4/29 Oren; AMPS=213;+2.75=428; +5=468;+8=547;PMPS=464;+4=393;dose advice

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Megan & Oren

Megan & Oren

Member Since 2015
Oren Yesterday
Probably going to need to increase dose again, as green has been elusive for a while. 2 recent possible partial fur shots didn't help, but I would appreciate others eyes and opinions on going back up, most likely to 5.75.
Though I'm home today, I am back to work tomorrow and so am considering waiting till Fri when I can be around to monitor more closely.

Hope everyone has a wonderful Hump day! Thoughts and vines to all in need.
 
Hi Megan,

When you have a fur shot even if it is partial fur shot the 6-10 cycle rule starts over. However he does look like he is running high, so maybe he really does need to go back up a bit, but if you decide to go back up you might want to only increase to 5.5u. because you did see some green when you first re-started the 5.25u dose after the vacation. Since you are thinking about waiting until Friday, hopefully you will get some more advice before you need to make your decision.
 
Good morning! Look at that sweet boy. He's starting out pretty good, don't you think? Of course, Zoey has set the BG bar high so they all look good to us today. :rolleyes: I'm definitely not an advice giver on doses. Didn't you say that you think you fed him some higher carb food? I know for certain that the carb count affects Zoey's numbers, so maybe that coupled with your possible fur shots is the culprit on those highs. (ECID) He's in some pretty good numbers starting out today. Peace of mind is worth something so your thought of Friday (if numbers stay safe today) sounds spot on to us. ....But we have proven time and again that our thoughts are pretty useless, so wait for others to chime in. LOL

Enjoy your day today!! And give Oren a chin tickle for Zoe.
 
No dose advice from me other than waiting out the 6-10 cycles after the fur shots. Who knows, maybe Oren will make the decision for you...and decide to stay put!

Marilyn and Polly
 
ugh. he's not cooperating at all! pretty sure last night and this a.m's shots were good. But this is a big jump in 2 hrs this a.m, the wrong direction!! (quit tagging along w/ Zoey please Oren!! ;).

Thanks everyone for the suggestions. I'm afraid unless he turns around today (doubtful) he's going up. Tina, I was kind of wondering about possibly 5.5 also; though I've had others suggest whenever you're over 5 units, increases/decreases are usually .5 increments. Still, it seems plausible to try that inbetween dose to me. But what the heck do I know! obviously not much!
 
Those "possible" fur shots sure do make it hard to figure out what's going on. Several times I thought I gave them it turned out that I didn't which is even more crazy making. Wait until you get down to lower doses and have bubbles in the syringe. Or maybe you are able to get rid of them which I rarely do. Work that juice now Zoey. Two good ones after one or two partials or missed likely aren't enough to replenish the depot.
 
@tiffmaxee ; yeah, the craziness is the hardest to take! one thing that was suggested on here (and forgive me, I forget who it was now) to ease the bubble situation, is to draw your dose + a little more as usual, then tap to get a main bubble, then draw MORE air into the syringe, and push up to correct dose, tap again, and bubbles shouldn't be a problem. It has worked well for me, though granted, 5+ units is perhaps easier than the lower doses? Might be worth a try though
 
I've tried everything to get rid of bubbles and I can't do it. It kind makes my caliper dosing to be precise whacky. :banghead:
 
Megan & Oren said:
ugh. he's not cooperating at all! pretty sure last night and this a.m's shots were good. But this is a big jump in 2 hrs this a.m, the wrong direction!! (quit tagging along w/ Zoey please Oren!! ;).

Thanks everyone for the suggestions. I'm afraid unless he turns around today (doubtful) he's going up. Tina, I was kind of wondering about possibly 5.5 also; though I've had others suggest whenever you're over 5 units, increases/decreases are usually .5 increments. Still, it seems plausible to try that inbetween dose to me. But what the heck do I know! obviously not much!
Click to expand...

Yes, I have heard that the increase move to .5u when you are over 5u. However, he was doing reasonably well on 5.25u before the fur shots.
And even when he was on a reduced dose of 4.75u while you were on vacation he was doing well. Do you know if he was eating normally those last few days of your vacation. Because if he was and was doing that well, it sort of makes me wonder if he is now getting too much insulin. I am not experienced enough to know for sure, but it might be something to review and consider.
 
@Tina & Sammy ; as far as I know, he ate just fine. I have never seen him NOT eat in fact. I think that would be one way I would definitely know something was wrong with him. He always has a good appetite, and willingly eats anything I give him. He's not terribly picky either; tho he apparently much prefers cooked chicken breast to thighs (of course, it's more expensive!). Gah, too much insulin... could that be it? Sure need some guidance to figure this all out. I suppose, there is the option of returning to 4.75 for ~3-4 days and just see what happens? or 5.5 the same?!
:banghead:

@Wendy&Neko , @julie & punkin (ga) , your take?
 
Well... Zoey has ran off and left sweet Oren. I'm telling you - does what she wants, when she wants. Of course, when I saw that black number this morning one of my voices in my head told me I should feed her smaller portions, often, but I didn't do it. I kept her on a regular feed schedule (she's been doing so well with it) and she just skydived into green by +4:45. (SMH). So now I'm feeding her smaller portions to keep her from ricocheting back to black. She is just that food sensitive. Maybe Oren is, too, and those small feedings you gave early on while the numbers were climbing just fed the numbers more and he'll start coming down some now that you're not feeding the later part of the cycle. If he does that, be aware that if he follows Zoey's lead you might want to feed the numbers instead of the schedule in the pm cycle. Who knows... food for thought, my friend.:p
 
Megan & Oren said:
@Tina & Sammy ; as far as I know, he ate just fine. I have never seen him NOT eat in fact. I think that would be one way I would definitely know something was wrong with him. He always has a good appetite, and willingly eats anything I give him. He's not terribly picky either; tho he apparently much prefers cooked chicken breast to thighs (of course, it's more expensive!). Gah, too much insulin... could that be it? Sure need some guidance to figure this all out. I suppose, there is the option of returning to 4.75 for ~3-4 days and just see what happens? or 5.5 the same?!
:banghead:

@Wendy&Neko , @julie & punkin (ga) , your take?
Click to expand...

I don't know for sure if he is getting too much, but it really does make me wonder. If he wasn't eating normally then that would explain the lower numbers on the 19th and 20th, but if he was eating fine then I don't know how to explain the better numbers. Hopefully someone else with a bit more experience could give you more advice to help you decide which direction to move in.
 
hey, i'm back...
if you really think he might have gone green last night... get a +4 tonite.... see if it looks a lot like last night...
and then get a +8 or +9....
alarm clock time.... sorry....
 
going down in dose is almost never the answer if you have worked up to the dose systematically. I would definitely NOT reduce the dose.

What I do when I am uncertain as to what to do next, is to look at the protocol guidelines again and compare the nadirs in the past 3 days or so to it:
Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
He's gotten to blue (probably at least 2 of the past 3 nights, so I would look at the guidelines for when you've had nadirs in the 100's. It says to hold the dose for 6-10 consecutive cycles before increasing the dose by 0.25u. Yes, you're over 5u, which makes 0.5u a very reasonable increase. If you choose to increase by 0.25u that's fine, but it's reasonable to go up by 0.5u. Sometimes it takes larger amounts to have an effect.

What makes you think yesterday morning was a possible furshot? Do you really think it was when you gave it, or were you just looking at numbers after the shot and thinking "must've been a furshot." If you really think you did have a furshot, then you'd want to hold this dose for a total of 6-10 cycles POST-furshot.

If he were mine, I'd increase his dose as soon as I thought I had 8 cycles at this dose unless I saw green numbers.
 
Hi Julie; the 2nd possible fur shot, i did smell some lantus at the site, but it wasn't super strong, and it didn't persist long. I truly think i got it in, but perhaps just didn't get it under the skin enough? there was no wetness (he still has shaved spots, they're growing back, but the hair is still quite short). Its not like it squirted clean through... but I don't know if that counts as a fur shot or not? and then the bad numbers seemed to bolster the idea.. I guess I'm leaning towards the .25 increase ; i think I will try and get a few extra tests tonight to see where he goes...
 
I think he is bouncing due to the fast drop last night. Over 200 points in four hours. It would help to be consistent in the small meals at the beginning of the cycle. He likes to drop when high so getting snacks in the first few hours may help slow down the drop.

I don't think it is too much insulin, because you have increased safely as per protocol. It is possible you are seeing a little glucose toxicity. With Neko it doesn't take very long before she gets used to high numbers again. I would increase by .5 u, as long as you can monitor. Fur shot are pretty obvious at this sized dose, spoken from experience. :oops:
 
less of a sharp drop this time from PMPS. meal at +2 and another just after the test. one more on tap for +6. I'll go back up tomorrow night, sigh, i guess to 5.75. was hoping he'd be on his way down the dose scale a bit, but apparently this reduction didn't take well. maybe it was because of the interruption of the vacation dose too? that's going to be an ongoing phenomena every other month , due to my need to travel. sigh...
 
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