YIKES! AGAIN! 9/19 Chester's pmps=100,+4.5=64

Another wild ride last night, although from the look at the SS it was totally uneventful!

viewtopic.php?f=9&t=25257

No clue what to shoot this morning. Leaning toward 1.75.

editing in: Well, I was hovering over the 2.0 and just couldn't do it. Probably should have...but did the 1.75 instead.

 

Re: 9/19 Chester's amps 277

You and Chester are doing wonderfully. A lot of this will smooth out for the two of you and it appears to be happening safely, with you at the numbers control.

I'm pouring extra strong coffee this morning, but it may be you need to go sneak back and catch a few winks.

You know, sometimes we can learn a lot from a sleeping cat. ;-)

 

Re: 9/19 Chester's amps 277

Hope you get to catch up on some sleep today, Jaye.

Regarding the ears; every once in a while, after I've been testing a lot and J.D. ears are sore, I'll put a little pain relief neosporin on his ear and he seems to appreciate it.

 

Re: 9/19 Chester's amps 277

Hi Jaye,
I hope you have a calmer day today and can catch up on some rest. I'm sure someone will be along soon to advise you on shooting. Maybe add something in subject line - Help Needed - if Chester's shot is due soon. You're doing such a good job.

 

Re: 9/19 Chester's amps 277

Chester did not earn a dose reduction. You really need to be sticking with the 2.0u dose. Your AMPS is a very solid number for shooting the full dose.
Remember what Libby said last night:

 

Re: 9/19 Chester's amps 277

Nice amps this morning! Great job Chester! You guys are really doing an awesome job - things will get easier as they go along, and much less stressful.

and I agree with the others - hold the dose - these numbers are what you want to see. He really is doing great.

 

Re: 9/19 Chester's amps 277

DANG! I should have had the courage to shoot the 2.0 this morning. I didn't and now Chester's number are terrible and he's looking at me like I'm to blame...which I am, of course. I was just worried that the only reason his numbers looked so good last night was because of constant feeding and I knew I couldn't do that come Monday and back to work.

Is it too late to rectify this if I shoot 2.0 tonight? Am I in for another wild ride, I wonder?

 

Re: 9/19 Chester's amps 277,+3=371,+5=311,+7=248

Jaye..you know how to steer the numbers with LC now....you do want the nice low numbers if you can get them. Chester will bounce after the lows so keep that in mind he following day.

I know that the lows are scary at first, but with the data you have collected, you will be able to study how he responds to food.
After shooting and feeding in the mornings, what hour do you leave for work?

You know that you can leave food out for him and that it will raise his numbers....right?
Remember that we are trying to gt those lower numbers...that is a good thing...
Remember also that you are in control....

 

Re: 9/19 Chester's amps 277,+3=371,+5=311,+7=248

Not only does Chester's liver have to get used to the lower numbers, so do my nerves!

It's kind of an intricate dance in the morning with my critters, having two diabetics of different species who both need to be fed at approx. the same time, tested, etc. walked (dog, of course). I start testing at 5:00 a.m., then put Chester in one room with food which he generally won't eat until I'm there to keep him company, usually end up spoon feeding him (I know, I know...SPOILED!) while I feed the dogs and other cats and prepare shots. I get back to Chester, make sure he eats enough, shoot and give meds by no later than 5:30 a.m. I'm out the door no later than 6:30, although this week it will be more like 6:15 because of a change in schedule for me.

I have an autofeeder with two timed slots and an ice tray for Chester, but the problem is the other cats, two of which should not have the high protein in Chester's food (CRF kitties) so if his numbers are lower and I think he might need snacks, I put him in a bedroom for the day. He hates that, though...he's very social. But if I put another cat (and believe me, I have plenty more to choose from) with him, they might get his food. It's a real problem. Added to that, because of friction between two of the other cats, some are on a alternating time loose in the house. The cat that I would prefer to leave with Chester has been kept in a different room all night. I hate to confine him during the day, too. (And all this without even mentioning my Felv cat and my FIV cat!)

Do normal people have these problems?

 

Re: 9/19 Chester's amps 277,+3=371,+5=311,+7=248,+9=174

I can't speak for "normal" people....I don't think I spend too much time with them... :lol:
I asked because I was wondering if you could get a +1 but unless you shot at 5:15 and tested as you walked our the door at 6:!5 it wouldn't be possible....I know that Achilles/Eva had to switch things around so she could get a +1...
just thinking out loud I guess...never mind then...you have such a tight schedule....

 

Re: 9/19 Chester's amps 277,+3=371,+5=311,+7=248,+9=174

Yeah, it's a crazy schedule, not helped by the fact that my DH is only home on the weekends. He's an archaeologist on an Indian Reservation and it's a 2.5 hour drive for him. He does do the drive mid-week sometimes to help, but it's a lot of work by myself.

I'm already getting up by about 4:15. I could adjust and feed everyone earlier, but that would be a problem (particularly this week) because I will just be coming in the door at 5:00 if I'm lucky.

 

Re: 9/19 Chester's amps 277,+3=371,+5=311,+7=248,+9=174

Yeah...well no, that wouldn't work...
Oh well, just carry on the way you are doing it Jaye...it will be okay... :razz:

 

Re: 9/19 Chester's amps 277,+5=311,+7=248,+9=174,+11+114

We're now lower than we were last night at +11 and I'm trying to convince myself that 2.0 is the way to go.

Am I wrong? Is the 1.75 where I should stay?

 

Re: DOSE ADVICE 9/19 Chester's amps 277,+5=311,+11=114

I can't comment on dosing, but I just wanted to suggest your trying a 5compartmant auto feeder. I do not separate my cats, and 3 eat the same wet foods, totalling ignoring my putting their own bowls down. I do start the morn by giving them a good breakfast before leaving for work, then leave a big bowl for Oliver, a bowl for Apple the kitten, and then fill the autofeeder for Shadoe. Because they sleep at different times and only she seems to know the feeder turning sound, chances are good that she gets most of the food in the sections before the others realize there is food now available. It works out well; Shadoe is still fat, not losing weight, but can afford to lose a few lbs.

Also, here is a part of the protocol, to remind you of the guidelines for dose adjustments, just in case the time happens you need to decide on your own some early morn. Usually, an earned reduction needs a number around 50 to be valid, and for shot time, you need to have a no-shoot number, or something that suits your cat's patterns:

"General" Guidelines:

--- Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).

--- Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).

--- Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.


Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.

--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.


Reducing the dose...
--- If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

--- If an attempted reduction fails, go right back up to the last good dose.

--- Try to go from 0.25u to 0.1u before stopping insulin completely.


Random Notes...
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.

A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.

Sometimes a dose will need to be "fine tuned" by adding some "fat" or "skinny-ing up" the dose.

 

Re: DOSE ADVICE 9/19 Chester's amps 277,+5=311,+11=114

We're down to 100 now. I'm really afraid to give him a chance to "earn" that reduction tonight. I know this sounds wimpy and somewhat selfish, but I've GOT to get some sleep tonight. I find myself making all sorts of mistakes the last week because of lack of sleep, including last night's thinking that I might have overdrawn his dose (which, thankfully, turned out not to be the case). If I need to be up with him all night again to keep him from dropping too low...

Also, we're not coming from a position of already being regulated and wanting to reduce the dose, but from a position of a way too high original dose, so I'm wondering how we would determine that 1.75 isn't the correct dose for him. Yes, he was high this morning, but he brought himself down to 100 at pmps. Guess I'm just not getting that part of the protocol.

 

Re: DOSE ADVICE 9/19 Chester's amps 277,+5=311,+11=114

since you've already done 2 cycles of 1.75, then you might as well stay with it. It will either work or it won't. ;-) If it doesn't stick then we can go back up, and at least that might give you time to ease into seeing lower numbers. Low numbers are a GOOD thing. If OTJ numbers are supposed to be 80-130 (AlphaTrak), then the only way to get OTJ is to spend time in the 80-130 range, right? And because Lev gives flat curves when it's used correctly, to be flat in the 80-130 range means you have to shoot in the 80-130 range. You wouldn't necessarily shoot 80, but definitely 100's. Look around at others' spreadsheets, most of us are shooting low when we get an opportunity, and it gives nice flat curves.

 

Re: DOSE ADVICE 9/19 Chester's amps 277,+5=311,+11=114

I can breathe with that...

 

Re: DOSE ADVICE 9/19 Chester's amps 277,+11=114,pmps=100

sounds good. Since this is your lowest preshot, please get a +1.

 

Re: 9/19 Chester's pmps=100, +1=200

Got it... his +1 was 200.

I read the sticky giving the example of a typical curve. I'm still a little foggy for the reason behind getting a +1. Is it to see if the other shot is wearing off or if there is overlap going on? Something like that?

 

Re: 9/19 Chester's pmps=100, +1=200

Whenever you shoot lower that you've shot previously, we encourage a +1 and usually a +2. This is a safety issue, especially if you've not been able to get any other tests late in the cycle. With a "perfect" curve, you'd expect the +1 to reflect a food spike. If it doesn't (i.e., it's the same or lower than your pre-shot), it's an indication that numbers may be dropping and that you should definitely get a +2.

 

Re: 9/19 Chester's pmps=100,+1=200,+3=124

Here we are at +3 (124) which is already getting low enough to scare me. I have to say...I hate this! Feeling that his life is so much in my hands and knowing that I have to get some sleep tonight. I don't know what to do tomorrow and it scares the cr*p out of me.

 

Re: 9/19 Chester's pmps=100,+1=200,+3=124

feed him a little low carb to see if that throws him on his surfboard.

 

Re: 9/19 Chester's pmps=100,+1=200,+3=124

Jaye...put the does you shot in the box next to this morning's AMPS, okay?
Have you given him a little LC at the +3? If not, you could do that...okay? A teaspoon...
You shot the lower dose...that is a good thing, right?

 

Re: 9/19 Chester's pmps=100,+1=200,+3=124

Oops! Sorry about leaving that amps dose off...I was less coherent this morning that I can remember being since college!

I'm giving him a little LC as we speak.

I did shoot the 1.75 and I think I'm past this being a temporary reduction now that we're in the third cycle of it.

What do you think about the possibilities of me sleeping tonight? And tomorrow leave the autofeeder at +3 and what other time do you suggest?

 

Re: 9/19 Chester's pmps=100,+1=200,+4=87

Looks like even with the LC at +3.5 we're about to earn another dose reduction! If, indeed, the AlphaTrak dosecrease number is 80, I should probably wait 30 minutes and see if he goes below it on his own without adding any more LC, yes? That way I'll know where he really is.

What's going on with this little guy? Just less than two weeks ago we were at 4.5 bid plus some occasional NPH to lower him from scary highs.

This is pretty amazing...and pretty scary at the same time.

 

Re: ANOTHER REDUCTION? 9/19 Chester's pmps=100,+1=200,+3=124

sounds good, feed a little LC and see you in 30.

 

Well, I guess Chester just earned his dose reduction for tomorrow. He just threw me a 64 and I gave him some HC gravy.

So, my diabetic cat is crashing and my diabetic dog suddenly has blood all over his eye! What a night! AGAIN!

 

ok, test again 20 minutes after the gravy to be sure it worked...

 

Worked a little but not much...up to 71. I just gave him some more and will test again in 20.

 

ok, see ya in a few.

 

Just tested again...128. Safe to go to bed for a couple of hours or should I give him a little more?

My dog is bleeding from his eye right now...so maybe sleep isn't in the cards.

 

any idea why he's bleeding? That doesn't sound good... Is it about +5? If you can check in a couple of hours he should be fine, just give him a good snack.

 

He's got a little cyst just above his eye and sometimes when he rubs his face, especially with his paw, he opens it. Trouble is, it's so close to his eye that there's not much he'll let you do and he is VERY much the drama queen...screams bloody murder at the drop of a hat. The vet dubbed him the drama queen but I have to agree with the assessment. I once saw him scream, before he even became diabetic, when a vet showed him a needle and syringe for a vaccine. She wasn't even touching him! The vet has seen it...not much that can be done about it. He won't lose his sight with it, I know, because he's already almost totally blind from the diabetes (he's 15). So I've been putting cold compresses on it to try to stop the bleeding... but mostly it's a matter of distracting him long enough for it to stop on its own and for him not to paw at it.