11/9 Ozy AMPS-218,+4-329,PMPS-354 Ohhhhmmmmmm

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donaleen and Ozy

donaleen and Ozy

Member Since 2013
Yesterday http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=105945

Thanks, Mariko and Marje for your replies late last night. The insulin is three months old now. I can't say I know how to recognize when the insulin is worn out. We have been using the same vial for a little more than three months last night. And, Marje, John has started using calipers. He found that there is almost a quarter unit of difference between last night's syringe and this morning's syringe. Hmmmph.

I hope Ozy comes down today. His AMPS is the lowest number he has had in two days.
 
Re: 11/9 Ozy AMPS-218

This "looks like" a bounce clearing. Please don't let me look stupid' Ozy. ;-)
 
Re: 11/9 Ozy AMPS-218

Gracie reads her condos and does stuff JUST to make me look stupid :lol:

I'm not surprised about the syringes. If the insulin is clear and has no floaties, it's likely fine. Some folks have used their vials almost six months. If the insulin starts to go toasty, the numbers will look really wonky.

Come on down Ozy! Have a great day.....off to TBP for me. :razz:
 
Re: 11/9 Ozy AMPS-218

Thanks for stopping by Angela and Marje. And thanks for the tips on the insulin.

I think I will look for a crown for Ozy... He is Ozymandius, King of Kings. He must need a crown.
 
Re: 11/9 Ozy AMPS-218,+2-300 Ohhhhmmmmmm

Hi Donaleen! Sorry I haven't been by in a while! I'm glad Ozy is off to a good start today. I hope he heads down into some blue later on!
 
Re: 11/9 Ozy AMPS-218,+2-300,+4-329 Ohhhhmmmmmm

I hope Ozy turns things around for you soon. The first vial of insulin I got for Furball lasted me almost a year. If you take good care of it, it can last a long time.
 
Ozy leaked some insulin today. I have been sniffing him for ketones pretty frequently and this afternoon around AM+6 he smelled like Lantus although he didn't smell like Lantus earlier in the cycle....
 
Hmmmmmm.......there have been a few cases where insulin has leaked out. If he is dehydrated, it might occur. You could very gently pinch the skin where you injected.

If the insulin did not leak out, he might have a bit of New Dose Wonkiness.

So...that would be my thoughts for his SS for today.....what do you think?
 
He doesn't seem at all dehydrated. The way I shoot him is I push his fur aside so I can see his skin, then I pull up the skin there and put the needle in the spot where I can see the skin. Today the needle didn't seem to slide in like it usually does. There was some resistance. I don't know what would cause that (some problem with his skin or some problem with the needle, just possibilities). So I don't know.

Despite his high numbers, Ozy seems to feel pretty good. He is alert and engaged. This is unusual for him when his numbers have been high for this long. As long as he feels good, the numbers aren't as upsetting to me. They don't please me, but they don't make me crazy.

What do I think? I think we will probably have to raise his dose to a fat 3.75 before we get any action.

I hope he keeps feeling good. That is most important to me.

Thanks for checking in.
donaleen
 
I don't know what it is. I don't understand why he went down like he did in September. The only explanation that makes sense in my head is that his pancreas was working pretty well for a while and now it isn't. I don't know how you adjust for a pancreas that works sometimes. That isn't something anyone talks about much. That is just what makes sense to me.
 
Mike and I have often wondered this and I did read something once that indicated that as the pancreas heals, the little beta cells are very fragile. They try to do a little work and numbers might come down but if it overtaxes them, numbers go up.

Sometimes I see kitties that run along in nice numbers and then toss out a yellow for no apparent reason. My own speculation but I wonder if those fragile beta cells just reached their limit?
 
Donaleen,
This may, or may not, help. It's a novella I posted in PZI a year and a half ago.
http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=67645

Back then, we were also getting input at times from Dr. Lisa on one particular case where she had done prior phone consults with the caregiver (Lori and her kitty, Copper). Here's what she said in one of Lori's threads to help us understand something critical - that we only have control over some things. I think I mentioned this in one of your condos a couple weeks ago. We can control how much, and when insulin, and food, goes into kitty's body. But that is only a small piece of the puzzle. What happens after we shoot and feed, inside kitty's body, is pretty much out of our control...

...Yes, it would be great if we really had *that* much control over the disease process but we don't.

(Lori - I am hoping that the last statement will take pressure off of you - not add to it. Copper's body is in charge and we are just along for the ride...doing the best that we can with the ability to affect only a few pieces of the puzzle....ie....diet, insulin, constipation, body weight - in the case of an overweight cat.)

Serum glucose, at any single time point during the glucose curve, represents the sum effects in the *rate* and *amount* and *timing* of:

*Exogenous insulin absorption

*Endogenous insulin production

*Intracellular uptake of exogenous and endogenous insulin

*Insulin degradation and elimination - different for exogenous vs endogenous

*Intestinal glucose absorption

*Endogenous glucose production

*Tissue glucose uptake and utilization

and then throw in the amount of exogenous insulin....excess body fat....inflammation....subclinical infection....etc...etc....

....and then add in Copper's recent bouts with constipation (stress => increased BG) which prompted an email to Lori to get Miralax (or generic PEG 3350) into him asap before he ended up needing an enema at her vet's office...which is not easy for her to get to and I hated the thought of Copper having to go through all of this. (Dosage Rx was to start with 1/8-1/4 tsp AM and PM - mixed into food - and dose upwards to effect.)
Click to expand...

Another thing she said, and this goes to your point about how Ozy was responding in September compared to today.

(paraphrased)
"Ozy isn't the same cat today as he was in September. And he won't be the same cat in November that he is today."

From that, I came up with this, that I use on occasion:
Don't assume that what worked last week will work the same way this week.
And don't assume that what fails this week will fail next week.

When treating diabetes, you're sort of shooting at a moving target. Things change daily.
 
donaleen and Ozy said:
I don't know what it is. I don't understand why he went down like he did in September. The only explanation that makes sense in my head is that his pancreas was working pretty well for a while and now it isn't. I don't know how you adjust for a pancreas that works sometimes. That isn't something anyone talks about much. That is just what makes sense to me.
Click to expand...

from what I see on your chart/history, its likely that he was having a p-titis flare which resolved and at the same time, his dose went down to 3U fro 4U (which looks like it was too high for him)

I've been dealing with this and its been driving me crazy too.. I get his p-titis flare under control (100ml subq/day, 8mg cerenia 5 days on/2 off, codeine, pepcid, B12) and then he gets a period with good numbers.

Then, out of the blue, its either high or bouncing. This is when I err on the side of the p-titis flaring up again affecting high BG values, as opposed to him needing a dose adjustment (most people on here who don't have p-titis kitties typically will see the BG numbers go awry and then assume that, as per "protocol", the dosage needs to be adjusted. Which would be entirely rational for a kittie with just diabetes. Chronic pancreatitis skews this; the pain/inflammation of the disease messes with our ability to understand BG readings and their relation to the rubric which people use for regulation (the various "protocols").

FWIW, it lookd like he did well with 3U. I wonder if he got 100ml subq/day, 8mg cerenia 5 days on/2 off, bupe, 2.5mg pepcid, 1000mcg B12 weekly - on a regular basis for a few weeks with no dose adjustment - how that would work for him? (that way you are throwing everything you can at the p-titis and giving him a good stretch to adjust to a dose)
 
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