11/28 Klinger AMPS 489 3.7u +4.5 566! +6 393 PMPS 483

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Re: 11/28 Klinger AMPS 489 3.7u

Thanks Judy.
I was looking at his ss again and noticed that I started a new bottle of insulin on 11/13. I think I'll give him his old insulin tonight to see if maybe the new vial is bad or weak.
 
Re: 11/28 Klinger AMPS 489 3.7u +4.5 566!

Sometimes I'm sure that Charlie thinks that high numbers are good, like having the most monopoly money at the end of the game. Klinger must be confused too. I've explained it to him over and over, but he still must not get it- the way to win the game is to have LOW numbers! I swear, these kitties are gonna be the death of us!
 
Re: 11/28 Klinger AMPS 489 3.7u +4.5 566! +6 393

I don't really see much difference on your ss after 11/13 but maybe Gator or Nancy will stop by and look at it.

At least you're getting a little action today.
 
Re: 11/28 Klinger AMPS 489 3.7u +4.5 566! +6 393

Yes Robin I looked at Klinger yesterday and was like :shock:

I gave my 5% increase every 3 cycles advice. Nancy thought .2u would be fine too at this point but thinks to hold the dose 3-5 days.

Here's my thing with that, the "normal"-ish increase is more approximate to 10% increases of the nearest integer up in dose. So for 3-4u that would be .4u increases every 3 days or so. But I think Nancy is worried about some of the unannounced drops Klinger has had in the past. I'm very confused_cat about Klinger. Something is up/different with the last months curves vs the previous months. Marcy was considering a rebound check too.

In the past Klinger has gone from 0-60 in like 2.2 seconds [or more like 60-0].

Has Klinger been doing the barfing thing lately?
 
Re: 11/28 Klinger AMPS 489 3.7u +4.5 566! +6 393

Marcy I thought I would also mention something about rebound related to delta. That was more my second example that I showed you before. You would usually see that type of rebound after a delta larger than 60-65%.

Joanna detailed some of the old talk about delta here:
http://www.felinediabetes.com/FDMB/view ... 09#p300109

And Klinger has had larger drops than 65% like on 10/29. So one might interpret that higher PMPS as rebound. But on 11/5 Klinger had a delta of 55%, within OK range, and he still had an elevated PMPS. Now the dose on 11/5 was .2u less but that's not a whole bunch less [such that that would cause the numbers to race off]. I guess this is just one aspect that I'm not so sure rebound is doing this and I'm not saying rebound isn't doing this but my reaction could be the wrong idea here. Basically I'm stammering around and saying I could be wrong.
 
Thanks for that link, Gator. I need to absorb the information.
He did barf once last week, but I think it was because he ate, went outside (it was cold), he came in and drank water, ate a little more (took a really big chunk) and barfed it all up. I think it was a combination of the cold weather (he was only outside long enough to pee) and eating that big chuck too fast. I still give him the pepcid every morning and add water to his food.

My other "theory" is now that he's gone through the dental and has had a month to heal, what we're seeing are totally new numbers in the sense that all of the old data should not be factored into what he is currently showing us. Kinda like starting over (but not literally) because those eight teeth obviously had an effect on his old data. Now that they are gone, we're seeing his true numbers. Does that make sense? I'm sorry I'm all over the place - he's rebounding, he needs more insulin in bigger doses and faster. It's just driving me nuts. :?

Thanks for the support.
Claudia, we definitely need to get our kitties on the same page with us. I wish they could read the message board. :lol:
 
mars72 said:
(he was only outside long enough to pee)
Click to expand...
OK. I'll take your word for it. ;-) As you may or may not know, outside kitties sneaking junk fud [even dog food] from neighbors is one of my favorite theories on wonky numbers.

mars72 said:
Now that they are gone, we're seeing his true numbers. Does that make sense?
Click to expand...
Completely. That's kind of one of the points/working theories I was trying to develop yesterday.
 
I know how you feel about outside kitties sneaking junk food and that might be true if he could get out of the yard. He's a little too hefty to jump the fence and his previous owner (whoever that was - Klinger was found on the streets with a big slash across his nose and a big chunk taken out of his cheek) had him declawed :evil: . He can't even puuullll himself up the fence.
 
DH kicked me off the computer....it's hard to type on this little keyboard.
If we just take klinge's data as his true numbers in the last month - is it possible that I've now missed his correct dose by not starting over at 1 unit? Just want to talk about that so it can be settled in my brain.
 
I think it is an valid consideration and important thought.

The last that *we know* he had a decent drop was 2 weeks after the dental.

Problem is I don't know how long it takes for the dental thing to resolve. I've probably seen it happen but I don't remember. This would be a good question for Joanna. I'd almost like to get her input on Klinger at this point too. Or even summon another opinion from another past pzi'er that I have in mind.

From what I can tell you seem to be really doing things right here and I'd like to see some progress for you guys.
 
You have a very good point.

Here is my take on it, let me know if I'm off base, with infected teeth his bg's would be elevated after the dental his bg's should drop if the infection has been removed but his insulin dose didn't change.

Maybe a rebound check is in order here.
 
10 days after the dental, she dropped to 3u and held it 2 weeks. (vet suggested holding a 3.2u dose for awhile, I think) At the time, I was used to this being a very conservative dose, but maybe it wasn't low enough.

I don't know Marcy's schedule, but I would like to hold this 3.7u another day or so (2-3?), to see if some of the readings today were...wonky (i'm suspicious the 566 may be off)

If he is still high and not responding then, a rebound check may be a good idea.

What do you think Marcy? One concern is whether his medical issues are subsided. BTW do we have poop yet?
 
Marcy,

Just got some input for you from a PZI old timer [who has switched to Lev now]. Se mentioned two ideas:
1) Potential use of R until you can get into better numbers [I cannot help you with that].
2) Potential switch to Levimir as it supposedly does not require the strict adherence to the 12/12.

So what you might want to do is drop in on the Levimir group and tell them about your requirements with your schedule and see if they agree that Levimir could be used the way you need [both for the amount you can test and the need to not stick to the 12/12].

Just thought I would plant those ideas. If you do get input from the Lev folks please let me/us know about it.
 
Hi there! I haven't been following along lately, but Gator asked if I could stop by ... so here I am!

My take is you were getting intermittently good results back around 10/17 and the days around then. Then started getting some improvement maybe (? a little puzzled why such good results on 10/30...?), but then started losing ground around 11/6 on the 3u, and then it looks to me like his body has been staying ahead of the dose since then.

My experience with Bix has been that it takes less insulin to keep him in good #s than it does to get there - I suspect it's because of a sputtering pancreas, which Klinger may or may not have. With Bix, if he gets up into pinks it can take a few cycles and higher doses needed to bring him back down, whereas if he stays in blues & a few yellows, a smaller dose is needed to keep things steady. I don't exactly mean sliding scale, though it's probably semantics, more that my sense is they can get sort-of stuck in higher #s (my read is their pancreas may have been helping at lower #s, and then goes back to sleep in the higher #s).

If that read is correct, I would expect you will see a breakthrough pretty soon, since you are at about the dose that seemed to breakthrough fairly well before. And then you may find a bit of a dose reduction path is needed, possibly landing you back around the 3.2 zone and still seeing decent #s. But if Klinger's patterns are like Bix's, I'd say that once you've lost ground, a good working dose is useless - you have to go back up to the breakthrough dose to get back to decent #s.

I'm not sure that made sense, what I'm trying to say is that (if my read is right) the #s make sense to me as 3.6 you got in good #s, then only needed 3.2ish to hold them, then got out of good #s and are losing ground pancreas-wise, therefore need to go back up to the 3.6 to get back to the good #s (and then if you are lucky will be able to come back down to 3.2 or so).

If you don't see better #s and start getting to doses over 4u w/no sign of better #s, then I'd say something else (?) may be going on.

I don't see a rebound pattern. That 566 on 11/28 is wonky, but everything else I see is pretty much U-curve, which is what you want.

If you have a desire to try early shooting that's one option - it is pretty daunting though, so I wouldn't push that on anyone. It does look like (past few days overall high #s notwithstanding) he hits the high #s by +12, so on a day when you do get good blue #s, shooting at something like +10 or +11 to head off the higher #s with some cats really works wonders. It's not too useful though if that means you can't shoot til +13 or +14 on the next cycle - it works best if you can take a long weekend or something and stay on top of the #s. It's hard for me to tell what in Klinger's #s might be liver training, and what is just that he throws high #s and needs a decent dose of insulin to counteract that.

On the dental front, when Bix had his teeth done his #s ran higher for a few days, and then after that seemed to go back to what they had been. He had several teeth out and possible infection/ABS, though they couldn't say for sure if he actually had an infection or not, so if not, that could explain the lack of change in his #s.
 
what Joanna described I have seen with Cody, and some others (acro) have written about. That sometimes a few cycles of a bigger dose are needed to bring the numbers down, and then a lower dose can hold it. I've seen that work with lev, I'm just not as sure about Prozinc. I think her description is very plausible.

Along the same thinking, I still suspect that there is some preset number that the body thinks is "the target", and if the numbers have been high, that's where they want to stay. Maybe it takes some firm steady increases to get ahead of the numbers. I'm hoping the 3.7 is a wake up call. Come on Klinger!!!!
 
I haven't been on the board for a day, but it feels like a week. Just finished a huge proposal at work. So glad it's done. :-D
I have to catch up on all the posts I missed, but just wanted to thank you all for chiming in.
 
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