12/26 Butters PMPS 54/+1 119/+2 153/+4 157

[Butters & Lyla]

Late nadir cats tend to nadir earlier when looking for a reduction. Of course ECID. Another thing to get out of today, when you get lows so early in the cycle, you still have a long way to go with the insulin just getting stronger. So (depending on the carb sensitivity of the cat), an early drop is a good reason for higher carbs and syrup, as is the 30's.

This is great information to know. Thank you.

Thanks for bringing this up but I’ll add that any cat (ECID) might show the nadir moving earlier when looking for a reduction. I’ve seen it in Henry and mentioned it to Robert. Of course, there are cats, like Sienne’s Gabby, who was always an early nadir cat so that little bit of “telephoning in” was not something that helped her.

Thanks for the additional clarification for other non-late nadir cats.

Butters is 58 @+10. I thought she'd be bouncing by now. It doesn't look like she will. She is also completely irritated and getting a little upset with the testing. I can handle it; I just worry about stress and her pancreatitis.

Insulin time is 70 minutes away. Do I shoot the 3.75U as long as her PMPS is 50 or above? Is it worth discussing a BCS of some type to drain the depot, over and above the .25U reduction?
Marje, I read what you wrote regarding BCS earlier. Butters has been at 4U for three cycles and 4.25U prior to that. Tonight would be cycle one of 3.75U after earning the reduction today. Do I assume her depot is 4.25U still, and is that considered a higher dose depot in the context of whether or not to do a BCS? I don't know if I can explain why, but somehow I think it is important to mention that I'm trying for a well-regulated cat, not a tightly regulated cat.

I understand that if I were to do a BCS of some type, it won't help with tonight's cycle.

TIA anyone who can help me with this.

 

[Colio]

made no promises about whether I'll get reimbursed for the $140 that is now missing from my bank account.

When they start to sort it out, I would escalate hard at the bank if they refuse to refund the money. Mine was also a debit card, and I got all of my money back. It's their responsibility to monitor for fraud - not all on you

Hope Butters settles - she really wanted a busy day for you today!

 

[Marje and Gracie]

Insulin time is 70 minutes away. Do I shoot the 3.75U as long as her PMPS is 50 or above? Is it worth discussing a BCS of some type to drain the depot, over and above the .25U reduction?
Marje, I read what you wrote regarding BCS earlier. Butters has been at 4U for three cycles and 4.25U prior to that. Tonight would be cycle one of 3.75U after earning the reduction today. Do I assume her depot is 4.25U still, and is that considered a higher dose depot in the context of whether or not to do a BCS? I don't know if I can explain why, but somehow I think it is important to mention that I'm trying for a well-regulated cat, not a tightly regulated cat.

For purposes of using the BCS for a high dose cat or as more fully explained in my post #37, no, Butters wouldn’t fall into that category.

Having said that, you hold the syringe. You know Butters is getting tired of this and while the depot will still be active tonight (and potentially the 4.25u depot), when she onsets, it’s “possible” she won’t onset with as much “vigor" as she did this morning if you shoot a half dose. I just don’t have a crystal ball to tell you that much. You can look at Henry’s SS on 12/21 when he shot a BCS, a.m. cycle. I believe his original intent was just for that to be a BCS but by PMPS, had decided it was the new dose but after two cycles, he didn’t like what it did, so he went back up.

It’s smart to look at your goals because you know the cycle could potentially be active even with the BCS. It might give you some breathing room later in the cycle; it might give it to you tomorrow during the a.m. cycle. I know I’m not being much help here

I just might not be the best person to ask because I never did it. Even if I’d had a crazy cycle, I always shot the full dose the next cycle (accounting for any required reductions). That doesn’t mean you have to do that; I was wanting tight regulation. There is no right or wrong answer for you; if you feel Butters needs a break and you need a little breathing room yourself, shoot a BCS. It’s really ok if this trek down is coming too fast. Sometimes, with that BCS and in terms of progress, they barely miss a beat and you start with the new dose the next cycle. It just gives you both that little bit of breathing room.

 

[Wendy&Neko]

There could definitely still be a smidge of the 4.25 unit depot at play today, but with a 32, even the 4 unit is too much. The larger depot influences 4-6 cycles after a reduction, towards the longer side for bigger doses.

As far as a BCS goes, a decision to do this is for the caregiver (you), not so much the cat. And with that BCS, the first part of the cycle could play out like you had shot the full dose anyway. But it does mean the latter part of the night might be easier and give you a possible break tomorrow. The other thing to consider is that this is possibly glucose toxicity breaking.

I did shoot the odd BCS, but only after a visit to the 20's . 32 is down there. But with Neko, she had changing conditions and BCS or "temporary" lower doses usually held. My goals were also not tight regulation but good regulation.

 

[Butters & Lyla]

It’s smart to look at your goals because you know the cycle could potentially be active even with the BCS. It might give you some breathing room later in the cycle; it might give it to you tomorrow during the a.m. cycle. I know I’m not being much help here

This helps! Thank you so much. And thank you for explaining why it was good that I mentioned my goal is a well regulated cat.

The other thing to consider is that this is possibly glucose toxicity breaking.

I did shoot the odd BCS, but only after a visit to the 20's . 32 is down there. But with Neko, she had changing conditions and BCS or "temporary" lower doses usually held. My goals were also not tight regulation but good regulation.

20s. I experienced mild shock over the 32.
If you're around, would you mind answering this? What do I need to consider with regards to glucose toxicity breaking and doing a BCS? This is the only thing making me hesitate a little bit.

I'm leaning toward a 2U dose for tonight, and then 3.75U tomorrow. But not if it could impact the breaking of glucose toxicity.

 

[Butters & Lyla]

54 @PMPS. Yay, Butters! Thanks for staying above 50.

 

[Marje and Gracie]

What do I need to consider with regards to glucose toxicity breaking and doing a BCS?

Just the potential that it could be which often means a bit of a wild ride down the dosing scale, often to just a certain point. It just makes reductions a bit less predictable because the kitty often doesn’t stay at a dose long. The one thing that often concerns me with these cats is they come down very quickly and earn alot of reductions then hit a stopping point. Some of them then have to go up higher than they were initially before they start coming back down slower. But, and I hate to be repetitive, but it’s ECID. Some come down fast but then hit a dose that they just level out at and they don’t go back up (i.e. there aren’t so many reductions earned so quickly that the dose becomes too small) but the reductions slow down.

But not if it could impact the breaking of glucose toxicity.

It’s speculation on the glucose toxicity. Yes, we can look at the SS and her patterns and surmise it’s glucose toxicity but we don’t unequivocally know. Again, I’d look at Henry’s SS because he must have built up some glucose toxicity. He was at higher numbers much longer than Butters was. You can’t see this because his BGs from when he was first diagnosed are not on the SS but it went back to last spring. For Henry, I do believe his was a combo of stopping LC dry food and glucose toxicity breaking.

Keep in mind that 54 might be the lantus second dip. It’s higher than the nadir.

 

[Tomlin]

It’s speculation on the glucose toxicity.

I am thinking similarly.

I think this is a good thing Lyla because I am hopeful that what you may be seeing here is the result of inflammation decreasing due to change of diet. Inflammation & the immune system being ramped up results in both higher BGs & insulin resistance. Many times, a pancreatitis flare is caused by inflammation of the GI track. When owners get lucky, making a diet change results in the inflammation subsiding & the pancreas is good to go ..... it takes a little time but it happens! Just as you saw the beef possibly aggravate her GI and BGs went higher, the opposite occurs when you find the diet that agrees with the sensitive Intestines ......inflammation & any insulin resistance caused by it resolves, less insulin is needed & BGs look good again .

 

[Wendy&Neko]

Sorry I wasn't on earlier. Glad you shot something tonight. That +1 shows that she isn't used to the 30's - thank goodness! That was the other option that might give you some sleep tonight.

As for glucose toxicity, it's not always as simple as just. As others have said, sometimes there is another change in play. Oberon is another one who recently came down scale fairly briskly, but seems to have stalled out. Of course, the IAA is a complicating factor. I'd consider it too early to say if it's glucose toxicity breaking, just a possibility.

 

[tiffmaxee]

Really good conversations and information here. Looks like a bounce might be starting.

 

[Butters & Lyla]

Really good conversations and information here. Looks like a bounce might be starting.

153 @+2
Darn. If I'd have known that she was going to bounce tonight, I would have shot the full 3.75U. I suppose it's too late to shoot the rest of the dose.

If she is still bouncing tomorrow, I'm thinking I could shoot through the bounce with the old 4U dose in the morning. Then start the reduced dose of 3.75U in the evening. Does that sound like a reasonable plan?
I have to read through everything.

 

[katy and mo (GA)]

Gosh, Butters, you are keeping mama on her toes!!! Stay above 50 for mum please!

Could you imagine calling the bank and saying "I think my cat has been using my credit card, but I'm not sure..." I want to be a fly on the wall for that conversation!!!!

 

[Wendy&Neko]

3.75 units in the morning. Shooting through the bounce is a one cycle kind of thing. Especially with the 30's!

 

[Butters & Lyla]

3.75 units in the morning. Shooting through the bounce is a one cycle kind of thing. Especially with the 30's!

Understood! 3.75U in the morning. I would never, ever want to do anything that risks Butters' safety. That's why I always ask before I make decisions. And I will call tomorrow morning's 3.75U cycle two of the new dose.

 

[tiffmaxee]

Look on the bright side. You get to sleep. Hind site is 20/20. She could just have easily not bounced. I never did shoot through the bounce.

 

[Marje and Gracie]

Wendy took the words out of my mouth.

This, too, shall pass. She might have a quick bounce in blue. Hope.

 

[Butters & Lyla]

I actually am looking forward to finally getting some sleep. I never did get to take that badly needed nap @Red & Rover (GA) recommended.
I need to re-read some of the later posts. I looked at Henry's spreadsheet but will look at it some more.

Thank you so very much to everyone who stopped by for all of the help, humour, support, information and conversations today. I appreciate all of you.
I have learned a great deal and I will be saving a link to this condo in my spreadsheet.
And for her final trick of the day, Butters actually played volleyball in her tunnel for a few minutes. I haven't seen that since before she went into the hospital in mid-October. Who knows what tomorrow brings, but tonight she is feeling very good!

 

[tiffmaxee]

That capped off a really good day. Go to sleep!

 

[Red & Rover (GA)]

"I think my cat has been using my credit card, but I'm not sure..."

I once had to tell my mechanic that my truck stalled every time I turned left. He looked at me as though I was not of this planet.

Get some much needed and earned sleep, Lyla. Sweet dreams.

 

[Marje and Gracie]

I once had to tell my mechanic that my truck stalled every time I turned left. He looked at me as though I was not of this planet..

 

[Cheryl & Jazzy]

Holy!!! What a busy day for Butters!! Slow down, girl I'm glad you were able to bring her back up.
Sorry about the debit card situation. Hopefully that gets straightened out quickly.
Have a good night and a restful sleep

 

[Diane Tyler's Mom GA]

Glad you are going to get a good sleep tonight, what a day
you had.