What would you consider a big drop?

[Tuxedo Mom]

Is there any % increment that would be considered a big drop. I know with higher numbers a drop of 100 or more points in an hour or so is considered a big drop. But what % would that be at lower numbers. Obviously if your kitty starts at a PS of 100 a 100 point drop would not factor in. Any opinions???

 

[BJM]

50% of the pre-shot seems about what we consider a big drop for ProZinc. Of course, the cat decides - if they bounce, it was a big drop, no matter what we thing!

 

[Tuxedo Mom]

50% of the pre-shot seems about what we consider a big drop for ProZinc. Of course, the cat decides - if they bounce, it was a big drop, no matter what we thing!

Thanks for the reply. Would Levemir fall into the same category as Pro-zinc? And how much time would have to elapse between PS and the 50% range for drops?

 

[BJM]

No Lantus and Levemir work differently as they are depot insulins. With them, you check at +2 to see if there was a food spike or level from pre-shot numbers, vs a drop of maybe 100 mg/dL or more. The latter suggests it will be an active cycle (fast drop in numbers, possibly heading too low).
What is it you are trying to determine?

 

[Tuxedo Mom]

No Lantus and Levemir work differently as they are depot insulins. With them, you check at +2 to see if there was a food spike or level from pre-shot numbers, vs a drop of maybe 100 mg/dL or more. The latter suggests it will be an active cycle (fast drop in numbers, possibly heading too low).
What is it you are trying to determine?

I know with my kitty if he is coming down from a high..say 300 for example..then a drop of 100 in 1 or even 2 hours is something to keep an eye on. But is say he started at 150 then a drop of 100 is definitely not in the same category, So there must be some sort of average % drop n the first hour or two that should be a red flag. I guess I am just trying to get mathematical figurations on what is a WOW and what is a HOLY WOW. So again my original question is what % drop at what timing constitutes a red flag watch closely situation. I hope I have explained the question correctly.

 

[manxcat419]

Unfortunately, that's probably one of those "it depends on the cat" things. Most of the time with Rosa, if she dropped more than 15-20% by +2 I knew it would probably be an active cycle. But there were two occasions where she either didn't drop at all (well, 2 points) by +2 or actually went up and then still went low a couple of hours later. And a few times when she dropped really quickly the first 2 hours and then just leveled out and didn't go much lower at all.

 

[Tuxedo Mom]

Unfortunately, that's probably one of those "it depends on the cat" things. Most of the time with Rosa, if she dropped more than 15-20% by +2 I knew it would probably be an active cycle. But there were two occasions where she either didn't drop at all (well, 2 points) by +2 or actually went up and then still went low a couple of hours later. And a few times when she dropped really quickly the first 2 hours and then just leveled out and didn't go much lower at all.

Thank you for your input. I know I have read that if the +2 is the same or lower than the PS then there is a good chance that the cycle will be active. I know that our kitties never follow any sort of pattern, but I was just curious to get some sort of "roundabout" % that should give a heads up warning as far as the rest of the cycle. It would be SO much easier if our kitties read the rules and followed them

 

[manxcat419]

It would be SO much easier if our kitties read the rules and followed them

Wouldn't it just!! I think my least favorite were the cycles that looked like they'd be fine because the numbers were the same or a bit higher at +2, quickly followed by a crash into reduction numbers. Those were real "what the @!*$ just happened" moments! But fortunately those happened less often than the usual signs we're told to look out for. It was definitely 15% or more for Rosa, though of course Tuxie might just have his own "watch out" percentage, but it's maybe somewhere to start when you're thinking about what to look out for at least.

 

[Tuxedo Mom]

Wouldn't it just!! I think my least favorite were the cycles that looked like they'd be fine because the numbers were the same or a bit higher at +2, quickly followed by a crash into reduction numbers. Those were real "what the @!*$ just happened" moments! But fortunately those happened less often than the usual signs we're told to look out for. It was definitely 15% or more for Rosa, though of course Tuxie might just have his own "watch out" percentage, but it's maybe somewhere to start when you're thinking about what to look out for at least.

Thank you for sharing your experiences. I know my Tuxie has never read the "rule book" so I can't count on rules and "normals" with him., but at least having some sort of idea what may be happening is better than nothing. Tuxie has done flat high numbers then a nose dive, so there is no rule, but this morning for some reason I had a "feeling" that the cycles were going to be busy today and I was right. It would be really nice is there was actually some sort of guidelines that our kitties followed...wishful thinking!

 

[julie & punkin (ga)]

I know I have read that if the +2 is the same or lower than the PS then there is a good chance that the cycle will be active.

Hi Mary Ann,

That +2 comment applies to Lantus only, and only to some cats. It's because Lantus typically has an onset of about 2 hours in most cats, so if the cat is dropping BEFORE the Lantus has onset, then that's a red flag for the person to be more on top of things than usual. There are some cats that typically have a lower +1 and +2 than their preshot, and that's just their pattern, so for them the comment you quoted above wouldn't apply.

With Levemir, the typical onset is about 4 hours, meaning that it begins to work to lower the blood sugar starting about 4 hours after the shot. So the +2 is basically meaningless. In that case, it would be the +4 that would be more significant.

But these are generalizations that might or might not apply to Tuxie. You'll have to look at his cycles and see if you can discern when you can see the Lev beginning to work to lower his blood sugar. Some cats on Lev have their nadirs around shot time, so roughly 8 hours after the Lev may have onset. That's one reason why those on Lev have to become used to shooting lower numbers, because they are sometimes shooting the very lowest number of the cycle, although that shot being given might not start doing anything for 4 or even more hours after it's given. You're shooting that distant number hours away, not the test you've got right when you are shooting.

Your question about what is a fast drop - certainly anything over 50 point per hour would be considered fast. It's not a percentage, but a flat #. Cats that have their insulin onset from a lower number won't usually drop as fast or as far as a cat starting from a higher number. The difference between shooting a high number and a low number is much like the difference between playing regular golf (the ball goes high and far) and mini golf (the ball stays mostly flat and doesn't go very far.) Both Lantus & Lev have the ability to give a flat cycle - one that might only move 10 points in the entire 12 hours. That comes from keeping the cat's blood sugar tightly regulated in normal numbers.

 

[Tuxedo Mom]

Hi Mary Ann,

That +2 comment applies to Lantus only, and only to some cats. It's because Lantus typically has an onset of about 2 hours in most cats, so if the cat is dropping BEFORE the Lantus has onset, then that's a red flag for the person to be more on top of things than usual. There are some cats that typically have a lower +1 and +2 than their preshot, and that's just their pattern, so for them the comment you quoted above wouldn't apply.

With Levemir, the typical onset is about 4 hours, meaning that it begins to work to lower the blood sugar starting about 4 hours after the shot. So the +2 is basically meaningless. In that case, it would be the +4 that would be more significant.

But these are generalizations that might or might not apply to Tuxie. You'll have to look at his cycles and see if you can discern when you can see the Lev beginning to work to lower his blood sugar. Some cats on Lev have their nadirs around shot time, so roughly 8 hours after the Lev may have onset. That's one reason why those on Lev have to become used to shooting lower numbers, because they are sometimes shooting the very lowest number of the cycle, although that shot being given might not start doing anything for 4 or even more hours after it's given. You're shooting that distant number hours away, not the test you've got right when you are shooting.

Your question about what is a fast drop - certainly anything over 50 point per hour would be considered fast. It's not a percentage, but a flat #. Cats that have their insulin onset from a lower number won't usually drop as fast or as far as a cat starting from a higher number. The difference between shooting a high number and a low number is much like the difference between playing regular golf (the ball goes high and far) and mini golf (the ball stays mostly flat and doesn't go very far.) Both Lantus & Lev have the ability to give a flat cycle - one that might only move 10 points in the entire 12 hours. That comes from keeping the cat's blood sugar tightly regulated in normal numbers.

Thank you for the in depth explanation.

The reason I was looking for some sort of "formula" was for example July 3...Tuxie dropped only 45 points in 2 hours from 155 to 110, but for him to drop in the first 2 hours is unusual. That was approximately a 40% drop which, for me, sent up red flags as far as monitoring him. That was the night he ended up with a nadir of 56 (on AT2 meter). So obviously this did not fall into the 50 point per hour rule. That is why I was trying to get some sort of % drop, especially when the numbers are not really high. I guess more like an early "warning system" for a potentially active cycle.

Sometimes I do believe I over-think everything. ECID and Tuxie certainly does not follow the rule book. Thank you for your well detailed reply and explanation. I think with the amount of testing I do I shouldn't get caught off guard, but it would be nice to be away from testing for 5 or 6 hours at a time. Maybe when I become less OCD about Tuxie's numbers.