GA Fly free sweet Cooper

Last thread: Dosing thoughts for K T and Cooper

Cooper's SS

Cooper has been on 1.2u for 6 cycles and he has had a couple nice smilies and at least one bounce from pretty yellows. None of the normal cycles had a nadir that was greater than a 50% drop. Therefore, all the cycles support increasing the dose in the next day or so.

My mom, Kathy, would be comfortable seeing a few more "smilie" cycles first, before increasing the dose to 1.4u. She is doing a terrific job wearing her Patience Pants and not rushing to increase the dose!

I've explained pros and cons to her. This includes that we would still consider increasing the dose if we don't see smilies, because sometimes if there isn't enough insulin, the BGs can be high and meandering. The protocol suggests several high and flat cycles mean a dose increase. We just want to avoid increasing the dose while he is bouncing, and mis-interpreting a high bounce value as a "real" high value. That's why we trial a dose for many cycles and let bounces settle out.

At this point, if today and tonight's cycles look like yesterday (a bit of a bounce at AMPS from yellows and a normal smilie cycle at night), then tomorrow morning would be about the earliest we could increase the dose.

What are your thoughts on this? Would you expect to see *no* bounces like yesterday morning for 3-6 cycles before increasing? How "settled" should he be before increasing the dose.

Thanks for your insight!

It would be up to mom @K T and Cooper, but I told her I would post the question to get your perspective deciding a dose increase.

 

Are you asking if you should wait to increase the dose until 6 cycles without a bounce?
He has plenty of room to drop so I would increase the dose. You might see bounces with the higher dose again but holding that dose like she has for the last 6 cycles should be just fine.

 

I agree with Steph. You can try 1.4 u.

 

I agree with both Kris and Steph. I think you have enough room to drop that it would be good to do an increase.

 

Yes. I know we shouldn't increase the dose based on BGs that are elevated due to a bounce, because those values aren't really "real" for dose-deciding purposes. But I wasn't sure if there should be NO bouncing at all.

Thanks @Rachel and @Kris & Teasel, too! We do talking behind the scenes, and I wanted to make sure that the logic I was sharing with mom was in line with what you would have suggested. Just being overly cautious and not making Lantus assumptions. We'll see what Cooper does over the next cycle, and then make a decision.

 

Thank you all for your advise. What would we do without you? We are shooting 1.4 tonight.

 

Looks like it's time to try 1.6 u.

 

Thanks, Kris and Teasel, and @Lisa & Leo for the same (and much appreciated) advise. Increased Cooper this morning.

 

One more dose of 1.6 u tonight and then up to 1.8 u tomorrow AM. You were at 2 u and above when you had blues and greens previously. You'll get back there.

 

Thanks K&T. Am anxious to increase without rocking the boat as we did before, and we will increase tomorrow morning. My question for you and @Lisa & Leo (or any other of the pros) is: Do you have an opinion? Are we high and flat perhaps because the increases are so small, or is it possible his twitchy liver is not being quite so twitchy? Thank for following us. It means a lot.

 

I think you're high and flat because the dose is a bit low. You got some blue on 1.6 u a while ago in the cycles shortly after the greens. The lows can leave him a little more insulin sensitive. Now, several days later, the 1.6 u isn't doing much. Also, sitting in high numbers for a while can create a degree of (reversible) insulin resistance such that an increase in dose is needed to "jumpstart" his responsiveness. I've been through all of this with Teasel.

 

Kris & Teasel - thanks for more insight.

 

Good job with the careful increases. I'd try 2 u tomorrow and be vigilant because this is the dose range where there was some green action previously.

 

Kris, @Lisa & Leo and everyone, Cooper increased this morning to 2U. Will keep an close eye on him. And for the first time since this all started he jumped up on the counter and waited for his shot (and chicken). I am taking it as a good omen! Thank you all.

 

That's great news! These slow, steady increases will pay off in time and I'm glad to hear that Cooper is jumping up and waiting for his shot now! He's getting used to it!

 

Yay Cooper! I am so pleased to hear that he has connected "shot" and "treat" in his head and opted for the treat!

 

Give the 2 u tonight and then think about 2.25 u tomorrow AM. Previously the 2 u dose brought him down quite a bit because he was coming off the lime green you got at 3 u. The lows leave then extra sensitive for a bit. Now, he's a bit resistant because he's been high for many cycles. You need to give careful small dose increases every 3 - 4 cycles to shift him out of that.

 

His +6 was a surprise high. Do you think he might be heading lower in the cycle earlier that we aren't seeing, that caused this like a bounce?

 

It's hard to say. Explaining a single number is almost impossible. Just scan the overall pattern and that gives a much better idea of what's going on. Cooper has been high for many cycles and this suggests either/both too low a dose and/or some (reversible) resistance building because of constant exposure to high BG.

 

I see you jumped in dose from 2.2 u to 2.6 u, bypassing 2.4 u. Should be OK.

 

TYPO!! Yikes. Thanks for hovering over us like an angel, Kris. It was 2.4. Just fixed it.

 

I wasn't sure what your dosing plan was and didn't want to be too "prescriptive".

 

What a valuable tool: being able to study other sugar babies' spreadsheets!

 

Heck, we always suggest folks spend time studying the SS in the remission thread...helps to see how other people dosed and got their cats OTJ.

 

Oh! Okay

 

Well, look at those nice blues today after a no shot!

 

It breaks our hearts to tell you our sweet Cooper is gone. We wanted so desperately to make him feel better, and while he had some good days after his illness and diagnosis they did not last. We finally realized and had to accept that his quality of life was gone. Much as we wanted to keep trying it was not fair to him to go on.

Thank you to everyone, especially our dear @Lisa & Leo, for your advice and encouragement. We wish you and your furry ones love and good numbers.

 

Oh KT, I'm SO SO sorry it was Cooper's time to leave.....BIG HUGE Looooooooong hug. He'll never really be 'gone', you just have to hug him differently.

Soar high on your new angel wings beautiful boy....landing softly back in your family's broken hearts.

 

Oh no! I'm so so sorry to hear about Cooper! It was so clear how much you loved and cared for him. Sending you comfort and peace. May your sweet guardian angel always watch over you.

 

Oh KT! I'm so so sorry to hear that your sweet Cooper crossed the bridge. You did such a wonderful job caring for him and he had love, warm beds, treats, and sunshine. What more could a kitty want?

Fly free sweet Cooper! Your mom and dad love you so much.

 

I'm so very sorry that you had to let your sweet kitty go. It 's a heart breaking decision to have to make.

 

So very sorry for your loss. Fly Free Sweet Cooper, Land Softly

 

So sorry that it was Cooper's time! RIP Cooper!

 

Sorry for your loss.

 

May fond memories of your beloved Cooper warm your heart always

 

Dear Mom and Dad - you did such a terrific job trying to help Cooper feel better. I am so glad I had the chance to come out and visit, and spend a "sugar week" out there with you guys and Cooper and Riley. You learned so much, and tried so hard. The sugar dance can be so encompassing and you were able to step back and see if all your hard work was helping Cooper get better quality of life. Despite all your research, your asking tons of great questions, your surfing the web and FDMB, your studying other sugar cat spreadsheets, your standing up to the vet, it just wasn't something you could fix, despite a very valiant and dedicated effort.

So you chose to let Cooper fly free and find peace.

Thank you for being wonderful fur-parents. Cooper was a very lucky boy. And a handsome one, too.

 

I'm very sorry for your loss.

 

So many years and so many of our babies flying free. We are the lucky ones to have been chosen, aren't we? xo

 

I am a better person from being a fur mom. I am glad that we are able to give them a home and security that will last their entire lives, even though we know we will lose so many of them over ours. xoxo