? 3/31: Sammy - AMPS 85; +6.5 142; +9.5 131; PMPS 89 (Fluids); +2 67; Dosing??? 2nd Inverted Curve

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Tina & Sammy

Tina & Sammy

Member Since 2010
Yesterday's Condo

Good Morning LL,

Last night I decided to try a decrease in Sammy's dose. We technically still had 1 more day at the previous dose before we could take a 14 cycle in normal numbers reduction, but I was getting concerned about the mid cycle highs before coming down at PMPS. Now, I do know that some cats can take a double dip on Lantus, but I thought the difference in numbers was a bit too high for a double dip.

I had read in another post that sometimes when cats get too much insulin they have an inverted curve. I don't think Sammy had that specifically, but I was still concerned about the mid cycle highs.

So I decided to try the decrease. I was either going to work or not, but without trying it I would never know. So far it seems to have worked, but we are still working on the depot a bit. My plan is to hold this dose for 14 cycles, unless I continue to see mid cycle highs after 6 cycles, which is when the depot should be emptied from the higher dose. If I continue to see the mid cycle highs then I will probably try the last decrease to .1u and then hold that for 14 cycles unless the mid cycle highs continue. I know this isn't normal Protocol, but we all know that ECID.

Last night he still had a mid cycle high, but it wasn't as high as some of the others. Usually the day time mid cycle are higher than night.

Sammy's appetite have been good, but I started sprinkling on or two Origin Wild Boar Freeze Dried Cat Treats on his food and he gobbles the entire thing down. He usually eats fine, but sometimes leaves a bit left over and then goes back later. With the cat treats he just eats it all at once, but remember I am still doing MiniMeals, no more than about an ounce of food at one time and then I spread the food out over the entire cycle. Right now I am feeding at AMPS, +2, +4, +6 (or so), +9 (or so). I have also been leaving the last snack out and if he doesn't eat it before +10 I haven't been too worried. So far it has worked for us.

Sending healing vines out to everyone.
 
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Things have not gone exactly as planned today. Sammy has done nothing but go up today, but he hasn't really been eating much today. When I went home at +6.5 I did give him some Famotadine and he did eat a bit about an hour later. I will be going home again at +9.5 to test again and hopefully stimulate him to eat again. He always tends to rise when he doesn't eat so I am hoping we see a lower number later.

It is a Fluids night so hopefully that will help bring down the BG if it just continues to rise today.
 
We did see a slight drop at +9.5, but not as much as I would have liked. He didn't eat much while I was home, but about a hour later he finished off his snack. I will be heading home shortly for PMPS and I am hoping to see a much lower number.
 
I am even more concerned about the inverted curve today. He never even went down this morning he just went straight up until after +9.5 and he came back down for PMPS. Now I will say that he didn't eat all that well today. I don't know if he had an upset stomach or if he was just bored with the food. I did give him a tiny bit of the Max Cat tonight, against my better judgement, but I needed to get him to eat, and it was really only the tiniest bit and he did eat it right up.

So I am wondering if the inverted curve was due to not eating or because he is getting too much insulin.
 
I am wondering of we should reduce the insulin again, keep it at this dose or discontinue all together at this point.
 
By the way, this is the second inverted curve in a row. Last night he had an inverted curve also, it just wasn't as dramatic as it was today.
 
I'll just throw out what I'm thinking and let you consider it. Hopefully others will add their 2 cents worth as well.

I don't think i'm seeing an inverted curve. Most of the time it looks to me like a rise at the end of the cycle. Today is a little bit different and it looks to me a little like a mini-bounce. I wonder if he got lower last night. It looks like he was coming up at amps/85 and since he was at 82 at pm+95, he may have gone lower after that 82. Sometimes cats give a last hurrah on bouncing and you'll see something like this, just a few hours of being higher. No way to know and I certainly wouldn't stress about it, but it just makes me wonder.

If I were guessing, I'd guess he has an early nadir. I see several around +3-+5. Nadirs do move, though, and it's rarely consistent all the time. I'm just wondering if his eating post mid-cycle during the days is contributing to the higher numbers later in the day cycle. Feeding at +9 is one of those things that can work sometimes and not other times, depending on the phase the cat's in. I'm just wondering if maybe Sammy isn't quite ready for that +9 feeding at this point. You might try feeding him everything before +5 or so in the day cycle tomorrow and for a couple of days and see if it changes the second half of the cycle. Sometimes if cats eat in the second half of the cycle it drives up the BGs towards pmps because the insulin is waning at that point.

As far as the difference between the day and the night cycles, so many cats have their lowest numbers at night that it might explain the difference between the 2 cycles.

Anyway, some musings from looking at his ss. See what you think.
 
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