10/31 Heart AMPS 103 - New "Normal"?

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dodgingwrenches

dodgingwrenches

Member Since 2010
Heart has been getting very low doses - such low doses I have a hard time measuring them with my BD Ultra Fine II needles. If he gets this tiniest dose, he has beautiful low numbers. And he's only been slightly elevated before shot-time. So last night I decided to skip a shot and see what happens, in case this tiniest dose is causing bounces (Somogyi effect). This morning he's at 103. For a cat that has had diabetes for three years (mostly in remission), could this be the new "normal"?
 
The Wiki page was put together quite some time ago. The references that are there are not annotated they way a reference should be presented (i.e., with the date and specific source of the information). Several of the links are dead. I would not trust the information given that it's apparently out of date.

Looking at Heart's pre-shot numbers, they are frequenlty outside of normal BG range (i.e., above 120). I don't think there's a new "normal."

Also, a bounce is not the same as Somogyi. I also don't think Heart is bouncing. I think you're seeing a typical cycle where the pre-shot numbers reflect that the insulin is wearing off and numbers are rising. There's no indication that this is too much insulin (i.e., there aren't inverted curves).
 
Morning. ~O)
I agree with Sienne.
Heart still needs that tiny bit of support...
He gets those above normal numbers, 169, 175, 142

It is unfortunate that our syringes can vary so much, it makes it difficult to keep the dose consistent. You could be giving tiny variations of a drop or more
between shots but there isn't much you can do about it.
You just do the best you can with trying to be consistent.

I went thru similar issues. Mine wouldn't drop low and earn decreases.....
She took her time , and made full use of the insulin all the way to the end where she was still iffy.

Try to focus on the positive....
Heart is staying in greens so very much and it is all healing time.
He will get there. ....that dreaded word..... patience. :mrgreen:
 
FWIW, Donovan was OTJ for about 1.5 years before I lost him. He spent a lot of time in the low blues, until he started throwing yellows because he needed dental work. I considered blues his "normal". Even his OTJ trial had plenty of blues in it. I guess it comes down to what you consider to be normal for *your* sugarcat.

MJ
 
Sienne and Gabby said:
The Wiki page was put together quite some time ago. The references that are there are not annotated they way a reference should be presented (i.e., with the date and specific source of the information). Several of the links are dead. I would not trust the information given that it's apparently out of date.

Looking at Heart's pre-shot numbers, they are frequenlty outside of normal BG range (i.e., above 120). I don't think there's a new "normal."

Also, a bounce is not the same as Somogyi. I also don't think Heart is bouncing. I think you're seeing a typical cycle where the pre-shot numbers reflect that the insulin is wearing off and numbers are rising. There's no indication that this is too much insulin (i.e., there aren't inverted curves).
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Hi Sienne,

Those ranges come from the Merck Veterinary Manual http://www.merckmanuals.com/vet/appendi ... anges.html. I just now got a 112 for him at almost 24 hours without insulin. What do you mean with inverted curves?

Sophia
 
MJ+Donovan said:
FWIW, Donovan was OTJ for about 1.5 years before I lost him. He spent a lot of time in the low blues, until he started throwing yellows because he needed dental work. I considered blues his "normal". Even his OTJ trial had plenty of blues in it. I guess it comes down to what you consider to be normal for *your* sugarcat.

MJ
Click to expand...

Hi MJ, My guy actually has a tooth that needs to come out. Have another appointment next Wednesday with a new vet to get an estimate for a dental, and then will be booking it. So hopefully in a month that influence should all be cleared up. Maybe without it he'd be in the greens?
 
If the tooth is causing any pain or any infection, it's possible that those things would inflate his overall numbers. So yes, absent the tooth problem, he might be more green than blue.
 
an inverted curve can show up when the cat is getting more insulin than it needs.

that means that you give a shot, say at 100, then the BGs rise for a few hours and perhaps +6 is 140, with the BGs decreasing as the next shot approaches.

so instead of a low mid-cycle, you have a high point in the middle of the cycle.

Heart isn't having inverted cycles. there's still a higher preshot and a lower nadir. in a cat going OTJ, usually the midcycle holds green first, then the PMPS, then last to come down is the AMPS. that puts the cat in all greens and then they're ready for an OTJ trial. that's the pattern that seems to have the best chance at sustaining OTJ.

generally you want all numbers under 120 before you do an OTJ trial. with a .25u dose, you could still reduce that dose if you needed to. if he were mine, i'd keep giving him the .25u and see if the rest of the numbers will fall under 120.

and i agree about the tooth - if there is any infection or pain present, that could be inflating his numbers.
 
You could also try to feed Heart around +9 to see if his pancreas might be able to produce some endogenous insulin and pull his PSs down. We suggest this occasionally for cats who are getting down to very low doses and still have higher PSs.

But I agree....I see no Somogyi, no bounce, and no inverted curve or anything to indicate he's got too much insulin.
 
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