2/26 GracieD AMPS 479, +1 430 , +3 227 Very Confused!

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Okay, I understand LTS and know she seems to be bouncing from lower than normal numbers, but her reaction to the insulin is what's confusing me. Why is she having such dramatic drops? Her AMPS was 479. She ate a big meal of FF Mixed grill at shot time, and still drops 50 points within an hour. I know the meters aren't perfect, but her numbers should have gone up, not down considering she ate and the insulin isn't supposed to kick in so soon. Yesterday she dropped over 250 points by +4. I'm at a loss. I understand and have read all the information about Lantus and have experience with it from a previous cat. Does Liver Training School explain all of the huge, quick drops and the jumps of 200+ in an hour?

My hope of getting her into remission quickly has faded. She is steroid induced and we caught it within a few weeks. I guess I wasn't expecting this rollercoaster. She does still have access to dry food(have 8 cats), but we feed her wet FF classic 5 times a day. She may nibble a little dry now and then and in the evening, but her numbers don't seem to be affected much. Changing her to low carb wet didn't seem to make any difference either.

Anyway, she's at 1.25 now and I try to be as consistent as possible. However, it is difficult to be exact and I'm wondering if that could be an issue. I'd prefer to be at a half dose for easier dosing, but I think she will settle into the mid/lower blues on 1.25 if her body would cooperate. I'm really just venting as I know this just takes time. This is a completely different experience with Lantus than my last and I guess I was just expecting a smoother ride.

Jason

Re: 2/26 GracieD AMPS 479, +1 430 Very Confused!

Hi, Jason :YMSIGH:
Sorry to see Gracie in higher #s, it would appear to me that Gracie is due for an increase so her body does not get used to the higher #s based on protocol:

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.

Click to expand...

However, I am not a dosing advisor.. please wait to see if one of the advisors can take a look at your SS & offer some suggestions.

Re: 2/26 GracieD AMPS 479, +1 430 Very Confused!

I think the piece of the bounce puzzle that you're missing is that it's not only lower numbers that can trigger a bounce. Bounces can happen from a relatively fast decrease in numbers, as well. So that drop from the 500s to the 200s yesterday caused a bounce. (Take a look at Gabby's SS on 2/19. She went from 335 to 96 by PM +2. Needless to say, she was in the pinks at the next AMPS. It was too fast of a drop.)

I'd also wait until the bounce clears before contemplating a dose change.

Re: 2/26 GracieD AMPS 479, +1 430 Very Confused!

Sienne and Gabby said:

I think the piece of the bounce puzzle that you're missing is that it's not only lower numbers that can trigger a bounce. Bounces can happen from a relatively fast decrease in numbers, as well. So that drop from the 500s to the 200s yesterday caused a bounce. (Take a look at Gabby's SS on 2/19. She went from 335 to 96 by PM +2. Needless to say, she was in the pinks at the next AMPS. It was too fast of a drop.)

I'd also wait until the bounce clears before contemplating a dose change.

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Does this typically level out? It seems we somewhat clear a bounce then head right into another one. It's hard to know what to do when we just go from one to another. I'm assuming it's not the Lantus but more her bodies reaction to it, but could Levemir be a potential consideration? On Lantus, she's had the bouncing issue on 1, 1.25 and 1.5u doses.

Thanks,

Jason

Re: 2/26 GracieD AMPS 479, +1 430 Very Confused!

It will level out. I doubt (at least at this point) that it's the Lantus. Sometimes it just takes a bit more insulin to get things to level out. Some cats get through this process very quickly. Others, not so much (sorry!). Gabby is in the latter category. So was Mocha but take a look at Mocha's SS lately!!

Re: 2/26 GracieD AMPS 479, +1 430, +3 227 Very Confused!

Sienne and Gabby said:

It will level out. I doubt (at least at this point) that it's the Lantus. Sometimes it just takes a bit more insulin to get things to level out. Some cats get through this process very quickly. Others, not so much (sorry!). Gabby is in the latter category. So was Mocha but take a look at Mocha's SS lately!!

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I hope so! Just did her +3 and she's down to 227! Another 250 point drop in 3 hours! Oh well, hopefully the ride will smooth out soon.

One other thing to keep in mind is the meter's allowable margin of error. The FDA allows meters to be off by up to 20% in each direction. What that means is, each number is essentially a range of numbers.

Your 479 PS really means that the number is somewhere between 384 and 575.
Your 430 really means that the number is somewhere between 344 and 516.

My point is, the drop on the first number may not have been an actual 50 point drop...those numbers aren't that far apart in the grand scheme of things. Then, the insulin kicked in, and you started heading downward. Great!! Some cats will fall faster than others.... Gabby and Mannie come to mind as a couple of our cliff diving champions! Other cats will come down more slowly. It takes time and patience. Marathon, not a sprint. Know that we've all been there, and the jitters about dropping will subside.

Hang in there and enjoy the ride! GracieD is on the road to better health!!!

Re: 2/26 GracieD AMPS 479, +1 430 , +3 227 , +5 189

Christie & Willie said:

One other thing to keep in mind is the meter's allowable margin of error. The FDA allows meters to be off by up to 20% in each direction. What that means is, each number is essentially a range of numbers.

Your 479 PS really means that the number is somewhere between 384 and 575.
Your 430 really means that the number is somewhere between 344 and 516.

My point is, the drop on the first number may not have been an actual 50 point drop...those numbers aren't that far apart in the grand scheme of things. Then, the insulin kicked in, and you started heading downward. Great!! Some cats will fall faster than others.... Gabby and Mannie come to mind as a couple of our cliff diving champions! Other cats will come down more slowly. It takes time and patience. Marathon, not a sprint. Know that we've all been there, and the jitters about dropping will subside.

Hang in there and enjoy the ride! GracieD is on the road to better health!!!

Click to expand...

Thanks Christie. I sometimes forget the meters are not a true number and can vary test/test and meter/meter. I thought drops swings of 100 were a lot with my last cat... little did I know

At +5 she was 189, so the descent has slowed. Her nadir's the last week or so have been +7 to +9, so hopefully we'll end up in the low 100's today and make a slooooow ascent.

Jason

hi, guys! just stopping in to say happy saturday!

celi & binks