2.20 Rufus AMPS 96, +1 132, + 2 109, + 3.75 75, + 5 120, + 7 154, PMPS 361, + 3 453

Discussion in 'Lantus (Glargine) / Levemir (Detemir)' started by Sean & Rufus, Feb 20, 2018.

  1. Sean & Rufus

    Sean & Rufus Well-Known Member

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    So I am very confused with the bouncing and the new lower AM numbers. I'm guessing that his dose is too high, seeing as his numbers actually climb after a dose.

    Any suggestions for dosing today? Half? I will not be home for about 3 hours later today.

    @Stacy & Asia any advice? First green for Rufus
     
  2. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    That green is awesome - this is what you're working for!

    He is breaking his bounces faster, which is a great thing - you are seeing progress. At this point, I don't think his dose is too high - he's just bouncing and adjusting to insulin and to the dental work. However, you definitely want to keep close tabs on his numbers - with the dental done and him starting to recover from it, it is possible he could go down the dosing scale quickly. But, you don't want to take reductions before they are earned - that could set you back from all this great forward movement.

    When do you have to go out today - is it late in the cycle, or early? If it's later in the cycle, and again as long as you have HC and test strips and can monitor closely until then, I would strongly consider shooting the full dose.

    With that said, I do have to go out for several hours myself in a short while, so I won't be able to check in again until probably around 1 or 2 EST.
     
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  3. Sean & Rufus

    Sean & Rufus Well-Known Member

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    I'll be leaving here in about 2 hours, so I can take a test in an hour and then before I leave. Should I just give full dose?
     
  4. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    Hmmmmm.......I admit, it is a bit of a tough call since you'll be leaving fairly early in the cycle. I really hate the thought of Rufus losing this gorgeous momentum, though. You'll be gone for 3 hours - do you think it would be more or less than that?
     
  5. Sean & Rufus

    Sean & Rufus Well-Known Member

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    I could probably be back in 2 hours. I don't want to lose momentum either. I think I'll just give full dose and if numbers go down, I'll just not leave I guess.
     
  6. Stacy & Asia

    Stacy & Asia Well-Known Member

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    Wow, Rufus is making some great progress! :woot: I agree with Amy, depending on what time you need to be out of the house, I would shoot the full dose and monitor closely. This is exactly what you want to see. It also might be helpful to either put a row demarcating when he had his dental, or at least add it to the comments. I'm sure it's making such a difference for him.
     
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  7. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    Since this is your first green and the lowest number you've shot, get a +1 to start seeing what's what. I have to leave in about 1.5 hours myself, and still have to shower and get ready to go, but I'll check back before I head out, and I've asked others to try and check in, too.

    If his numbers do start going down (too much), you can abort the cycle by loading him up with high carb food. Mind you, this is something you'd only do under circumstances like this, with you having to leave for a while, because of course under normal circumstances this would be counterproductive. But with you leaving for 2-3 hours a good meal of high carb food should carry him through should it be necessary.

    But, let's see where the numbers are.
     
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  8. Sean & Rufus

    Sean & Rufus Well-Known Member

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    I think so too. I also think if would have had dental done back in August we wouldn't be here. But so is life. I have the dental in there, it was on the 14th. Crossing fingers!
     
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  9. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Sounds good. Thanks for your help, so much appreciated :)
     
  10. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    This is remarkable how well he is responding after the dental ! As Amy said, he could go quickly down the dosing ladder which is a great thing. :cat: Glad you can monitor today. Usually when you shoot a green number the cycle is flat. But since this is his first green he is likely to bounce. But with cats, we can't assume anything.......

    Oh and this is for you, the Coveted Balls of Steel which is presented after shooting your first green.

    upload_2018-2-20_9-41-22.png
     
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  11. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Hahahaha! Yeah, I debated for sure and was scared! I figure he'll bounce, so we'll see. Don't want lose the good numbers we're seeing!
     
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  12. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Looking good! ***knocks on a thousand pieces of wood***
     
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  13. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Should I give him some treats if he's at 75? He's really nauseaus but did eat some deli turkey.
     
  14. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    I would give him some low carb food and test again within an hour. Has he had ondansetron today?
     
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  15. Sean & Rufus

    Sean & Rufus Well-Known Member

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    I just gave him some fancy feast, and he's actually eating it! I did give him an ondan about 5 hours ago. I might have to up it. I'm think this up and down bg is a big part of the nausea.
     
  16. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    Yes, the fluctuations might be bothering him a bit.

    Great with the Fancy Feast! You might after intervene with something higher carb soon, but if we can keep him surfing without high carb, that's ideal. If he falls below 68 on your AlphaTrak, though, that's when you'll want to give him some higher carb stuff.
     
  17. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Oh OK. I was pretty worried that hypo starts at 68, and not sure how long he would have to get back up. So there is a little leeway per se, and ecid?
     
  18. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Really really glad I postponed my meeting for today!
     
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  19. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    Actually...is he still eating any dry? I can't remember the details....just trying to remember if you are doing TR or SLGS.
     
  20. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    68 is the bottom edge of what we consider safe (as well as being the bottom of the normal range); below that, ECID but we don't like to find out. If you're doing TR and he falls below 68, you would reduce the dose. I have to admit, right now I'm not remembering the reduction number for SLGS on your meter, but will do some digging.
     
  21. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    68 is the reduction number on the AlphaTrak whether you are doing SLGS or TR. So, if Rufus does drop below 68, you will reduce his dose by .25U.
     
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  22. Sean & Rufus

    Sean & Rufus Well-Known Member

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    He's not supposed to be eating any dry, per the vet, but I don't always remember to pick up the bowl after Ozzie eats. I don't think he's had much if any at all since last Wednesday.
     
  23. Sean & Rufus

    Sean & Rufus Well-Known Member

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    The plan is to do SLGS, but was confused on the 2. Somebody explained it a little, but I don't remember where.
     
  24. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    There are the two stickies at the top of the forum that outline both methods...check them out and of course we can answer specific questions for you. The slight monkey wrench is that the two are both built around a human meter rather than the Alpha Trak, but folks here do work around that issue.

    If you keep the dry out of the picture, you certainly test in the "TR manner" of testing.
     
  25. Sean & Rufus

    Sean & Rufus Well-Known Member

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    I've read the stickies, but don't get what to do after you do the curve. If Rufus is in "normal" range, and we stick with that dose, what do we do then? How often would we test besides amps & pmps?

    I have about 80 strips left for the Alpha Trak, and then will be switching to a human meter. Vet doesn't want me to, but too bad. Unless she wants to pay for the strips :)

    And dry will always be around. Hoping for young again, but might be Dr Elseys.
     
  26. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    Ok, so with dry always being around, you are SLGS. If you put that in your signature, it will help those who are helping you.

    Yes, if he's in the normal range, carry on with the current dose.

    With both methods we always recommend at least four tests per day: AMPS, PMPS, and at least one test in both the morning and evening cycle, with numbers dictating how often you test (like on days like today, where you NEED to test more than that because his numbers are lower). Testing is for determining how well a dose is working, but almost more than that, it is for safety. No matter which method you follow, you want to be sure the numbers are always, always safe.

    And, I was just informed that the reduction number on the AT for SLGS is actually 90, not 68. So, since Rufus hit 75 today while you are still using the AT, he has earned a reduction! Starting this evening, his new dose would be 5.75U.

    At this point, you can either keep him surfing safely in his current numbers, or if you want to boost him up a tad, you can give him some high carb food. Even though you are doing SLGS, he is safe as long as he's over 68.
     
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  27. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Thanks for the info! Do you think 5.5 would be ok? That's hard enough to do, I don't know how I could do .25!
     
  28. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    Do you have syringes with half-unit markings?
     
  29. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Ok. He ate his whole can of food an hour ago, now up to 120.
     
  30. Sean & Rufus

    Sean & Rufus Well-Known Member

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    I do, but I don't like them because the needle is so short. I guess I'll have to make it work somehow.
     
  31. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    Reducing by .25U really is ideal, so I would try those half-unit syringes again. If you reduce too quickly, you could end up undoing all the good work that you've done the last few weeks. None of us love those "between the line" doses, but you do get used to doing them.
     
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  32. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    And that 120 is good. I would hold off on feeding more for now, but definitely grab another test or two as you can.
     
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  33. Sean & Rufus

    Sean & Rufus Well-Known Member

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    So this 75 to 120 is a pretty decent jump, no? Do you think food alone would do that?
     
  34. Sean & Rufus

    Sean & Rufus Well-Known Member

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    I guess my concern is I still don't know where his nadir is. So far it's looking like early AM. I'm going to have to continue multiple tests per day to finf out when the nadir is right? Also, if that 75 to 120 was food alone, if I free feed his numbers could be jumbled all the time depending on when he ate.
     
  35. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    It's possible that's a a food spike, or it could be the start of a bounce. Only time and tests will tell for sure. If it's food, he'll likely either surf with a slight rise into PMPS, or he may possibly go back down a bit once the food wears off. If it's the start of a bounce, well, you know what will happen.

    Nadirs can be a moving target, so even if you figure his out, don't get too attached to it. You can get a general idea of when he'll nadir, but it could change at any given time...just because.

    Free feeding can make it challenging to see what's going on. We usually feed several small meals at the front end of a cycle, and definitely nothing withing 2 hours before pre-shot test time so you now the preshot number is not food-influenced (you want an accurate read before shooting).
     
  36. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Nice cycle today Sean!

    Did you feed some food or higher carb food around then? It could very well be a food bump. Bubba used to always get about a 50 point hike with canned food before we started feeding raw.

    Free feeding does make it harder to find the nadir and to know what numbers have been food induced. If you could get him on a scheduled time to feed it would be more ideal. I put my numbers and feedings together in a cell so I know what's doing what. You might what to add the carb % in the cell so that you know how he responds to higher carb food when you are trying to boost him up. It will help you the next time.

    Congrats on the reduction to 5.75. Here is a pictorial guide to show you what it looks like. Practice with a used syringe and water. You've got young eyes so I know you'll be able to do it!

    upload_2018-2-20_14-27-16.png
     
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  37. Nan & Amber

    Nan & Amber Well-Known Member

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    Just going to throw this out there: isn't 5U about when one starts moving in 0.5U increments for high-dose conditions? Where I'm going is that a reduction of 0.5U, at least this one time, might not be a bad idea. If it's too big a reduction, Rufus will just go back up, but since he's just had a pretty dramatic change in numbers with a possible cause (dental), I'm thinking it might be appropriate to do a slightly more dramatic move for this reduction.

    Of course, even by the above arguments, after this change you'll have to move in 0.25U increments, so probably you'll have to move to the other syringes. You can sort of figure out 0.25 with full-unit markings, but it is harder.
     
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  38. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    Since Rufus is just starting to see an improvement in numbers and bouncing, I would hate to see him lose that momentum by possibly taking too much of a reduction/reducing too quickly. Of course Sean holds the syringe, so ultimately, the decision is his.
     
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  39. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    You might be right about that. Hopefully some of the higher dose peeps weigh in. I agree that this has been dramatic and that he might be able to handle .50 reduction.
     
  40. Sean & Rufus

    Sean & Rufus Well-Known Member

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    It was fancy feast tender beef and liver, only 2% carbs. I did add his cosequin and immune suppoert additive to it. He's up to 154 now, so I'm guessing a slight bounce? He's been pretty sleepy all day, think he needs to get used better numbers :)
     
  41. Sean & Rufus

    Sean & Rufus Well-Known Member

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    I'll see if Wendy can help! @Wendy&Neko , any suggestion for reduction? .25 or .5 ??
     
  42. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    I'm guessing it's the start of a bounce....hopefully he won't take it to the stratosphere. And hopefully he is getting used to these better numbers!

    Do you know if the cosequin and immune support have any sugar products in them? That's one thing to consider...lots (but not all) of these supplements and meds have some form of sugar in them.
     
  43. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Looks like all of his supplements are free from sugars
     
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  44. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    Good!
     
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  45. Wendy&Neko

    Wendy&Neko Well-Known Member

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    I never noticed a bump from Cosequin, it should be OK.

    Congrats on those lovely greens today - the first part of today is an ideal cycle. Although scary the first few times, pretty soon you'll crave these nice numbers. What might help you the next time you see greens, is to keep track of any foods outside of the regular meals that you feed. Knowing what food you fed, when, and how much, can be an invaluable tool next time you might need to steer his numbers. I used to track extra foods in the Remarks section.

    With you using the AT and getting down to 75, that would be a reduction earned when following SLGS. Because he is on his 6th day after a dental, and is over 5 units dose, I might go with the 0.5 unit decrease. 5.5 units didn't do anything for him before, but maybe the dental is making a big difference and I like to be cautious with larger doses and hence larger depots.
     
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  46. Stacy & Asia

    Stacy & Asia Well-Known Member

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    Check out Rufus being the cool cat over there! :cool::D:cool::D Hooray for dental work! :cat:
     
  47. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Thanks. Another thing to consider (possibly), is he is off his pain meds since Sunday night. He's tried eating dry kibble a couple times (he wasn't supposed to be), and I noticed that he was still eating the same way he was before dental i.e. weird tongue sticking out, manipulating the food, dropping food, head bouncing. The dental tech vet just called and asked how he was doing. I told her about these things and that I was kind of worried, but thought maybe he's still inflamed. She said it was actually ok for him to be eating dry food and he should not be exhibiting those signs. He had 2 teeth that were questionable, but they left them in. Kind of wish they would have just pulled them since they were already "in" there. Check up is not until next Wed, but she said to put down the kibble and watch him eat. If it continues, she might want to see us this week. So long story short, hahaha, he might be in pain somewhat still, and that could further complicate things.
     
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  48. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Stooopid tech - dry food is NOT good for diabetics. And wet food will probably be easier to eat.
     
  49. Sean & Rufus

    Sean & Rufus Well-Known Member

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    It is young again brand though! I know, I know. No dry is good. He loves his water though and drinks plenty.
     
  50. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Glad that Wendy weighed in and agrees that the 0.5 reduction is the way to go.

    One thing I forgot to mention earlier is be careful with Deli meats as often they add sugar to them.
     
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  51. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Bounce bounce bounce......
     
  52. Sandy and Black Kitty

    Sandy and Black Kitty Well-Known Member

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    Look at Rufus!

    My BK is the poster kitty child for what a difference healthy teeth and gums can make. Once he finished his 10 days of antibiotics the free fall started for us.

    I’m glad you took the .5u reduction today. Being he was up to 6u, he does have a large depot which has potential to add fuel to a trip down the dosing ladder, if he is indeed going in that direction.

    Keep your eyes on the road and your hands on the wheel (and possibly one foot on the brakes).

    A slide down the dosing ladder can be a very emotional ride so it’s good to solicit feedback as you navigate this post dental period.
     
  53. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Thanks! Hopefully he goes down nice and slow. These bounces are getting to me though, they really are something! I'm sure we'll see it for a few more days now though, from the decrease. He's been sleeping almost all day, I think the low numbers are getting to him.
     
  54. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Rufus! My bouncing baby boy....75 this am to 453 tonight. :banghead::banghead::banghead:
     
  55. HWright

    HWright Well-Known Member

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  56. Nan & Amber

    Nan & Amber Well-Known Member

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    Oh, Rufus! :eek:

    He'll come back down. Now that he's gotten a taste of a nice long blue-green stretch, he'll be back!
     
  57. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Ugh. 512 this am :(
     
  58. Stacy & Asia

    Stacy & Asia Well-Known Member

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  59. Sean & Rufus

    Sean & Rufus Well-Known Member

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    I liked this "from my perspective... the problem is you're equating bouncing as a problem. :D
    until a cat is tightly/well regulated bouncing is normal. thank g_d kitty bounces! that means his body is doing exactly what it's supposed to be doing... Mr. Liver is on the job and working! this is a good thing. once Mr. Liver gets used to what it feels like to be in lower numbers he'll start relaxing a little. he won't become panicked when seeing those lower numbers. eventually, Mr. Liver relaxes enough to say,"hey, this isn't so bad. i kind of like feeling what it used to be like... before diabetes." that's when you'll see a lot less bouncing and eventually flat cycles."

    I guess bouncing is "normal" just freaky when you go from 96 one day to 512 the next
     
  60. Stacy & Asia

    Stacy & Asia Well-Known Member

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    That's exactly the bit that shifted my thinking. As far as epic bounces go, I just choose to think my cat is interested in space exploration and occasionally has to go to the moon to see if it's really made of cheese! ;) Looks like Rufus has some similar interests.

    IMG_2793.JPG
     
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  61. Sean & Rufus

    Sean & Rufus Well-Known Member

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    And I just knew something was up with him this morning. Happy, purring, cuddly, and ate his entire meal. Yup, he sure enjoys being in the reds and blacks :rolleyes::banghead:
     
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  62. LeeAnn (Lannie)& Freckles

    LeeAnn (Lannie)& Freckles Member

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    That was a good read. Thanks for sharing.
     
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