12/28 Need advise for Lily

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Sally and Lily GA, Dec 28, 2020.

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  1. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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  2. tiffmaxee

    tiffmaxee Well-Known Member

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    Yes. I would go up to .25. You don’t want to hold a dose longer than 7 days unless it’s a good dose. She’s seeing nadirs in the 100’s but you want to see Nadirs under 100.
     
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  3. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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    Thanks Elise. Will increase tonight then.
     
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  4. Critter Mom

    Critter Mom Well-Known Member

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    Hi Sally,

    Hope your Christmas went well. :)

    I've been keeping an eye on Lily's spreadsheet as usual, and agree that the dose needs to be increased to 0.25IU. According to SLGS, the dose should have been upped a couple of days ago but I didn't suggest it earlier because Christmas. With the dose increase you may well need to monitor more intensely if Lily's response is very strong. Trying to do that on top of all the yuletide stuff might have been a bit too much of an ask.

    BTW, I think that the pinks you have been seeing may have a bit of a bouncy element to them, and I do wonder whether sometimes Lily might be dropping a little lower in the second half of the PM cycle.

    How is Lily doing with the timed feeder now?


    Mogs
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  5. tiffmaxee

    tiffmaxee Well-Known Member

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  6. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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    Hi Mogs! Our Christmas was nice. I missed seeing most of the family but did cook for my crew. Hope yours was good too.

    I was thinking the same thing about the pinks. I will set my alarm a few times at night and check her. She now eats great with her feeder, even the +6 that she used to sleep thru. She has gained some weight and is probably back to her 8 lbs now.
     
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  7. Critter Mom

    Critter Mom Well-Known Member

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    I am well aware of this.

    Under normal circumstances I would have posted on Sally's previous thread to suggest the dose increase sooner. For right or wrong, I made an allowance for the demands on people's time common at this time of year. I was concerned that with the larger dose and the associated build-up of a larger depot there was a potential risk that Sally might be put into a position where she might have to drop everything else going on with her family in order to intensively monitor Lily for safety. It was an avoidable risk, and only involved a brief delay before the dose could be increased in a much less pressurised environment.


    Mogs
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    Last edited: Dec 28, 2020
    Reason for edit: Grammar.
  8. Critter Mom

    Critter Mom Well-Known Member

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    Glad to hear that you had a nice Christmas in spite of covid and the fact that you couldn't get together with the rest of the family. Patty told us how sad she was about that too.

    Delighted to hear that Lily's getting on better with her feeder now and, better again, that her weight is improving. (((Lily))) :cat:


    Mogs
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  9. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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    Thanks so much for keeping up with us Mogs!!!!
     
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  10. tiffmaxee

    tiffmaxee Well-Known Member

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    I wasn’t criticizing you. I was pointing this out for Sally.
     
  11. tiffmaxee

    tiffmaxee Well-Known Member

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  12. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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  13. Critter Mom

    Critter Mom Well-Known Member

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    I always think it's better to start with a dose increase on a daytime cycle (assuming that BG monitoring is a given).


    Mogs
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  14. tiffmaxee

    tiffmaxee Well-Known Member

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    I always increased in the morning too. Max didn’t always respond to the first increase though. :confused:o_O
     
  15. Critter Mom

    Critter Mom Well-Known Member

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    Just seen Lily's spreadsheet. Bet you're glad you didn't increase the dose earlier this evening, Sally, with your girl clearing that bounce. :) Hope she levels out soon so you can get some sleep. :bighug:


    Mogs
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  16. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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    Morning Mogs! Looks like she is might be headed back up. Do you think I should hold off on her increase?
     
  17. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Hi Sally, Lily definitely needs more insulin. I would take her back up to 0.25U.
     
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  18. Critter Mom

    Critter Mom Well-Known Member

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    Hi Sally,

    Just woke up. Give me a minute to have a look at Lily's spreadsheet. BRB...


    Mogs
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  19. Critter Mom

    Critter Mom Well-Known Member

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    Hi again.

    Lily didn't drop below the 130 last night so there's a lot of room for improvement at nadir. As Bhooma says above, the increase to 0.25IU is definitely indicated so I'd go ahead with it this morning.

    Based on previous days, Lily might bounce a little today.

    You OK with this, Sally?


    Mogs
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  20. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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    Yes I am fine with it. I will be able to test her as much as needed. I want o see those blues and greens! Thanks!
     
  21. Critter Mom

    Critter Mom Well-Known Member

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    Boing! Your girl's trampolining again, I see. ;)


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  22. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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    Yes, looks that way.
     
  23. tiffmaxee

    tiffmaxee Well-Known Member

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    I’m glad that you took the increase. I hope you start to see blues and greens.
     
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  24. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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    :) Thanks Elise!
     
  25. Critter Mom

    Critter Mom Well-Known Member

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    You doing OK, Sally? I notice that Lily looks to be clearing that bounce big time.

    Remember that if you need help and FH is quiet, try tagging Bhooma (Bandit's Mom) or Bron (Bron and Sheba (GA) ). NB: Sometimes tags don't go through so you could also try sending them a PM with the link to your thread. Also, you can always try posting for help on the Lantus board.


    Mogs
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  26. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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    Yes, we are doing well! Thanks for the reminder Mogs, hope she will level out but I will keep checking her tonight. Have a great night and really appreciate you!!:bighug::bighug::bighug:
     
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  27. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Hi Sally, just an observation. Even with SLGS, you held onto the 0.1u a little longer than you needed to, after 7 days of the same dose, and nadirs above 150 you can increase. You are testing enough to get a sense of how low the dose was taking Lily. Best not to let her get too used to the higher numbers. Good luck with the increase :)
     
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  28. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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    Thanks Christie!
     
  29. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Good luck with the increase :cat:
     
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  30. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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    Thank you!!:)
     
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  31. Critter Mom

    Critter Mom Well-Known Member

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    Hi Sally,

    Happy New Year to all of you.

    I've been following along as usual and I notice that Lily's in higher numbers again. There's been no obvious trigger for a bounce so I am wondering whether it's possible you might be seeing something referred to here as New Dose Wonkiness (NDW). Here's info about it:

    https://www.felinediabetes.com/FDMB/threads/new-dose-wonkiness-ndw-and-failed-reductions.46012/

    While it's more often seen a bit sooner after a dose increase, as the first couple of posts in the above thread advise, the phenomenon may occur several days after a dose increase. In particular, there's a recommendation to be alert to the possibility that there may be a sudden improvement in numbers as the dose 'settles'.


    Mogs
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  32. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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    I was wondering why I haven’t seen any improvements in Lily’s BG ! This would explain it. Thanks for watching out for us Mogs!! Happy New Year!!
     
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  33. Critter Mom

    Critter Mom Well-Known Member

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    Hi Sally,

    There's no guarantee that NDW is what's going on here, but after bouncing it's the next thing to consider, especially as one needs to be watchful for an improvement as the dose depot gets better established. Remember that infections and the like can also elevate BG levels (but hopefully that's not the case here!).

    While I'm here, would you consider moving onto the Tight Regulation dosing method? It is a more aggressive protocol (doses increased faster, reductions earned when BG goes below 50 instead of the 90 threshold used in SLGS) but you're testing frequently enough and if Lily keeps sitting in this higher range it might be the better way to proceed.

    Here's the link to the dosing methods sticky so you can review the differences:

    Lantus Dosing Methods: SLGS and TR


    Mogs
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  34. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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    Yes Mogs, we can move to TR if you recommend. I want to do all I can for Lily and do appreciate your input!
     
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  35. Critter Mom

    Critter Mom Well-Known Member

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    Hi Sally,

    I'm going to tag @tiffmaxee to ask her to please review your spreadsheet and ask her whether she thinks NDW might be at work here (in which case it might be better to hold the 0.25IU dose for at least a couple more cycles to see whether it will clear and BG levels improve) or whether to make the switch to TR in the morning (in which case tonight will be the 6th cycle on 0.25IU and, in line with the TR guidelines, the dose would be due for an increase to 0.5IU starting tomorrow morning).

    How do you think you'd like to play things yourself, Sally? (Remember to take into account how you're fixed for monitoring if considering the dose increase tomorrow - you haven't had time to plan for it, so I thought it best to check how you're set.)


    Mogs
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    Last edited: Jan 1, 2021
    Reason for edit: Grammar.
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  36. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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    Sounds good. I am good to monitor in the morning.
     
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  37. Critter Mom

    Critter Mom Well-Known Member

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    PS: To cover all bases:

    ... unless it's a really, really long one from that 130 nadir on the PM cycle of 28 December. (Lily typically clears them a bit faster than this, but tonight's PM cycle is still within the normal maximum of 6 cycles that it can take a bounce to clear.)


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  38. tiffmaxee

    tiffmaxee Well-Known Member

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    Hi ladies. I think it’s been too many chucks for NDW. If you don’t see better numbers I would increase in the morning. If she comes down then hold for a total of 10 cycles.
     
  39. Critter Mom

    Critter Mom Well-Known Member

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    Thanks, Elise!


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  40. Critter Mom

    Critter Mom Well-Known Member

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    Sally, at what local time do you give insulin in the mornings, and also can you please remind me which US time zone you're in?


    Mogs
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  41. tiffmaxee

    tiffmaxee Well-Known Member

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  42. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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    7 am Eastern time zone
     
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  43. tiffmaxee

    tiffmaxee Well-Known Member

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    So if in doubt at amps tag @Bandit's Mom okay? I’m on the west coast so I’m not up.
     
  44. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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    Yes, will do thanks so much Elise!
     
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  45. Critter Mom

    Critter Mom Well-Known Member

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    Good to know. I'm also hoping to be around in the early part of the cycle and I want to set an alert on my tablet.


    Mogs
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  46. tiffmaxee

    tiffmaxee Well-Known Member

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    Better go to sleep soon then. Just saying. :confused:
     
  47. Critter Mom

    Critter Mom Well-Known Member

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    :p

    OK, I can take a hint! Reaching for the meds... ;)


    Mogs
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  48. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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    :bighug::bighug:Thanks Mogs!
     
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  49. Bandit's Mom

    Bandit's Mom Well-Known Member

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    That's 5:30pm for me today. Will watch out for your post. :)
     
  50. tiffmaxee

    tiffmaxee Well-Known Member

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  51. Sally and Lily GA

    Sally and Lily GA Well-Known Member

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    Thanks! :)
     
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  52. Critter Mom

    Critter Mom Well-Known Member

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