7/10 Tigger Update PMPS = 300; PM +2/179 & 167! Go Tigger!

Hi Lantus Land People!

We're back after a downed satellite internet. ohmygod_smile

Tigger's doing better on the increased dose, but he's been leveling off, & today's his third day.

Time for an increase of .25 tomorrow AM? I'd love input if anyone has the time.

The Nova Max ketone monitor read 1.1 (warning level but not DKA) 2 days ago, for 2 days. nailbite_smile Got great help from alot of you members to pull me off the ceiling - THANK YOU!!!!

I called my great vet, but she's out of town this week.
The On-call vet essentially said: "There is no animal baseline for the blood ketone monitor, so we can't really interpret those numbers. If he's acting normal, that's an important sign - if he's well & hydrated, his body will naturally flush itself. If possible don't test for a week, and hold the new dose for 7-10 days because it takes a long time for the depot to be established. Otherwise, a hypo could result. That's the issue with testing - the results can make people worry unnecessarily. If Tigger stops eating, gets dehydrated or starts acting sick, & his ketones are elevated (I presume by dipstix) then give fluids & bring him in." She was very nice, but I can't agree with that entirely.

But - I understand the point- how is the cat acting in spite of the test results - ECID

A positive note that evening - I got a fresh-catch of Tigger's urine, normal on the multi-stix - so I went with that result, combined with Tigger acting normal.

Today, I had the courage to test his blood ketones: .5: in the normal range, so I'm happy with that, too.

Thanks to you all for your on-going support & assistance - its so much better than being alone in the wilderness!
Tigger's Condo

Re: 7/10 Tigger AMPS/343 +3/271 +5/296 +7/269 Dose increase

Suzanne,
I agree with most of the vet's take on it. Don't know about the waiting 7-10 days (sounds like she's more comfortable with the "start low go slow" approach and maybe doesn't know about, or advise the Tight Regulation protocol?
Don't agree at all with the "don't test for a week". Is she talking about ketone testing or blood glucose testing? Either way, not good advice in my opinion.

That's the issue with testing - the results can make people worry unnecessarily.

Click to expand...

Testing can make people worry too much, in some cases, I think. That's why I try not to get too hung up on specific numbers and look at "trends" and "patterns" on a spreadsheet. It's easier to think in "colors" than in numbers at times. But one number that jumps up and slaps you in the head is a 40! Not that you've seen one yet, but telling somebody to not worry about testing for a week or more is pretty dangerous advice. If they are worried about a "hypo" due to a dose increase that (in their opinion) takes place too quickly without letting the depot be "established".... how does that square with the risk of not testing and missing a number under 50 on the current dose?

If they tell you to not test for 10 days, then they say "okay, test today and give us the numbers", and Tigger happens to have a cycle of numbers that is high and flat, they'll most likely tell you to increase his dose, right? But what if, in that week, he dropped under 50 a few times, and the one cycle of high numbers you got on day #10 was just Tigger bouncing all day because he went down to 40 the day before? You'd be increasing the dose when the TR protocol says you should be lowering it! I don't understand their logic...

Looking at the past three days of data, I understand why you want to increase the dose. However, I think I would wait for a daytime cycle to do so, and on a day when you can test a few times to see if it does anything quickly. Sometimes a cat will react to an increase in the first cycle afterwards. Sometimes not. It doesn't appear that TIgger has. Yet. But he could. I think I'd lean towards staying with this dose for one more day, and if you don't see "movement", then increase on Friday morning if that works with your schedule?

Re: 7/10 Tigger AMPS/343 +3/271 +5/296 +7/269 Dose increase

I think I understand Carl's point. I'd lean toward increasing anytime after the 6th cycle providing Tigger doesn't hand you any surprises. Given the fluctuating ketone level, I'm not sure I'd want to hold off on increasing.

Just my 2 cents for your consideration.

Re: 7/10 Tigger AMPS/343 +3/271 +5/296 +7/269 Dose increase

Thanks, Carl & Sienne,

Carl, you stated what I was thinking more specifically & succinctly, thank you. I'm one of those people who freaks out with test numbers, & when you told me awhile back to look at the color patterns rather than getting hung up on a specific number, that really helped - & encouraged me to look beyond one cycle or one day - till I got the elevated ketone number 2 days in a row. But that could be the meter itself - the dipstix after the fact showed normal.

3 out of 4 vets that I talked with are either against or not advocates of home testing. In part, I believe, because it may create more work for them in terms of phone calls & less office visits & revenue, especially if a patient gets worried by the results, as I did. I can't stop home testing - the evidence in support of it are just too compelling, as you state. But I'll remember to also consider the Whole Cat Analysis in conjunction.

I appreciate both your viewpoints on whether to increase or not. I would always want to increase on a day cycle - I'm too sleepy at night & will be around both Thursday & Friday. Given the ketone issue, that would be my inclination for Thursday AM increase vs. Friday, but I'll see how he does tonight.

Thanks so much for your input, both of you.

Re: 7/10 Tigger AMPS/343 +3/271 +5/296 +7/269 Dose increase

Hope the increase works for you and Tigger can find some pretty blues!

Re: 7/10 Tigger AMPS/343 +3/271 +5/296 +7/269 Dose increase

Hi Suzanne

I would also increase in the morning to 1.5u provided tonight looks like the other cycles.

What kind of syringes are you using as I saw on the SS that you were having problems with bubbles. Anything we can help with? Some syringes are worse about bubbles than others.

I hope the ketones stay down. I'd stay on top of them.

Also...low numbers worry everyone and they should cause a caregiver to be alert and vigilant. But remember that you are in control because you can test and you have food to manage the numbers.

I asked my vet why she thought so many vets are against testing and she said the exact thing that you surmised....they don't have the time for panicky caregivers calling them all the time; they have no way to help manage FD as we do here.

Re: 7/10 Tigger AMPS/343 +3/271 +5/296 +7/269 Dose increase

Thanks for your input Marje,

1.5 what my gut is saying, unless we go blue tonight.

I was using the SureComfort (big bubble almost every time). Just got Monoject tonight - so tomorrow will try those. I'm a fan of Terumo needles & may try those if I don't like the Monoject. Any sugestions?

I need to test myself with the blood ketone monitor. I keep getting normal with the dipstix,mostly with clay patty testing after the fact, but I think it takes a higher value to show up on those (?) I'm thinking, as Jill said, if I can keep Tigger's BG lower, the ketones will stay lower, too.

I really like our new vet (thanks again, Ann!) who supports home testing & FDMB, but have gained so much more education from members here -

Thanks everyone for the input - I feel surrounded by experience!

Re: 7/10 Tigger AMPS/343 +3/271 +5/296 +7/269 Dose increase

Thanks for the support, Tara - I hope so, too! Sure like Buster's pretty blue & green SS!

Re: 7/10 Tigger AMPS/343 +3/271 +5/296 +7/269 Dose increase

OK, so just when I think I'm understanding Tigger's color gyrations, he gives me a 179 @ PM +2 after a PMPS of 300 & all day pink & yellow!

I didn't believe it - re-tested & got 167! ohmygod_smile

Re: 7/10 Tigger Update PMPS = 300; PM +2/179 & 167! Go Tigg

:lol: :lol: :lol: :lol: :lol: it's the old LL trick. Dose threat and voila! Blue...green!! Works almost every time.

Lets see how low he goes.

I have used many different syringes. The problem with the MJs is they have a hub at the top and the insulin gets in there. So from shot to shot, you get different a,punts of insulin depending on how much of the insulin goes into the syringe from the hub.

I like the Terumos. They take a little getting used to....they slide quickly but they are sharp, I like the in between needle length.

Re: 7/10 Tigger Update PMPS = 300; PM +2/179 & 167! Go Tigg

Good Morning, All!

Fyi, Tigger got down to 154 @ +3.25. I crashed after that & didn't test again till +5.25 = 159. I think he probably went a little lower in-between.

Then he ran back to his comfort zone: +9/281 & +10/329

Think I'll stick with the 1.25 dose for now & let this play out.......

Thanks again to all for your input - it really helps me feel I'm going in the right direction! :mrgreen:

Re: 7/10 Tigger Update PMPS = 300; PM +2/179 & 167! Go Tigg

Way to go Tigger! Don't take those does threats laying down! I think patience is one of the hardest things to learn about the sugar dance!