Re: 01/23 Gentle AMPS 93 +7 107 PMPS 272 +3 254

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Pat or DC and Gentle

Pat or DC and Gentle

Very Active Member
:RAHCAT

8:00AM : Test 44
8:15AM : Retest 49
8:30AM : Retest 93 Shot 3.0 ( new 12hour shot time )
Fed 3% FF LC

9:30AM : PlusOne 86
10:30AM: PlusTwo 71
11:30AM: Plus 3 55
12:30PM: Plus 4 59
1:30PM: Plus 5 57
2:30PM : Plus 6 (SKIPPED)
3:30PM : Plus 7 107
Plans to shoot 3.25 at evening shot (8:30 PM)
8:30PM : PMPS 272 Shot 3.25U
11:30PM: Plus 3 254


Previous:
Goodmorning
No shot this morning yet. His number was low, should we wait to shoot him, should we lower it to 3.25U?
Gentle is doing fine, 5 Ps good! Bkfst FF 3%! :RAHCAT
 
Re: 01/23 Gentle AMPS 44 re test 49

I would retest in 15 minutes. I could not and would not shoot this. I don't know what to suggest for you. Hopefully one of the more experienced eyes will be here by next test. I know the options are skip, BCS, etc. Also has earned a decrease.
 
Re: 01/23 Gentle AMPS 44 re test 49

Wait I'm having problems opening Spreadsheet this afternoon :evil: Ok I'm gonna try and tell you what I would do.........

Yesterday you shot 3.5U on a green PS and it went ok. You have a number below 50 so you have earned a decrease, and considering your cat is on a somewhat larger dose of insulin I would make the decrease .5U, so I would think as long as Gentle is eating normally and you are able to do some spot checks today I would shoot the 3U and get +1 right off. Then let that guide you as to when your next tests should be.
 
Re: 01/23 Gentle AMPS 44 re test 49 retest 93

thanks everyone. he's eating now, and we took the suggestion to go with 3.0 we'll retest at +1 and +2
 
Re: 01/23 Gentle AMPS 44 re test 49

Good luck! I hope the 3U works out...looks like he doesn't bounce too bad. If it doesn't hold then you go right back to the last good dose.
 
Re: 01/23 Gentle AMPS 44 re test 49

you shot the 49?

How long ago was that? Can you test again now? This was probably a dropping number (the rise from 44 to 49 is barely a rise anyway, and was food influenced). He *should* be on his way up now after eating, but I would be sure. You'll want to keep testing until his bounce starts (which it will, but we need to be sure the bounce starts before the insulin kicks in, or else you'll need to intervene with food).

Just to throw my opinion into the mix, I would also suggest a new dose of 3.25 instead of the straight 3. Gentle is a long-time diabetic and is ketone prone. He has only been in "good" numbers for a few days. For those reasons I think Gentle should have to work a little harder for his reductions, so he can maintain his progress and stay in these nice blue and green (but slightly less green than 44!) numbers. Generally our reductions in the LL version of the protocol are done by 0.25 or less.

When you get a new number, please post it in the subject line of your first post, but also post a reply to your first post so you'll get bumped to the top of the forum. Thanks!
 
Re: 01/23 Gentle AMPS 44 re test 49

Libby she shot at 93 I think. I didn't realize that he needed a below 40 to earn a decrease, the SS only went back to January. She was going to test at +1 again which should be soon (about 5 minutes)
 
Re: 01/23 Gentle AMPS 44 re test 49

Morning guys. Libby asked me to look in.

For future reference, if you get a low pre-shot #, you have a couple of options: You can stall (without feeding) and retest in 15 min. You are looking for a rising number and want to be sure it's rising. (A 44 to a 49 is pretty much the same #.) You may need to repeat this a few times. Or, you can give a BCS (big chicken sh*t) dose -- this is a reduced dose and it will effect the shed. You want to try to avoid stalling AND reducing the dose. Or, you can skip the dose.

Because of all of the reasons Libby outlined, skipping is probably not the best of options for Gentle -- or at least not now -- plus it has the biggest impact on the shed of the options noted.

Please post your +1 and depending on the number, you may want to get a +1.5 but definately get a +2 test.
 
Re: 01/23 Gentle AMPS 44 re test 49 retest 93 +1.5 86

Gentle ate FF 3% he seemed to be rising , under the same logic, an 86 might be the same as a 93.
so we should check again in 30 to 60 mins?
we'll switch back to 3.25 for the PM shot

thanks
 
Re: 01/23 Gentle AMPS 44 re test 49

Yes -- shoot the 3.25 this evening (all things being equal and you don't get a low number).

If I may, can I ask you to clarify? Did you shoot on the 93? If so, this is your AMPS number. It's also where the clock started for your PM shot. If I'm understanding this correctly, could you edit your SS to reflect the number you shot on? The 44 and the 49 would be your +12, +12.5 (or whatever the time was). You can either put this in the comments section of the SS if that's most convenient for you.

I'm always cautious so I would suggest testing in 30 min.

FYI, in order to actually see the numbers you are posting, you need to edit the subject line in your first post of the day. A reply in the condo will bump you up to the top of the page but we have to open the condo to see if help is needed. It's why Libby suggested BOTH changing the initial subject line and adding a reply.
 
Re: 01/23 Gentle AMPS 93 +1.5 86 + 2 71

We've now outlined the full scenario in the original post for viewing and will update throughout the day.
Thanks everyone
 
Re: 01/23 Gentle AMPS 93 +1.5 86 + 2 71

You scared me!! I opened the condo and poof! Different first post. (I thought I had hallucinated from lack of sleep and only one double espresso this morning - lol!!). I would give Gentle some LC to nibble on -- 1 or 2 teaspoons -- to keep him surfing.
 
Re: 01/23 Gentle AMPS 93 +1.5 86 + 2 71

Unless you think otherwise, I'd also suggest testing at +2.5 (or definitely at +3) to make sure Gentle is firmly on that surfboard.
 
Re: 01/23 Gentle AMPS 93 +1.5 86 + 2 71

:lol:

Ok that's what I thought. This morning I didn't want to stall to long and decrease the dose on top of it. I saw that yesterday you had shot a nice green and had a good day. I also didn't see much bouncing going on anywhere. I didn't realize in the rush (I was PM'ed to look at this) that you needed a 40 for a decrease, and well a 44 is splitting hairs if it is the same as a 49 then it's also the same as a 39 right? :-D Anyway further back in your SS you had made changes in .5U increments both up and down. Which is what the protocol states as well

If the cat drops below 40 mg/dL once (2.2 mmol/L) Reduce dose immediately by 0.25-0.5 IU depending
on if cat on low or high dose of insulin
Click to expand...

A high dose is >3U
 
Re: 01/23 Gentle AMPS 93 +1.5 86 + 2 71

Sienne and Gabby said:
You scared me!! I opened the condo and poof! Different first post. (I thought I had hallucinated from lack of sleep and only one double espresso this morning - lol!!). I would give Gentle some LC to nibble on -- 1 or 2 teaspoons -- to keep him surfing.
Click to expand...

I came back to follow this and had a similar reaction! I'm glad it seems to be working out well.
 
Re: 01/23 Gentle AMPS 93 +1.5 86 + 2 71 + 3 55

Keep him up on that surfboard! Looks like your gonna have some testing to do today :shock: Your dose is in it's onset now so your going to have to keep him surfing through either when the rebound kicks in, or the dose begins losing it's strength. I hope it is a nice gentle surf and not to much of a rebound (if any).
 
Re: 01/23 Gentle AMPS 93 +1.5 86 + 2 71 + 3 55

I would test at +3.5 (I'm assuming you fed a few bites of LC at +3). Either way, test at +3.5 and let's see where Gentle is going. Are you comfortable with letting his numbers drift down to a bit below 40 so he can earn a decrease?
 
Re: 01/23 Gentle AMPS 93 +1.5 86 + 2 71 + 3 55

Gentle ate a 3oz can of FF LC, finished it off at +3

we are testing again in ten mins. for a +4

and yes, we're going to try and following the numbers, i'm sure he'll break the 40 mark
 
Re: 01/23 Gentle AMPS 93 +1.5 86 + 2 71 + 3 55

i'm sure he'll break the 40 mark
Click to expand...
better make it a 39 or to be safe a 38, but not much lower :mrgreen: Good luck! Boy today is going slow, but it is almost ni-ni for me!
 
Re: 01/23 Gentle AMPS 93 +1.5 86 + 2 71 + 3 55

FYI - Gentle may want to gnaw your leg off, but don't overfeed at this point. The idea is to balance out the food with BG to keep him surfing (or not dropping too quickly) with not getting numbers that reflect a food spike. The other issue is that if you need to feed HC because numbers are running low, you don't want him to be so full that he won't eat. It's a juggling act.

With Gabby, she gets 1/8 of a can of FF about every 2 hrs in the early part of the cycle. If I'm testing hourly because I'm monitoring her numbers, she gets about that amount -- maybe a little less.
 
Re: 01/23 Gentle AMPS 93 +1.5 86 + 2 71 + 3 55 +4 59

Okay, we'll be mindful of overfeeding. After thinking about it, he's already eaten a can and 1/2 of food already today!
I probably won't feed him again until late this afternoon around 2 or 3 depending.

Thanks
 
Re: 01/23 Gentle AMPS 93 +1.5 86 + 2 71 + 3 55 +4 59

Make sure you wear thick pants then, we don't want anyone to lose a leg here! :-D
 
Re: 01/23 Gentle AMPS 93 +1.5 86 + 2 71 + 3 55 +4 59

If necessary, you will want to steer Gentle's numbers with food. So if you want to or need to feed, think in terms of "bites" vs. banquets.
 
Re: 01/23 Gentle AMPS 93 +1.5 86 + 2 71 + 3 55 +4 59 +5 57

From what I can tell, Gentle seems to have his nadir in the latter half of the cycle. I would keep an eye on numbers since he's flirting with the 50s. A bite of food at +6 along with a test wouldn't hurt.

That string of green on his SS is very pretty!! You guys are doing great (as is Gentle) today.
 
Re: 01/23 Gentle AMPS 93 +1.5 86 + 2 71 + 3 55 +4 59 +5 57

Watching all this action! I hope Gentle surfs away the day for you. :-D

Sienne, can I invade the condo and ask a follow-up question on what you said earlier?

You want to try to avoid stalling AND reducing the dose. Or, you can skip the dose.
Click to expand...

I've always wondered: Most of us stall at least for 30 minutes waiting to see a low pre-shot number rise. How long can you stall before you have reached the point where you're stalling AND reducing the dose? Can you stall up to, say, 45 minutes, then decide to decrease? Or should we make that decision about whether to decrease the dose before then?

I hope that's clear.
 
Re: 01/23 Gentle AMPS 93 +7 107

Hi ,
Ran out of room on the subject line, had to erase, but our monitoring is in the body of the original post, which I'm updating as close to hourly as possible!

Thanks
 
Re: 01/23 Gentle AMPS 93 +7 107

What a great surf you have going on!! Great job.

Don't be surprised if there's a bounce into high numbers.
 
Re: 01/23 Gentle AMPS 93 +1.5 86 + 2 71 + 3 55 +4 59 +5 57

Wow! Missed lots of action this morning I see! :shock:

Kathy and Kitty said:
I've always wondered: Most of us stall at least for 30 minutes waiting to see a low pre-shot number rise. How long can you stall before you have reached the point where you're stalling AND reducing the dose? Can you stall up to, say, 45 minutes, then decide to decrease? Or should we make that decision about whether to decrease the dose before then?
Click to expand...

Not sure if this is what you are asking, Kathy, but every minute you stall it is a reduction in dose (late shot = a dose decrease). Sometimes you have to do what you have to do, though. Usually we want to get some insulin in by +14 if you are stalling, as that's when the majority of overlap wears off. It depends on the comfort level of the person shooting, as well as the history of the kitty. In a cat that has recently had ketones a different decision would be optimal than with a cat that had never had ketones. Also have to figure in the ability to monitor. Yes, we don't want to stall and also shoot a BCS dose if at all possible, but if the bean is going to be gone all day and the kitty is not rising, sometimes it is done.


I agree with Libby on the reduction amount. While Tilly does state that reductions on larger doses can be done in 0.5u, virtually no one does that here in LL, particularly not kitties that have been diabetic for a substantial length of time. Those are often the cases that we shave the dose by a drop or two rather than even reducing in 0.25u increments, if they have proven to not hold reductions well. It is far too easy to lose momentum in a long term diabetic even with a 0.25u decrease, and a 0.5u decrease can make momentum grind to a halt in many kitties.

Of course, this is something that Pat and DC will have to determine in Gentle - what works best for Gentle - while balancing the possibility of being ketone prone.
 
Re: 01/23 Gentle AMPS 93 +7 107 PMPS 272

what a day! glad you went with 3.25u for all the reasons previously mentioned.
good luck with the reduction!
 
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