will def increase tomorrow AM and get on the new dose regimen.
     
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  10. Sue and Luci

    Sue and Luci Well-Known Member

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    Nov 3, 2017
    Good luck with the increase...I hope Zoot gets back to that nice beach soon :)
     
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  11. carfurby

    carfurby Well-Known Member

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    Feb 19, 2012
    Good luck increasing the dose tomorrow.
     
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  12. Cinnie Cole

    Cinnie Cole Member

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    Jun 1, 2019
    Half hour before PMPS, he threw up twice - undigested food (probably from a +6 feeding). Very unusual for him to vomit. Tonight he seems to be doing fine - no more vomiting. A big dip at +11.75, so I retested a few minutes later and he was 143. Gave him LC food and will test at again at +5.25.
     
  13. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Good luck with the increase. If kitties aren't feeling well/upset tummy, it can cause them numbers to go up. That could have been what caused those ugly numbers today. Glad he's eating well now.
     
  14. Cinnie Cole

    Cinnie Cole Member

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    Jun 1, 2019
    Yeah - poor guy. Seems much better now.
     

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