8/9 Jai Jai - AMPS: Hi; PMPS: 533, +2: 446, +5: 355

Yesterday's Condo: http://www.felinediabetes.com/FDMB/threads/7-9-jai-jai-amps-506-pmps-398-2-349.143937/

Glad to see Jai Jai's BG came down a bit last night. I tested the PM+5 but I do not remember the figure at the moment, it was a yellow.

Perhaps Jai Jai went down more at the latter part of the cycle, so today's AMPS recorded a "Hi" result.

He has lost some of his appetite recently, I need to feed him tuna that is much more enticing than his normal food. At least, he eats.

I have to thank you all for your guidance and support during the time when Jai Jai had got blue or skyrocketing figures. That gave me a lot of help him get through the not very stabilized moment. Sending you all some hugs and love. Have a nice day.

 

Sending "clear the bounce" vibes to Jai Jai. I hope he gets back into blues and greens again soon.

Have a good day!

 

That's not the best way to start the day Jai Jai - try sticking to that sunny yellow, although I don't see that on your spreadsheet

 

It was my bad for not inputting the figure last night. He had 250-ish. I assume it was a bounce this morning.

 

If you're following TR, you will want to increase Jai Jai's dose. I do suspect he's bouncing but I also suspect that yellow last night was the result of the fluids.

 

May I re-confirm the dose? Assuming that the blue appeared at AMPS of 6/9 was the nadir of that cycle, should I hold the dose of 1 unit at least until 11/9 PM according to the TR?

• 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.

 

You base your decision on where the majority of the nadirs fall. In the last 8 cycles, you've had 2 nadirs that are below 300. Although you've not had any spot checks during the last 2 AM cycles, most of your tests are above 300. You do not want Jai Jai to get comfortable with those very high numbers. It that's the case, then you have to contend with glucose toxicity.

Your cycle count (barring a skipped or reduced dose) begins at the cycle where you change a dose. The count isn't based on when one lower cycle occurs.

 

Hi, @Sienne and Gabby . Julie reminded me of seeing clearly how low this dose is getting Jai Jai to before I increase again. If he is still bouncing from the yellow and blue, I am hesitant to increase on weekdays. I know that most the tested figures these few days are on the high side, I myself also do not take the risk of glucose toxicity but safety is my rule of thumb. Also, having reviewed Jai Jai's ss, he got his hypo from 1.25 to 1.5 u, increasing the dose this time makes me feel less comfortable. But, if most of you think that it is appropriate to increase again within these 1-2 cycles, I'll try my very best to ask for a day-off and monitor the increase.

Meanwhile, I would like to put forward another discussion on dose increase. Referring to http://www.uq.edu.au/vetschool/content/ccah/diabetesinfo/link4.pdf, this paper suggests that when the nadir is blood glucose concentration < 200mg/dL but peak is > 200mg/dL (11 mmol/L), then Increase every 5-7 days by 0.25-0.5 IU depending on if cat on low or high dose of insulin.

What are your views on this? Is it slightly different from the TR people are using on this forum?

 

The guidelines you linked are the same that we use. The link is in the TR Protocol sticky. We use a slightly modified version.

Again, when these guidelines refer to the nadir, it's not one value out of 6 - 10 cycles. It's where the majority of the nadirs fall. Please refer to my post above. You don't base a decision to increase based on one value.

Ultimately, it's your decision whether to increase or when or by how much.