2/5-2/6 Fred PMPS 187, AMPS 465 Never. Stops. Bouncing

Max bounces for nearly year. I don’t understand your reductions though. I don’t see that they were earned as he wasn’t under 90 ever.
Does the Lantus sting as I have read it does at higher doses? I would switch to Lev when ready. :bighug:
 
He has been, actually. He hit 75 back in March, but I was away on vacation, and all kinds of craziness with his numbers ensued. Then 84 on 5/2, and a hypo event on 5/12 with mild symptoms. 74 on 5/17.

Because Fred goes all over the place when I'm away, sometimes the weird one-time reductions happen b/c I'm trying to keep him safe when under the care of a petsitter.

He doesn't seem to feel any sting from Lantus as of yet, fortunately. Have to work up my courage for that Lev! It's the late-onset that's the worry.
 
Purrberry said:
Then 84 on 5/2, and a hypo event on 5/12 with mild symptoms. 74 on 5/17.
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That is ages ago in the life of a diabetic cat. What he did in the last two weeks is all we care about in terms of dosing. Much less looking at March. A cat's insulin needs can change over time for many reasons, including glucose toxicity which Fred likely has. If you have to reduce for when you are away, that's fine - most people do that if their cat is seeing greens. Then you go back up when you are home again.

Since you are following SLGS (could you add that to your signature), it means waiting 7 days for an increase, which it looks like he needs. As he gets closer to a better insulin dose, the height of the bounces will diminish. If we had an explanation for why he needs as much insulin as he does, it might shed additional light onto his numbers.

I also was worried about the unknowns of the switch to Lev and delayed starting it. Then after I did I kicked myself for being so slow to switch. :banghead: It's unlikely a vet visit or virtual vet visit will change anything.
 
Thanks, @Summer and Susie. He did have a decent day yesterday, which kind of makes me sad. It shows what he could perhaps be doing if not for the constant bouncing. I was also away all day, and even though he had food from his timer feeders, he was hungry. That always drops him lower, which is why things go pear-shaped when I'm away on vacation. And/or, it was a bounce-breaking day.

@Wendy&Neko I know those under 90s are long ago and few and far in between. Scalded in my memory, though, is the night he went too low. It's made me so gun shy. I don't know...I know plenty of people go through it, but I now have a serious constant dread of it. Shooting a full dose at 187 last night took a lot of steel on my part! What's also scary to me is that I'm learning that he really does not get much of a food bump at all. So if he were to go hypo again, I fear I'd again have a hard time bringing him up.

As for the vet visits, they have access to my spreadsheet. I just sent it to the specialist in the hopes she will look it over before our appointment. I am worried about the switch, but I also didn't want to have to get into defending, to both my regular vet and the specialist, why I flew in the face of my regular vet's advice in terms of the starting dose of Levemir. (she wants me to basically do a reset) I'd like to see if the specialist says any different. Fred will be getting bloodwork done on Tuesday, and of course, the hope is that nothing evil shows up.

Wendy&Neko said:
As he gets closer to a better insulin dose, the height of the bounces will diminish
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I keep waiting for this to happen! :banghead:
 
None of us are comfy when are cats are in low numbers, but we learn the tools and techniques to handle them. If you want to keep your cat high enough to avoid the chance of him ever getting low, he will seldom spend time in normal numbers either. Meaning, he won't get used to them and will continue to bounce. The solution to bouncing is more time in normal numbers, which does include more of a chance of getting to lower numbers. It's a trade-off and you have to decide which side you want to stand on, accept more bouncing or accept that you might have to deal with lower numbers. It's not a decision we can make for you and will support you either way.
 
Thank you...I appreciate the support. I'd honestly be one of those who would be happy with a cat in yellow and blue..not always in green, but below the renal threshold. I also truly fear something happening when I am not home and have no means or tools to help or save him.

I also intend to ask the specialist about exenatide extended release (EER). It seems to show a lot of promise in cats with a great deal of glycemic variability...or bouncing. Bydureon is the brand name. The studies were initially on cats in remission, but have expanded to those with GV. This is science-filled but very informative.

https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.15915
 
Remember than renal threshold differs by cat, but even with the AT, can be lower yellows. Regulation is however, a good goal.

I will be interested to hear what the specialist says about Bydureon. From this study, and the one you referenced the following cats were excluded from the study:
Of 52 cats with newly diagnosed DM admitted during the study period, 30 cats fulfilled the inclusion criteria and were enrolled. Twenty‐three were excluded because of acromegaly, hyperadrenocorticism, hyperthyroidism, hypertrophic cardiomyopathy, mesenteric lymph node abscess, neoplasia, pancreatitis, prior corticosteroid administration, relapse of diabetes or because they had received insulin for >4 weeks before admission.
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They only focused on newly diagnosed cats, the easiest to control. And the focus was on cats with no other underlying conditions. Something (TBD what) means Fred needs more than 6 units of insulin. Also note that any medication/treatment that helps lower blood sugar is likely to mean lower numbers at some point.
 
Wendy&Neko said:
From this study, and the one you referenced the following cats were excluded from the study:
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Yes, they researched the same way that most human studies are conducted. Too many underlying conditions mean too many variables for the result. What I don't like is that they say it can cause weight loss, nausea, and decreased hunger, and that's the last thing I want!

Wendy&Neko said:
I will be interested to hear what the specialist says about Bydureon
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I'll be sure to let the forum know. I may get shot down. I searched FDMB to see if anyone else has ever tried it, but I think only one kitty had it suggested to her, and they decided not to go ahead with it due to kitty being an Acrocat. (I'm sorry I don't have the name on hand)

Wendy&Neko said:
Also note that any medication/treatment that helps lower blood sugar is likely to mean lower numbers at some point.
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Duly noted. I think I'd be OK pushing for lower numbers if I weren't always so surprised by them-it's the unpredictability with Fred that makes it very difficult for me to know what is the right path to get down as well as keep him safe. (especially when he goes completely off-piste when I'm away)
 
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