11/1 Minnie 164@amps; 191@+4

https://www.felinediabetes.com/FDMB/threads/10-29-minnie-194-amps-85-5-5.237732/

We had a few days of higher preshot numbers, but then some nice green nadirs, and it looks like we’re back to sailing the blues today. Her dose has been 6 units for a while now because I think it’s working, but I wonder if I should try to go up to 6.5 to see what happens? She might just earn a reduction and go back to 6, so I’m not sure if it’s worth it.

 

Hmm, no tests last night and a bounce today. I wonder is yet another cat did a little midnight swim under the full moon? I joke, but it's really a thing - many cats seem to do a little diving the night of the full moons.

As for dose, what are your goals for Minnie? Her nadirs are drifting up to higher greens (at least during the day time) and she's seeing a fair bit of pinks. If you'd like her to spend more time under renal threshold, I'd increase.

One other thing to consider, when cats get to 6 units of insulin, and are on all low carb wet or raw food, we usually suggest getting them tested for the secondary endocrine conditions that can cause the need for more juice. I'm specifically referring to acromegaly and IAA (insulin auto antibodies). My girl had both - one in four diabetic cats has acromegaly. The way to battle known insulin resistance is also to keep on the increases per the protocol.

 

There were fireworks last night because of Dia de Los Muertos and I couldn’t get either of them out from under the bed... same thing when the Dodgers won, it was a nightmare.

Is it possible she could have developed acromegaly and/or IAA after May? Before the hospitalizations she was regulated at 2.5 units

I obviously get nervous about the increases taking her too low overnight, but this surfing the blues had also never happened in the past. It seems like a new thing to her

 

I have seen a cat see signs of IAA after being regulated. Doodles was close to OTJ when he developed a heart condition, then IAA caused his numbers to go rocketing up. Acromegaly is more subtle. The benign pituitary tumour waxes and wanes. We have even seen acros go off of insulin, then come back and get to much higher doses. Without testing, we really can’t say if there is anything behind the need for higher doses, though once a cat is at 6 units, the likelihood is high.

 

I had an hour long talk with her new IM last night and he said he’s seen a fair share of cats on budesonide whose bgs do go up. We’re discussing adding a steroid inhaler for her asthma symptoms and he said even that could also affect it. Anyway, I’ll have the tests done at her next checkup which should be this month. Having said all of that though, look at her perfect numbers today! 188 amps; 70@+5.5 and 241@pmps. If I had increased she may have earned a reduction back to 6