3/25 Honey AMPS 389, +6 171, PMPS 414

Da sharks are in the deep deep waters. It's okay to be in the water as long as your feet are touching the bottom. You gotta get the sand out from between your toes.
 
Here we go again. All kitties fasten your seatbelts and put your tray tables in the upright position, it looks like we are heading for some turbulence...:confused:
 
Jill & Alex (GA) said:
Cool! She's doing exactly what you want her to do!
Based on all your testing... looks like Honey has plenty of room for an increase to 0.75 unit bid.
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Was going to try and do a curve once she stopped bouncing and get a pm mid cycle if I can. What do you think? Would getting a +4, +6, +8 and pm +4 be enough, providing she looks to have stopped bouncing, rather than a full curve?
 
Julie and Honey said:
Was going to try and do a curve once she stopped bouncing and get a pm mid cycle if I can. What do you think? Would getting a +4, +6, +8 and pm +4 be enough, providing she looks to have stopped bouncing, rather than a full curve?
Click to expand...
With as much data as you have accumulated at this dose, I wouldn't bother doing a curve at this point. The reason for a curve is to determine how low the current dose is dropping kitty. Today is the 15th cycle at 0.5 unit and I believe it's logical and safe to conclude Honey isn't dropping any lower than mid-blues... ample wiggle room for a dose increase.

What do you think?
 
Jill & Alex (GA) said:
With as much data as you have accumulated at this dose, I wouldn't bother doing a curve at this point. The reason for a curve is to determine how low the current dose is dropping kitty. Today is the 15th cycle at 0.5 unit and I believe it's logical and safe to conclude Honey isn't dropping any lower than mid-blues... ample wiggle room for a dose increase.

What do you think?
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I guess my only concern is if she is any lower than 150 mid cycle at night? It is very hard for me to test in the middle of the night, but I can try another one tonight, but she may be bouncing off this big drop today? How do you get them to stop bouncing long enough to get accurate numbers? I know a bounce can affect numbers up to 6 cycles, but after that what if they just keep bouncing?
 
I'm sorry if I misunderstood if your goal is to keep Honey above 150. In that case, keep on with what you're doing. If your goal is to bring her BG numbers down, more insulin is likely.
Julie and Honey said:
How do you get them to stop bouncing long enough to get accurate numbers?
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Any numbers you get are accurate/valid for that moment in time.
Usually it takes more insulin to flatten them out. On the other hand, some cats never stop bouncing. ECID.

Maybe this will help your mindset...
Forget about "accuracy". Focus on the action of the insulin... the action over approximately 6 cycles. I like to think of it as "waves" of action (visualize waves in the ocean).

Generally speaking, this is what happens over a series of 6 cycles in the beginning:
  1. going down low/lower than before
  2. going up
  3. high, but can bobble up and down some
  4. again high, but can bobble up and down some
  5. coming down or a flat high
  6. coming down, often, but not always dropping into the next preshot number
Begin again.

That's what I look at to figure out what's happening at a given dose. Eventually, the waves become flatter if kitty's body cooperates. BTW, I don't look at individual cycles and *usually* any data more than a couple weeks old doesn't matter any more.

The data you want to collect also involves finding out how food effects Honey's numbers at different points in the cycle. That's why I mentioned forgetting about fasting and focusing on quantities fed, what percentage of carbs, and when they were fed in the cycle.

Data isn't just about numbers. It's about the combination of effects of food and insulin on kitty's blood glucose levels.
Julie and Honey said:
I know a bounce can affect numbers up to 6 cycles, but after that what if they just keep bouncing?
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It happens, but it's extremely rare for a cat to bounce more than 6 consecutive cycles.


Hope this helps...
 
Jill & Alex (GA) said:
I'm sorry if I misunderstood if your goal is to keep Honey above 150. In that case, keep on with what you're doing. If your goal is to bring her BG numbers down, more insulin is likely.

Any numbers you get are accurate/valid for that moment in time.
Usually it takes more insulin to flatten them out. On the other hand, some cats never stop bouncing. ECID.

Maybe this will help your mindset...
Forget about "accuracy". Focus on the action of the insulin... the action over approximately 6 cycles. I like to think of it as "waves" of action (visualize waves in the ocean).

Generally speaking, this is what happens over a series of 6 cycles in the beginning:
  1. going down low/lower than before
  2. going up
  3. high, but can bobble up and down some
  4. again high, but can bobble up and down some
  5. coming down or a flat high
  6. coming down, often, but not always dropping into the next preshot number
Begin again.

That's what I look at to figure out what's happening at a given dose. Eventually, the waves become flatter if kitty's body cooperates. BTW, I don't look at individual cycles and *usually* any data more than a couple weeks old doesn't matter any more.

The data you want to collect also involves finding out how food effects Honey's numbers at different points in the cycle. That's why I mentioned forgetting about fasting and focusing on quantities fed, what percentage of carbs, and when they were fed in the cycle.

Data isn't just about numbers. It's about the combination of effects of food and insulin on kitty's blood glucose levels.

It happens, but it's extremely rare for a cat to bounce more than 6 consecutive cycles.


Hope this helps...
Click to expand...
Thanks. Not trying to keep at 150 per se, just that looked to be a key level and if daytime low number is say 170, possibly night time low could be say 140 or less, seemingly saying to hold the current dose according to what I read. Would like her in healthier numbers, was hoping to get her off insulin someday, if at all possible. She needs a dental too, so her numbers may be somewhat higher than they would be if her mouth was in better shape. I plan to get that done if I can get her in a range that is relatively stable.

It will take time for me to go through and figure out her food. I was keeping the fasting times in for now as it still shows last time she ate, I keep track of amount eaten as well, everything is written down, just have not had time to transfer data.

I need to check in with my vet too, she does not even know I started insulin. Last time we spoke we were going to try and do a dental first, but she wanted me to get some weight on her which had been difficult without the insulin. Then her numbers started creeping up, so
I went ahead and started the insulin. I think the vet will be fine with .75 BID since I am checking her at home and can supply her with data on BG numbers, I am monitoring her weight, ketones. etc. I just want to inform her so she is in the loop, still need a vet:)
 
Julie and Honey said:
Not trying to keep at 150 per se, just that looked to be a key level and if daytime low number is say 170, possibly night time low could be say 140 or less, seemingly saying to hold the current dose according to what I read. Would like her in healthier numbers, was hoping to get her off insulin someday, if at all possible.
Click to expand...
*Usually* this won't happen hand-in-hand. More often than not, getting her into healthier numbers will require a higher dose. In most cases, getting a kitty off insulin is hard work and will take more insulin.
Julie and Honey said:
She needs a dental too, so her numbers may be somewhat higher than they would be if her mouth was in better shape. I plan to get that done if I can get her in a range that is relatively stable.
Click to expand...
I encourage her to have the dental done as soon as you can. Her mouth is only getting worse the more time that lapses. In turn, that will make her more unstable. It's kind of a vicious circle.
Julie and Honey said:
I need to check in with my vet too, she does not even know I started insulin. Last time we spoke we were going to try and do a dental first, but she wanted me to get some weight on her which had been difficult without the insulin. Then her numbers started creeping up, so
I went ahead and started the insulin. I think the vet will be fine with .75 BID since I am checking her at home and can supply her with data on BG numbers, I am monitoring her weight, ketones. etc. I just want to inform her so she is in the loop, still need a vet:)
Click to expand...
Oh, yes. It's important to keep your vet in the loop. My vet and I didn't always agree, but we had an awesome working relationship!
 
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