10/05 Ozy AMPS-324,+5-180,+8-137,PMPS-228

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Re: 10/05 Ozy AMPS-324

Delayed bounce? Get a +4. If it's a yucky number, put away the meter until PMPS.

Keep the faith. :YMHUG:
 
Re: 10/05 Ozy AMPS-324

Ive only been at this a couple months but it still looks to me like your making progress overall.

Hang in there!
 
Re: 10/05 Ozy AMPS-324

Might be New Dose Wonkiness (NDW).

"Many cats will occasionally react to an increased dose with increased BGs - within the first 2 to 3 days after an increase, usually lasting for less than 24 hours. Nobody really knows what the reason for this phenomenon is (perhaps a "panicky liver"?) - hold the dose and ignore the fluctuations."

Usually when I increase or return to the last good dose, Chip has a short bounce. It's expected and normal for him. NDW is a necessary evil, but better than sustained higher numbers or losing progress after a failed reduction or after holding a dose which isn't performing for too long.
 
Re: 10/05 Ozy AMPS-324

Donaleen,

I totally see how easy it is to lose faith! I am not an expert or able to explain, but maybe someone like Marje, Dyana, or Sienne can explain. (sorry if I left anyone out!!)

If you look at Rex's numbers, you will see we had to keep going up and up and up.
Finally we had a breakthrough - and now his number look better than they every have! (I am learning)

ECID - But I make it my mission to shoot low, to keep him low, and earn reductions.
I know it is hard and confusing at times. But I would encourage you to befriend and expert and ask lots of questions!

We are all here for each other! We all want the best for you and Ozy! Honestly!!

Rich and Rex
 
Re: 10/05 Ozy AMPS-324

Well, once again that simple protocol fails to enlighten me about what to do....which of the many sub-rules to follow. Increase dose? Hold dose? Reduce dose? I don't just want to know WHAT to do, I want to know WHY to interpret the rules in such and such a way. What is really going on? Sick of everything being explained by a bounce. Sick of being told I did it wrong (held it too long, didn't hold it long enough). Didn't get a test at such and such a time. Tested too much. It's all random. I might as well be playing pin the tail on the donkey.

A protocol that I can't interpret doesn't help me very much.
 
Re: 10/05 Ozy AMPS-324

donaleen and Ozy said:
...A protocol that I can't interpret doesn't help me very much.
Click to expand...
I hear you on that one. I went though something the same or even worse since I was essentially on my own, when I taught myself Tilly dosing.

But being able to hash it out here and put it under your rock helps a lot.

NDW is the one type of bounce you shouldn't have to worry about so much, because it often clears quicker than some other bounces.
 
Re: 10/05 Ozy AMPS-324

Put on those patience pants and keep on trucking. And as Carl said perhaps take a break from the meter for a few hours. I still want to test at least every 6 hours when Chip is in a bounce, so I can get a sense of when it clears. But I do test less often when he's pink.

Chip is much like Ozy, he usually doesn't feel good at high numbers so I know how frustrating it is. I sometimes try to distract or comfort him while we wait out the bounce.

And do whatever you can to distract and comfort yourself. :smile:
 
Re: 10/05 Ozy AMPS-324

Some people say 3 days (6 cycles). Others say 5 days (ten cycles). 3 days is aggressive, 5 days less so. But a lot will have to do with Ozy's history. Some cats take longer than others to settle into a dose, and if history shows it normally takes 4 or 5 days for you to see something definite from a dose change, then that's where you use history to dictate what to do "now".

Increasing the dose:
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.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...

*Note - it isn't too often that the third option is used. Most adjustments are done in .25u increments, but in special cases (like for kitties showing trace ketones for example, along with lots of reds or black numbers, upping by .5u might be a better way to go)
 
Re: 10/05 Ozy AMPS-324

Thanks, but you didn't really help me. Are you saying you see a bounce? The dreaded word. I don't see one. I am not believing so wholeheartedly in the bounce theory. One of the reasons I test so much is because any time I don't, I am told that a bounce must have occurred in that window when I didn't test. If there is no window where he could have gone low, then the bounce theory doesn't work.

Aggressively it is time to raise his dose. It has been six cycles. And unless someone can show me evidence of this bounce, I am raising his dose.

Telling me he went green four cycles ago doesn't do it for me. He has gone green lots of times and not bounced. Why would his liver need more training? At this point I am not believing all this. It seems like made up reasons for what is happening.
 
Re: 10/05 Ozy AMPS-324

Donaleen,
All I can do is read the protocol, and make suggestions based on it, and on what I've seen in other cats over the past year or so that I've been trying to help in Lantus Land. I don't have any magic answers. I've never used Lantus or followed a protocol with Bob.

Because of that, I will usually go with "conservative" if I have to choose one way over the other. I'm willing to be more aggressive with PZI advice because I used it aggressively. Provided the data supports an aggressive approach. From my perspective with Lantus, I'd rather be conservative and wrong than aggressive and wrong.

You hold the meter and the syringe. No matter which way you go, all I can promise is that I'll support your choices.
 
Re: 10/05 Ozy AMPS-324

Well, Carl, I do appreciate your efforts. I would mention that the protocol never mentions bounce. And that the protocol talks only about the nadir, another reason I test so much... tracking the elusive nadir.
 
Re: 10/05 Ozy AMPS-324

(((Donaleen)))
First of all, hugs to you. :YMHUG:
I'm sorry you are so frustrated.
I will not be of much help as I am not good at understanding SS, especially not Lucy's, but this is what happened before.

Lucy did lots of greens for a while, and didn't bounce.
And she did a few cycles of no green at all.
And one day she went to green just for a short while, wasn't even a low green, but she had a mini bounce after that.
Lucy doesn't normally bounce hard, so it was just a higher blue bounce, but her number was a little strange.
I think when she has a green after a few cycles of no green, she may bounce a little, but then she may not.
Maybe Ozy is like Lucy... maybe his liver forgot that green is still safe, but it'll remember it soon, if that's the case.

You increased his dose on 10/3 AM cycle, and we do like that cycle.
So why not count the 6 cycles from 10/3 PM?
You have 2 more cycles to hold - bounce or no bounce, that's not too bad, and you can re-evaluate the dose for tomorrow's PM shot.
By then, you will be more confident that you are seeing what 3 unit is truly doing to him - bounce or no bounce.
And by then, you may receive some more good advice that makes you "ah ha!!!". :smile:

In the meantime, I just want to show you support and send you calming vines.
 
Re: 10/05 Ozy AMPS-324

Donaleen, I'm curious what the average number of months it is for a cat to go into remission. From your spreadsheet, you've only been shooting since July. Could someone recommend some spreadsheets you could look at that show similar difficult situations? Did it take several months for the cat to show stable improvement? Unless I'm missing something, and you've been addressing this a lot longer, it's only been 3 months. My guess is that there are many on here who have been shooting much longer and taken much longer to see stability. Am I right or wrong???

Debbie
 
Re: 10/05 Ozy AMPS-324

Debbie, You are probably right. That doesn't make living with a kitty who feels bad any easier. That doesn't make it any easier to decide when to increase/decrease/hold his dose. I never expected him to go OTJ. I just want to take care of him myself. I want to understand things well enough to do it myself. I am that kind of person. I like to understand what is going on and make my own decisions. It doesn't seem like a lot to ask. I've spend a lot of time and effort to no avail. And I HATE that. I love him and I want to take care of him.

I don't want to wait for a message from the Big Giant Head. Maybe it's because I grew up in a remote place where you HAD to take care of yourself. Maybe it's because the forum was down so much when I first started. Whatever. I want to do it myself.

From looking at SS's, I'd say there are people here who have been shooting for years and still don't see stability.

When I don't understand it, it seems like mumbo jumbo.
 
Re: 10/05 Ozy AMPS-324

You're just awesome, Donaleen. I learn so much from you, and your refusal to take "sick" or "confusing" as the norm for your Ozy.
I don't have any answers, but just want to say how great your spirit is.
 
Re: 10/05 Ozy AMPS-324

(((Donaleen))) It does take a while to understand on your own what to do next. That's why we encourage people to ask. I don't want to think about how many months I had "Dose increase?" in my first subject line. It was very frustrating.

I see Ozy has come down to a blue mid day, that's encouraging. Those pinks are likely not NDW, it's gone on longer than 24 hours - I just got a pink after an increase today so I'm putting away the meter until PMPS. And I know you hate that word (we all do) but it could still be a residual bounce to those greens Ozy got during the day on the 3rd. You didn't miss another low, it's just still hanging around longer than you'd like. Someone previously mentioned a delayed bounce. Neko's highest number from a bounce are often the third cycle after the low. How do you know when the bounce is clearing? - when he gives you a nice blue or green preshot or you get to a low blue or a green in that cycle. And why do we care so much about when bounces are done? - because if you do an increase in the cycle that a bounce is clearing, there can be added downward momentum and you can have a way too exciting cycle. We try to avoid that.

You also ask how long to hold a cycle before increasing and as Carl said, you can hold 6-10 cycles depending on aggressive or conservative, unless he earns a deduction. If there is lots of green nadirs, but high green, I'd go more conservative. If all you are seeing is blue or higher nadirs, then go a bit more aggressive. But wait for the bounce to clear before increasing. I like Mariko's suggestion, wait 6 cycles from the 10/3 PM, unless you see the bounce has cleared before then. One exception to holding for 6-10 cycles happens if Ozy was spending most of his time in normal numbers The other way cats can earn a deduction is to spend 7 days/14 cycles in largely normal numbers.

Debbie - each cat is truly different. There is no "average" for remission and even the range isn't set. Carl provided a great example of Mocha's SS of a bouncy cat that took her time going OTJ. Susie just checked in yesterday with a Day 39 OTJ condo and Elian was also a bouncy cat that took his time (7 months) going OTJ.
 
Re: 10/05 Ozy AMPS-324

Donaleen, I know it is frustrating at times, but hang in there. You're doing your best to help Ozy. :YMHUG: :YMHUG:

I know bounces are frustrating, but I wanted to mention that sometimes Furball will bounce one day, seem to come down from the bounce and then bounce right back up the next day. So she is really having a two day bounce with a little drop in between.
 
Re: 10/05 Ozy AMPS-324

Wendy&Neko said:
(((Donaleen))) It does take a while to understand on your own what to do next. That's why we encourage people to ask. I don't want to think about how many months I had "Dose increase?" in my first subject line. It was very frustrating.

And why do we care so much about when bounces are done? - because if you do an increase in the cycle that a bounce is clearing, there can be added downward momentum and you can have a way too exciting cycle. We try to avoid that.

You also ask how long to hold a cycle before increasing and as Carl said, you can hold 6-10 cycles depending on aggressive or conservative, unless he earns a deduction. If there is lots of green nadirs, but high green, I'd go more conservative. If all you are seeing is blue or higher nadirs, then go a bit more aggressive. But wait for the bounce to clear before increasing. I like Mariko's suggestion, wait 6 cycles from the 10/3 PM, unless you see the bounce has cleared before then.
Click to expand...

Okay, thanks Wendy. That helped. Putting it under my rock. I also think (thanks Carl) that this cycle is looking like 9/26, when he went down the whole cycle. Is that what a bounce clearing cycle looks like? down, down, down.

Well, that did NOT happen.
 
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