05/25 Skipper AMPS: Hi, bounce?

[millerb]

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=71639

I raised Skipper's insulin to 4 units beginning last night when I got a Hi reading PMPS. I checked it again at +4 and it was 300. I think it must have bounced overnight, as it was Hi again this morning. I feel like I'm in a crazy game, one in which I have a loose grasp of the rules, but they rules keep changing every day. I asked my husband to check it at lunchtime today, so we'll see where it is.

While I'm happy that he is eating and keeping his food down, what I'm noticing is that Skipper is no longer sleeping with me. He is usually never more than 6 inches from me at all times, but for the last few nights, he has slept on the dog bed downstairs and not with us. When my German shepherd was very sick with cancer 2 years ago, I noticed she gradually distanced herself from us -- she would stay in another room than the one where we were. I wonder if I'm reading too much into it, but it's very unusual behavior for him.

 

[PeterDevonMocha]

Hi guys .. sorry to see such a high number this morning .. I know you are probably feeling very discouraged .. but sometimes it takes awhile for that right dose to settle in and get some nice consistent numbers .. we just have to wait it out, and follow protocol .. hang in there! When mocha was first diagnosed she also changed her behavior .. but it slowly came back .. Not sure if it was all the attention we were giving her and she felt smothered or what .. of course now that her testing days are slowing down, she basically insists all we do is love on her!

 

[millerb]

Re: 05/25 Skipper AMPS: Hi, bounce, +7 437

My husband took Skipper's BG at lunchtime and it was 437. I'll be interested to see where it is at 5 pm when I get home.

 

[Marje and Gracie]

I just wanted to remind you that we don't raise the insulin based on Preshots. You have to get those mid cycle numbers in order to know whether he needs a dosecrease. Sienne's Gabby has been 400 at AMPS, 40 at nadir, and 400 at PMPS. If she didn't test like she does, she would have missed the 40. See why it is important to not dosecrease unless you know how low they might be getting?

Here is what Sienne said in yesterday's condo:

With Skipper in these numbers, I'd consider continuing to raise the dose by 0.5u just like you did previously. If you will get a minimum of one spot check per cycle, you can be more aggressive and raise the dose every 4 cycles -- BUT, you must get the tests in.

I put the bold in. I do not agree with you raising the dose if you are NOT getting the spot checks. You could be overdosing Skipper. What concerns me is that he was getting into greens on 3u and he is a very bouncy kitty. I think spot checks every few days may be missing the mid cycle lows and that could be why you are seeing such high numbers and the higher you go, the lower he might be going mid cycle and bouncing up....a viscious cycle. Let's see what others may also think but please do not raise him again based on a PS.

I'm sorry I haven't had a chance to read back through everything but you are feeding him really higher carb foods between the dry DM and the Core salmon (which is about 13% carbs). I understand he has alot of health issues and that may be why you're feeding what you do. But his numbers might be better if his diet was a little bit less in carbs. Having said that, I am a big believer in the adage that the best food for a cat is the one it will EAT.

 

[Sienne and Gabby (GA)]

I'm going to quote myself louder:

With Skipper in these numbers, I'd consider continuing to raise the dose by 0.5u just like you did previously. If you will get a minimum of one spot check per cycle, you can be more aggressive and raise the dose every 4 cycles -- BUT, you must get the tests in.

Let me clarify further. DO NOT raise the dose without spot checks. I'm really, really scared by how you are dosing Skipper. You do not have enough data to do anything with dose and by anything, I especially mean raising the dose. Just because you are seeing ugly pre-shot numbers is not adequate information to raise the dose. Your mid-cycle numbers could be in the 20s and by raising the dose, in the absence of concrete test data, all you may be doing is overdosing your cat and skating on very dangerous ice. You are putting Skipper's in jeopardy of a hypoglycemic crisis. No one here will put your cat's safety at risk my making a dose recommendation in the absence of data.

I said the following in another condo yesterday and it applies to Skipper as well:

Using any insulin requires that you respect the medication. Taking a drug like Tylenol is safe as long as you take it as directed. Take too much and you go into liver failure and you may die. Shoot insulin and don't monitor and your cat can be in a hypoglycemic crisis that not even a very skilled emergency vet can fix. If you have the capacity to test, then please, get at least one spot check at night. Right now, you do not have enough data to know if your cat is like mine -- a diving diva. Gabby has been known to go from the 400s at pre-shot into the 40s and back to the 400s all within one cycle. I've also caught her dropping into the 20s. If I hadn't been testing and if I didn't know how to manage her cycles with high carb food, the outcome would not have been good.

If your goal is to help your cat get into remission or to achieve tight regulation, then you need to do so while keeping her safe. We will be totally hamstrung trying to help you achieve your goals if you do not have the data. There are very few people here who will overlook safety in order to help you with a dosing strategy.