? 09/01 Hercules AMPS 135, +4 76, +7 63. PMPS 229 Dosing help, please.

previous thread: https://www.felinediabetes.com/FDMB/threads/07-01-hercules-8-94-pmps-146.241149/

Hercules continues to keep me guessing. After @Wendy&Neko advice, I have been holding hercs at 0.75U for two extra days. So tomorrow morning is the time to adjust the dose.

So of course, today he decides to throw a completely unexpected day....I believe based on TR I do not need to reduce, becuase he did not go under 50, but I have propped him up with a lot of HC, which I won't be able to do at night. Should I reduce his dose as of this evening?

But just 3 days ago, following the TR protocol I should have increased his dose
It was by luck (I was too tired) that I decided to hold the dose for an extra day. Should I go ahead and reduce tonight, or give it another day to see if this is a weird blip?

On a different question, giving my very short experience trying to follow TR, is it perhaps not worth it with hercules, at least at the moment?

Many thanks for you insight!

 

Beautiful greens!

No, on TR you only reduce when kitties goes <50 (on a human meter). Here's the link just for a refresher.

I'm not sure if you are just nervous but you and Hercules are doing great on TR! You test enough for it and keep Hercules safe. If you are worried about him dipping below 50, it will be okay For me, I was so nervous for Jax to dip below 50 for the first time...then he did and I survived and I learned that I can keep him safe (and all the people here were 100 percent right lol).

I'm sure Wendy will stop by when she comes online.

Surf safely, Hercules You are doing great, Karen

 

Thanks Susanne! I really appreaciate the support!

Yes, I caught my mistake on the TR protocol.

and yes, I am nervous. I can handle the low numbers during the day, but panic about what is going to happen at night. I *think* that if I wasn't giving him the HC every half an hour as I am right now, he would have gone much lower..... I can stay up for a PJ party tonight, but can't do it more than once a week.

 

When you start seeing greens on a dose, we ask that you hold the dose to see if the greens come back after the bounce clears. I would continue to hold this dose for now. He might bounce tonight like he did on the 7th

Susanne will tell you how addictive greens become. Once you get a taste of them, SLGS becomes too slow! And if he goes low at night, we have members in different time zones, so I am sure someone will be around to stay with you.

You do not want to feed him any more HC. I would continue to help him surf the greens with LC.

 

I haven’t even reached any green numbers yet but I am very nervous to see them! Hercules looks like he’s doing so well, very promising to see as I’ve only just started TR Lantus with Simba.

 

Thanks @Bandit's Mom !

With regards to your advice to keep him surfing with LC, my reasoning was that the first green was quite early on the cycle and I really wanted to avoid some massive bouncing again. In restrospect, the HC has manage to keep him remarkably stable at 4.3. So, just that I am 100% I understand what you are saying, are you suggesting that from +6 on, I should try to manage him with LC, or are you suggesting that in the future I try to just manage with LC?

 

You are right in that we do intervene with a little HC or MC if there is a steep drop very early on in the cycle. And also when the BGs fall below 50 (HC).
I was suggesting that you see if he will continue to surf on LC from +6 onwards since he is at or near his nadir.

 

I think Lantus is the key word here. If you click on the 2020 tab when we were on prozinc you'll see a very different picture......

 

Got it! Thanks for helping me understand!

 

You're welcome! Feel free to ask as many questions as you'd like!

 

I am afraid Hercs in not done going down.....
He has a few cycles with a clear nadir at +6, but he has many non-typical days where he just kept going....
I think I am going to break the world records for tests in a day.....

 

Oh wow!!! like day and night!

 

Nadirs are later in bounce breaking cycles. Looks like he is headed down even with HC?

That record is already taken by @Butters & Lyla most recently. Look at her SS for last month!
https://docs.google.com/spreadsheet...R3-hgldFQg77eAqdlQOMNhVNiUVY0uGSHb2jB/pubhtml

 

Beautiful surfing! Looks like Herc is hitting his stride now!

You may want to get an auto-feeder for those nights when you have to get some sleep. We've all been there - no one is super-human!

I like the PetSafe from Amazon and use it when I have to leave the house for long periods of time (ie my surgery, etc.) Life happens...autofeeders are life-savers!

 

Thanks Sue. I did invest on an auto feeder, but I don't have any trust that he, instead of his buddy, will get the food.... perhaps is time to invest on a camera.... Amazon has loved hercules diagnosis!

 

92 at +7.5
I think he is done with his snacks (he is not happy about it...), and I'll give his ears a break for a while. I'll check at +10 to see if he bouncing to the moon or taking a second dip (as he has done...)

 

Yes, that's a sign that he's reached his nadir so you both can have a pokie break now. After a while you'll get used to seeing his patterns, I know once Luci makes that turn (a higher number around mid-cycle)...she's highly unlikely to turn back...although on an odd occasion it happens...but typically I stop the pokes once that happens and give us both a rest.

 

I don't know.... I might be beating today.... watch out @Butters & Lyla

I am terrified of holding the dose for tonight. Anyone wants to reassure me is the right thing to do ?

 

Try not to worry about tonight - yet. This is new territory for Hercules. I predict by PMPS you're going to see the bounce - if not before. And you're probably not going to like the number you'll see at that time.

The reason for the bounce is that all this lovely green is a new thing for his body - he hasn't seen much green before - and his liver has stored glycogen for just such an 'emergency'. His body is going to dump all that glycogen into his bloodstream to compensate for those low numbers...and the BG's will soar...and that's why it's called a bounce. There are more organs involved...but basically it's the liver coming to the rescue (or perceived rescue)...to save the day as it were...

Hang on... let's see what's going on at that time before you make a decision on any dose changes.

 

LOL!
12/28: 21 tests
12/31: 22 tests
It's on

 

Rather than +10, I would get a +11.5 so you get an idea of what his PMPS will be and can post here for advice on what to shoot.

@Sue and Luci is right in that he might be bouncing but still be lower than you like (lantus double dip). Remember you have shot 146 on 7/1 and 135 this AM. So any number within 20% of that would be the same given meter variance.
And yes, do not feed any more so we know that the PMPS is not food influenced.

 

so... 11.5 is 12.7

 

It is higher than at AMPS, but not quite as high as other nights. I have shot lower, but he was bouncing, so I don't think that data informes me much.
I think I'll have to give the full dose and be prepared to be awake.... he is probably still going up from his adventures in greenland

 

I agree.

 

Get a +2. If the same or lower than PMPS feed a little mc and test in an hour F a lot lower test in 30. If steady or higher test in an hour.

 

I usually feed him 3 portions in the evening cycle. I usually give him 1/3 at +2. Should I be giving an MC on top of that?

The third feed is either at +3 or +4

 

You are fine to feed at your normal times.

 

14.8@ +2

It looks like it will be a calm evening... I'll test at +3

 

I think you are seeing a bounce from the string of greens today. I think you will likely not need to test after +3 but let’s see the results of that first.

 

+3 is 15.
Not much change.... but he has eaten an hour ago.
I think I'll take a nap and check in 2 hours just to be sure. It can go both ways with these numbers...

 

I am glad you shot that full dose, the bounce was likely.

I know those greens make us all nervous at first, but food is your best tool to keep him safe. Good job at tracking what you fed, how much and when. Pretty soon you'll have a good idea how Herc responds to food and you'll know what to leave out for him to eat over night. Remember, those green numbers are healing for the pancreas.

 

Go to sleep. He'll be safe.