7/14/10 Harley AMPS 297, +10 383, +14 373

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It looks like last nights increase worked. I hope it holds. I'm going to try to get home at lunch for a midday check.

 

Re: 7/14/10 Harley AMPS 297

Way to go Harley make momma happy Angels watching Prayers coming Green light all around Harley LOL Kath

 

Re: 7/14/10 Harley AMPS 297

Thanks Kath!

Harley & I appreciate your support. I didn't get home at lunch for a spot check.

I'm sure hoping the increase is "his dose" and he sticks with it and doesn't go bouncing around.

 

Re: 7/14/10 Harley AMPS 297

Yay, looks like progress!

Don't stress yourself too much worrying about bouncy stuff and dose increases. Sometimes it just works that way.

My experience has been that there often isn't a "dose" that is perfect - many cats seem to need to move up through the doses to get to good #s, and then once there, they move quickly back down through them. I think it's probably more the lifers who have already gone through liver training who may end up on more of a stable dose ongoing. But really most cats I've seen come through here need some insulin help to get in good #s, then more insulin to knock their livers into submission, and then they go down to tiny doses, or often OTJ. Hard to say which cats won't follow that pattern of course... they like to be tricky, our kitties!!!!

 

Well I guess he's one of the ones that decided he didn't like it afterall.

Ok, more questions. I shot 2 hours late, I couldn't get home in time. Would it be better to have shot 1-1/2 hours early or the 2 hours late and why? My schedule is why Lantus was so stressful because it needed to be more structured. It's usually only one day a week that this happens.

How long do I let this dose settle. I want him out of the 300's before it starts causing other problems.

 

I wouldn't conclude there isn't progress - you don't know what happened mid-cycle, so it's hard to draw too many conclusions. That's actually some really nice hang time til +14, no zooming, which is interesting, and good! Sometimes if they get better #s (which could have happened overnight last night, or during the day today), they will run higher for a cycle or two in protest, so it's possible that's what you're seeing now (I'm not sure, but it's possible - a lot of times you'll see red #s when that happens).

There's nothing magic about how long to hold a dose. You can raise as fast as you want really, and you can raise by 0.5 increments instead of 0.2s if you want. Because you've seen some blues along the way I'd probably stick with 0.2u increases approximately every 3 days, but that's me. If you want to go faster, go for it!

If you do, I would recommend you keep getting spot checks when you can in the early half of the cycle just to be sure you aren't hitting low #s unexpectedly. As long as you know what to do if you get #s that are lower than you want (feed a few bites of LC or HC depending on the #s and the point in the cycle where you are, and if you are seeing scary lows, retest more or less every 30 minutes til you are past nadir time), it's a managed risk.

If it were me, I would probably try to get in a spot test somewhere in the +4 to +7 range, and as long as that isn't in non-diabetic #s, I would go ahead and raise to 1.4u. I can't say that's the only answer, the options are pretty wide open, how long you want to hold the dose is up to you, and also how much you want to raise by.

On the timing, PZI is really flexible - you always want to shoot on a rising # past nadir time. If you shoot early, you lower the dose a bit to compensate, and if you shoot late you can raise the dose a bit to account for the loss of overlap. With Bix, if I shot anywhere around +11 to +13 I would keep the dose the same, at +10 I would lower maybe by 0.2u, and if at +14 raise by maybe 0.2u. With Bix, on a late shot he would almost always run high, even with the increased dose, and the next PS would be high, and sometimes it would take a couple cycles after that to get back on track.

On the whole, I like shots that are a little early, especially when they are in higher #s, sometimes a shot at something like +10 can make all the difference in gaining some overlap with the last shot, and sometimes you can get really good results off that. If you shoot at +9 or earlier, I would definitely reduce the dose a bit, since the results can at times be dramatic. And if you shoot then, you want to test to be sure the #s are rising. A lot of people have used early shooting strategies with PZI to get the #s down, even when they don't need to schedule-wise. For a lot of cats, PZI just doesn't last the full 12 hours and shooting early can really help.

With your schedule, you will probably need to do some experimenting and data gathering to figure out what works best. If you can pick to shoot early over late, I would go with early. But if it's late, no big deal, you will learn how to adjust the dose to get the best effect you can from the insulin.

 

Thanks Joanna,

I wanted to shoot early but since I ran home and tested I wasn't sure if the high # was food spike or not. I picked up the food dishes and left. Now I know that it wasn't food spike and feel more comfortable shooting early next week.

I don't know if I can go home to test until lunch time that day. Sometimes I can and sometimes I can't. This morning I set up a relief backup so I could go home but at lunch time he got called out to the field and couldn't cover me so I couldn't get the test.

Hypo's scare me but the 300's scare me just as much. The unpredictable mid cycle tests make me hesitant to be too aggressive.

I love my Harley Boy and want him to stay with me a very long time (14 years isn't long enouth). But I like being employed and having all of us living living indoors even more.

I guess I'll figure this out eventually with everyone's help.

Peace,
Robin

 

You are doing the best you can and you will seethings coming together Bless you sending Angels and Prayers to help you and Harley LOL Kath

 

Thanks Kath, we appreciate it, keep the angels and prayers coming and I'll send them out to you as well.

Robin

 

,Robin Your welcome and thanks for sending them back welcome them with open arms Hugssssssss LOL