11/14 Oberon PMPS 149, +3 113, +4.25 82, +5 85, +6 82

Lisa & Oberon

Lisa & Oberon

Member Since 2020
yesterday: mostly greens, and a good conversation about reductions https://www.felinediabetes.com/FDMB...-10-100-pmps-105-2-112-4-73-5-74-6-72.255427/

OK, after all that talk about me knowing what I'm doing, this morning I wasn't sure what to do. He was 51, and I dithered about whether to go ahead and give the full dose, give a BCS, or skip. I decided to go for it. Prepped the syringe and put food out, but then decided to check him again before giving the shot. 48. So at the very least I'm stalling, but now he's eating so I'd have to wait 2 hours. I'll keep checking him to see if he starts to spike upwards, but I have a feeling we're just skipping this morning. Reduction earned, and new dose this evening will be 5.25 U.

(And yes, 51 and 48 are basically the same number, given meter variance. If I had gotten 51 and 55 I might have gone for it, figuring we're comfortably above 50. But 51 and 48 tells me we're right on the edge. Also, his last measurement at +8 was 66, so he's trending downwards. Another reason to be cautious.)
 
Next question: what do I do with the syringe I prepped? (I adjusted it down to the new dose.) Can I hang onto it and use it this evening? I know you're not supposed to prep them far in advance (e.g. for vacations), but is 12 hours too long to sit? Hate to waste it if I don't have to.
 
I think I'd have hemmed and hawed and shot maybe a token, but you also know his crazy non-pattern patterns. I'd have to stare at spreadsheet for half an hour.

I know you said yesterday IAA doesn't seem to be going anywhere, but that's the problem with it (and the way Oberon is)...I think anytime he does this you kind of have to assume it could be
 
FrostD said:
I think I'd have hemmed and hawed and shot maybe a token, but you also know his crazy non-pattern patterns. I'd have to stare at spreadsheet for half an hour.

I know you said yesterday IAA doesn't seem to be going anywhere, but that's the problem with it (and the way Oberon is)...I think anytime he does this you kind of have to assume it could be
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Yep. And the other problem is that he's bimodal... pinks and greens, and very little in between. If I back off on the dose to stay out of low greens, he gets stuck in pinks. No happy medium. (He just waves to lemons on his way from pink to green and back.) I could back off on the Lantus and try to use R to keep him out of the pinks, but that's tricky itself.
 
I wonder if he would be less bimodal on Levemir. Just a thought. It does have a later onset/nadir which doesn't always work for people's schedules.
 
Wendy&Neko said:
I wonder if he would be less bimodal on Levemir. Just a thought. It does have a later onset/nadir which doesn't always work for people's schedules.
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I've wondered a bit about that. We just stocked up on Lantus, though... hmm. (11 or 12 pens in the fridge, and we're going through about one a month.) But maybe I'll talk to the vet about it the next time he's in for a checkup. How easy is the transition?
 
OK, you have a lot of Lantus on hand! Transition is to start on a lower dose (70%), just because some cats respond sharply to the change in insulin. Some thought it confuses the antibodies at first, don't know if that's it. Most cats need around the same eventual dose as they were doing on Lantus, but not all. You can fast track up in dose if it's clearly too little, with some guidance. Only do the transition when you can monitor closely.

I found the change frustrating at first, cause I felt like a newbie relearning onset/nadir and Neko's patterns. Having said that, formerly rainbow cat's second cycle on Lev was flat blue. It can also take the cats body a little while to get used to the new hormone (insulin) so there is a settling in period. Neko liked the change. Instead of occasionally walking away from the Lantus shot, she often purred through the Lev one.
 
I was just drafting a post to ask whether the antibody response was affected! I know Lantus and Levemir are made by making different modifications to the regular insulin, so it seems possible that the antibodies might bind differently.

I'm also back to wondering whether there might be something going on in addition to IAA to cause insulin resistance/high doses. We've ruled out acro, and he had a recent dental and no other signs of current infection/inflammation. Could there be some glucose toxicity kicking in during his long bounces? Something else I haven't thought of? Just trying to rethink things to make sure I'm not missing something obvious.
 
Lisa & Oberon said:
Could there be some glucose toxicity kicking in during his long bounces?
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I found with Neko that if she went 5 days without seeing greens, she had a little glucose toxicity develop. I think that's ECID on the timing. Since you are a whizz at spreadsheets, maybe see if a plot of numbers gives you a pattern between his love of pink and greens? Or redo the dip pattern sheet? Nothing leaps out from his labs. Has he ever had any cardio tests? That's the only thing I can think of that can cause insulin resistance that you haven't tested for. I think it's the Cardio proBNP test, could add it on next time he goes in for blood work. How is Oberon acting/behaving these days?
 
Wendy&Neko said:
I found with Neko that if she went 5 days without seeing greens, she had a little glucose toxicity develop. I think that's ECID on the timing. Since you are a whizz at spreadsheets, maybe see if a plot of numbers gives you a pattern between his love of pink and greens? Or redo the dip pattern sheet? Nothing leaps out from his labs. Has he ever had any cardio tests? That's the only thing I can think of that can cause insulin resistance that you haven't tested for. I think it's the Cardio proBNP test, could add it on next time he goes in for blood work. How is Oberon acting/behaving these days?
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Spreadsheet fun... I'll work on that! I don't recall that we've done any cardio-specific tests; I'll think about that. He's acting fine; zoomies this morning, chasing the other cats, etc.

Morning data: AMBG 51 recheck 48, skip, reduction earned, +13 59, +14 65, +16 102, +20 140

Apparently I forgot to actually tell him this morning that we skipped a shot and he could take a break. PM +3 and he's already coming back down...
 
Lisa & Oberon said:
Spreadsheet fun... I'll work on that! I don't recall that we've done any cardio-specific tests; I'll think about that. He's acting fine; zoomies this morning, chasing the other cats, etc.

Morning data: AMBG 51 recheck 48, skip, reduction earned, +13 59, +14 65, +16 102, +20 140

Apparently I forgot to actually tell him this morning that we skipped a shot and he could take a break. PM +3 and he's already coming back down...
Click to expand...
Well, you've found the secret to blue :joyful:
 
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