8/25 Max AMPS 119 PMPS~163 +11.5~75

Hello All,

Well, Max had a 130 for his +2 last night. I'm not sure that means anything; maybe he got into the cookie jar in order to celebrate his ONE MONTH OF REGULATION ON LANTUS!!!! WHOOO HOOOOO! This morning he's back to his common PMPS in the low three digits.

This evening's shot will be the 6th on-time shot in a row, and I hope to start getting some very accurate data tomorrow morning about this dose. I suppose I don't see the point in raising it just to drop it again if and when he gets a below 50 number, but there may be some logic in that -- a higher dose will give his pancreas even more rest? We are closing his 7th month since diagnosis, and I suppose there is no hurry to get him OTJ if he's going to do that. Maybe there is?

I'm just VERY HAPPY that he's regulated, and that I'm getting a good night's sleep again. I really should be getting up at mid-cycle to check him, and I will tonight knowing that we will have had 6 on-time shots in a row. I did that 4 nights in a row earlier this week, and just caught him surfing. I suppose that could be because the shed wasn't full or overflowing? However it would make more sense that he would surf if the shed was just right, wouldn't it?

Need some experienced eyes on this: Leave the dose alone or raise it a little?

Yesterdays: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=77787

Re: 8/25 Max AMPS 119 Three Questions?

Checking the SS, Dale. Be right back.
Jane

Re: 8/25 Max AMPS 119 Three Questions?

Ok. Looked at the SS, and here's what I see. You've been with the 0.75u since the 8th of August, so a good three weeks. With the exception of those yellows on the 12th, there haven't been any blips into above-200 numbers, and in fact mostly, Max has stuck to healthy blues and greens, dipping into the 50s/60s every few cycles (and more frequently in the past few days). You're right that a full/overflowing shed would affect him more drastically - as we've seen, with Max! - but surfing isn't only a sign of a perfectly "balanced" shed, it simply also shows how much better a cat is regulated (since "surfing" is technically what an OTJ kitty does, with the steady release of pancreatic insulin as the day/night goes on and food intake/activity levels etc. vary and the BG fluctuates).

To me, it looks as though he's still showing progress on this dose (rather than stagnating): His nadirs are more readily at the lower end of the healthy, safe 50-120 range. His blues are less frequently noticeably higher than that range. You did have 7 days in the sub-120 range, before you got that 122/130 yesterday. Still - I think it's good to remember that the TR protocol is already an *accelerated* path ideally towards remission. Technically, you'd re-start your cycle count since Max went above 120. This is not to say he wouldn't hold a reduction/increase well. But he *may* do better with another few days on the current dose - reducing too soon *could* set him back (if only in that he'd have to refill the shed if it didn't take).

He's on his way, I'd say, given his progress. I wouldn't push it too hard right now - there's no hurry, if that's where Max is going to go. He'll go there anyway, if that's his goal. Going more slowly won't change that - what it might do is make for a stronger remission in the end. That's also what's behind giving a cat insulin as long as they'll tolerate it - to make the transition, the weaning off process, as gentle and safe and *lasting* as possible. In other words, I wouldn't reduce/increase quite yet, IMHO. (You mention being able to get more sleep - I hear you! But bear in mind that an increase *may* require some late nights again... Again, IMHO, I'd wait a little more.)

Hugs,
Jane

Re: 8/25 Max AMPS 119 Three Questions?

Hi Dale
Given that Max has been in the normal range for 8-9 days - I only see three or four tests above 120 -, and that he has flirted with a reduction a couple times over that same stretch... if I were thinking about adjusting dose, I think I would be thinking in terms of "drops" if any.

How many drops are in .25u of Lantus?

Carl

Re: 8/25 Max AMPS 119 Three Questions?

Thanks, Jane and Carl. I would rather leave the dose alone right now, and I'm glad to hear that Jane thinks I should. If it ain't broke . . .

I don't know how many drops are in a .25 u dose of Lantus. I spoke with my husband about the drops method, and he said that he wasn't sure that was very accurate. I suppose it's the best method we have, but he said that the needle itself is not generally used for anything other than simply getting the insulin into the cat. Due to this, he thinks that the needle is probably manufactured in the least precise way compared to all the other parts of the syringe. He said the volume of the drop that forms on the end of the needle is dependent on the shape of the needle, and if one needle is different than the other, which they surely are, the drop on needle #1 is going to be bigger or smaller than the drop that forms on needle #2. So, you can measure out the drops, but if you were to do it with a different needle you would get a different number of drops. For example, the difference between 5 drops and 6 drops could be very, very different.

We really need the syringes that are used on lab rats, I think. Why do you suppose we can't get these from our vets? Don't they use them? Are they too expensive? It's a mystery to me.

(On a side note, the Hubs also said that he saw a documentary about how syringes are made, and that because it isn't reasonable to try to get all syringes to have the same diameter on the inside of the barrel the manufacturer has a way of dealing with the variances. Apparently, the markings on the side of the syringe are spaced in a certain way depending on how much liquid fits in the syringe. Syringes are tested to see whether they fit T,U,V,W, X ,Y or Z amount - and all those that fit T amount are marked with one set of markings; all those with U amount another set of markings, and so on. The zero line, however, should always be in the same place.)

Re: 8/25 Max AMPS 119 Three Questions?

Wow, some great interesting info there - thank you, Dale's DH! (Can we call DH by his name, Dale?)

Max is doing beautifully! Personally, I do think he's got certain travel plans, fingers crossed - just the itinerary, well, that always the kitty's secret :mrgreen: Did you see Karre's question to Max in the caturday condo?

How is Emma doing?
Hugs,
Jane

Re: 8/25 Max AMPS 119 Three Questions?

Jane,

DH's name is Randy. He is something of a Renaissance Man -- he can pick up information easy as pie, and if it interests him he can retain it for ages. Amazing.

Emma is doing just great. She's starting to try to run. She falls a lot, and she had her first knee scrape the other day. She tries to help me with the posts. She loves the :RAHCAT and the bcatrun_gif and especially the :dizcat I want to get her into Baby Sign Language Classes, and I hope Max will stay stable enough that I can attend all of them. They aren't cheap, but apparently, babies can use language before their vocal chords allow them to make the sounds and combinations of sound, more importantly, that we use in our language. She talks all the time; I just have no idea what she's saying, but I can tell she does know!

No, I didn't read the Caturday condo yet. I'll check for that.

Glad Karre is doing soooooo well!

Re: 8/25 Max AMPS 119 Three Questions?

Then thank you, Renaissance Randy :mrgreen:

Those baby sign classes sound amazing! Go Emma, you tell everyone what's on your bright young mind!
Thanks for the Karre-Cheering, Dale!

Hugs
Jane

Re: 8/25 Max AMPS 119 Three Questions?

max&emmasmommie said:

Emma is doing just great. She's starting to try to run. She falls a lot, and she had her first knee scrape the other day. She tries to help me with the posts. She loves the :RAHCAT and the bcatrun_gif and especially the :dizcat I want to get her into Baby Sign Language Classes, and I hope Max will stay stable enough that I can attend all of them. They aren't cheap, but apparently, babies can use language before their vocal chords allow them to make the sounds and combinations of sound, more importantly, that we use in our language. She talks all the time; I just have no idea what she's saying, but I can tell she does know!

Click to expand...

Hi Dale!
Just wanted to comment off-topic on the baby sign language. I taught myself and my granddaughter sign language and it was wonderful! I began signing as I was talking to her when she was 6 months old. It may have looked weird to outsiders but she was watching and by 9 months she could sign a few important signs to me. There was much less frustration because she knew she could 'tell' me what she wanted. Milk, juice, water, crackers, and the sign for MORE were really helpful to learn first. If you think about it, every baby learns a sign pretty early and most of us don't realize it. Babies learn to wave "bye bye" and they understand what they are doing. So you are right, they CAN learn to communicate with their hands much earlier than with language.

There are some good videos that use songs to help you learn. Good luck and have fun with it! My granddaughter is now 10 years old (oh my!) and we still sign a little to each other... especially "I love you." cat_pet_icon And when we want to say something silly. :roll:

Re: 8/25 Max AMPS 119 +3~95 Three Questions?

CD,

That is a great story!!! I tried to start earlier, but I found it difficult to manage everything at once. Yes, she too says Bye Bye with her hand, and she points, but I know she wants to make us understand more. We pretend to listen intently, and respond to her as best we can, but goodness knows what's she's learning when we respond in a way that has NOTHING to do with what she's saying to us!

She does use more words with other people and other children. We theorize that it's because we understand what she wants or what she means so easily. With other people she has to talk more. With other children, well, they just understand each other better in general it seems. I think we are too closed minded, and if we don't hear what we expect our minds hear jibberish when it's not really, but a little imagination is needed to decipher her words.

Re: 8/25 Max AMPS 119 +3~95 Three Questions?

I don't know how many drops are in a .25 u dose of Lantus. I spoke with my husband about the drops method, and he said that he wasn't sure that was very accurate. I suppose it's the best method we have, but he said that the needle itself is not generally used for anything other than simply getting the insulin into the cat. Due to this, he thinks that the needle is probably manufactured in the least precise way compared to all the other parts of the syringe. He said the volume of the drop that forms on the end of the needle is dependent on the shape of the needle, and if one needle is different than the other, which they surely are, the drop on needle #1 is going to be bigger or smaller than the drop that forms on needle #2. So, you can measure out the drops, but if you were to do it with a different needle you would get a different number of drops. For example, the difference between 5 drops and 6 drops could be very, very .

Click to expand...

I've asked the "how many" drops question a couple of times, but the only answer I've gotten is "two drops". I have no idea. But if what DH thinks is correct, then how does one micro-dose effectively or with any degree of accuracy?

Carl

Re: 8/25 Max AMPS 119 +3~95 Three Questions?

It sounds like Emma is eager to learn too. It is a good age to learn because you will probably have more back and forth communication. With my DGD signing was really one-sided for a long time until one day she decided to tell me she wanted 'crackers.' I had more free time than my daughter so I could teach myself and study the videos etc. My daughter didn't have that luxury of free time, so I understand how difficult it is for you too. Mommies are very busy!

And I agree that parents 'know' more what their children need/want that outsiders. I'm sure you communicate better with Emma than other family or friends can. I guess I felt I needed the extra communication help, hahaha! My second granddaughter was not motivated at all about sign language because her older sister interpreted most everything for her and this second child started talking WAY earlier than her older sis (and hasn't stopped yet!) :lol:

Re: 8/25 Max AMPS 119 +3~95 +4.5~97 Three Questions?

CD,

I've heard that, too. My friend says that her daughter, who is 4, is always saying "Kaleb needs this . . Kaleb needs that . . ." Kaleb is 2.

You want to hear something really funny? It took me to longest time to fully understand that my baby could not see in the dark! After having a cat for 15 years and just relying on the fact that he could see everything all the time, I found myself expecting Emma to be able to see even if the room was dark. I would change her in the dark to avoid waking her up too much; feed her in the dark, etc. Pitch black it was sometimes. If she jumped when I touched her I'd be surprised. Then, I'd have to say to myself, "She's not a cat. She's can't see in the dark!"

Max, of course, still lies in the middle of the hallway in the the dark, and hisses if I step on his tail. I'm quite sure he cannot understand that I don't see in the dark. I know he's thinking, "One of those two-legged things just stepped on me AGAIN!" When I turn on the light, he gives me this look that means, "You are such an idiot I just can't believe it sometimes!"

Carl, of course, I know that you know that I don't know the answer. :lol: I see the spreadsheets of people who give/gave their cats only several drops, and they see Yellow sometimes. The numbers are all over the place. However, look at Orange's spreadsheet: https://docs.google.com/spreadsheet/ccc?key=0AhCDMNNXEvRUdDRUR0dzTndSQllrZkpKS0NfLUh4WEE#gid=0. At the end, it doesn't really look that much different than the spreadsheet of a well-regulated cat who is getting insulin at a dose that is easy to see on the syringe. His BG isn't jumping around that much. Must be ECID.

At the doorstep to OTJ, does the pancreas only kick in enough to compensate for the missing insulin, and when we see a below 50 we take action, but maybe 9 times out of 10 we shouldn't have to? No one's going to test that theory, I hope, but suppose that's why Orange's numbers aren't all over the place despite the fact that it's unlikely he was getting precisely the same dose every time she tried to give him 0.1 unit?

Maybe when a cat is ready to go OTJ, the pancreas is working so well that it doesn't matter than the dosing is very difficult to get right, but when a cat isn't ready, the difficulty getting the proper dose in drops makes a huge difference?

Or maybe it's the opposite. Maybe beans for cats who are ready to go OTJ are giving the insulin in whatever dose they can manage, but it's way off sometimes. However, as they test, test, test, they are really controlling the differences in the drops with the food instead of getting the dose right?

If the cat's pancreas isn't almost ready to regulate the cat on it's own, it may be that micro-dosing may not work very well to regulate a cat that needs insulin, but it's best we can do. I think if I face that situation, I'm going to try to get someone to give me some rat syringes if there is such a thing.

Re: 8/25 Max AMPS 119 +3~95 +4.5~97 Three Questions?

I think if I face that situation, I'm going to try to get someone to give me some rat syringes if there is such a thing.

Click to expand...

We need to contact Hasbro, or whoever makes Barbie dolls. Maybe create a Dr. Barbie, and Ken or Skipper can be her diabetic patient? A syringe that small might be just the thing we need :lol:
Carl

Re: 8/25 Max AMPS 119 +3~95 +4.5~97 +10.75~191

I think Max ate some food after +7. He's never this high at +8. I didn't have a chance to pick up the bowl. Emma's teething. She's beside herself. However, he's never this high, period, which concerns me. I spilled some sugar on the floor. Maybe he walked in it and then licked it off his paws? Seems like that wouldn't be enough.

Re: 8/25 Max AMPS 119 +3~95 +4.5~97 +10.75~191

Dale,
Dumb question, but did you retest in case it was a "bad test"? Let's see what happens between now and PMPS?

Carl

Re: 8/25 Max AMPS 119 +3~95 +4.5~97 +10.75~191 PMPS~163

Hi, Carl, yep, I re-tested at +10.5 when I first got a high number, then the +10.75 was high, and here we are at PMPS. Oh, well. Maybe I gave him a fur shot a few cycles back; maybe it was the sugar; maybe it was both. At least it's coming down.

I hope it wasn't a bounce from a crazy low number!

Re: 8/25 Max AMPS 119 +3~95 +4.5~97 +10.75~191 PMPS~163

Don't think it was a bounce, or if it was, he's become very efficient at clearing one. :smile:
Still "oddly high" numbers compared to where he's been hanging out for a couple of weeks though. Maybe it's "sympathy stress" for Emma's teething misery. I know that's no fun (for her or for Mom and Dad).

Carl

Re: 8/25 Max AMPS 119 +3~95 +4.5~97 +10.75~191 PMPS~163

Most interesting condo of the day award here - on the syringe talk and the baby sign language - fascinating stuff :smile:

Re: 8/25 Max AMPS 119 +3~95 +4.5~97 +10.75~191 PMPS~163

Howdy,
I hunted when I first got here and got the information for the lab rat syringes.
The problems with them: They are expensive (like $35 for one) , glass so you have to sterilize them each use, I don't know how much the needles cost ( i think it was $35 as well, but I don't know if you got more than one for that price or if it was a box) and then the reviews say "they have a large dead space at the tip"
so they sound rather problematic for microdosing.
I guess they aren't microdosing with as much accuracy as we want on the rats. ? :?:


http://www.felinediabetes.com/FDMB/viewtopic.php?f=22&t=38803

I've been begging for some barbie syringes. If only they would do it right, I'd be contacting Mattel. :lol:

Re: 8/25 Max AMPS 119 +3~95 +4.5~97 +10.75~191 PMPS~163

Thank you, Rhiannon! Might be worth a try.

Vyktor's Mum, Just as long as Max doesn't make it MORE interesting! :razz:

Re: 8/25 Max AMPS 119 +3~95 +4.5~97 +10.75~191 PMPS~163

Hi Dale!

I'm back..haunting evening condos

You know, call me crazy, but I'm just seeing something different on Maxs SS. I actually think he's starting to creep up in BG a little.....and I'm discounting tonight's PMPS and his few tests before it.

I'd hold the dose tomorrow morning and see if he comes back down. If he stays up in blue, I would consider fattening his dose if you can grab a few more tests. BUT I also know your plate is really full and if it's tough to catch a few more tests, you might want to leave him at this dose longer.

I agree with Randy that dosing by drops can be difficult to do consistently because needles can vary. Ann/Tess doses by drops and has a method for consistency but I've never been able to replicate it. Thus I use digital calipers for dosing

Re: 8/25 Max AMPS 119 PMPS~163 +1.75~92

Hi, Marje,

So good to have you back. I hope you are feeling okay. You probably need to rest up for a while, but thanks for visiting my condo.

I thought the numbers were creeping up because we gave him late shots about every two days, on average, for about 10 days. He has had 9 on-time shots in a row as of the PM shot tonight. Also, four days ago, I discovered that the treat chicken I was giving him after his tests had sugar in it. He hasn't had that in 6 full cycles now. Maybe the sheet will start to look more like Max's sheet soon. Last night, everyone who looked at my condo thought I should hold this dose a little longer. Then, we got these crazy numbers today. I'm hoping he'll level out, and we can stay at this dose. Fingers crossed.

WHOA! How's that for a drop? PMPS at 163 and Plus One Seventy-Five (+1.75) at 92. The 92 is from the Relion Micro, which I haven't used in a while. The Ultima, which gave me the 163 registered 109 with the same drop of blood that the Micro indicated was 92. Either way, these are big drops. Now, if he was having a food spike at the PMPS, then, maybe this isn't such a big drop, but I'm going to have to watch him carefully tonight. We gave him 100 cc fluids tonight, but that shouldn't absorb for another 6 hours at least.

Re: 8/25 Max AMPS 119 PMPS~163 +1.75~92

Dale,
When you give him squids, do you usually see any impact on his numbers? Bob, and a couple other pzi cats seemed to have lower bg's in the cycle of, or following squid treatments.
Carl

Re: 8/25 Max AMPS 119 PMPS~163 +1.75~92

Some cats can really drop with squids. It will be interesting to see how the rest of the cycle is and how he does tomorrow. Sometimes they just like to toy with us! And there's the old "threaten a dose increase and down they come" strategy :lol: :lol:

Doing better, thanks....I've just missed everyone too much. But I'm doing baby steps!

Hugs!

Re: 8/25 Max AMPS 119 PMPS~163 +1.75~92

Hi Dale, just checking in!

Some interesting developments in here, with those wonky higher numbers... Threatening the dosecrease *does* seem to work quite often! Fingers crossed that it does for Max. Quite a drop there. Are you getting another follow-up BG test?

Jane

Hello all. I did get a follow up, and I wanted another, but I couldn't wake up at +4. He ate at +2.5, and I thought I'd wait until +4. He's low this morning, and I don't think he's eaten since then.