? - mimi 11/13 AMPS 139 - shot 1.25 at +12.45, +1 202, +2 254, +6 258 PMPS 248 | Feline Diabetes Message Board - FDMB

? mimi 11/13 AMPS 139 - shot 1.25 at +12.45, +1 202, +2 254, +6 258 PMPS 248

Hi Rosa! Wow you had an interesting night!

I would get a +1 and +2 test and good job shooting!!
Hi! I was wondering - what if I waited to get a +4, +5 because doesn’t the dose start declining after your shot- or is the +1 and +2 to see if it to see if it drops a lot?
 
On second thought, you could maybe get away with a +2 or +3 if you wanted since it's quite true that Mimi is rising.
 
She’s like “but moms I iz gettin my sun tan- do we have to put the sting thing in my ghost detectors?”
 

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Awesome, Rosa! Sorry I made you sort of waste a strip but the bright side is you have more data :D

Haha @ ghost detectors!!! Love that!
 
Hi Rosa,
congrats on Mimi's reduction.


You asked this last night
“If I think she’s dropping low”. How would I know if she was if I didn’t test her?
As Bron noted you wouldn't know for sure without testing, but Mimi did give you a heads up that she was up to something.

  • At PMPS last night she was 278 then at +2 she dropped to 185, that's a big drop for +2, usually if kitty was having a 'typical' cycle +2 would be about the same or slightly higher than the PS.
  • The reason for this is that the previous shot (in this case the am shot) has run it's course and is 'wearing off', and the insulin you just shot (in this case your pm shot) will only have just onset or there abouts.
  • Additionally kitty has just eaten their PS meal, so that will be pushing numbers up.
So what does a +2 that is so much lower than PS tell us?
  • That this is an active cycle, and you can expect the BG to continue to drop as the cycle progresses
  • in this case it looks like the 'bounce was breaking' (she was stopping bouncing) and they can really move downward quickly when that happens

This all brings us back to another question you asked last night

So what would a normal curve look like?

Because knowing what a 'typical' curve should look like helps us understand what 'phase' kitty might be in in any given cycle,
  • is she bouncing?
  • Clearing?
  • Having an active cycle?
  • How active that cycle might be?
and knowing that can help us to keep kitty safe, by stepping up testing if we are home or knowing when it might be wise to leave higher food out or more snacks if we cannot test.

So this is from the Basics Sticky.

Example of an ACTIVE, but NOT necessarily typical Lantus/Basaglar cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus/Basaglar 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. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+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/Basaglar/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

So the above is what we are aiming for, until a cat becomes well regulated we don't see these patterns regularly, but eventually as you achieve regulation the above cycle is closer to what you can see.

So don't worry that you are not seeing that yet in Mimi, but use the differences to help you keep her safe.

As a general rule, a sharp drop like last night would have always prompted me to do a follow up check.

How soon I would follow up would depend on how much 'margin' I had, so last night she was in high blue I would have left it an hour probably to follow up, she was in high blue, so you had margin to let her drop.

Had she dropped from let's say 180 PS to 80 @+2, so still a drop of 100pts, she is safe at 80 but if she continued to drop at the same rate (50pts an hour) if I waited till +3 she would be in her 30's, so I would not have risked waiting an hour and would have followed up 30minutes later.


Does all that Help?
What do you think Today's cycle looks like so far?
 
Yes I just bookmarked this page because it’s extremely helpful!! So this is why TR is so important is to try and get kitty’s pancreas to learn it’s got some help now?
Today she looks like she’s bouncing. Her Nadir was 258. Which might be because she dropped so much last night her pancreas is working harder? Those little bodies, and tiny organs they have trying their best. So cute. Lol
 
I also saw that you asked about bouncing a couple days ago but I’ve been a little under the weather so just getting back to it now. Thanks for your patience.

When our kitties are diagnosed, they have probably been at higher numbers for some time and it doesn’t have to be a long time. The body, especially the liver, acclimates to those higher numbers and sees them as the “new normal”. When we start insulin therapy and then get to a dose that starts to work, we see lower numbers. The liver senses this as a bit of a “danger” to the body so, with the pancreas, they excrete hormones which cause the BG to come back up to what they deem as “safe”. This is what we call a bounce.

The BG does not have to go really low to cause a bounce. It can be caused by numbers that are just lower enough than what the liver sees as normal; it can be caused by rapidly dropping numbers (which we call diving); or it can be from really low numbers. The thing to remember is that bouncing is not bad. It shows the liver is doing it’s job. It’s important to not get too wrapped up in bouncing but just watch for the clues when it might be about to break as you don’t want to increase the dose as a bounce is clearing. Most bounce clearing cycles are already active ones so if you increase the dose at the time a bounce is clearing, it can make for a very, very busy cycle requiring alot of testing.

In most cats, the liver will get used to those normal numbers the longer it stays in them so that it doesn’t need to release any hormones to counteract the lower BG.

Does that help clarify?
 
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