Lucky 7/29- 50% drop at +3

I'm thinking this is too much of a drop by +3, right?

His AMPS was 371 and +3 is 184. Last night on the same dose, almost the same PS, he was 365 at +3.

I'm glad we are finally seeing blues, guess I'll have to wait and see what +6 says.

The +6 will tell you if he's zooming back up or surfing along.

Harley always dropped at +4 and would surf along until about +8, lets hope that is what Lucky is doing.

Okay, +6.5 was 62 so I fed him 3/4 can of Friskies which is higher carb than what I usually give him and I came back home and checked him at +8.5 and it was 139.

So, does this mean he zoomed, or is what happened a good thing? I hope he doesn't shoot back up to the 300's by his PMPS :-|

No, that would not be considered a zoom.

I might be repetitive, so if so please forgive me--but Prozinc "supposedly" has a duration of 12 hours. The insulin is injected and in 12 hours that dose is out of the system. In a perfect world, and we know there is no such thing, the cat would have his lowest bg reading (nadir) at +6 and then would gradually head back up----and then then pattern/cycle would begin again at the next preshot. (nadirs normally occur between+4 and +8)

BUT, what we see is that Prozinc's duration might last less than 12 hours in some cats---so those cats are said to "zoom", or go up rapidly in the later hours of the cycle, because there is not insulin left. It has been depleted. While some other kitties, might actually have a duration a little longer than 12 hours---BUT, it appears that is less likely.

A Prozinc curve should be "U" shaped-- and even though we would like for the kitties to stay at the "nadir" reading, that will not happen without pancreatic function. The goal is to find a dose that will give you the lowest preshot possible without sending the cat into hypo numbers at nadir. You must take the nadir into account when finding your dose. To me, nadirs are as important--maybe more so, than preshots when detemining your dose. But, we like low preshots!!! You have to consider both--preshots and nadirs.

The only way to know if Lucky is zooming at the end of the cycle is to test after his nadir (maybe every hour) and see if you catch a quick and fast up swing in your numbers.

What you have posted from today looks normal and good to me--a good nadir--you fed him and he came up, but not dramatically.

I hope this makes sense!

You might get varying opinions---but, this is how I see the Prozinc insulin cycle.

Okay, so "zooming" means to shoot back up at the end of a cycle. I was thinking of zooming down or something. Thanks for clarifying!

He might actually be a zoomer because I've noticed that he'll be doing really well and then shoot up to the high 300's by the PS. I'll keep an eye on it though.

Edited to say....if I had just read Robins post more carefully, I would have noticed the zooming "back up" part!!! LOL sigh.

You are doing Great! Just keep testing and getting your data...it will all fall into place. He is having a great response to the insulin.

Yup, he zoomed. Am I right? His BG a little more than doubled in 2 hours.

+10.5 is 340

+8.5 was 139

Sorry if I wasn't clearer.

That was a big drop from PS to nadir, it wasn't too low, just a big drop so you may see a very high PMPS called a bounce. Do not react to a bounce and shoot more insulin. Actually I would back down to 1u so you don't start a vicious cycle of big drops and high PS's.

Or you may end up with a low PMPS, then you need to come back and ask, you will probably need to lower your dose.

Just my 2 cents.

Something obviously happened....either his liver panicked at the low 62 and dumped "sugar" to protect him or it is a zoom.

Let Robin or Joanna give you an explination---but, yes that is a fast upward swing. It will now be interesting to see if he surfs where he is, continues to go up, or comes down a little before your preshot. That will also give you good data concerning what is happening.

You are doing great!

That fast upward swing could be a combination of things working. A reaction to the drop + the higher carb food + the insulin giving out. Since it seems he usually gives you a late nadir, and might have gone lower than 62 had you not intervened with food, I'd back down to a solid 1u and hold it there for a few days to see what comes.

Lately I have personally been calling my Oscar the Mazda kitty "zoom - zoom - zoom"! (both up and down *sigh*)

That is not a zoom from insulin poop out. That is a bounce from the steep drop and higher than ususal carb food.

When he got to a bg of 62 which is a normal non diabetic number his liver saw it as a hypo because he hasn't seen a number that low in a long time so his liver dumped sugar to protect him so it is an inflated number.

I would go with 1 unit and ride out the bounce.

I shot a fat 1u tonight. His PMPS was 363. We keep going through this cycle of dropping too low and then bouncing, then lowering and then his nadirs are too high, then I increase dose, he bounces, decrease dose, nadirs too high....you get the picture. So is it okay to keep going through this cycle?

The whole reason I increased to 1.1u is because he wasn't responding as well as he could have to 1u. I just can't believe just a .1 difference causes such a dramatic drop and bounce. But we'll see what happens on the 1u tonight.

I have family that just came into town today. 3 adults and a 2 yr old. Lucky is already freaking out. I imagine his BG is going to be a bit higher for at least a couple of days till he gets used to them being here. They leave on the 8th.

A lot of times after you have a cycle that has a "bounce" it will take a couple of cycles for the numbers to come back down. So, don't be alarmed if you see a high cycle tonight--that is a normal pattern. Don't increase and shoot into the bounce, it will clear on it's own. Good job holding the 1 unit tonight.

Good Luck with the "visitors"----until the 8th???!!!!! :roll:

You are doing great---stay with it!

I'm with the crowd. Stay with the 1u for a few cycles.
As for the company. Try to give Lucky a place to "hide" where people won't bother him and he won't stress out. And don't you stress out either! If you think his increased numbers (assuming you're correct and the visitors will cause stress) are family related, I'd still stay with the 1u. On the 8th or 9th when they leave, his stress will drop. If you've increased the doses during the visit, and the stress is removed from the equation, (his numbers will have been artificially heightened), the result might be numbers that are lower than you were planning on.

I know in the past couple of months, I've had days where the whole dance just had me crazy. Occasionally, my wife was there to talk me out of my tree when necessary, and everything looked better the next morning. Take it one day at a time, or as someone wise recently told me "life can be lived in 12 hour increments."

Carl in SC

Well, it's family that I don't get to see too often. My grandmother, my sister and my niece (who I have never met!), and my mom. My sister and my grandmother are meeting my daughter for the first time since she's been born too! So, it's a good visit lol

As for Lucky, he has totally surprised all of us! He's up here right now just chilling! He's acting completely calm, I wish you guys could see him just laid out in the floor watching everyone...of course the little kids have gone to bed ;-) Now I'm mostly concerned about the civvie who will hide under the bed the whole time and probably won't eat much. She's lost a lot of weight since we switched to wet food over a month ago. I have to coax her to eat most of the time. She's pretty timid.

But about the bounce....so when will I know to increase the dose again? This gets confusing! Just when I think I have a plan, something changes :roll:

You will know when the bounce clears, it will show in your numbers---they will get lower. Sometimes it clears the next cycle, but normally not. His body will get accustomed to the lower numbers the more he sees them and eventually he will accept them and quit bouncing. One of the biggest mistakes people make (including me!) is increasing your dose on the bounce---it only makes it worse! If you don't notice when the bounce has cleared, people here will be able to tell you-- just keep the SS updated. I would hold the 1 unit for a few cycles. It gets confusing, but there is help here---so, just keep getting your data.

You really are doing a great job!

Enjoy your family!

OK, I am going to attempt to expain this whole process the way that I think it works. And don't take this for gospel by any means. I'm an amatuer and I'll probably say something wrong. Luckily there are lots of people with a great understanding of diabetes that can correct anything I mis-speak on.

Basically, Lucky's pancreas is screwed up. Which is why you have to give him the insulin that his pancreas is supposed to be producing. During this "dance", his pancreas will begin to heal, but until then, you're his pancreas.
You dose him when he's at say 400, and the insulin pushes down his BG until he reaches nadir. That could be 200, 100 or lower. The lower it goes, the greater chance his body will say "hey, wait a minute, this doesn't feel right at all". It could be a BG that is perfectly normal or higher than normal in a non-diabetic cat. But Lucky is so used to "living high", that his body can't deal with "normal". So his liver decides "hey, I can dump sugar into the blood and "fix" this problem". So it does, and even though you've gotten a nice drop to "normal", it's too much too soon. So his BG 12 hours later is right back where it started. And you're sitting there saying "I don't understand!, It was low, now it's high again. Even higher than it was! What is going on????"
At some point, Lucky's pancreas will begin to heal. Right now, the insulin you are giving him is letting his pancreas "rest and recouparate". When it starts healing, it will supplement the insulin you are shooting. I think at that point, his "curve" will begin to look more flat. You might shoot at 300, and he'll only drop to 150 maybe, then go back up to 275. Once that "flattening" occurs, at that point you might make adjustments to dosages. You might even have to increase the dose so that he starts and ends at 200 and his nadir is in the "normal" range. His pancreas will continue to heal and his numbers will continue to drop at that dose. Once his pancreas is in good enough shape, you'll start decrease his dose and let his body start taking care of itself.
This entire process might take months, or it might just be a matter of weeks. Bob went from almost dead to almost OTJ in about 10 weeks. But, as is said, ECID.

That's my layman's version of how this dance works. Like I said, I might have said some stuff that isn't right, and I'm hoping one of the more experienced and knowledgable members will correct as needed!

Carl in SC

Thanks for the explanation, Carl!

It just gets frustrating because I was holding at 1u for several cycles and it obviously wasn't enough, so I increased. Now because of a bounce, I'm right back down to 1u and I know tomorrow he's going to be higher than I'd like for most of the day....I hope not though.

Joanna and I have been discussing shooting 1.1 on higher PS's for awhile and decreasing a little on lower PS's (like low 200's) depending on the response to the 1.1u. This was an alternative way of tackling the higher BG's and getting the #'s I want instead of sticking with the same dose since I haven't seen a whole lot of consistency on one dose. Basically I'd be picking and choosing dose based on previous results and PS #'s.

I'm going to go to bed and maybe I'll wake up and see things a little more clear. Right now I've got information swimming in my head :dizcat