08/05 Pearl PMPS=96, +4=388 What do I do??

[Pearl and Emily]

hello, all!

Pearl has been providing some regularity(?) since starting our 1.25u 8 cycles ago. Between yesterday and today, it seems her nadir is around the PMPS mark! Because of today's numbers I am going to try to get more readings surrounding the PMPS (+11, +1, +2) to collect more data.

The work week starts tomorrow and so I am wondering what others may recommend as far as how I proceed. We are still attempting to follow the TR protocol and per that protocol:

• Hold the dose for 3 - 5 days (if nadirs are less than 200) before increasing the dose by 0.25 unit.
• when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing

Because we are so freshly into this green range, is it safe to say I should hold the 1.25 for at least 2-4 more cycles as it suggests?
Her nadir seems to be unreliable, unless the past two days is her new 'normal'. I am trying to learn her patterns but she is hard to predict so far!

Just looking for some advice with the TR protocol in mind. I mention that my (3 day) work week starts tomorrow because I will not be around as often to monitor.

 

[Chris & China (GA)]

Because we are so freshly into this green range, is it safe to say I should hold the 1.25 for at least 2-4 more cycles as it suggests?

Yes, I'd hold the dose longer since she's new to the lower numbers

 

[Pearl and Emily]

Thanks. I just took a + 2 reading and we're all the way up to 285. She gets the same quantity of food every 4 hours so I know this can't be food-related. Is there any reason to think that the insulin is actually causing her to rise so quickly in BG?

 

[Chris & China (GA)]

Is there any reason to think that the insulin is actually causing her to rise so quickly in BG?

No.....it's probably the beginning of a "bounce"

Her body isn't used to living in those lower numbers anymore, so even though that's what WE want, we have to give her body time to re-learn that it's OK to be there.

But it's nice to see some greens sprinkled in now and then lately!! That's progress!!

 

[Pearl and Emily]

I realize this is not necessarily as dangerous as Pearl being hypo, but there is obviously some insulin resistance happening here. Can anyone with similar experience give me a suggestion?
The Lantus obviously should be working by now...
It seems like her liver is WAY overcompensating and dumping out glycogen.

My vet and I spoke earlier about decreasing her dose and/or giving the insulin onxe daily as it has not been wearing off in time for the pm dose. However, this bounce is so drastic that I am not sure where to go from here.
Do we just ride this bounce out and stick with the 1.25u every 12 hours?

 

[Jill & Alex (GA)]

I realize this is not necessarily as dangerous as Pearl being hypo, but there is obviously some insulin resistance happening here. Can anyone with similar experience give me a suggestion?
The Lantus obviously should be working by now...
It seems like her liver is WAY overcompensating and dumping out glycogen.

What you're seeing is typical... a bounce from BG numbers her body is not used to. Try not to analyze or expect action in every cycle. Instead, think of "waves of action" when using Lantus. These "waves" will often last for 3 days until kitty becomes better regulated. The verdict's still out on how long these waves of action will last with Pearl...

 

[Chris & China (GA)]

It seems like her liver is WAY overcompensating and dumping out glycogen.

That's exactly what I think is going on and unfortunately, it's totally normal (and frustrating!!)

Our kitties are masters at hiding that they are sick in the first place.....by the time we humans see enough signs that something is wrong and get the diagnosis, they've usually been diabetic for a very long time. Their bodies have become used to living in those high numbers.

By dropping into "normal" numbers, her liver is just over-reacting. They don't necessarily even have to drop "low".....just dropping from 350 to 200 is enough to set off some cats.

It's just going to take time!!

Time for you to get your first pair of "patience pants".....they can be uncomfortable, but we all have to wear them at some point!!

 

[Pearl and Emily]

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Thank you, I am just driving myself crazy with worry for her safety. I appreciate your encouragement!