1/22 Baby PMPS 222 +2 182

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Nicole & Baby

Nicole & Baby

Very Active Member
Good morning, Lantus Land!!
This morning Baby was 267 at +11, she was really hungry - so I fed & I do think the AMPS # is a food spike! I have a challenging time not feeding when hungry. Anyway… After today will be 72 hours since we dosecreased, can we go back up to .75 for our PMPS? Or do we wait until the morning? Or do we go someplace between .50 & .75?

QCR Baby had a healthy appetite this morning, was full of energy & playful : ) she was bringing me toys in her mouth as I was stepping out of the shower… the nerve of me to actually have to go tbp!
We are loving life & Sadi (sister) too!

Have a Blessed, Beautiful Day….. So thankful to have a good job to spoil my furbabies, but I am sooooooo happy the weekend is here!! :mrgreen: :mrgreen: :mrgreen:

Yesterday's Condo
 
Re: 1/22 Baby AMPS 303 +3 214 Dosecrease?

Awww, Baby sounds so cute with her fetching. Soo happy to hear that she is feeling good and loving her sister Sadi! Enjoy the last day of the workweek.

Anxious to see what happens with you have a dosecrease :mrgreen:
 
Re: 1/22 Baby AMPS 303 +3 214 Dosecrease?

May I ask why you are changing doses so frequently?

Have you read the protocols about dose changes? Lantus is not an insulin that you want to dose hop on.

From what I see on your ss you were at .75 for 3 days got some low numbers that warranted the decrease and now are at .5 for 2 days. While I don't see any greens on the .5, you also need to give it time to settle in.

And rather than go back to .75 you may want to consider a FAT .50 dose instead.

My guess is that the ideal dose is somewhere between .75 and .50.

So if you feel it necessary to change the dose, make it a FAT .5.

Just my suggestion, I'm sure others will be along with their recommendations.
 
Re: 1/22 Baby AMPS 303 +3 214 Dosecrease?

Awwww, thanks Paige!! Have a Fabulous day off today! Enjoy yourself, do something for yourself & enjoy those furbabies too!!
 
Re: 1/22 Baby AMPS 303 +3 214 Dosecrease?

Hilary, I am changing doses because the dosing advisors have recommended I do.
Yes, I read & research & am making no decisions on my own - every decison I make is based off what Jill, Cassandra, JoJo or others have leaded me to.
 
Re: 1/22 Baby AMPS 303 +3 214 Dosecrease?

Hi Nicole,

I am going to tell you what I have been told so many times. Be patient. I know it is extremely hard, and all you want to do is get those numbers down, but maybe she is all wonky because the dose keeps changing. I can't give you any real advice since I am still new at this myself, but maybe Baby just needs to stay constant for a little bit longer to see where she goes. You might have to increase anyway, but at least you will know if it is the dose and not wonkiness.

I know I mentioned yesterday that Sami was doing some wonky stuff too and I stuck with the dose and was pleasantly surprised. Today, Sami is seeing a little rebound from the lower numbers yesterday, but I am still going to stick with this dose for another day or two to see if she doesn't level out on her own.
 
Re: 1/22 Baby AMPS 303 +3 214 Dosecrease?

Thanks, the only reason I was asking about a dosecrease is because someone said yesterday to allow 72 hours for the #s to balance out & today will be 72 hours.
As far as Baby's dose changing, she has not changed anymore than any other kitty - we stick to the full cycles & amount of doses before increasing her. Again, I take all advice from the dosing advisors - I apologize if people think I am just randomly moving her dose around. That could not be further from the truth.

I hope everyone has a great day & sorry if I upset anybody by asking for a dosecrease.
 
Re: 1/22 Baby AMPS 303 +3 214 Dosecrease?

I think you should stick with the dose at least until the weekend when you get some extra checks in between +4 and +10 your SS is pretty empty during those times on this dose so you really don't know if she maybe has had some lower blues or even green. If after 3 whole days (4 or 5 if you actually get some nice blues) she hasn't improved then you could try fattening up the dose a little. She is definatly going under 200 during each cycle so there is no reason to raise the dose.

Hold each dose for 5-7 days. However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU. Alternatively, if the cat is continuously producing moderately elevated BGs (nadir always >=200 mg/dl), increase the dose every 2-3 days by 0.25 IU ( if the cat is getting a low dose) or 0.5 IU (if the cat is getting a higher dose).

According to the protocol it recommended you hold this dose for at least 5 days as Baby has had nadirs under 200. If she hadn't gone under 200 you could increase sooner. Her Preshots are also not extremely high.
 
Re: 1/22 Baby AMPS 303 +3 214 Dosecrease?

Nicole & Baby said:
Hilary, I am changing doses because the dosing advisors have recommended I do.
Yes, I read & research & am making no decisions on my own - every decison I make is based off what Jill, Cassandra, JoJo or others have leaded me to.
Click to expand...


OK - was just offering suggestions since you were asking for help. I can see that it is not needed here. No problems.
 
Re: 1/22 Baby AMPS 303 +3 214

Thanks, Monique - I appreciate your feeback & input. I had not been getting +4 & +5 because I read this:

"To save cat's ears, really the +8's and +9's and the +4's and +5's are the numbers that yield the least amount of important data once you have well established the nadir in your cat. Yes, get them here or there on spot checks, but do not forget to get the "neglected" spot checks... the very early and very late parts of cycle. They are more useful than most realize."
 
Re: 1/22 Baby AMPS 303 +3 214 Dosecrease?

Nicole & Baby said:
Thanks, the only reason I was asking about a dosecrease is because someone said yesterday to allow 72 hours for the #s to balance out & today will be 72 hours.
As far as Baby's dose changing, she has not changed anymore than any other kitty - we stick to the full cycles & amount of doses before increasing her. Again, I take all advice from the dosing advisors - I apologize if people think I am just randomly moving her dose around. That could not be further from the truth.

I hope everyone has a great day & sorry if I upset anybody by asking for a dosecrease.
Click to expand...
Nicole, I don't think anyone things you are randomly moving the dose. I was looking at your spreadsheet and was a little perplexed at why you increased on Sunday after seeing 88 as a nadir on Saturday. But then I re-read the protocol, something that I have to do often when contemplating changing Sami's dose.

"If nadir blood glucose concentration < 200mg/dL but peak is >
200mg/dL (11 mmol/L)

Increase every 5-7 days by 0.25-0.5 IU depending on
if cat on low or high dose of insulin"

And I realized that Baby still fell within this guideline.

And it is so obvious why you lowered her back to .5 units.

I guess for me I probably would have stayed at the .5 units for a few more days after the nadir of 88, but I can relate to the freak out and the desire to change the dose to bring the pre-shot numbers down.

Anyway, I hope someone comes along to give you some SOLID advice, but if Sami were in Baby's shoes, knowing what I know now, I would probably stick with .5 for at least another day or two to see what happens. But that is just me and what I would do with Sami.

In the end you have to do what you feel comfortable with. If you feel in your gut that you need to increase then you need to do it for your own piece of mind. I know I had those moments and have gone against protocol and the advice of the people on this board, only to find out that I screwed up and I need to slow down, think, make a decision, think again, revise my decision, re-read the protocol, and think again. It is so hard and trying to make a decision can be very difficult and frustrating. After making a decision I always wonder if I made the right decision. So far I have been wrong more than right, but I am getting better, I just need to keep a level head and remember the protocol.
 
Re: 1/22 Baby AMPS 303 +3 214

Yes that is true, if you need to save the ears, but you really don't know when Baby has her nadir (sometimes it takes months to establish a reliable pattern) all the spot checks are important, it is just that many people who have used another insulin before Lantus are used to always checking PS, +4, +6 and PS and they neglect those other times which with Lantus can be useful. So when we say be sure to check those too it doesn't mean forget about the middle ones. I thought maybe they were missing because of being at work.

If you look at yesterday you had a nice AMPS then already at +3 she was going into blue (which at that time the Lantus was just begining it's onset) then you got a pink at PMPS, I suspect that the pink is perhaps a little bounce from Baby having gone into much lower blues or even a green during those hours between+4 and +12. You want to test as much as possibla at random times each day. When I couldn't test as often then I tried to mix up my testing times each day while on the same dose so eventually when I spent 3 days on a dose I had a complete curve (every hour) when I combined the test data from those 3 days.

Day 1 AMPS +1 +9 PMPS +3 +11
Day 2 AMPS +2 +6 PMPS +4 +7
Day 3 AMPS +5 +8 PMPS +3 +10

It doesn't always work out so nicely, life gets in the way, alarms don't go off, numbers go to low and you have to change your stradegy but that's the general idea.

Measuring curves regularly is important, as well as measuring all pre-shots and taking random spot checks. It is important to know that most cats do not have reproducibly-timed nadirs. It also is not uncommon for a nadir to occur at +12 hours after a shot. If you are fortunate to have a cat with a very reproducible response, you can test less often than with a cat that has a varied response.

You don't have enough data yet to know if Baby is predictable or not, and every change you make means the data can change as well. My general observation has been that at higher doses the nadir comes sooner, when I began lowering the dose my cats nadir moved later and eventually he was at his lowest at Preshot!
 
Re: 1/22 Baby AMPS 303 +3 214

Tina & Sami, Monique & Spooky,
Thank you for the wonderful advice - I will leave Baby on .50 for now & then get some +4 & +5s this weekend! I do appreciate you taking the time to review with me & educate me. I will never go against protocol of FDMB, you all have been the absolute best & I never question your judgement or advice on dosing or diet! Thank you!
 
Re: 1/22 Baby AMPS 303 +3 214

I agree with Monique. Baby is too newly diagnosed to have an established nadir, they can move along and Baby is still getting blue on this dose. A few more spot checks this weekend in +4 to +8 range during the day are needed. Also remember, this is a marathon, not a Race. you've only been on Lantus for 16 days. Regulation and probably OTJ will come, but it doesn't happen over night. Baby is doing great for less then 3 weeks on insulin.
 
Re: 1/22 Baby PMPS 222

((((((Nicole))))))) I understand your frustration. This is such a complicated game that we play and we tend to overstress ourselves about our kitties BG numbers. Baby is doing fantastic for only being on insulin for such a short time. Max is going on a year on insulin and we are just now in an OTJ trial. Be patient - her numbers will settle down once her shed has built up completely and you find a comfortable dose for her. But that too will take a little bit of time.
 
(((Lynee and Max ))) Your encouraging words mean soooooo much! Thank you for taking the time to comment & for being positive. We really appreciate it! I hope you & Max have a fabulous weekend!! Congrats on the OTJ trial .... we are cheering for you!!!

:RAHCAT :RAHCAT :RAHCAT
 
Yay Baby a pretty blue :RAHCAT

I hope you have a good cycle, keep up the good work Baby!!! Hang in there Nicole, you are not alone!!!
 
Baby is doing great!! I know you didn't like that pink this morning but look at what Baby did with it. Her numbers came right back down, you got a pretty yellow surf and I'm going to bet you'll see some pretty numbers tonight!

I agree with Heather and Monique - holding the dose a bit longer, because of the blues you are seeing, and trying to mix up some of the spot check times if your schedule permits will fill out Baby's SS. I also realize there are a lot of people who are jumping in and giving advice and making suggestions. Some of the people who are visiting have a great deal of experience and an incredible depth of knowledge. Several of them are the people who walked you through Baby's hypo. These are the people I listen to and rely on and learn from. Take each piece of information offered and do your best to see how it fits with what you are learning and with what you know about Baby.
 
Sienne and Gabby, your words mean so much to me. I was literally in tears this morning when I got some of the feedback - I thought people thought I was a bad mommabean... Thank you for offering support & encouragement to me as a newbie. I am so happy to see her in the Blue & will stick to this dose until I am advised otherwise. I just appreciate that you take the time to care for Baby & I!! Kind words, in a positive way... make us all feel so much better. :YMHUG:

Have a Blessed, Beautiful, Furbaby, Evening.
 
I'm coming in late, after you've already decided what to do, but I agree with holding the dose for at least another cycle or two. The PM blues are a good sign, tonight's cycle looks good, so if she doesn't move to green tomorrow then we might want to go back up in dose. I think I would hold at least through tomorrow's AM cycle though.
 
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