9/22 Olive's AMPS 359-Question:Why was BG so high after a lovely previous cycle?

OlivesMom

Member Since 2020
https://www.felinediabetes.com/FDMB...rs-is-keeping-her-steady.235690/#post-2640734

Morning. After yesterday's beautiful AM cycle I couldn't understand why the PM cycle was so so high. It didn't rise or fall too wildly so I know she got her insulin, but why stay so high? I think it's too soon to tell, but would the PM cycle be an indicator that she just might be ready for an insulin increase? And you know with Olive the word "Increase" is like throwing gasoline on a fire. lol. Even though I'm new to diabetes, it would seem that the only way to get her BG levels consistently more towards the blue side is a teeny weeny increase in insulin. Any thoughts? Or suggestions? She's at +4 and only down to 257 from the AMPS BG of 359. I'm only going to try this for the day as getting weight on her means more at this time so if every 2 hours she gets fed so be it until then, but for today I'm trying not to feed her but every 3 hours and at that time trying to get her to eat more. I wasn't successful at +3 but I got her to eat a smidge more through the night feedings, but I'm trying to see how her levels do if she doesn't get fed every 2 hours like she has. I guess hoping that her levels will go down if she doesn't eat as often. I'm testing that theory you could say. I've got to run to the store to get some relions to try. Be back later.
 
I have no idea why this posted in duplicate, so sorry everyone. I don't know how to delete the extra one.
 
Just here to bump up your post - I can't give dosing advice but the rise over the PM Cycle was likely a bounce from those nice yellow and blues. She's not used to them yet so the liver freaks out and dumps extra sugar in the blood stream - isn't the body great ;)? More time in low numbers, less time bouncing. It does look like Olive cleared the bounce pretty quickly.

Here is the explanation on bouncing from "The Basics" sticky -
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
 
Okay, so ready for some interesting news? We bought a second caliper to use on the new Relion brand syringes I picked up today as I wanted to keep the original settings on my original one just in case we needed them later and I didn't want to have to reset it. But what I discovered by comparing the two syringe brands explains a lot. For starters, I did a bunch of test syringes with the walgreens syringes first using cherry juice. I measured the same amount of 0.01 IU on all the test syringes and I got completely different amounts of liquid when I squirted the drops of fluid onto parchment paper. No wonder Olive's BG has been so inconsistent. The drop comparison tests literally were cut in half depending on the inaccuracy of the syringe. I was using the top of the caliper arm tucked under the "brim of the hat" as I call it on the syringe to always know where to line up as my zero lines were always in different places on these syringes (which is one reason why I got fed up and switched brands..air bubbles was the other complaint) but come to find out that too was inconsistent. So her dose of insulin hasn't been steady all this time despite the caliper. Which leads me to the second great realization: She's NOT been getting 0.01 IU like we thought. The caliper tested 0.01 every time, time and time again we did it as we wanted to make certain the amount the digital thing was showing was indeed 0.01. In fact, I even attached a photo one night for this sites review and it did indeed show a setting of 0.01 IU. It always registered the same. We didn't realize until today when I did the cherry juice comparison with the Relion syringes using the 2nd and new caliper that what we thought she'd been getting was in fact closer to half a unit! It's just under. I think hubby said it was .46 or something like that. So which caliper is right? I'm going to say the new one because when we aligned the old one and the new one together they both are showing almost exactly the same exact gap measurement but one reads 0.01 and the other closer to half a unit. That's an incredible difference! And if I go by the new Relion syringes and the fact so far all of them have a near perfect zero line stamped on it so I finally have an accurate scale to measure by, what it's saying is the 0.01 is in reality just under half a unit. Wow! So I think what I'm going to do is skip the caliper now and because the Relion's stamped lines are so consistent, I'll simply measure out to the half unit line here on out. I also did a side by side drop comparison with the relion and walgreens syrings measured with the same caliper and it would seem the Relion is slightly skinny in the droplet by comparison to the walgreens one. Another reason I think shooting for the half unit mark now would be a better option. We both just thought it was the constant inconsistencies of the stamped lines on the walgreens syringes that were making us think she was getting a different dose since the lines were always in a different place. Makes sense now. It all does. I'm floored. All this time. I'm not even going to touch/change the insulin amounts on the SS and just note all this in my remarks for the future. Olive's PMPS is coming up in an hour and I'll be using the new Relions for the first time. Let's see what happens.
 
Oh, ok. Thank you for the response. That would make sense then. I accidentally duplicated my original post somehow this morning so I have two going until tomorrow. My other one is about the insulin amounts we discovered today.
 
Susanne is right, Olive was bouncing. But it's nice to see her coming down already today. :cool: By the way, you should have gone to sleep last night after that +2. With it so much higher than preshot, she wasn't going to have an active cycle. Save the sleepless nights for low numbers.

I will merge your two threads.
 
As for the two syringes, different brands have different thicknesses of barrels, which is why people need different caliper measurements for different brands of syringes. Switching between two brands. With small doses, you can try measuring the number of drops in one brand of syringes, then see if you can get the same number of drops in the other.
 
Susanne is right, Olive was bouncing. But it's nice to see her coming down already today. :cool: By the way, you should have gone to sleep last night after that +2. With it so much higher than preshot, she wasn't going to have an active cycle. Save the sleepless nights for low numbers.
See, that's exactly why you guys are great, because I'm always afraid she'll bounce low on me and if I'm asleep I won't know it. So I test frequently to play it safe. I wish there was a rule book for when it's safe to sleep and when you need to be watching and when you need to freak out. ;)
Switching between two brands. With small doses, you can try measuring the number of drops in one brand of syringes, then see if you can get the same number of drops in the other.
I can try that. I've only got a half hour to play with it.
 
With small doses, you can try measuring the number of drops in one brand of syringes, then see if you can get the same number of drops in the other.
I did my best to get the new Relion syringe measuring the same IU as the Walgreens brand. I even counted the drops. The walgreens syringe offers slightly more insulin than the Relion so I tried to compensate a hair. Either I got the dosage wrong in the new Relions (which I LOVE by the way...much better than Walgreens brand) or Olive decided to do some major bouncing. Hubby thinks I caused the bounce because I decided to see if Olive would eat more for dinner and she actually ate nearly twice her normal. She ate 6 tsp instead of 4. Did I cause the bounce by feeding her more? I've also got a question: I don't know what the DM is considered, if it's low carb or medium, but what I do know is Raw is NO carb. So would it be better to feed Olive Raw only 2-3 hours before shot time if her BG is still high? And if it's low to feed the DM/Raw mix to get it up? I wondered how the carbs play into the standard cycle. Since she's going to stay high tonight I'm going to get more sleep and only wake up to feed her a bit and then go back to bed. Until tomorrow.
 
Food doesn't cause a bounce. Going lower than used to, or doing a fast drop causes bounces. Numbers wobble around during a bounce, sometimes bounces can be delayed. My girl's worst bounce numbers were 3 cycles after the event that cause the bounce. That's a bit unusual, but so was she. :p

DM wet is low carb, just not great quality ingredients and many kitties grow tired of the flavour. Not all raw is no carb, so you do have to check the particular one you are giving. In general, you want to feed something before onset (typically 2-3 hours after the shot), to help prevent any fast drops, and to give the insulin something to grab onto. Then you need to get her daily calories into her, so splitting into a few meals to make it easier on the pancreas is a good idea. Anything with carbs should be limited, where possible, to the first part of the cycle as carbs after nadir, when insulin is waning, can shorten duration and cause higher numbers at preshot.

Go to sleep early tonight!
 
Food doesn't cause a bounce. Going lower than used to, or doing a fast drop causes bounces. Numbers wobble around during a bounce, sometimes bounces can be delayed. My girl's worst bounce numbers were 3 cycles after the event that cause the bounce. That's a bit unusual, but so was she. :p
I feel so much better now, thank you. I think Olive is ranking right up there in the unusual realm. :facepalm::p And thank you for the when to feed advice. I'm going to implement this and see what happens.
 
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