4/27 Eeyore PMPS+10=427 AMPS=487 PMPS=443

Daily Digest:
PMPS+10=427
AMPS=487. Evo out, shot 2U.
PMPS=443. Sigh
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Yesterday's condo: viewtopic.php?f=9&t=12988

Morning, LL!

He's sky high at +10, so...who knows where he'll be at AMPS. Food still in the bowls, so I don't think anyone bottomed out last night...

I really wish I could understand why he does these giant bounces (seemingly daily), you know? Just don't really have any idea what I'm doing wrong, or why he's doing these big bounces daily. I'm sooo hesitant to increase his dose because his lows are low enough; it's just the high at the beginning and end of the cycle that I don't quite understand.

If anyone has any ideas, or suggestions, I'd love them...

Best-
Michele

Re: 4/27 Eeyore PMPS+10=427

I hope someone will come along after looking at his SS and be able to give you some ideas...he does swing a lot, doesn't he?
Good chance that he is going into greens when you aren't around. When are you off again...is it Friday? Maybe check his mid cycle levels then to see how low he is going on this dose....

Re: 4/27 Eeyore PMPS+10=427

Hi, just dropping in to see how you and the sweet Eeyore are doing.

Is this the first new pen/cartridge you've opened since he came to you? If so, maybe after a few cycles you'll see some change.

The problem is duration, and one would think he's been on Lantus long enough to build up duration. The idea that pops into my head would be to try a different insulin--Levemir. That is, if you don't see some change from this pen.

Re: 4/27 Eeyore PMPS+10=427 AMPS=487

He's 487 right now...sigh. I have done a lot of midcycle testing at this dose, and he is usually down in the low 100s or green...

I've thought about doing a t i d dose, because he does see the action from lantus. It's almost like it wears off too fast; which is the reasoning behind the t i d dose. I'm not sure...I will have time this weekend to see how that works, so I may give it a shot and see if that does anything.

I suppose I could switch insulins, too...just am not certain about Levimer...ah, learning curve, thy name is "challenge"...

Other than that, Ms. V, Eeyore is simply darling and wonderful. A great addition to the household, a great buddy for Malachi, and a wonderful snuggler for me. No regrets whatsoever.

Best-
Michele

Re: 4/27 Eeyore PMPS+10=427 AMPS=487

You're using vials, right? How old was the previous vial?

What I've seen with Gabby is that the pen may look fine but for whatever reason, she seems to "know" when it's after 28 days. Her numbers get wonky. There will be drops, which says the insulin is OK, but there will also be highs -- the action of the insulin is inconsistent with what I had been seeing previously. Let's see what happens with Eeyore's numbers with the new insulin. If it's a matter of the insulin, it may take a few days for the shed to refill.

Re: 4/27 Eeyore PMPS+10=427 AMPS=487

Yes, Sienne, I'm using vials (I like them, a lot!!). Eeyore and Esse are using the same vial, so if her numbers don't come down, I'll suspect the insulin.

But Eeyore gets the drop - it just doesn't stay for long. I so don't know what to think...I'm tempted to take him off all insulin, give him a fresh start after a few days off it...I just don't quite know what to think about this whole thing.

Best-
Michele

Re: 4/27 Eeyore PMPS+10=427 AMPS=487

I have no idea what to say about those swings, Michele. I have no idea how you can sneak up on a liver and get it to calm down. But I wanted to say hi and wish you the best.

Re: 4/27 Eeyore PMPS+10=427 AMPS=487

Hi Michele, I only have a few minutes, but I saw your posting about Eeyore.
Before you consider an "insulin holiday" read this thread from Think Tank. (Don't be thrown by the title...)

viewtopic.php?f=22&t=9070

I don't have an answer for you about why Eeyore bounces from low to high so much, and it may be some of the things already suggested, lack of endurance or going so low when you are at school, Lantus pooping out ... not sure why, but the insulin holiday has me a little worried. I know you are just brainstorming right now so I wanted you to have some more info to think about.

Hang in there, you are doing a great thing for Eeyore! (((Michele)))

Re: 4/27 Eeyore PMPS+10=427 AMPS=487

Michele and Esse said:

I've thought about doing a t i d dose, because he does see the action from lantus. It's almost like it wears off too fast; which is the reasoning behind the t i d dose. I'm not sure...I will have time this weekend to see how that works, so I may give it a shot and see if that does anything.

Click to expand...

I would have suggested TID, but I assumed your schedule was such you couldn't do that. Back in the old days, before the formality that is now Lantus Land, there were a few cats TID on Lantus/Levemir, some just for weekends.

Re: 4/27 Eeyore PMPS+10=427 AMPS=487

Before jumping to conclusions and dramatically increasing the potential for very low numbers with TID dosing, I'd like to see how a new vial of Lantus works. From Esse's SS, it looked like this bottle was almost 3 mos. old. Some cats will respond just fine to older insulin; some won't. Let's try riding a horse before deciding that riding a zebra is in order.

Re: 4/27 Eeyore PMPS+10=427 AMPS=487

Sienne and Gabby said:

Before jumping to conclusions and dramatically increasing the potential for very low numbers with TID dosing, I'd like to see how a new vial of Lantus works. From Esse's SS, it looked like this bottle was almost 3 mos. old. Some cats will respond just fine to older insulin; some won't. Let's try riding a horse before deciding that riding a zebra is in order.

Click to expand...

I agree. I should have repeated from my first post on this thread...

That is, if you don't see some change from this pen.

Click to expand...

Re: 4/27 Eeyore PMPS+10=427 AMPS=487

hi michele. i was asked to take a look at what is happening with eeyore. my take is a little different than what i've read here today. imo, eeyore is under dose... not by much, but still under dose. before the recent reductions, you were very close with the fat 2u.

personally, i would have slightly increased the dose in an effort to extend duration while using food to manipulate the numbers. in other words, try feeding mini-meals the first half of the cycle to prevent drops below 50 (maybe even 60-70) and don't feed the second half of the cycle. feeding the second half of the cycle only serves to put the brakes on whatever action is left in the cycle. eeyore needs whatever action is left in the second half of the cycle.

we have to remember, eeyore's body is not used to double digits. it's only natural for him to bounce. at this point in his journey, i'd be concerned if he didn't bounce. we need to continue to show him the green until his body stops panicking by dumping stored glucose from the liver into his bloodstream.
kwim?

fwiw, just my thoughts...

Re: 4/27 Eeyore PMPS+10=427 AMPS=487

I started the vial I just finished on 3/23...just about a month ago. So not three months, as someone thought.

I am brainstorming right now. Nothing is set in stone, I haven't decided to do anything about it yet. I want to do something, and soon, but I just haven't figured out the best approach.

I am considering t i d, if only Thu - Sun, and in a few weeks, every day once school is done and I'm getting ready to take the boards and then find a job. So there will likely be some time there to play with the t i d dose.

Jill, at the moment, he does eat most of his food in the early part of the cycle. When in school, I'm outta here about 6:15 am (latest), so have fed breakfast and put down lunch. At night, I feed at 6 pm, and put down more food when I go to bed...about 8. So the food is available early in the cycle, and not much is usually left when I get up at 3-4 am and/or when I come in from class (about 6 pm). He always is back at the bowls by the time I've gotten the food down from the cabinet, and his nose is right in the bowl as soon as food is down. So not much gets left (and don't forget the rest of the herd also needs to eat, too...).

One of the reasons I am considering an insulin holiday is that my vet felt that because there was no sugar in his urine, we were ODing him...at 1 unit b i d. I know smogyi and/or rebound can come from too much insulin...and I know it's a controversial topic. But I'm wondering if, considering he no longer eats dry dog food in a closet (!!!) and is completely transitioned to Wellness and Evo, if he may not need the insulin, or need as much. He is so much healthier than he was 6 weeks ago...totally different beastie. So between the change and clearing of his system from the condition he came to me in, and the vet thinking we're ODing him because of no glucosuria, I'm wondering if in fact he may not have become diet controlled, or that we've missed the correct dose at a much lower level than where he is now.

honestly, I just don't know. I really don't. I don't know if it's the insulin; the food; the timing (either of insulin or food); or sneaking up on a screaming liver with a butterfly net and trying to get it to rellllllllaaaaaaaaaaaaxxxxxxxxx a bit. I just don't know.

Best-
Michele