3/24 Hank AMPS-91,+5.5-96, +9:20-71, +11.5 PMPS-73, +2-92 :(

viewtopic.php?f=9&t=10007 Yesterday's condo.


Can we get some advisement on whether it appears to be time to transition toward OTJ?

I have read and read and tried to ascertain what I could about this in other's condos. Just wanting to clarify the protocol and rules that make sense for us specifically at this point.


Even while on our wonky schedule, and reducing doses thinking it was interim such that we'd get numbers I was comfortable consistently shooting, he's still throwing lower numbers at me beyond my comfort zone to shoot leaving me uncertain what to do. We ultimately did skip last night and now back on normal schedule. (w/in 10-15 min)

Happy with these numbers obviously, just don't want to mess anything up or affect his progress not understanding what we are supposed to be doing with them
or for lack of a clear path.

Appreciate any guidance on how we should be approaching this now.

thanks!

B&H



Please see yesterday's condo.

 

Re: 3/24 Hank- AMPS- 91

Wow, Hank is doing so well. Even with the skipped shot last night!

Normally kitties that have been here less than a year - we like to see them get to below 50 to 'earn' a dose decrease.
We don't see a lot of Hank's numbers mid-cycle because of your particular situation - but real life happens.

Based on his preshots and the need to skip a shot due to low preshot BG... if this was my kitty, I would try the next lower dose BEFORE going completely OTJ.

• You have given the 1 drop or 0.1 unit a few times already so why don't you try doing that for a few cycles and see how Hank responds?
  
• The concept is to give as much 'support' and healing time to the pancreas before letting it go it alone.
  
• If you can do this and test mid-cycle as much as you can - you might SEE him get some lower BG's that convince you (and everyone) that he is totally ready.

That is what I'd do. Hank does look like he may be one of the lucky ones that doesn't need insulin for too long. Help him with a touch of insulin for as long as you can* to make sure the pancreas gets the maximum healing time before trying OTJ. When the time is right we all want the OTJ to stick.

*until he goes below 50 on that 0.1 drop.
-OR- has normal numbers for at least a week.

 

3/24 Hank- AMPS- 91 +5.5- 96

Thanks CD-

+5.5- 96

We did do several mid-cycles Sunday (1st day I was hme in awhile). I just did one now..very similar number to this morning. (have yet to find our Nadir)

Which mid-cycle test would be best and most informative in this period. I can try for the ones i can when here.


We aren't too far from normal for 1 week (this vet thinks we are already there). I've seen so many different 'normal's. Do we say 80-120?

if you think better I keep him here for a few more days, as long as him PS numbers aren't too low, we can sure stay. I think it's all in the same ballpark as I am never sure at these microdoses how precise it is anyway. Today's buubles make me think I got a skinny anyway (or a F.1??)

The LAST thing i want to do is rush him. i want him to have proper healing and to not pull him prematurely. I want the best possible chance for this to be permanent.

Yet still not sure on these low numbers and shooting. Would you have had me shoot the PMBG 75 dropping to 69 last night?

What rules might I follow with 91 now being my lowest number shot? I feel he is staying pretty low..at least that's the pattern.

I don't know when to try for his peak..so far it hasn't been +3 +5.5 or + 6.5. Maybe he's on the earlier side?
Also did you see the other night where he was rising then did a turnaround before PS? He keeps throwing me off.


Is the below 50 at ANY time during the cycle? Or does it need to be multiple times/occasions? Perhaps it's better for us to chart one of those before changing..i can jsut lean to the skinny or fat side of the .25 depending on the PS??

I need to visit your charts again to see how you knew.
I've looked at several others wondering why THEY haven't yet transiitoned as it appeared longer then 7-14 days. I couldn't discern the patterns and when's/whys.

thanks for visiting & checking in on us & your comments.

Keep letting us know what to do- we need it!

 

Re: 3/24 Hank- AMPS- 91 +5.5- 96

 

Re: 3/24 Hank- AMPS-91, +5.5- 96

CD-

You have been SO helpful. thank you so much.

Aside form the way low number (for us) I'd thought rule of thumb was not to shoot 'dropping numbers' on retest.

We are cross-posting here a bit and PM so won't repeat everything, but condiering what you said there, and the correction here to what I was considering 'normal' range. I may tend toward leaving him at this dose, maybe steering fat or skinny depending on the number he gives, until we get a full week in. I was thinking we already had, but not at these numbers mentioned.
If he throws me something scary, i hit the 50 mentioned, etc.. i can THEn look at the next step decrease. I say it again, I am hardly precise at measuring these..so who knows really if I'm totally .25, .1 off, drop or air, etc..
I will skew toward what i am going for best possible.

You've given me terrific advice and I so appreciate it.

Since his mid-cycle test today gave me a high 90's with over 1/2 way left to go, I may stick where we are at least couple more days.

And shoot for some mid-cycle tests at suggested times.

i will absolutely confirm here before changing permanently, or in the interim if we get anything we don't know what to do with.

Thanks!

B & H

 

Re: 3/24 Hank- AMPS-91, +5.5- 96

You are correct. I should have said you could have shot that 69 if you had tested again and determined it was a steady BG, and no longer dropping. Sorry 'bout that.

• If Hank's preshot is low:
• Stall and test again to see if number is dropping. If steady or beginning to rise, it usually is safe to shoot a number like 65 and above since you are shooting a micro-dose.
• Shoot a token dose, in Hank's case it would have been 0.1 unit.
• Skip the shot.

 

Re: 3/24 Hank- AMPS-91, +5.5- 96

Just spot checked +9:20- 71! What's up with that? He was 96 at +5.5 and I figured i'd missed his Nadir again.
He's being all wacky.
i thought he'd been asleep earlier..maybe he'd eaten a bite or something I wasn't aware of?
If he keeps this up, I imagine I will try the .125 or whatever!
instead of the .25 couple more days i thought..was trying to keep a full week...and thinking he was rising also.
Hmmmmm


Thanks for all the great advice today.

yes, for all those reasons we skipped the shot. Lowest PS ever, re-tested in 25 min and was still going down, was really late and we had to go to bed, plus we were over 2 hours off schedule(making it up in inches). Killed many birds with one stone so to speak. My orginal inclination was the .1/drop, but not after re-testing.

And double yes, i do think I'm thrown and decisons driven by the PS number in front of me. it's hard to just shoot anyway if you've never been there. (low) or if it's high you might re-think reducing.




see ya'll tonight!


b&H

 

Re: 3/24 Hank AMPS-91, +5.5 -96, +9:20- 71

Awesome! Go Hank Go!
He is doing great! I can't wait to see what his +11 or +12 will be.

 

Re: 3/24 Hank AMPS-91, +5.5 -96, +9:20- 71

does coming down this late in cycle after being higher 4 hours ago make sense to you?
He did some similar version of this over the weekend, but it was even later in cycle +9(higher) to PS (lower)
I can't figure him out.


thanks for checking.

grabbing some dinner.

see ya'll in a bit.

b&H

 

Re: 3/24 Hank AMPS-91, +5.5 -96, +9:20- 71

It may be that Hank has a late nadir. What adds to the potential confusion is that the nadir can change. It's not always at the same point in the cycle.

Hank is doing great.

 

Re: 3/24 Hank AMPS-91,+5.5-96, +9:20-71, +11.5 PM(PS?) -73

Ok- here we are at +11.5. - 71 Was to be PMPS (we are catching up appx. 10-15 minutes). Then I feed.

Ok CD...i guess i will take the dive. Normally panic would set in (still here a little) and questions of what to do.

This is basically 20 pts less than anything we've shot. BG about the same as 2 1/2 hrs ago.

I guess i do the slightly reduced dose and give it a whirl for a few cycles. will try for between .01-& sk.25.
(so I stick with it even if he is high in the AM????)


YIKES!

Hope he does good. And hope I know what to do if he doesn't (high or low). I will feed him before shot and make sure he gets bites before bed.

I may be able to catch a +1 or 1 1/2 tonight if we are up.

Am I doing this?

B&H

 

Re: 3/24 Hank AMPS-91,+5.5-96, +9:20-71, +11.5 PM(PS?) -73

Yup, you can DO this! It is such a tiny drop and Hank will be fine. Get a before bedtime BG test... +1 or +2

This is not too low to shoot since you are only giving that new dose of 0.1 unit. Celebrate!

Leave food out for him in case he gets hungry.

Shoooooot!!

 

Re: 3/24 Hank AMPS-91,+5.5-96, +9:20-71, +11.5 PM(PS?) -73

Hi-
It's done. I'd already gone down to get him fed & shot before seeing your post.

Can you believe you give me an 'ok go ahead' number earlier today of 70 or above and he gives me a 71!!!
(i think I saw you say 69 would have been ok too) BUT THEN WHAT? what about if it's lower? Good lord Hankie.

Here's the other thing. I decide to have a look at the chart with the .01, .25. fat 0, doses on the sticky's before going down to get it ready.
After looking again, I think maybe what I've been giving these last days IS closer to a .01 than a .25 already. I tried to keep a smidge of daylight above the -0- line, but when I checked, mine have more approximated the .01 in reality.
Tonight, I simply tried to make it ever so slightly less than I'd been doing..closer to the line at 0 but not all the way into or below it. I SURE HOPE SOME WAS IN THERE.
There was also a mishap...I pinched & was sticking him and he sort of moved, it stuck in again. I don't THINK it was a fur shot, but now wondering what actually got in him between wondering if any was in the syringe and him moving like that. I squeezed really hard with it still in him. Then once I pulled it out, I squeezed really hard again...and did not even see a speck of liquid at the end of the needle. This is what makes me wonder. normally after plunging really hard to be sure it all goes in, there is still a miniscle amount that comes out the tip when you squeeze once removed. Tonight....Zippo.

Hopefully he got at least a drop.

So, I will make sure he eats a little more. may not be up 2 more hours but will try to test before bed.

But what about tomorrow AM?
If in actuality already been giving less than the .25 (maybe a skinny) do i just try to do a teenie bit less?

If for some reason it went in dry tonight (or maybe partial fur shot?) and his numbers are higher in AM...should I still stick here regardless?

I sure hope they aren't...but just preparing. less panic in advance than trying to sort through under pressure.

He better not be getting any lower than this at PS, 65 and above is all I'm authorized.

Ok, we either did or we didn't...he definately got poked..the rest is a mystery.
He sure is meaning business lately. Guess he's tired of all this.

Guess i won't be accused of having BOS. I'll probably have a heart attack if he gets in the 50's.

thanks again for all your support today!!!!!!! : )

 

Re: 3/24 Hank AMPS-91,+5.5-96, +9:20-71, +11.5 PMPS-73 OY!

You did great!

If lately your dose was closer to the 0.1 unit, then I'm REALLY happy at the beautiful numbers Hank has been giving you.
This is wonderful. See how well he is doing on so little insulin! You know what that means? His pancreas is healing for sure.

If he is higher tomorrow, continue with this dose. Don't raise it yet, keep going. Let's see how well he does for a few cycles.

If he is too low to shoot... below 65 or so... stall and see if he goes up. This isn't far from what you just did, but we want to make sure he isn't still dropping.

Of course if he is 50 or below at any time. --- NO SHOT.

 

Re: 3/24 Hank AMPS-91,+5.5-96, +9:20-71, +11.5 PMPS-73 OY!

One thing that many people do here with the micro doses is to practice. If you draw up milk or some other colored liquid, hopefully you can see what's in the syringe and then squirt it out onto a paper towel or piece of wax paper so you see how much you're shooting.

 

Re: 3/24 Hank AMPS-91,+5.5-96, +9:20-71, +11.5 PMPS-73 OY!

oK..51-65..STALL....re-test in 15-20, if it is going up, then shoot this token microdose. If same or going down, DON't shoot- SKIP. ( i think I am already at token dose, so that BCS option goes away)

50 or under- skip.


these rules are becoming ever more important as this little stinker is really racing here quickly. We had a 350 only 8 days ago.

I'm telling ya..if it's in the 60's, regardless..i am typing for hand holding anyway. Ultimately we don't want to skip right now.
And you can only hedge for so long without screwing up the schedule. There is such a narrow window to work it out- hence the pressure.

Sienne, look, I hedged & stalled on one at 50 pts higher than this only 5 days ago.
he better not drop to -0-.
BTW, that's a great idea on the syringe...i tired it w/ water, but ultimately it's all so miniscule, it's the difference between a drop and a bigger drop.
Did I mention Hank weighs 19 lbs? this vet basically said even the .25 was nebulous (& wondered how one could even measure that)
I think I have to just look at it as he is getting 'SOME'. though not sure tonight.

Thanks for all the great advice, really..these are wonderful tips.

Ok folks, back for tomorrow.
what do you think he's going to throw at me then?


thanks a million, seriously! i feel like we have a lot going on now, and really appreciate the support more than you know.

 

+2 before bed. 92. Now I really do wonder if we got any in the syringe or into Hank. It was so miniscule, he moved, was it a partial fur shot? he ate some, but it was a couple hours ago.

SHOOT...... NOT HAPPY. This was NOT a skipped dose, it wasn't supposed to be at least.

we do not want rebound, certainly not now. Let's hope for a good AM number.

 

This is not a problem at all, remember it's a healthy healing number. And the onset of the tiny drop of Lantus probably hasn't even started yet.
Hold the fort! If it WAS a nothing shot... and Hank's numbers stay around this 90 something... it is just fine! Let's see what tomorrow brings. I'm very pleased with your boy.