8/28 Eddie AMPS 241, +6/192, PMPS/383, +7/224

Yesterday's Condo

Yesterday: AMPS/470, +1/377, +2/344, +2.5/333, +6/210, +10.5/224, +11/213, PMPS/331, +1/374, +2/290, +3/257 +6/185, +7/176, +8/166
Today: AMPS/241, +1/274, +2/236, +2.5/256, +6/192, +10.5/313, PMPS/383 (DOSECREASE TO 2.25), +1/414, +2/376, +3/344, +4/298, +6/241, +7/224

Good morning LL!

Eddie bounced through the day yesterday, although it a mostly yellow bounce, which is an improvement over the red AMPS or a flat pink cycle. It looked like he might slide down to PMPS, but headed back up at the end of the cycle. From there, he slid back down again into blues.

This AM there is a YELLOW AMPS! Not red or pink! He's looking pretty flat so far this AM. Eddie happily nommed on all four breakfasts (as usual), and right before I was running out the door, he was bopping around being silly. If you've ever seen bull riding or bronco riding, Eddie hops around like a bucking bull when he's being goofy - it's hilarious! I tickled him and he rolled over to get face smooshes and to hand wrestle. Of course, I had to leave right when he was being super cute.

Barring anything dramatic happening today, or a suspicious slow cycle-long slide with a low PMPS, we'll take his dose back up to 2.25 tonight. He did well there before, and we've gone up and down between 2.25 and 2.0 a couple times in the recent past. Hopefully the little bit of extra juice will help him settle down the bounce/dive pattern. He dipped below 50 three times on 2.25 previously, but he didn't really do it in dramatic style, so hopefully it won't take him too low. My hope is to be able to help him avoid reductions by keeping him above 50 (and for sure 40). We have changed some things with his food since the last time he was on this dose, so hopefully that will do the trick.

Vines and hugs to all in need today!

Re: 8/18 Eddie AMPS 241, +2/236

Okay, Eddie. Be a good boy and get ready for the 2.25. I hope it flattens him out, Jen.

Re: 8/18 Eddie AMPS 241, +2/236

Yay for a lower preshot! It's always so hard to leave the house when they're being extra adorable. Good luck with the dose increase!

Re: 8/18 Eddie AMPS 241, +2/236, +6/192

Hi Elise and Deanna! Thanks for visiting! Eddie was snuggly at lunchtime when I stopped at home to check on him. He seemed a little confused as to why I wasn't making lunch, but he got some FD shrimpies and some snuggles instead.

+6 = 192, so sliding down at a reasonable rate. It will be interesting to see how the rest of the cycle goes. If he's lower at +10.5 (DH's in-the-door test), or flat in low blue or high green numbers around that time, the dosecrease may have to wait. I'm a little chicken about shooting an increase if he's going to be bounce clearing, given his new favorite hobby of jumping off the diving board. I suppose it's possible Eddie knows that I've given a lot of thought as to how to proceed to address his bouncing, and might flatten out just to keep me guessing.

I'll have to just anxiously wait to see what the rest of the cycle brings! nailbite_smile

Re: 8/18 Eddie AMPS 241, +2/236, +6/192, +10.5/313

I owe you a post. I'm sorry....I didn't get home from work until 8:30 last night. I promise to get something up by tonight.

Re: 8/18 Eddie AMPS 241, +2/236, +6/192, +10.5/313

No worries Marje! Sometimes we all have to step away from the computer for a bit! ;-)

No bounce clearing slide tonight, so up to 2.25u we go! Despite the yucky number, DH reported that Eddie was racing around the house when he got home.

Re: 8/18 Eddie AMPS 241, +2/236, +6/192, +10.5/313

Jen:

This could still be some bounciness from the greens on 2/26. It can take up to 72 hours for a bounce to clear. If it were me, I might hold the dose to see if the bounce does, in fact, clear. One of the situations that can be challenging is raising the dose at the same time a bounce breaks. You have the momentum of the bounce clearing out coupled with more insulin. This could cause numbers to drop like a rock.

Re: 8/18 Eddie AMPS 241, +2/236, +6/192, +10.5/313

No advice from here, Jen. I still struggle to figure out Polly...oh, and her dosing, too. :roll:

Just want to send vines that Eddie settles down. C'mon, Eddie. You can do it.

Marilyn and Polly

Re: 8/18 Eddie AMPS 241, +2/236, +6/192, +10.5/313

Good luck if you increase the dose. I'm glad Eddie is feeling so good.

Re: 8/18 Eddie AMPS 241, +2/236, +6/192, PMPS/383

Hi Carla and Marilyn! Thank you for your visits! I think the hardest part is figuring out whether he wants more insulin or less. He seems to continue to get good nadirs with lower doses, but the bouncing starts to get out of control. :roll:

Hi Sienne!

I didn't see your post before shooting tonight, and we went ahead with the increase. I agree that Eddie's still probably bouncing from the greens the other night. We seem to be in a cycle of a bounce clearing dive (which I've been working on with food management) followed by several bounce cycles where he sort of clears, but isn't able to quite stop from heading back into another bounce, so he's always either bouncing or diving lately. With his steep climb at +10.5 I felt pretty sure he wasn't going to do an early cycle dive tonight, so from a timing standpoint, it seemed as good a time as any to increase. Although he could always dive tonight just to prove me wrong. I've definitely made the mistake before of increasing when Eddie was clearing and had a busier cycle than I anticipated. The hope is that increasing (despite good nadirs) will help flatten out the bouncing. In the past he's seemed to flatten out better on a higher dose, so that's what we're hoping for again.

I do have a question that you may specifically be able to address since Gabby is the captain of the LL dive team - I've studied her SS to get ideas for food management, and when Eddie's jumping off the cliff, I've been working on slowing the drops with food. The part I'm scratching my head about is when Eddie's dropping from pinks or reds. If he's dropped a lot from a pink PS to a yellow PS, I typically do add carbs to try to slow in that situation. If he's dropping - sometimes 100 points or more - from early in the cycle off a pre-shot in the 400's down to pink - I can't decide whether I should also try to slow a drop like that. One, with meter variance, it's hard to tell sometimes whether there has even been a significant drop, and two, do I want to slow him down from getting out of super high numbers? I may have overlooked it, but I didn't really see many situations where Gabby's dropping out of the 300's or higher. Any suggestions on that front?

And finally, I'll toss this question out there - nobody thinks I should just let Eddie earn his reductions and that the worsening bouncing is because he wants less insulin, right? (K - just checking ;-) )

Re: 8/18 Eddie AMPS 241, +6/192, PMPS/383, +6/241

Jen

I think your point is well taken that, at high numbers, you don't know if he's dropping or it's meter variance. I'd be a little hesitant to carb him at that point. I might check him again an hour later and see if he has the same drop and, if he does, apply some brakes.

We've gone both routes on the dive/bouncing cycles. We've taken her down and we got her flat.....but yellow flat. The. We took her up and she stayed flat but it took us a bit to get her back up to blue/ green numbers. We've found it's best for Gracie to take her up. You will have to figure out which works best for Eddie. Try them both but if you take the dose down and he flattens out, you'll need patience to take him up.

When Gracie was on Lantus she would slide all day to PMPS and give me a dropping number (usually a 50) at PMPS. I started giving her a tiny snack at +10 and it leveled her off so I could shoot reliably. ECID....who knows what it would do for Eddie.

I think if you are trying the "increasing" method, I'd hold off on the R until you see what he does.

Re: 8/18 Eddie AMPS 241, +6/192, PMPS/383, +6/241

i just had a chance to go back and read your condo a couple of days ago about the R usage. I am a big fan of R.

There are a couple of strategies for using it. One is to give it with the Lantus shot in order to bring the numbers down farther so that the Lantus can "grab hold" of the blood sugar and do the Lantus thing. The other is to give it just as a bounce begins in order to knock it off at its knees.

I prefered to give R in the second half of the Lantus cycle - any time after the nadir had waned and punkin's numbers were starting up. Mostly my preference for that was because it felt safer in that i was confident the amount i used would not cause a plummet. I used small doses of R most of the time and was just thinking in terms of trying to minimize the rise of BGs, or hold them flat, or minimally bring them down. So the R, in my mind, applied resistance against the normal end-of-cycle rise, or the beginning of a bounce. Think of it as putting a 100lb backpack on as you climb a mountain. Might not keep it from going up entirely, but makes it harder! :lol: I used it other times as well when i though he needed it. You do want to be at a pretty "right" dose of Lantus so the R is just supplementing the L, not replacing it.

I did find that the next cycle after I'd used R showed lasting effects. The R brought down the numbers to the point where the following cycle was lower overall and flatter. All good things.

The warning, as you know is twofold - one is that you MUST pay attention to the nadirs for each insulin and make sure they don't coincide. In other words, if Eddie has the nadir on R at +3, and his Lantus nadir is at +6, you would not want to shoot R at +3.

Another warning is that shooting at the end of a bounce can really cause the numbers to plummet. Then you have the momentum of a bounce clearing, combined with the R bringing the numbers down, and if the speed gets going it alone can cause another bounce. You want to give it only at the beginning hours of a bounce.

Overall, though, i think R is an excellent tool for your "toolbox." It's inexpensive, it's effective, one vial will last you forever, and as long as you know what you're doing, it's safe.

Marje's suggestion to try Lev is a good one too. I've seen many cats do well on it - and it wouldn't mean you couldn't try R with it too. You can always sell your current Lantus on craigslist or to another member on the Facebook group.