But a similar number... How does this indicate an "active" cycle. Doesn't a similar number indicate that it's going to be a normal cycle with a slow, gradual decline until nadir and the a slow gradual incline until PS?
Let's say he's 150 at AMPS; at +2 he's 145. Similar, right? Basically same number. If his previous PMPS shot was wearing off and he was not going to have any overlap between the two shots, he'd likely be much higher. Often as one shot wears off before the next one kicks in, numbers can go up pretty fast. BUT, let's say he got some really great duration and so as the PMPS shot from the night before is barely waning by +2 so the BG is not coming up, the AMPS shot kicks in, and off we go for an active cycle.
Conversely, if he's 150 at AMPS and at +2 he's 275 because he doesn't have any carryover so he also doesn't have any overlap because the PMPS shot already pooped out. So when he onsets at +2, he doesn't have the overlap of the two shots working together. The ideal lantus curve is basically flat because of the carryover and overlap.
If he's a lot lower at +2 and he onsets, it's going to really push numbers down fast, most likely. So it could be from a full depot or it could be that all of a sudden those counterregulatory hormones have cleared out, the shot kicks in, and you have a low number early. And yes, it is often a fast, early drop.
Maybe I'm not understanding the context of the term "active". Are you saying that a similar number at +2 is a good thing and indicates that the remainder of the cycle is going to be a slow drop and then a slow rise? :?
I'm not really pinning "good thing" or "bad thing" on an active cycle. It's more a "pay attention" notice. Also, because there are other variables, like absorption of that particular shot, the cycle might be a slow drop, it might be faster, or in a tightly regulated cat, it's going to be flat.
We never ever mind anyone asking questions. We are all here to learn no matter where we are in this dance or how long we've been doing it.
One more thing - As for the bounce-clear-bounce-clear theory, I'm probably getting way ahead of myself and I know that it's too early to draw any conclusions (yes my hopefulness is likely getting in the way of logical thinking at this point) but what if Webster doesn't even need insulin?
Look around at other SS's. Many cats do this bounce-clear-bounce and they are on bigger doses. Gracie did it a lot on lantus and she does still do it on lev but she's not quite as dramatic about it most of the time. Look at Gabby's SS. Gabby is a long-term diabetic. In my mind, that kind of cycle does not equal ready to go into remission when you don't see the cat earning reductions when they go low. There are times that I know Gracie is ready for a reduction because I have to really work to keep her BG up and usually she will still dip below 40. Also...look around at the cats who have recently gone into remission; Webster's SS does not look like theirs.
Are some cats overdosed and do they tank and then fire back up? Yes. But those cats are the ones that were started at huge doses by the vet and raised a unit at a time. If you use the TR protocol correctly, you can't overdose the kitty because the dose adjustments are so small. Can the food change make a difference? Absolutely. But I'm not seeing it on his SS. But that's just me. It's always good to hear other thoughts.
I know you want him in remission and he might very well get there. But I think the focus, right now, should be on regulation.
