? 5/14 Marshmellow AMPS 265 Nice flat day yesterday. Question regarding bounce/ increase?

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Marshmellow & Steve

Marshmellow & Steve

Member Since 2015
Yesterday

Marshmellow her usual rambunctious self this AM. All is well. Yesterday, Marshmellow's numbers were very consistent, I would have liked to get a PMPS +6, but she was having nothing to do with it! Planning on increase tomorrow (would do today, but won't be home most of afternoon).

A good day to all and safe surfing to all the kitties!
 
Of course I cursed myself...another bounce. I still think an increase is in order, but just to clarify, I should still be OK to increase even though she is bouncing, correct, at least that's what I was told last time. The reason I get confused is because of this from the NDW and Failed reductions condo:

julie & punkin (ga) said:
A second cause of a bounce is if a cat drops very quickly. 100 points in an hour, for example, regardless of the range the BG number is in, can cause a bounce as well.

So, what to do now? don't increase the dose because of these higher numbers. once this bounce clears, which can take up to 3 days of high numbers if mr liver is super-active, then if you had increased the dose, it would be too high. you are entering the phase of treatment that we say requires "Patience Pants." when you think you're seeing a bounce, you have to wait it out, then you can see what the dose really does. You will know the bounce has cleared when you start seeing numbers you were seeing before - like that 148 again.
Click to expand...

I am wondering if I am at a point where I should "be wearing my patience pants" and give this dose a few more days to she if she holds it?
 
I'm not sure why you were told it's okay to increase on a bounce. It's usually not recommended because when a bounce is cleared is when you find out what that dose will do. I hope someone will clarify for you. I'd put the ? icon in your subject line.
 
In this condo, 5/2/15 I question raising her insulin when she is bouncing. I still don't quite understand all the mumbo jumbo, but what I was being told makes sense when I think about increasing when looking at her nadirs. But Marshy keeps bouncing around at this dose and I am thinking I should try to stabilize her drops with small amts of LC food to see if I can keep her flat like she was yesterday. If you look at the spreadsheet, she was pretty flat on 5/11 and 5/13, I am thinking of giving her an extra little bit of LC food at her (1/2-3/4 ounce) at about +4-5 to see if it will hold her, or should I just be patient a few days to see more of a pattern? Ideas?
 
I'm definitely not an expert, but when I was thinking of doing an increase, I was advised to wait a few more cycles cause she tends to level out around her 8th cycle and it is good to see where the dose takes you. I was itching to get her increased but decided to put on my "patience pants" and waited. I tried looking at your SS but wasn't really able to see a pattern (I just started to be able to interpret mine successfully). Maybe Marshmellow just needs a few extra cycles since, well, ECID :)
 
The issue isn't one of increasing during a bounce. The concern is that you want to try to avoid increasing when a bounce is breaking. When a bounce is clearing, numbers are usually dropping. If numbers are headed down and you add more momentum to the downward trend by increasing, you can have a long day or night of trying to bring numbers back to safer levels.

Looking at Marshmallow's SS, the 2.0u dose brought her into the 90s. Then she bounced. It looks like the bounce cleared last night but you don't know if she stayed in the blues or saw green. Then she bounced. It seems like she has the potential to spend time in blues and greens on this dose. She's clearing bounces relatively quickly. I think you should see what her numbers look like later this evening/at AMPS tomorrow and decide. If she has cleared the bounce, an increase would be fine if you want to see her numbers in a lower range than what she's already seeing.
 
So I was about to say I'd increase based on Libby's post until I read what Sienne wrote. The thing is you don't know what the nadir was last night. It is likely it was a green number and another bounce so it makes sense to see what happens tonight and decide if an increase is needed tomorrow.
 
The idea is that you want to be fairly certain how low the dose is taking Marshmellow in between the bounces. Those nadirs are the most important numbers. You've got one green 95 - and boy did she bounce fast from that! It only took her 2.5hrs to get to 355! That suggests that her body isn't used to those normal numbers.

We don't know how low it got her last night when she cleared the bounce, but it only took her 1.5 days to clear the bounce. Of course she took off again into a new bounce. That's pretty typical at this stage. I think it's likely you'll need to increase her dose again, but it wouldn't hurt to see what she gets to when she clears this current bounce. I'd probably hold just a little longer and try to catch how low she goes when this current bounce clears. If it's green, you may want to keep holding the dose. If the low point is higher then you want, then you can increase.

What Chris was saying in that previous post was that you want to base your dose increases on how low the dose takes the cat. It's ok to increase on a bounce if you've evaluated that dose and know how low it takes the cat, for example, if the cat starts a new bounce before you've had a chance to increase. You just want to avoid increasing as the bounce is clearing, as Sienne explained above, or if you choose to increase anyway, just understand what the consequences of increasing a dose when a bounce is clearing might very well be.
 
Thank you...it's all so confusing! I wanted to get a nadir last night, but she doesn't like to come near me. Will try to get a nadir tonight if I can, it's tough when my wife works. I have tried treats, and as much as I hate to do it, I'll fake her out with food. But I do understand that I need to see both nadirs<
 
it is confusing - so keep asking questions on whatever you don't understand.

I think it's ok to use treats. We always encourage people to reward the kitty for getting poked by giving a treat. I always shot punkin's insulin when his face was in his bowl. Whatever works for you and rewards her. That becomes a mutually satisfying arrangement, you know?! ;):D
 
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