1/4 Munchie AMPS 368, PMPS 294

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ewest

ewest

Member Since 2011
Yesterday's Condo

Munchie's up there again. Thinking need to increase her back to 1.25u. Not sure if need to wait today for any bounce to clear.

From yesterday in case folks have thoughts to offer on this (See yesterday's post for my intro post on her):
Question:
"If the cat will not stay in the normal range after a reduction, immediately increase the dose again to the last good dose."

How long does one give for the cat to get in the normal range if they had a bounce like Munchie did? In other words, I know the blood sugar can be higher for up to 3 days after a bounce so should one wait 3 days before putting them back up to the last good dose to make sure the bounce has cleared? She did get in blues last night so that seemed good but not sure how tonight will be. Even on the 1.5 or 1.25 she was alternating between good numbers and bounces it seems (one cycle green/blue, next pink).

I know this is in one of the sticky notes "Worse case scenario is when you over fill the shed/insulin depot... get very low numbers... then empty out shed by dropping dose too much... or having to skip the shot. Then you'll see high numbers from the combo of the effects of rebound and an empty storage shed/insulin depot. Most react by bumping the dose back up which overfills the shed/depot again resulting in a roller coaster ride to nowhere. Not the way to work this insulin." I don't know that I dropped the dose too much unless she really didn't get under 50 the 2nd night and just got right on the edge? But it sounds like from this to not increase too quickly. Just not clear on difference between this and the "immediately increase the dose again" part.
 
Re: 1/4 Munchie AMPS 368- dose question

I decreased her from 1.5 to 1.25 when I got a below 50 reading a few nights ago. Then got a 53 the next night but caught her rising...is likely she snuck below 50 again but wasn't 100% so did a 1.25s instead of a full reduction (it's possible she hovered at the edge). Next night she did Somogyi and I caught her rising again (not her lowest point) so I did a minute change of 1F (thinking I may have missed her getting under either that night or the night before). I think the difference b/w my 1.25s and 1F is about a drop...I may need to get those magnifying glasses (where do we get those?). Anyway, decided to give her a 1.25s this morning hoping to help her out of the pinks.
 
Re: 1/4 Munchie AMPS 368- dose question

I just posted to you, but my post disappeared :roll:
I would have stayed with the 1F until the bounce cleared. Others will be around to help you, in a bit.
 
Re: 1/4 Munchie AMPS 368- dose question

I tend to be conservative with dose reductions. If I don't see a reduction worthy number, I don't give the reduction. In addition, when you take as many reductions as you have back-to-back, the dose doesn't generally hold. I would stick with the 1.25s for 3 days unless you test and get a number that's below 50.

Just as an FYI, the original research on Somogyi was done in 1938 and has never been replicated in humans, let alone with cats. At best, the concept of chronic Somogyi rebound is controversial. Further, none of the research has ever been conducted using a long acting insulin like Lantus or Levemir. After having done 2 literature reviews in medical and veterinary databases, the best I can tell you is that there is no confirmed evidence for Somogyi in cats on Lantus.
 
Re: 1/4 Munchie AMPS 368- dose question

Hi guys .. again, I have no dosing advice to offer .. looks like you got some good advice from others though .. It seems like right up till the last day mocha was on insulin we were still asking how much to give! Have a great day guys!
 
Re: 1/4 Munchie AMPS 368- dose question

Thanks so much everyone. I thought the 53 was a hard one to decide on since I didn't really know how low she had gotten. And interesting to have after a reduction. Have others seen this?

So I'm gathering folks would generally stick with the dose reduction for 3 days and then increase back up if need to unless get a recorded # under 50. Let's hope for at least yellows tonight.
 
Had a yellow for the PMPS, even though a higher one---we'll take it. Very cold and dry where I'm at---going to work on getting humidity in the air. Will see how she does this evening.
 
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