C
Carl & Polly & Bob (GA)
Guest
Haven't posted here in forever, but I used to do so quite frequently...
You might have noticed three "info" threads that got "bumped" today? First off, thanks to @Jill & Alex (GA) for bumping the first two, on Glucose Toxicity and Insulin Resistance. And the 3rd is about Carryover and Overlap. Three old threads with tons of good information for you to read if you have time. Sort of a "PSA" if you will.
I think what I'm trying to do is encourage people who might not be seeing good numbers (yet), while at the same time trying to share some tidbits I learned in the past four years. One of the people who I have had the pleasure of "talking to" here on the board is Dr. Lisa. Several years back, she posted a few times (see below) in threads of "Lori and Copper" (owlgal). And those posts left a huge impression on me and others here at the time. So much knowledge and wisdom is so few words...
Here are some links to three threads, and things I think are extremely helpful that Dr. P posted at that time:
The first is a good thing to look at when you find yourself at a loss trying to explain what your cat's BG numbers are doing. It isn't just about the dose you are giving. You only have control of two things in this adventure.
1 - the dose amount and timing
2 - the food you put in the bowl.
What happens after that is completely up to your cat. And it sometimes can't be explained by just how much insulin you shot.
Entire thread:
http://www.felinediabetes.com/FDMB/threads/wackiness-s-copper.61241/
Dr. Lisa's post:
http://www.felinediabetes.com/FDMB/threads/wackiness-s-copper.61241/#post-663242
#2 is a long post about "rebound" which is usually called "bouncing" here. And the important distinction as to whether the rebound (the high numbers you might see at preshot) are "warrented" or if they are "unwarrented". Was a bounce caused because the cat actually went "hypo" or just because the numbers dropped lower than the cat's body has become used to after weeks or months of diabetes? It's important because if it is "warrented" than that probably means you might need to lower the dose. If "unwarrented", then you might want to think about doing "nothing" in terms of adjusting the dose. In other words, don't lower the dose just because your cat bounces.
Entire thread:
http://www.felinediabetes.com/FDMB/threads/new-day-after-yesterdays-hypo.58953/
Dr. Lisa's post
http://www.felinediabetes.com/FDMB/threads/new-day-after-yesterdays-hypo.58953/#post-642503
And the last one has several posts by Dr. P, and you should read the entire thread. Good info regarding "repeatability", and why you shouldn't always react to things just because they happen once. Sometimes you might see a wonky number that makes no sense to you. Like a low green number that you haven't seen that just sticks out like a sore thumb in a sea of blue, yellow or pink numbers. The first thing you should do when you see something really ODD is immediately retest. Maybe it was a strip or meter error. But basically, don't ever assume that what happened yesterday will happen again today. And never assume that what happened today is going to happen tomorrow, even though you shoot the same dose all three days. Don't overreact to a "one off" reading. And don't obsess over one number on your spreadsheet.
http://www.felinediabetes.com/FDMB/threads/very-confused-now-what-is-going-on-with-him.57769/
Summed up nicely in one short sentence by Dr. Lisa:
"Look for repeatability before panicking or making any important decision."
There are a few things that I believe, based on personal experience and on reading thousands of threads in the past 4 1/2 years. You may or may not agree, and that's fine.
1 - I think PZI is best used when dosed on a sliding scale based on prior data and your gut feeling.
2 - I do NOT believe that PZI is an insulin that requires that a cat "settle in to a dose". It's a 12 hour insulin, it doesn't work like a "depot insulin" such as lantus or levemir. You shoot a dose, it does its thing, and you start over 12 hours later. YES, there is such a thing as carryover and overlap from one cycle to the next. But it isn't something that happens every cycle, and in some cats, it rarely or never happens. ECID is true, but honestly, most cats are pretty much the same.
3- I don't advocate "micro - adjustments" on dose. Sorry, but I don't believe that there is a definite difference in what you might see as far as numbers go if you are tweaking the dose by .1u. Not that can be proven to be due to that small of a dose adjustment. It is far more likely that the difference in your numbers was caused by one of the many "something else" reasons detailed by Dr. Pierson on a day by day basis. If you are going to adjust the dosage, IMHO it should be by enough so that you can draw some real conclusions afterwards.
I don't give dosing advice primarily because my advice would be seen as too aggressive. And because I addressed Bob's diabetes very aggressively (and it worked for him), I can't tell anyone that they should do it the way I did it. Because Bob was my cat, the treatment was my decision, and I sure could not live with myself if something I suggested led your cat to suffer, or worse. But I truly believe that most cats are dosed too conservatively, and that staying with insufficient doses for too long leads to insulin resistance due to glucose toxicity. I will never again treat a diabetic cat myself. I can't. But I truly wish all the best for you and your sugarbabies. I guess my parting thoughts would be "don't be afraid of insulin, don't be afraid of low numbers, trust your gut instincts and use the data you have spent so much time collecting".
Love to all,
Carl
You might have noticed three "info" threads that got "bumped" today? First off, thanks to @Jill & Alex (GA) for bumping the first two, on Glucose Toxicity and Insulin Resistance. And the 3rd is about Carryover and Overlap. Three old threads with tons of good information for you to read if you have time. Sort of a "PSA" if you will.
I think what I'm trying to do is encourage people who might not be seeing good numbers (yet), while at the same time trying to share some tidbits I learned in the past four years. One of the people who I have had the pleasure of "talking to" here on the board is Dr. Lisa. Several years back, she posted a few times (see below) in threads of "Lori and Copper" (owlgal). And those posts left a huge impression on me and others here at the time. So much knowledge and wisdom is so few words...
Here are some links to three threads, and things I think are extremely helpful that Dr. P posted at that time:
The first is a good thing to look at when you find yourself at a loss trying to explain what your cat's BG numbers are doing. It isn't just about the dose you are giving. You only have control of two things in this adventure.
1 - the dose amount and timing
2 - the food you put in the bowl.
What happens after that is completely up to your cat. And it sometimes can't be explained by just how much insulin you shot.
Entire thread:
http://www.felinediabetes.com/FDMB/threads/wackiness-s-copper.61241/
Dr. Lisa's post:
http://www.felinediabetes.com/FDMB/threads/wackiness-s-copper.61241/#post-663242
#2 is a long post about "rebound" which is usually called "bouncing" here. And the important distinction as to whether the rebound (the high numbers you might see at preshot) are "warrented" or if they are "unwarrented". Was a bounce caused because the cat actually went "hypo" or just because the numbers dropped lower than the cat's body has become used to after weeks or months of diabetes? It's important because if it is "warrented" than that probably means you might need to lower the dose. If "unwarrented", then you might want to think about doing "nothing" in terms of adjusting the dose. In other words, don't lower the dose just because your cat bounces.
Entire thread:
http://www.felinediabetes.com/FDMB/threads/new-day-after-yesterdays-hypo.58953/
Dr. Lisa's post
http://www.felinediabetes.com/FDMB/threads/new-day-after-yesterdays-hypo.58953/#post-642503
And the last one has several posts by Dr. P, and you should read the entire thread. Good info regarding "repeatability", and why you shouldn't always react to things just because they happen once. Sometimes you might see a wonky number that makes no sense to you. Like a low green number that you haven't seen that just sticks out like a sore thumb in a sea of blue, yellow or pink numbers. The first thing you should do when you see something really ODD is immediately retest. Maybe it was a strip or meter error. But basically, don't ever assume that what happened yesterday will happen again today. And never assume that what happened today is going to happen tomorrow, even though you shoot the same dose all three days. Don't overreact to a "one off" reading. And don't obsess over one number on your spreadsheet.
http://www.felinediabetes.com/FDMB/threads/very-confused-now-what-is-going-on-with-him.57769/
Summed up nicely in one short sentence by Dr. Lisa:
"Look for repeatability before panicking or making any important decision."
There are a few things that I believe, based on personal experience and on reading thousands of threads in the past 4 1/2 years. You may or may not agree, and that's fine.
1 - I think PZI is best used when dosed on a sliding scale based on prior data and your gut feeling.
2 - I do NOT believe that PZI is an insulin that requires that a cat "settle in to a dose". It's a 12 hour insulin, it doesn't work like a "depot insulin" such as lantus or levemir. You shoot a dose, it does its thing, and you start over 12 hours later. YES, there is such a thing as carryover and overlap from one cycle to the next. But it isn't something that happens every cycle, and in some cats, it rarely or never happens. ECID is true, but honestly, most cats are pretty much the same.
3- I don't advocate "micro - adjustments" on dose. Sorry, but I don't believe that there is a definite difference in what you might see as far as numbers go if you are tweaking the dose by .1u. Not that can be proven to be due to that small of a dose adjustment. It is far more likely that the difference in your numbers was caused by one of the many "something else" reasons detailed by Dr. Pierson on a day by day basis. If you are going to adjust the dosage, IMHO it should be by enough so that you can draw some real conclusions afterwards.
I don't give dosing advice primarily because my advice would be seen as too aggressive. And because I addressed Bob's diabetes very aggressively (and it worked for him), I can't tell anyone that they should do it the way I did it. Because Bob was my cat, the treatment was my decision, and I sure could not live with myself if something I suggested led your cat to suffer, or worse. But I truly believe that most cats are dosed too conservatively, and that staying with insufficient doses for too long leads to insulin resistance due to glucose toxicity. I will never again treat a diabetic cat myself. I can't. But I truly wish all the best for you and your sugarbabies. I guess my parting thoughts would be "don't be afraid of insulin, don't be afraid of low numbers, trust your gut instincts and use the data you have spent so much time collecting".
Love to all,
Carl
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