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? 4/17 Yum: why do dose increases start good only to fade?
- Thread starter MJW
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Sandy and Black Kitty
Member Since 2009
One possibility is some degree of IAA (insulin auto antibodies).
Overall, it looks like Yum is losing the blacks and reds.
I would continue increasing as indicated in the TR protocol. I also recommend always testing before shooting and getting some BG spot tests in the PM+4 to PM+11 range so that you know where the BGs go during those overnight hours. Many kitties run lower on the overnights.
Doodles & Karen
Member Since 2015
Please get a test before every shot. Kitties like to surprise us. As Sandy mentioned a before bed test is very informative. Think of the SS as a puzzle...the more spots you have filled in (testing at different times) it helps see what Yum is doing. A +2 test on Lantus usually gives an indicator of how the cycle will go. This is found in the
The Basics New To the Group Sticky . Kitties nadir at different times and they even move around often. Just take note of the +2 test.
Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.
I also agree that Yum could be going lower at night and bouncing like crazy during the day. Bounces are normal and very frustrating for us beans.
This is also found in the same sticky I linked above. This link has a fast amount of information that I booked marked and read something almost every day.
Where Can I Find
Keep posting and asking questions. We all understand your frustration and the more you post/ learn the easier it gets.
The Basics New To the Group Sticky . Kitties nadir at different times and they even move around often. Just take note of the +2 test.
Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.
I also agree that Yum could be going lower at night and bouncing like crazy during the day. Bounces are normal and very frustrating for us beans.
This is also found in the same sticky I linked above. This link has a fast amount of information that I booked marked and read something almost every day.
Where Can I Find
Keep posting and asking questions. We all understand your frustration and the more you post/ learn the easier it gets.
Doodles & Karen
Member Since 2015
I see Yum went OTJ after a few days and had a relapsed. My Doodles never went into remission but did get IAA at 78% almost a year after being a tightly regulated cat and I also had tons of data. Many have come out of remission and got back OTJ.
Let's see how Yum looks after filling in some of the blanks on his SS. Hang in there!
Let's see how Yum looks after filling in some of the blanks on his SS. Hang in there!
MJW
Member Since 2017
MJW
Member Since 2017
Well, I had to chase her upstairs and downstairs and around in circles---then I had to prick her ear 4 times---but I got a late (for us) PMPS+4 blood test. 387. The lowest of the day but not great. I guess it was probably elevated due to the stress of the chase. I will increase her dose tomorrow morning by .25 or .5.
Doodles & Karen
Member Since 2015
Sorry for your losses
. Only increase by .25. TR is aggressive as written. Do you give treats after each poke? There are many freeze dried diabetic friendly treats on the market.
. Only increase by .25. TR is aggressive as written. Do you give treats after each poke? There are many freeze dried diabetic friendly treats on the market.
MJW
Member Since 2017
She doesn't really seem to mind the pokes. She purrs usually and enjoys the affection. However, she does object to my grabbing her if she's not sitting with me already. Maybe she thinks we are going to the vet. She can be very suspicious. She was feral and she doesn't like anything out of the ordinary. I gave her sardines this time post test. I failed to tempt her with them pretest. Tomorrow's AMPS will probably be impossible. So frustrating.
Chris/China (GA)/Garfield
Member Since 2013
Here's something I wrote up for others that needed help with testing...maybe it'll help you too! (substitute "her" for "him"...LOL)
It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!
You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!
It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well.
When you're first starting, it's also important to use a lower gauge lancet, like 25-28 gauge. Most of the "lancet devices" come with 33 gauge lancets and they are just too tiny to start with. The bigger lancets (that are lower numbers) make a bigger "hole". As you poke more and more, the ears will grow new capillaries and will be easier and easier to get blood from...we call it "learning to bleed"
Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!
If she likes the sardines, try picking one place and taking there as much as possible (without trying to test) and just give her a little snack....hopefully she'll learn to associate the place with the snack sooner as well as re-learn that every time you pick her up, she's not going to the vet
It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!
You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!
It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well.
When you're first starting, it's also important to use a lower gauge lancet, like 25-28 gauge. Most of the "lancet devices" come with 33 gauge lancets and they are just too tiny to start with. The bigger lancets (that are lower numbers) make a bigger "hole". As you poke more and more, the ears will grow new capillaries and will be easier and easier to get blood from...we call it "learning to bleed"
Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!
If she likes the sardines, try picking one place and taking there as much as possible (without trying to test) and just give her a little snack....hopefully she'll learn to associate the place with the snack sooner as well as re-learn that every time you pick her up, she's not going to the vet
julie & punkin (ga)
Member Since 2011
I always have had success by getting a cat to come to me rather than going after a cat. I keep treats in a small yogurt container that I shake and call the cats to come to the kitchen. It works really well.
Overall, Yum's blood sugar numbers look like they are coming down. I think you haven't gotten to the right dose yet, but you will get there. If you shrink the overall page (on my Asus I can hit control - ) then look mostly at the progression of the colors. Lots of black in the beginning. Now the black is nearly gone and blue has appeared. That's all very good!
The best way to get to good numbers is to just be persistent, which you are doing, in increasing the dose per the guidelines. You will get him into better numbers, it just takes being methodical. Because so many cats have their lowest numbers at night, it is so helpful to grab a test before you go to bed every night. That test can often be very revealing!
Hang in there - you are on the right track and are seeing some progress.
Overall, Yum's blood sugar numbers look like they are coming down. I think you haven't gotten to the right dose yet, but you will get there. If you shrink the overall page (on my Asus I can hit control - ) then look mostly at the progression of the colors. Lots of black in the beginning. Now the black is nearly gone and blue has appeared. That's all very good!
The best way to get to good numbers is to just be persistent, which you are doing, in increasing the dose per the guidelines. You will get him into better numbers, it just takes being methodical. Because so many cats have their lowest numbers at night, it is so helpful to grab a test before you go to bed every night. That test can often be very revealing!
Hang in there - you are on the right track and are seeing some progress.
Sandy and Black Kitty
Member Since 2009
MJW
Member Since 2017
Thank you Chris for your tips. They "learn to bleed"? That is great news!
Julie---I'm trying to let her come to me. She greeted me this morning at our snuggle spot, so it was easy for me to test her in between some snuggles.
Sandy---of course. It's good that I now know about IAA whether she has it or not.
Hope all the kitties have a good day today.
Julie---I'm trying to let her come to me. She greeted me this morning at our snuggle spot, so it was easy for me to test her in between some snuggles.
Sandy---of course. It's good that I now know about IAA whether she has it or not.
Hope all the kitties have a good day today.
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