1/16: Esse PMPS=285 +3.5=85 3.75=73 +4=71 +4.5=90

[Michele and Esse]

Daily Digest
AMPS=463. Wellness for breakfast. Grooming, alert. Will get a ketone test today.
+2.5=431. A little movement in the right direction...
+7.5=378. A bit more movement in the right direction. Food still in dishes from before barn...
+9.5=355. Hrm. Is she clearing??
+11=360. Surfing? Better than rising...
PMPS=285. Clearing all right...Wellness down, no ketone test yet. WCR: apparently my dinner is what she thinks is hers...shoo, Esse, shoo. Big drop in an hour, tho...
+1=272. Nice and yellow...
+2=166. Into the blue...a bit earlier than I thought she'd go, but she's here. Wonder where she'll be in an hour? Serving of LC.
+3=116. Another serving of LC. She's quite hungry...
+3.5=85. Gave a mixture of LC and HC Whiskas (bits and gravy).
+3.75=73. Gave straight HC.
+4=71. no new food given. Gotta let the HC have a chance to work...
4.5=90. Seems the feast has taken hold. WCR: happy camper, full belly, snoozing under the sidetable. Wants nothing to do with me and the pokey thing...

*******************************************
And with that, lords and ladies, hep cats and hepper kitties, I'm putting food out and heading to bed.
*******************************************
Yesterday's condo: viewtopic.php?f=9&t=2676#unread

Sigh. Well, she apparently got the "don't you dare go low on Saturday" memo...

Darn it all. We were making such good progress...I wonder what happened??

Best-
Michele

 

[Amy and Six]

Re: 1/16: Esse AMPS 463

Yikes Esse!!!! Come on down!

I'd check the phone bill...I think Esse called Six last night for some advice.

Monday and Tuesday were great days!!! Things are so looking up for Esse and you.

Enjoy your Saturday Michele!

 

[Pat+Raja+Shadow (GA)]

Re: 1/16: Esse AMPS 463

Oh Esse....what's up with the numbers today?
Something bugging you Girl? Try to bring that down a few notches, k?
Hope the day brings some changes for you...good changes that is...

 

[Michele and Esse]

Re: 1/16: Esse AMPS 463

But Amy, I hid the phone (even *I* can't find it...) and the computers were off...so she's just being psychic again, I suppose. Sigh.

She is currently napping, and being Esse. I was going to get a +1, but decided against it. I will get a +2 before I head to the barn...if she's dropping precipitously, it should show by then. But somehow, I doubt she will...tonight she can, though...

Sigh.

Best-
Michele

 

[Amy and Six]

Re: 1/16: Esse AMPS 463

Does Esse have a cell?

What's your current sleep intake? Is she waiting to provide you with Saturday night plans, again?

 

[Michele and Esse]

Re: 1/16: Esse AMPS 463

At the moment, my sleep shed is nice and full. The abx are having an effect (they tend to make me tired), but overall, I'm ready for what she'll throw at me. 'Course, that also means she won't throw anything at me...'cause I'm ready for it. LOL.

Best-
Michele

 

[Roni and Moonie]

Re: 1/16: Esse AMPS 463

Michele--You are my new HERO!! Said it like it is on a different condo... ;-)
Esse, let's see some nice numbers from you today--Think Blue!!!!

 

[Michele and Esse]

Re: 1/16: Esse AMPS 463

You're too funny...yes, Esse, think blue - but not until 3 pm. LOL.

Best-
Michele

 

[Lydia--(Rosie & Basil) GA]

Re: 1/16: Esse AMPS 463

Esse, baby, would you like a call from Basil?

 

[Michele and Esse]

Re: 1/16: Esse AMPS 463

Esse, baby, would you like a call from Basil?

Yes, yes, and yes again. I took off her aluminum hat days ago, but she apparently didn't realize it. LOL. She's holding at 431.

Off to the barn for some hard storm prep in about 30 minutes, and then I'll be back later...

Best-
Michele

 

[Blue]

Re: 1/16: Esse AMPS 463 +2.5=431

Roni, I agree that Esse has a brave bean and so as a reward, Esse, I think you should show us some nice blues, what do you think?

 

[Barbara and tuffy]

Re: 1/16: Esse AMPS 463 +2.5=431

Is this a "Becareful what you wish for". I must say, Esse is very accommodating. Hope she comes down and surfs blue for you while you are gone. Hope the storm prep went well. I'm leaving to unstick a tractor. Dumb bean.

 

[Helene & Tizon]

Re: 1/16: Esse AMPS 463 +2.5=431

Hi Michele (1L),

I'm with Amy... am thinking that Esse is saving it for the evening.... because.... that's what cats do.
Esse dear.... no need to hang on the the 4th floor .... the specials are on the 1st floor!

 

[Cassandra and Sasha]

Re: 1/16: Esse AMPS 463 +2.5=431

I read a few posts by you that made me :mrgreen: this morning.

Is there any way to move your shot times a little bit so that you can get a +3 or +4 at night rather than a +1.5 or a +2? Perhaps sleep tests instead of moving the times? Just wondering how much green is being missed. If there isn't any, then a dose increase is warranted.

 

[Michele and Esse]

Re: 1/16: Esse AMPS 463 +2.5=431 +7.5=378

LOLing at you guys. I swear, Barbara, this is a "be careful what you wish for..." moment...sigh.

Barn is ready for the storm...I'm sore as you-know-what. I have a sprained shoulder, and it is screaming at me right now...but the barn is ready, and Tango has been ridden 'til he was a wet sweat mess...(ahem, so was I...). Tomorrow we'll ride again!

Cassandra, the shot times are set for my school schedule - I need to be out the door at 6:15 am latest, so that's what we work with. I could go earlier, like 5 am, but the problem comes in in the afternoon there, because of study group (we study 4x weekly from after school to 6 or so...). I will work harder on getting some nighttime numbers, but from what I can see, there ain't no green in them thar hills...I do suspect she went really low that one night a few days ago, just based on how high and long this bounce has been.

If I change the dose, it has to be tonight, because otherwise I won't be able to be around for day tests until next Friday. So what do you all think about me taking it back up to 2.5 until we see this clear? If not tonight, then she'll have to wait until Friday so I can get two days' time to watch...OTOH, we could just wait this out, or I could give a skinny 2.5 just for tonight and see if that helps. I swear - it's like her dose is 2.33...good grief. She's a complicated kitty!

Helene, I've told Esse to come on down, that YOU told her too...but she just yawned. What do you think that means?

Lemme know your thoughts...

Best-
Michele

ETA: You know, I'm sort of wondering if this is clearing...she started way up there, and it's been declining ever since. It took a whole day to get her to 463, so I'm just wondering if this isn't a slow, wide rebound and it's clearing on it's own. In which case, maybe I shouldn't help her dose along...dunno.

Best-
Michele

 

[Cassandra and Sasha]

Re: 1/16: Esse AMPS 463 +2.5=431 +7.5=378

Cassandra, the shot times are set for my school schedule - I need to be out the door at 6:15 am latest, so that's what we work with. I could go earlier, like 5 am, but the problem comes in in the afternoon there, because of study group (we study 4x weekly from after school to 6 or so...). I will work harder on getting some nighttime numbers, but from what I can see, there ain't no green in them thar hills...I do suspect she went really low that one night a few days ago, just based on how high and long this bounce has been.

I suspect she may have had green on PM of 1/11, PM of 1/12, and maybe AM of 1/14. If there would be any way to work in a +4, +5, or +6 some nights along with the +2 that may show more.

If I change the dose, it has to be tonight, because otherwise I won't be able to be around for day tests until next Friday. So what do you all think about me taking it back up to 2.5 until we see this clear? If not tonight, then she'll have to wait until Friday so I can get two days' time to watch...OTOH, we could just wait this out, or I could give a skinny 2.5 just for tonight and see if that helps. I swear - it's like her dose is 2.33...good grief. She's a complicated kitty!

You don't have to be able to test during the day when you change the dose unless it makes you feel more comfortable or if you won't be able to do any night testing. Most people don't test mid-cycle on both AM and PM. If you aren't going to be able to get any day testing in on a dose change, though, you really will have to get some mid-cycles in at night.

I'm usually more of a fan of raising in 0.25u increases as per the protocol in newly Dx cats and testing more frequently, but I do tend to be a bit aggressive, so take that with a grain of salt. It is not abnormal for doses to have to be tweaked to fats and skinnies, particularly in kitties that have used other insulins previously. I have to do it myself....am going blind because of it, I swear! :shock:

Why don't you try and get a mid-cycle tonight and see where it is and perhaps think about raising the dose tomorrow if she doesn't show you any green. She's staying pretty high and flat so far yesterday and today. With meter variance at those numbers, they are really very similar as you know.

Just my thoughts. :smile:

 

[Michele and Esse]

Re: 1/16: Esse AMPS 463 +2.5=431 +7.5=378 Dose question...

I agree with her greens on those days...pretty sure, as a matter of fact.

The thing I'm thinking is, that if she's declining (and yes, surfing at this pink), then perhaps she's handling it on her own. I will stay up as late as I can to get some mid-cycle, but I'm trying to train myself to get up at 4 am...so I may not make it much past 10 pm. That's the most difficult part of this for me - those mid cycle pm checks.

So...there it is. LOL.

Let me see what I can do tonight, and see where she is.

Best-
Michele

 

[Michele and Esse]

Re: 1/16: Esse AMPS 463 +2.5=431 +7.5=378 Dose question.+9.5=355

her 9.5=355. She's still coming down. I'm thinking she's starting to clear this by herself, so am not going to be switching the dose tonight. I'll still try to get some midcycle numbers tonight...

Let's see where she is at PMPS...

Best-
Michele

 

[Michele and Esse]

Re: 1/16: Esse AMPS 463 +9.5=355 PMPS=285

Bless her heart...she's clearing on her own. She's at 285, and if behavior is any predictor, she'll hit blue in about +3. She thinks that my dinner is for her, and won't leave me alone. And she dumped the trash over - in front of me!!! - looking for something better than the Wellness. LOLing at her, nope...she'll get "the good stuff" if she goes below 50...not before.

At lesat this is after the barn storm prep...she was a good girl to not be low today...ROFL.

Best-
Michele

 

[Barbara and tuffy]

Re: 1/16: Esse AMPS 463 +9.5=355 +11=360 PMPS=285

Nice PMPS. Yes, she waited to go down until her bean was done with the barn chores. What a thoughtful kitty. Hope the shoulder feels better.

 

[Michele and Esse]

Re: 1/16: Esse AMPS 463 +9.5=355 +11=360 PMPS=285

Barbara, my shoulder (and back, and legs...) are hurting a lot. LOL...took an IB800, and hope that will help. It's gonna be rough getting out of bed tomorrow, and harder slinging a leg over Big Handsome. But hey, I gotta do it, right?

Best-
Michele

 

[Dyana]

Re: 1/16: Esse AMPS 463 +9.5=355 +11=360 PMPS=285

You don't have to stay up late to get night time checks. You could set an alarm for a +6, or +4 or 5, or whatever, and then just go right back to sleep.

 

[Michele and Esse]

Re: 1/16: Esse AMPS 463 +9.5=355 +11=360 PMPS=285

You don't have to stay up late to get night time checks. You could set an alarm for a +6, or +4 or 5, or whatever, and then just go right back to sleep.

You so funny...

(I have a hard time getting to sleep, especially if I've slept a bit before...)

Best-
Michele

 

[Barbara and tuffy]

Re: 1/16: Esse AMPS 463 +9.5=355 +11=360 PMPS=285

Michele: There is an old saying by my Orthopod, "No pain, No gain". Do you have a rice bag. They really help.

 

[Dyana]

Re: 1/16: Esse AMPS 463 +9.5=355 +11=360 PMPS=285

You so funny...

(I have a hard time getting to sleep, especially if I've slept a bit before...)

I had a hard time too for awhile. Especially, if I turned on the computer and posted and then went back to bed, I would stay be up for an hour or more. I would pay the price in the moring. Sometimes, I sleep through the alarm..it must be part of my dream those nights. But, if I just get up, test quick, and go right back to bed (maybe read a page or two), I am learning to not loose that much sleep in the middle of the night. With us working or going to school, we need to get the mid cycle tests somehow.

 

[Michele and Esse]

Re: 1/16: Esse AMPS 463 +9.5=355 +11=360 PMPS=285

You're right, Dyana, and I will try. But just got the updated weather report, and we may get up to 20 inches of rain; the entire horse community has been emailed and asked to be ready and on stand-by for sandbagging and evacuations...and apparently the local news station has already positioned cameras in the area. This is not looking good; I'll be sandbagging and getting horses out tomorrow...so hopefully, Esse doesn't get too low, and doesn't worry this bean too badly. And I think that sleep is going to be deep and dreamless, given the day I've had and the days that are coming.

Sigh. It will be interesting...I will definitely try to get some numbers during the night cycle...

Best-
Michele

 

[Michele and Esse]

Re: 1/16: Esse AMPS 463 +9.5=355 PMPS=285

Bless her heart...she's clearing on her own. She's at 285, and if behavior is any predictor, she'll hit blue in about +3.

I had to quote myself...I was wrong by about 45 minutes. 166 at 2.25...she's in the blue. I'm hoping she won't be scary low in an hour...

Best-
Michele

 

[Cassandra and Sasha]

Re: 1/16: Esse PMPS=285 +1=272 +2=166

Feed her some LC and let's try and get this girl surfing.

20 inches of rain!

 

[Michele and Esse]

Re: 1/16: Esse PMPS=285 +1=272 +2=166

Feed her some LC and let's try and get this girl surfing.

20 inches of rain!

Done. I hope we can stop the drop...I'd love to give her body a chance to "rest and relax" at this number...and not drop so low she starts another rebound.

And yes, 20 inches. Even conservative estimate gives us 12 inches...130 year average gives us 15.3 inches annually, so we're looking at an entire year's rain in 6 days. Add that to the huge burn area from this last summer, and we're talking lots and lots and lots of problems. It's gonna get really, really nasty before next Friday, and there are some forecasts calling for rain through next Sunday - 8 days from now.

And with gale force winds, I don't think an umbrella is going to do much...

Best-
Michele

 

[Cassandra and Sasha]

Re: 1/16: Esse PMPS=285 +1=272 +2=166

Test at +3 and let's see where she is going with it....

Even 12 inches of rain would be awful. Doing the opposite of a rain dance for you and keeping everything crossed that everything and everyone stays safe.

 

[Michele and Esse]

Re: 1/16: Esse PMPS=285 +1=272 +2=166

Test at +3 and let's see where she is going with it....

Even 12 inches of rain would be awful. Doing the opposite of a rain dance for you and keeping everything crossed that everything and everyone stays safe.

+3=116. She's doing the limbo...

Gave another serving of LC, but am considering another smidge with some HC gravy...I want to stop the drop, you know? At least it's slowing down.

Some forecasters are saying up to 28 inches in some areas. I'll take 12 if there's a choice...thanks for the dry dance...I think we are gonna need everyone dancing pretty quickly if we're gonna make it through this. Hillsides will be coming down pretty quick...

Best-
Michele

 

[Libby and Lucy]

Re: 1/16: Esse PMPS=285 +1=272 +2=166 +3=116

LC should be fine for this test, and maybe MC if she hasn't slowed down by the next test.

Sending anti-flooding vines...

 

[Michele and Esse]

Re: 1/16: Esse PMPS=285 +1=272 +2=166 +3=116

She hasn't slowed down...just did a 3.5, 85. So gave some LC with HC gravy and bits. Will test again in 15.

Sigh.

Best-
Michele

 

[Libby and Lucy]

Re: 1/16: Esse PMPS=285 +1=272 +2=166 +3=116 +3.5=85

hooray for green!

Now surf, Esse.

 

[Cassandra and Sasha]

Re: 1/16: Esse PMPS=285 +1=272 +2=166 +3=116 +3.5=85

Break out the surfboard, Esse!

 

[Michele and Esse]

Re: 1/16: Esse PMPS=285 +1=272 +2=166 +3=116 +3.5=85

3.75=73.

Another pouch of Whiskas. Will see what she is at +4.

Best-
Michele

 

[Cassandra and Sasha]

Re: 1/16: Esse PMPS=285 +1=272 +2=166 +3=116 +3.5=85 3.75=73

Drop slowed nicely. One more test in the same range and she is officially surfing green.

ETA: Just realized that was a 15 minute test, so SURF ESSE!!!

 

[Michele and Esse]

Re: 1/16: Esse PMPS=285 +1=272 +2=166 +3=116 +3.5=85 3.75=73

Then she's surfing...she's +4=71.

I did just give her another pouch of Whiskas...she ate most of it (the kitten stole the rest...but she didn't seem to actually care). I'm not going to give her any more right now; she's had enough in the last hour to spike her...so I have to just let her digest it, you know?

I'll test again in - say, 15 minutes?

And what do you all think about a dose decrease? I didn't like the speed of this drop...

Best-
Michele

 

[Cassandra and Sasha]

Re: 1/16: Esse PMPS=285 +1=272 +2=166 +3=116 +3.5=85 3.75=73

You can wait 30 minutes for the next test.

Clearing rebound can cause drops like this, but we do not decrease if you are following the protocol unless she goes below 50. Of course, that is just the protocol, and you have to make your own decisions about that as you are the one that knows Esse best.

I wouldn't decrease unless she earns it, but that is just me.

 

[Michele and Esse]

Re: 1/16: Esse PMPS=285 +3.5=85 3.75=73 +4=71

I know the protocol says under 50, but I've wondered about that. I mean, sure, that's the "number". But what if a bean treats aggressively before 50, like I did, to slow the drop? If I hadn't fed her (at 116, and then at 85, and then at 73...) she probably would already be under 50, and I'd be throwing HC at her hoping to bring her back up.

Does that thought make sense?

Also, (was it you?) someone said that they were pretty sure she hit green a few times overnight this last week, and I agree...and that would've set up this bounce. So if she's going green (and fairly low, it would appear, for the rebound that high) regularly, and tonight I got aggressive with early treatment, wouldn't a decrease make sense?

OTOH, I don't have an issue following the protocol; just wondering about the above. (and me being a weenie....)

Best-
Michele

 

[Michele and Esse]

Re: 1/16: Esse PMPS=285 +3.5=85 3.75=73 +4=71

Actually, now that I spend some time on her ss, I'm noting that this green is the first confirmed green for this number. Not sure how to interpret that...

Best-
Michele

 

[Jill & Alex (GA)]

Re: 1/16: Esse PMPS=285 +3.5=85 3.75=73 +4=71

fwiw, with the numbers esse has been throwing, i'd be looking to hold onto the dose as long as possible rather than thinking about a reduction. afterall, lantus and lev are known to have trouble bringing down higher numbers. i'd want to give her as much insulin as safely possible to be able to pull those higher numbers down.

just my thoughts...

 

[Michele and Esse]

Re: 1/16: Esse PMPS=285 +3.5=85 3.75=73 +4=71

fwiw, with the numbers esse has been throwing, i'd be looking to hold onto the dose as long as possible rather than thinking about a reduction. afterall, lantus and lev are known to have trouble bringing down higher numbers. i'd want to give her as much insulin as safely possible to be able to pull those higher numbers down.

just my thoughts...

Good thoughts at that.

I'm not anxious for a decrease, what I am is worried she'll drop and bounce...or drop and go hypo. I will hold the ship into the wind, however, and see what we can see.

+4.5=90. Food seems to have worked. Am going to get more out for her, and then head to bed...long day stuffing sandbags tomorrw...and then the rains come.

Best-
Michele

 

[Cassandra and Sasha]

Re: 1/16: Esse PMPS=285 +3.5=85 3.75=73 +4=71

I know the protocol says under 50, but I've wondered about that. I mean, sure, that's the "number". But what if a bean treats aggressively before 50, like I did, to slow the drop? If I hadn't fed her (at 116, and then at 85, and then at 73...) she probably would already be under 50, and I'd be throwing HC at her hoping to bring her back up.

I have found that every time I've tried to adjust based on 'maybe this would have happened', I have been wrong and the doses haven't done well. Have to look at cold hard data that has been collected, at least in my experience.

Also, (was it you?) someone said that they were pretty sure she hit green a few times overnight this last week, and I agree...and that would've set up this bounce. So if she's going green (and fairly low, it would appear, for the rebound that high) regularly, and tonight I got aggressive with early treatment, wouldn't a decrease make sense?

Just don't know how low she has been going without seeing it. Again need to actually catch the numbers in order to get the reduction, at least with circumstances like this.

I completely agree with Jill that holding each dose for as long as you possibly can will be the most beneficial while Esse is still going through liver training. Decreasing too rapidly will most likely just leave her high and flat. Feeding curves while you can to hold a dose is certainly a technique we use often here, especially with kitties like Esse that need to train their livers.

 

[Cassandra and Sasha]

Re: 1/16: Esse PMPS=285 +3.5=85 3.75=73 +4=71

what I am is worried she'll drop and bounce...or drop and go hypo.

She is going to drop and bounce, as that is part of the liver training everyone goes through with Lantus and Lev. It just is. Everyone has to go through it, unless the liver was trained on the previous insulin (like Sasha's was). No way around it. Dropping the dose does not solve it.

Hypo....have to try and get you over that fear. There is a reason we all say we haven't seen one happen to a cat in LL....it just is that rare. Low numbers are low numbers and they will happen. But there have been so many cats through LL that have registered in the 20's or LO and are completely asymptomatic. Clinical hypos just are not something that are seen here, again, at least in my time in LL.