10/16 Pumbaa AMPS/343 +5.5/365 +9.5/286 PMPS/372 +3/345

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Pumbaa

Pumbaa

Member Since 2012
Well, Pumbaa is certainly taking his darn sweet time settling into this dose. :(

This is his fifth cycle at 2.0U, and I think his numbers were better at 1.75U. What is up with that?

I'm going to go nap on the sofa tonight and catch a +7 reading. I'm thinking it's encouraging that he at least went down slightly for his +3 tonight instead of going up.

Suze
 
I swear, who knows why they do what they do? Missy has been up, too, after her nice run. I have a hard time not being able to understand things, but I think I have to stop trying or lose my sanity entirely!
 
Mares: at least for a short time Missy was low enough at pre-shot that you didn't have to giver her the "R" insulin. How high have her numbers been since 10/14?

Sheila: Hopefully! But at 1.75U Pumbaa at least showed some signs of dropping lower after 4 doses. I'm :roll: because every time I increase his dose, his numbers go higher and his reaction to the previous doses looks better and better to me. The total lack of logic behind that boggles my brain. Do I wait longer for him to settle into these doses, or do I forge ahead and increase, hunting for the elusive magic dose? Sometimes I swear I'm just shooing water and not insulin! *LOL* But, I am still counting my blessings that Pumbaa doesn't run away anymore once that insulin hits his body!


Suze
 
And I am still looking for a clear indication that he might be rebounding - and that reducing the dose would be helpful, but it isn't really there. However, better numbers on a lower dose is one indicator so it is confusing. Going back to 1.75u and seeing if his numbers improve is always a possibilty.

He just may not be *as* insulin resistant to lev (yet) as he was on previous insulins so he is getting more action out of it at similar doses to the other ones, but still dealing with glucose toxicity and, therefore, insulin resistance. That is probably a more likely scenario, so methodically raising the dose will get you where you want to go (or him where you want him to go).
 
Sheila, how can you tell the difference between NDW and glucose toxicity/insulin resistance?

If it's GT/IR, would raising his dose tonight (after 6 cycles at 2.0U) be the right thing to do? Or should I let this ride for a few more cycles and see what he does?

I hate seeing his numbers so high, but I don't want to increase prematurely, either.

At 2.0U on Lantus, Pumbaa was at least hitting blues and greens....then bouncing and diving. I do not miss the diving one little bit! But I sure would like to see those blue numbers again.

Suze
 
Suze,
I have to go and update her SS, but 10/14 she was 208;260 and 282 with no R given. 10/15 she was 209; 261; 280 with .5 R given. 10/16 she was 292; 350 ( :o ) 283 and 277. She got 1 unit R at AMPS and .5 at PMPS. This morning AMPS was 214 :smile: . I also dropped her back to 6.25 units Lev.
I thought that if I increased the Lev, maybe she wouldn't need R, but her numbers were going up. I dropped to 6.5 minus one drop (trying micro dosing based on advice I received) but that was when she had the 350, so I dropped her back to 6.25. She definitely likes the R.
I have tried everything with her....all the tests, did the Hodgkins protocol for a while (10 hour dosing, which is hell) and even did 8 hour dosing because my vet said she had had success with that in high dose kitties. None of it did anything. She was doing ok at 10.25 units Lantus....getting greens but bouncing horribly. That is why I like the Lev...she bounces, but not so high. I guess if i have to give her both insulins, I will. I just want to see decent numbers.
They definitely like to keep us off guard, don't they?
 
NDW settles out over a few cycles (varies by cat), GT and/or IR will take a long time to break and, I think, you won't see much change in numbers until you have made many increases (also varied by cat), but then it will "break" and you will have good and better numbers fairly suddenly.

I actually think I am up against GT/IR with Cami now. She had an immediate response to lev, probably because it was a new insulin and she had not had insulin for a while in her system. Now her body is used to it and resisting it. I'll probably increase her over the weekend.

However, with Pumbaa, his numbers are following the same pattern they did on 1.5u and 1.75u (except for that nice second cycle, which was out of the pattern). He hit a good mid-200 today. I would be inclined to hold through tomorrow - especially if his PS is in the 200s tonight.
 
Mares:

Other than 10/16 and that 350, those numbers aren't too bad!

Yep, they might still bounce on Levemir, but the bounces don't seem to be as high. And, at least Missy is on a lower dose of Levemir than on Lantus.

You've done so much with Missy to try and control the FD. I hope that her body, one day, settles down and says, I'm tired of being on insulin, and her little pancreas takes over again!
antijinx-emoticon.png
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Sheila,

I still think Cami is doing great on .50U considering her stress levels! And, she just went off dry food about five days ago.

My fingers are crossed for you that a) she's going to be a low-dose cat, and b) she's going to be one of those cats who goes into remission quickly, once they are off dry food and getting insulin.
antijinx-emoticon.png
. (That anti-jinx icon is really coming in handy. *LOL*)

Pumbaa hit a 287 at +8.5, but hopefully he won't go into the 300's by PMPS. And he's acting really sluggish with these high numbers. If he hits above 300 for his PMPS, I might just increase him to a fat 2.0U.

Suze
 
If you are going to increase, go ahead to at least 2.25u (don't forget to think about percentages) You aren't in the "fine-tuning" stage yet so dose changes should be in the 20-25% range at this point, which would actually be to 2.5u.

Cami, did not just stop dry on Sat. She was switched in August in the hopes that a low carb diet would help, but I am not sure that she only got the FF classics. There was a box for a case of "gravy" ones, but owner said "it's just an empty box". And wasn't it full at one time....?
 
Sheila, Pumbaa hit 305 for his PMPS, so I did just go ahead and increase him to 2.25U.

Well that is good news that Cami had been switched over to wet already! That made your life a little easier!

So the nice low numbers that you have seen so far could be due to her not getting any high-carb gravy food, or just due to the fact that she was finally getting insulin. In any case, she's still doing better in the first 5 days after you took over her care than she was without getting any care, especially when her stress levels are high, and you deserve a huge pat on the back! *pat, pat, pat*

Suze
 
Pumbaa said:
Sheila, Pumbaa hit 305 for his PMPS, so I did just go ahead and increase him to 2.25U.

Suze
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That's good news since Chip already earned a reduction again. :shock:

So they were only on the same dose of the same insulin for a single day. I kept it pretty low key so Pumbaa wouldn't get wind of it. ;-)

Of course I'm sure I didn't sneak it past Pumbaa which explains Chips's brief pink wonkiness I suspected was steering carb overshoot. :mrgreen:
 
Chippendales:

Pumbaa is way behind Chip in the Levemir process, and is still going up the dosing scale, whereas Chip is now coming down (and thank God for that!). Chip is doing great, once again! So good to see that, not that I want you to go back to never sleeping and staying awake 24/7 to test him. *LOL*

Don't keep Chip's progress low key! I want Pumbaa to have a mentor to emulate, especially for the good numbers! I would love Chip to communicate with Pumbaa every time he hits a green and feels great! Pumbaa doesn't seem to respond to me talking to him and providing encouragement/cheerleading. :(

Suze
 
That would be great if Chip could just drag Pumbaa down. But that isn't the way it always seems to work.

Now you can at least learn from Chip's big adventure. And all the mistakes.

Don't you remember how much flack we used to get when we discussed switching to Levemir?

I wish I had started out with it, but there is always a lot to learn. I guess we learned from Lantus.
 
Dale 'n' Chip said:
Don't you remember how much flack we used to get when we discussed switching to Levemir?

I wish I had started out with it, but there is always a lot to learn. I guess we learned from Lantus.
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Oh yes, I do remember all of the flack I received when I first brought up Levemir vs. Lantus as a potentially better insulin for Pumbaa, the diver/bouncer.

And I, too, wish I would have started Pumbaa on Levemir instead of Lantus, from the beginning. But, I didn't know in the beginning that Pumbaa would be a diver/bouncer on Lantus. But, once that MO was established, I would have thought there would have been more support for switching to Levemir than there was, even though there were no guarantees that Pumbaa would even out more on the Levemir. It was still very worth trying due to Pumbaa's diving/bouncing and his reaction to the sting of the Lantus every time I injected him.

I truly do NOT understand a loyalty to one "L" insulin over another, when the loyalty should be to the FD cats and their treatment, and to the caregivers of those cats.

And I truly wish Pumbaa was exhibiting better numbers, so his previous vet (the one who wouldn't prescribe the Levemir because she was afraid of hypo's) would have a miracle to look at on his SS, and his current vet wouldn't be second guessing the change, just based on the currently high BG numbers. (While I am still blessing the lack of sting during the injections, and the lack of erratic dives to dangerous low numbers, and the relatively flat numbers, even if they are high right now.)

Suze
 
Its easy to second guess the past. I am glad I started Beau on lev and I don't think I will ever use another insulin on a cat. However, I am grateful for those of you that did start on lantus and then switch to lev so that we can see the differences in response. I am especially interested in the mood/behavioral changes in many of these cats. To me, this provides information for people with tough to regulate or grumpy cats on lantus (which certainly is not most of them) that there is another direction to take.

It appears that the differences in the insulins might extend to how well they break through things like glucose toxicity and insulin resistance. Perhaps lev is not as good at it and/or it just take a higher relative dose to do it. Or, if the cat has done badly on lantus it is because their body make up together with lantus set up a particularly resistant IR and higher doses are needed to overcome it.

I will be interested in how Cami fairs with lev having never had any other insulin. Both of my boys were started on vetsulin. Cami is a true "clean slate". Certainly she must have both GT and IR, so how high will the lev need to go before she hits greens?
 
Sheila & Beau & Jeddie (GA) said:
However, I am grateful for those of you that did start on lantus and then switch to lev so that we can see the differences in response. I am especially interested in the mood/behavioral changes in many of these cats. To me, this provides information for people with tough to regulate or grumpy cats on lantus (which certainly is not most of them) that there is another direction to take.
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I agree. And I was thankful that Dale switched Chip before I did so that I could watch/learn from what they went through.
 
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