7/5 Papaya AMPS=556 +6=236 PMPS=133 walking everywhere!

Yesterday

We are starting off the same as the last two days, with a very high preshot, but the last two days it has slid all the way down into a green by PM's +6. And then zoomed back up.

I am starting to feed moderately higher carb at +1.5 and +3 to see if this can flatten the curve. Last night despite the extra carbs she was still quite low before bed, but not below 50 so at least we avoided that low.

The interesting thing that also started last night is that it's like she suddenly remembered she can walk. She's been showing signs of wanting to walk on her own without help over the last week or so, but I haven't seen so much activity as last night and this morning for a long time. I put her on my bed as usual after the pre-bedtime test and snack, but I was back out in the living room finishing a movie when I heard a bump from the bedroom, followed by Papaya plodding her way to the litter. She took her time about it, resting a lot on the way, but she did eventually come back into my room after I had gone to bed. This morning, too, she walked to the litter all on her own and when I came to sit on the couch with my laptop, she bit by bit made it over to the old couch cushions I have stacked to let her get on and off the couch more easily. I put her on the cushions but then she made it the rest of the way onto the couch on her own. It's still totally awkward staggering around on her hocks, but it's been AGES since she did that much on her own, so I'm really happy to see it.

Silly cat, she'd probably be much cooler if she stayed on the hardwood floor but she just sits there and looks offended if she doesn't get to come up on the couch. As soon as she is on the couch she starts grooming or settles in comfortably to sleep. I've been wiping her down with a damp towel occasionally to help keep her cool - like a giant cat tongue, I guess, since she doesn't mind it at all.

Enjoy the long weekend, for those of you in the US, and don't get sunburned!

Re: 7/5 Papaya AMPS=556 +6=236 walking everywhere!

It really warms the heart when they perk up and you see some green. My Chyna was limping but wasn't on her hocks yet when diagnosed; but quite often had to stop every few steps and sit down to rest, it broke my heart...the methylcobalamin really helped that, and so did some lower BG numbers. I'm glad that it's working and your Papaya is walking better I hope you have a great day!

Re: 7/5 Papaya AMPS=556 +6=236 walking everywhere!

Come on Papaya sweetie, those paws were made for walking.

http://www.youtube.com/watch?v=SbyAZQ45uww

Thanks for the encouraging words, Rachel! I hope Chyna is doing well now.

Deb - I think Papaya must know that song! When I was visiting my parents a couple months ago, I was sitting in an armchair and Papaya was on the carpet nearby. She seemed restless so I thought she'd rather have me sitting down there with her. As soon as I slid out of the chair she pretty much used me as a ladder to get into the armchair, which was clearly her design all along. My mom thought it was hilarious - obviously Papaya could get around not too badly when she felt like it. Now I guess she just needs some high-heeled boots :lol:

That's great news to hear that Papaya is more mobile! I love hearing when kitties feel better.

Go Papaya Go! I could just picture her walking slowly - just warms the heart!

Amy

What great news that Papaya is walking and moving around more!!!

As I said yesterday, I don't mean to frustrate you. I already know how frustrating a bouncy cat can be. I do think that trying to follow the modified protocol as much as possible at first to see if it will work for a kitty is the best thing. If it doesn't, maybe try the TR protocol as it was written. If that doesn't work, what will?

I'm also not lumping you into a specific group; I don't do that when I look at a SS because a cat is a living, breathing soul and so is the caregiver. I also don't think there is anything abnormal about Papaya. I see lots of bouncy cats....lots. And they don't all just snap in a few months and go off the insulin. Some of them take almost two years. Check out these Spreadsheets: Mocha's SS, Tuffy's SS, Lucy's SS. Look around LL and you'll see lots of bouncy cats.

I don't expect you or anyone to test like I test. I understand that you have a life and you need sleep so you can work. I think the basic principle of test more when they are dropping and less when they are flat works just fine. That's why I suggested you try to get a +2 as much as possible. Perhaps you can see if it is true that if she is much higher at +2 than her PS, you can lay off testing; if she's the same or similar, it's best to get at least a mid cycle test, and if she's much lower at +2 than PS, you should expect to test more.

If you feel Papaya doesn't hold her reductions, then allowing her to go between 40-50 three times before you reduce is fine. Or if she goes below 40 once, you should take a .25u reduction (for safety because this is an aggressive way of earning reductions). Of course, if she bounces really high the cycle after she gets below 40, you can shoot through the bounce once and then take the reduction the next cycle. I see on your SS that you do this.

As Sienne said, if you are dosing a different way, it would help us to know why you are. For instance, on 6/14 p.m. cycle, she was at 47 and 6/16 p.m. she was at 58 but you raised the dose on 6/17. On 6/19 p.m. cycle, she went back down to 38 but you continued to hold the dose and held it for a total of 4 drops into the 40s on different days (including the 38 one of those cycles). I understand that when she's getting into green and bouncing up, it's difficult to take the dose down because then you wonder if she will hold the reduction. But I do think you are missing reductions and if you let the depot get ahead of you, it can also contribute to this diving/bouncing cycle she's on.

We do say "every cat is different" but we also say "know thy cat". Do you know her onset, nadir, and duration? yes...I understand nadirs can change but if you know these basic things about her, it can help you manage her curve a little better. If you know when she onsets, be sure she has the higher low carb food on board to try and counteract a big drop. Try to feed the drop; Sienne explained to you how she does that with Gabby.

Do you know what triggers the worst bounces? I know that Gracie bounces the highest when she dives so my focus is, first, to feed in a way to slow the dives and flatten her curve. Second, I know she bounces when she gets into the 40s so I try to keep her above 40. She tells me when she's ready for a reduction because I am not able to keep her above 40 with LC food....and usually not even higher LC food (the most I use is 10%).

Answering these questions might require that you do a little experimentation. Yes...maybe testing more for a bit on weekends or when you are home to gather more data.

But, for me, the biggest thing I see on her SS is that she is going low and that is causing her to bounce up and then she dives because you've missed reductions.

Libby gave me some great advice which I will pass onto you. It actually is one of the things that I really concentrated on and I believe it has helped me with Gracie's regulation:

isn't it Suze/Pumbaa who is constantly repeating "they bounce until they don't?" It's true, there's no secret, they stop when they're ready to stop. I remember being frustrated that Lucy was pink at AMPS almost every single day, even though she went green at night. Jojo told me not to worry about the pink, she was spending more and more time in green so the little bit of pink didn't matter. She finally got to the point where she was pink for just a few hours every morning. One day she just completely stopped bouncing. I didn't do anything to make that happen, it just happened. Then what you're calling "dives," Jojo would say "look, she is racing as fast as she can to get back to those green numbers that she loves." Perspective.

So yes, I would dose to the nadir you want and wait for the numbers to fall into place. If you want nadirs in the 60s (which seems like a good goal), then adjust the dose until the nadirs fall into the 60s. Then STOP. She will eventually start to flatten out. That might take a long time. Once she flattens out, it might be higher than 60s, so you would adjust the dose again to put her back where you want her. If she drops lower than 60s, reduce the dose again to keep her nadirs in that range.

Spend some time studying Mocha's spreadsheet. Devon was good at holding doses once they started doing good things. At one point she held the 3u dose for basically a whole month, with numbers that looked a lot like Gracie's do now. Some other doses on the way down the dosing scale were held about that long because the nadirs were good. Also look at Tuffy - she was on 3.5u for almost 3 months. It took 2 months for her to start to flatten out, but then she headed down the dosing scale.

Don't try to minimize them, seriously just ignore them. Another thing the ever-wise Jojo always said is that Lantus (and Lev) are "Zen" insulins. You have to wait for the numbers to come to you. If you are someone who wants to chase numbers, these are not the right insulins for you to use (not "you" individually, but that's what she always said).

Click to expand...

The other thing I was doing with Gracie was, after a reduction, just giving her a couple cycles to clear the bounce and then taking her right back up again. It wasn't working. Now, I'm trying to give her a little more time. Look at the reduction I gave her on 7/1. She was in pretty flat, high blue for four cycles with just a tiny bit of time coming down into normal numbers. But I made myself hold the dose because she was dipping her toes in normal numbers; now she's adding more green to her cycles. I don't have any idea if that will work for Papaya. But it's just a thought and it goes back to Libby telling me not to chase numbers.

I truly am interested in helping in any way I can. Others may have very different, insightful opinions and that is the beauty of this forum. My comments are just based on what I see but it's JMO. Please let me know if there is any way I can help.

Thanks, Marje. I guess I have hesitated to take reductions because I hate to see how she feels when she is getting too little insulin. It seems less clearcut how you are supposed to know that a reduction has failed and to go back up, and I was really not happy with how she ended up feeling when I did a lot of reductions close together. But I think she is spending more time in those better numbers now, so I agree I probably I do need to take reductions more and see how she does with them.

+2 for Papaya is often higher than the preshot, I figured it was the food just kicking in around then, unless she's just clearing a big bounce in which case it's lower. Onset usually seems to be a bit after +2, so even +2.5 seems to be a more meaningful number. So I have gravitated more to testing at +3 to tell me where the cycle is going and still have a chance to head off a drop, or on work days more at +4 since it tells me what to feed her before I'm out the door. Since right now I am trying to feed a bit higher carb food at +1.5 and +3, I think I will test at +3 before I feed again to see where things are headed.

It's hard to generalize her nadirs; often around +6 but if she's dropping from a bounce she just keeps going down, down, down to the lowest number basically at the next shot time. So mid-cycle tests for me are generally around +5 or +6. But again sometimes I have tested at +8 and realized she was lower then. So it's quite a bit of guesswork for that part of know-thy-cat!

I appreciate your thought at the end of the post where you mentioned giving the cat a little more time at a reduced dose - I am seeing that the reduction to 2.00 is definitely holding, so maybe the next reduction will too. I think I will definitely be looking for input the next time she earns a reduction, to see whether I should be holding that or going back up if the numbers aren't great. Thanks for being willing to look at the numbers so carefully. I will see how the bit of extra carbs works to flatten the cycle for now, and be more aware of taking earned reductions . . . stay tuned

Thanks again.

You're welcome, Amy.

It looks to me like she has changed because alot of the +3/+4 tests, she's already on her way down quickly. I do understand, too, about the bounces clearing and she drops and drops so the lowest number is the next PS. Gracie did that to me all the time on Lantus and I had to learn to shoot dropping numbers...everything above 50... to keep her on track. I know that can be difficult to deal with.

On the reductions, I think the best advice I can give you is to not get attached to a dose. Stay on top of your reductions and If you reduce and she stays in yellows or higher, take her back up. If she comes back down into blue, maybe give her just s little of time and see how she does.....you should be able to tell in four or so cycles.

We're always happy to help so let us know any time you have a question. I hope she continues to improve with her mobility.