5/27 Neko AMPS 415 +3 310 +5 200 +7 197

Yesterday http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=71859 was a bounce recovery day.
A little lower this morning so hopefully we'll see the end of this bounce soon. This is now dose 9 at this dose.

Neko was asking for breakfast early this morning, but that's because the alarm went of early as DH was off to his course again. We had a good tummy rub and purr, but that only distracted for a little while. These beans can be so dense! :lol: If you are up, then food is on the agenda! Clean plate club achieved, good yard patrol, and now she is lying beside her autofeeder waiting for her friend to deliver.

We had our best ever 24 hours on this dose with back to back low blues and blue PS. The previous dose had a nice green surf in the 60s. So I'm not sure what to do next. Do I wait and see if this does settles down to more reliable numbers? At least her bouncing at PS seems to be red instead of black, so we have some improvement from Mr. Liver. Or do we push on and increase? There is always the concern that if we wait too long at a dose we get some insulin resistance building. But also a concern about going to far above a dose that got results in the 60s. Thoughts? I guess I'm not sure when we know we've reached "the good dose".

Re: 5/27 Neko AMPS 415 +2 352 - dosecrease?

Neko come down slowly! You hear that? Dosecrease! You'd better work on the juice!

Re: 5/27 Neko AMPS 415 +2 352 - dosecrease?

Maybe he's coming down from his bounce, today. You don't want to do an increase in the middle of a bounce.
Let's see what others have to say.

Re: 5/27 Neko AMPS 415 +2 352 +3 310 - dosecrease?

+3 310, coming down but slowing down. Looks like yellows coming soon.

@Helen - I think she might be listening to you again.

@Dyana - I would wait for Neko's numbers to be settled if I was to dosecrease, so I am looking for advice on whether she needs one in general, and would wait the timing until appropriate.

Re: 5/27 Neko AMPS 415 +2 352 +3 310 - dosecrease?

Hi Wendy,

I think you should wait for one of the experts, but from looking at her ss, if Neko was mine I would decrease. In fact, it looks like 2u was the best dose. I think Neko is bouncing from too much insulin. Just my opinion and others know more than I do. Racci was a high dose kitty also (all the way up to 5u at one time) and I worked her back slowly. I thought I would never get her regulated but now she's at 3.25 and regulated and still working backwards.

Good luck,

Melanie & Racci

Re: 5/27 Neko AMPS 415 +2 352 +3 310 - dosecrease?

MelanieAndRacci said:

Hi Wendy,

I think you should wait for one of the experts, but from looking at her ss, if Neko was mine I would decrease. In fact, it looks like 2u was the best dose. I think Neko is bouncing from too much insulin. Just my opinion and others know more than I do. Racci was a high dose kitty also (all the way up to 5u at one time) and I worked her back slowly. I thought I would never get her regulated but now she's at 3.25 and regulated and still working backwards.

Good luck,

Melanie & Racci

Click to expand...

if you look in Wendy's signature, you would note that she had been using the NOTORIOUS FreeStyle meter which NEVER gives a BG reading over 299. The 'new technology' of the butterfly strips have been proven faulty with every single cat.
That 2u dose is nowhere near what Neko needs.

Re: 5/27 Neko AMPS 415 +2 352 +3 310 - dosecrease?

Wendy,

A lot of people, including myself, used the freestyle meter and no longer do because their new strips are screwed up. They are notorious for reading low by as much as 100 points. I'm sorry to have to tell you this. I know I was heartbroken when I found out. I switched to the Bayer contour which I like but nowhere near as much as the freestyle. There's no way to tell how accurate your readings are with that meter and strips. I'm sorry. A lot of us went through this.

Edit: In light of this, I wouldn't make any changes without getting a new meter, especially since you had that beautiful blue run.

Melanie & Racci

Re: 5/27 Neko AMPS 415 +2 352 +3 310 - dosecrease?

MelanieAndRacci said:

Wendy,

A lot of people, including myself, used the freestyle meter and no longer do because their new strips are screwed up. They are notorious for reading low by as much as 100 points. I'm sorry to have to tell you this. I know I was heartbroken when I found out. I switched to the Bayer contour which I like but nowhere near as much as the freestyle. There's no way to tell how accurate your readings are with that meter and strips. I'm sorry. A lot of us went through this.

Edit: In light of this, I wouldn't make any changes without getting a new meter, especially since you had that beautiful blue run.

Melanie & Racci

Click to expand...

Melanie,
if you look at Wendy's signature, she posted that she was using FreeStyle until March13th and you will see from Neko's ss that the numbers soared when she switched to Relion meter.

The string of 100s was good to see, but holding a dose too long makes room for resistance to slip in.
By following the protocol, holding for 6 shots is often sufficient.

One consideration would be to try Levemir as it does give a much smoother curve for some cats.
My Oliver was on Lantus, then switched to Levemir, and his curves never were all that much different but he never bounced.
My Shadoe did have issues with erratic numbers, but she settled quite a bit once switched onto Levemir.

I am sure that after the long string of 100s, +10 thru pmps to +5, Neko is likely reacting and waiting another cycle or 2 to settle could be an idea.

Re: 5/27 Neko AMPS 415 +2 352 +3 310 - dosecrease?

Here's what I'm thinking. The numbers look like a bounce off of the blues on 5/25. Typically, it can take up to 72 hours for a bounce to clear. In many cases, we suggest you wait until the bounce clears before increasing. The rationale is that if you increase, you can drive the numbers lower than what those low numbers were that caused the bounce. However, with Neko, the numbers were in the blues and you have a margin of safety there. Also think you're going to need to be aggressive with regard to breaking through what appears to be either glucose toxicity or insulin resistance. I would probably give this current dose until tomorrow before increasing unless it's very clear that the bounce has cleared by your PMPS. If you increase tomorrow, please be sure to get spot checks.

NOTE: For those of you who are commenting on Wendy's choice of meter, she switched from the Freestyle to a Relion. The change is noted in her signature block and it's also noted on Neko's SS (see comment on 3/13/2012).

Re: 5/27 Neko AMPS 415 +3 310 +5 200 - dosecrease?

+5 200

Looks like this bounce is easing off and Neko is about to enter the blue lagoon. Paws crossed it doesn't cause a major B.

@Sienne - thanks for the advice. I have been trying to stick to the 6-10 cycles and no more before going up. Maybe I should be targeting 6 cycles only unless she is in the middle of a mega bounce. She seems to be clearing it out today. Depending on how the rest of the day goes, I'll go up either tonight or tomorrow AM. I will be around tomorrow for spot checks and out for a couple hours tonight which is another reason for waiting until tomorrow.

@Gayle and Melanie - yes, I have a perfect example of a spreadsheet that shows why you shouldn't use Freestyle. My Freestyle meter did actually registers pinks. I hate to think what the numbers really were at that time. I do have a Bayer Contour for backup, as I had lost trust in meters at that time and fortunately it is within 10% of the Relion. I like the Relion because it uses the same size drop as the Freestyle (and the strips are cheaper).

Re: 5/27 Neko AMPS 415 +3 310 +5 200

Wendy

While I think Levemir is an excellent insulin and it has been really nice for Gracie....cats still bounce on Levemir. Take a look at Gracie, Tess, Checkers, Leo, JD....just to name a few. Just like lantus, it is ECID. What I do like about it for Gracie ....and again ECID...is that she typically gets longer duration out of it. I don't think Neko has been on lantus long enough to warrant making a switch. I'd give it some time.

Re: 5/27 Neko AMPS 415 +3 310 +5 200

I should add that we are thinking it's the butterfly strips that are the problem with FreeStyle meters, so people who still have a stock of the old strips, they may be just fine with the FreeStyle meters.

Sadly, too many people got fooled with the FreeStyle when the new strips came onto the market.

Re: 5/27 Neko AMPS 415 +3 310 +5 200

Wendy, Sorry I didn't notice in your signature you had switched. I didn't know the Relion had the same size drop as the Freedom! If I had known that I would have bought one. Is it smaller than the Contour? I haven't used it in so long I forget. I am not a great fan of the Contour. It is just what I've found that was acceptable since the Freedom. Thanks.

Melanie & Racci

+7 197 officially in the blues (but just). I'll take it. She was probably lower at nadir.

@Marje - After starting with Caninsulin, then switching to Lantus, I'm reluctant to make any more changes in insulin for a while, so I agree that sticking with Lantus for a while is the way to go. I think I'm getting a handle on how Neko reacts to this insulin, so it's just a matter of pressing on.

@Melanie, I believe the paper comparing meters says that the Contour needs a .6 size and the Relion a .3 size drop of blood. It's my experience in using both that the Relion does need a bit smaller size. When I was first starting blood testing, the smallest possible drop was a key consideration and the vet told me to get the one with the smallest drop size, which is how I started on the Freestyle and the butterfly strips.