7/16 Tomcat AMPS 141, +1=155, +3=223 PS value worries

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afternoon all

I have a few questions and PLENTY of concerns about Tom's PS BG values the last two days. He is not one for a low PS value....and has given me 2 in the last two mornings. Both times I have delayed.....yesterday AM by 4 hrs...and this morning 2.5 hours. while this news is great!!.....it is what we all are striving for....Tomcat is thrilled....he is running around on his morning garden walk...(well....one quick sprint)....he is not as hungry....etc. I am a tad overwhelmed however.....as this is new territory. I feel somewhat like I have lost that confidence of "control"....lost that feeling of "oh yeah, I know how this cycle is going to go....".

is this normal for his cycles to slowly start to adjust like this?

Am I right in delaying his shot by sooooo long every time? Most of you agree, as well as I, that I don't have enough data to shoot at low low numbers....even this morning was pushing it for me....but I didn't want him climbing back in the Reds like yesterday's delay caused....

IS tom's nadir changing to a very late one? Or is this a nice Lantus cycle?

Can anyone reassure me that dosing a Low PS value is "safe"? I am monitoring very closely...(hello lack of sleep!!) but my concern is that his food intake doesn't really seem to push up his values...ie his plus one is only 155. I certainly do not want to make those number climb (or maybe I would like a stress free nap! ha) but at what point do I add a tiny amout of MC food if his numbers aren't moving at like +2....or is that silly!

or do I just calm down and wait for the infamous 49 to feed the lows?

Also, is it too "weird" on his system that his shot times are all over the place? or as long as I have at least 12 hrs between shots....he doesn't know the dif?

what PS number would you all think is safe for me to shoot when he does this again tomorrow morning...or tonight?

We thank you for any answers

~kelly

Re: 7/16 Tomcat AMPS 141, +1=155 Low PS value newbie worrie

Hello Kelly - what a lovely cycle for Tomcat last night! :mrgreen: :mrgreen: It looks like you didn't get much sleep but you did gather some useful data. And most importantly, unlike yesterday morning, at PS time this morning you knew that Tom was rising and not dropping. People here often get a +11 or +10 test before PS to determine where their cat is going. If he's rising at PS, you are generally safe to shoot. BTW, Neko started out at 155 this morning, so we're starting close to you today.

When I was starting out, I had a "no shoot" or comfort level. On this board, we generally say that below 150 is the number where you post and ask for help before shooting. Then you gradually lower it as you get more comfortable with low numbers. I remember having 90 as my no shoot green when Neko first gave me a green of 81. They do like to push your boundaries on this. :lol: Tomcat will probably do the same for you. It's great to hear that he's feeling better and not eating as much, all really good signs.

Tomcats numbers look as normal as normal can be. Cats don't generally follow a rule book, but yes, the preshots do start coming down and the cycles start looking flatter at the right or close to right dose. You could have shot earlier this morning, because you knew he was going up. But there is also that comfort level to keep in mind. Often people will delay the first couple of times, then they'll see what that does to the numbers and shoot earlier. If they have that +10 or +11 that is. I now will shoot dropping numbers, but I have a ton of data. You aren't ready for that yet.

As for the nadir, last night it was mid cycle. Nadir can and will change. Neko's are highly variable. She's a bit unusual, but has gone from +9.5 one cycle to +4.5 the following one.

I'd hold onto your MC until +2 or +3 if you saw a really fast drop after onset. A rule of thumb Sienne taught me was if you +2 or +3 is half the PS value then slow it down a bit with higher carb. Otherwise, just observe. Looking forward to that +2.

Re: 7/16 Tomcat AMPS 141, +1=155 Low PS value newbie worrie

tomtom13 said:

Most of you agree, as well as I, that I don't have enough data to shoot at low low numbers....even this morning was pushing it for me....

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There's no easy way to jump into suddenly shooting lower numbers. You just have to slowly lower the number you're comfortable shooting as you continue to get more data. So today gives you a really valuable opportunity to gather information. Tests you get throughout the cycle today will let you know what happens when you shoot at this level, which will give you more confidence for next time.

And those are actually great numbers you're seeing. The protocol says:

Phase 3: Holding the dose
Try to keep the cat at a dose where the BGs are in the 50 to 200 mg/dl range for as much of the day as possible. The majority of cats are actually able to achieve consistent BGs in the 50 to <100 mg/dl range with consistent dosing.

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Keep posting updates and if Tom starts to drop lower than you're comfortable with, ask for help and someone will be around to make sure he stays safe.

Thanks you guys for your quick response!!

Well, is it awful that I am relieved that he is climbing!! That just isn't right for me to feel that way!! ;-)

yes, you are right.....the more days like this that I have.....the more confident I will become.

Just knowing that you all care and only want the best for all our kitties...does give me the courage to push that plunger down like you are all in the room with me! I just need to do it sooner!!

I haven't read this one before...so helpful!!!:

A rule of thumb Sienne taught me was if you +2 or +3 is half the PS value then slow it down a bit with higher carb. Otherwise, just observe

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Last night I used the rule: if +2 is lower than PS value...it will most likely be an active cycle. Be prepared.

And I was. All these bits of knowledge and rules are SO HELPFUL~ thanks everyone for sharing their experiences!

~kelly

Well, I may have said that to Wendy but it was most likely specific to Neko and probably prior to his having his acromegaly treated. (Managing a cat with acro's numbers can be a bit more challenging.

I just want to double check on when you're shooting. If you delayed 4 hours yesterday morning, your shot last night would have been 12 hours after you actually gave Tomcat his AM injection. If you delayed 2.5 hours today, then it's the same deal -- your PM shot would be over 6 hours later than your original shot time.

The pre-shot numbers are great! The basic mantra in these parts is, "Shoot low to stay low." I would encourage you to think in terms of shooting lower numbers since it's looking like Tomcat isn't going to give you a choice.

Sienne said:

I just want to double check on when you're shooting. If you delayed 4 hours yesterday morning, your shot last night would have been 12 hours after you actually gave Tomcat his AM injection. If you delayed 2.5 hours today, then it's the same deal -- your PM shot would be over 6 hours later than your original shot time

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yes. I am off by over 6 hours from my usual shot time. which is fine. just upping it by 15 mins every shot. I know to keep a safe 12 hours between two shots.......(minus the 15)

I would encourage you to think in terms of shooting lower numbers since it's looking like Tomcat isn't going to give you a choice

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.

what would you think would be a safe lower number right now? here is my concern:

~~~~~ when I look at very low PS value kitties....they are usually fairly regulated/bodies are used to their insulin and for the most part have a nice flat cycle....and MOST IMPORTANTLY on much lower doses. (tom is 4.5) so I think well....look at all this juice he has to process....it is too much for such a low figure!!!

for example if Tom has a 100 PS value....and I shoot 4.5 units of insulin in him, I think:....gee, lady...what is all this insulin supposed to "eat"? Given there is such a low amount to "sugar" for such a "large" amount of insulin to work on..... :shock:

I guess I thought that by the time he would be giving me nice PS numbers, I would have been on the "decreasing" aspect on the protocol..and therefore, on a much lower dosage----giving me a lot more wiggle room

the last few shots at lower numbers, I swear as I am drawing up that insulin I am thinking: is today the day? am I going to over-dose my poor cat today? that is very scary. and I haven't felt that before.

Wendy said:

You could have shot earlier this morning, because you knew he was going up. But there is also that comfort level to keep in mind. Often people will delay the first couple of times, then they'll see what that does to the numbers and shoot earlier. If they have that +10 or +11 that is. I now will shoot dropping numbers, but I have a ton of data. You aren't ready for that yet

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.


I guess I thought that I should either see a significant rise (just to be sure it really is rising to offset the meter variance) OR two higher numbers. so therefore, this morning, I didn't even consider shooting until the 121 value...but I thought I need another value ....so when I got the 108.....I didn't shoot. I take it I should have been comfortable shooting the 121 value right?

+9=100
+12=103
+12.5= 121
+13=108
+13.5=126
+14.25=144

or am I looking at these values at the wrong angle so to speak. I should have looked at the PS 103 value and compared that to the +9=100 value and determined he wasn't dropping.....so shoot!
:idea:

OKAY I think that is all my questions for the moment.

SUPER THANKS

~kelly

Whew! I just wanted to make sure you didn't shoot at your usual time!!

If Tomcat has a pre-shot in the 300s, you could shoot early. You'll need to test by +11 and if you've got a high pre-shot, you could shoot an hour early.

I think it's a common assumption to think that if my cat is at 300 at pre-shot and drops to 78, what will happen if my pre-shot is 150? Would he drop into negative numbers? Obviously, the answer is "no." I've had Gabby drop from the 400s to the 40s and I've shot a 78 and she surfed in the 80s. When a cat is at a higher pre-shot, there can be more momentum when numbers drop. When the numbers are lower at pre-shot, there's a greater likelihood of a "flat" Lantus cycle. That's not to say that numbers can't drop into low ranges -- they can. However, you're testing. Your best friends are your glucometer and strips. As long as you have those and high carb food, you can steer the cycle.

What I'd suggest is deciding that you can shoot a lower number -- say 120, for example. And the next time Tomcat is in that vicinity, as long as you have strips, HC and can monitor, shoot. Plan to get at least a +1 and +2 and they you'll figure out when to test next. Put a note in your subject line so folks can keep an eye out.

It's a process of getting comfortable shooting progressively lower numbers. The dose is really irrelevant. The dose is what your cat needs. The more time Tomcat spends in lower numbers, the greater the chance of his pancreas healing and his needing less insulin. Every cat that has gone OTJ has been on that kitty's highest dose of insulin. It may be 4.5u or it may be 1.0u or it may be 8.0u. It's what the cat needs.