12/28 Lee Lu - AMPS 359, +3 408, +6 197, +10 311, PMPS 325, +2 322

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pandabur

Member Since 2014
Seems that the protocol is to link the previous day's thread:
http://www.felinediabetes.com/FDMB/threads/12-27-lee-lu-amps-317-3-259-7-292-9-299-pmps-364.130483/

Here we are in the land of pink flamingos. Pink is not a good color for either me or Lee.... blues and greens look much better on us.

Frustrated with this development. All the P's are here, the only other DB related symptom she's exhibiting is mildly excessive water drinking. Otherwise, she's happy all around.

Any insight, let me know. I know I said I was going to stick with 0.50 for multiple days, but her reads show me she needs more.
 
Hi Amanda,

Remember that with Lantus, you are dosing based upon how LOW the dose takes her, not the highs in between. The trouble is without evening cycle tests, it's pretty impossible to know how low the 0.5u is taking her. It is one of the characteristics of diabetic cats that it's not uncommon for cats to show most of their low numbers in the evening cycle while they are in the process of becoming regulated.

One reason is likely because of Dawn Phenomenon http://www.diabetes.org/living-with...re/blood-glucose-control/dawn-phenomenon.html where the body releases hormones in the early morning hours that increase the blood sugar in the morning/day cycle.

It's also possible you're seeing bouncing, where she may be going low at night and those lows are causing highs. I see exactly why you're thinking of increasing her dose with all the pinks, but I'm looking back to early December where the 0.5u was getting her into greens. It's definitely possible she needs more insulin. However, it's also possible she's going lower at night and bouncing during the days.

The way to know for certain what to do with her dose is to get a before-bed test. That will tell you what you need to know about how she's doing with the dose and you can be confident about what to do with it.

If I were you, I'd get a mid-cycle test in both cycles for the next 3 days and then you'll know exactly what you need to do.
 
Hi Amanda

I have no advice other than keep up the good work. Hopefully others will chime in. Is there any way you could get a pm blood glucose reading. This would help fill in the picture somewhat.

Did you reduce the dose to 0.5 because you felt lee lu might be bouncing?
 
Yikes, now I'm freakin' out a bit. +3 is 408!!! I think she needs an immediate increase to 0.75u. I know it is reactionary but she hasn't been tested at 408 in 8 months, since April!!
Could the insulin be bad? Its a new pen from Marks. Food is the same, no changes, no sneaking of other items, just bizarre.
 
Again, it's possible the high numbers are from hitting low numbers at night. When a mid-cycle test is higher than the preshot, that can signify a bounce.

You can't use Lantus to beat down high numbers. It just doesn't work that way. Lantus is like steering a barge - make a slight adjustment and then see which direction you end up going and if you're headed for the target. You're thinking like it's a speedboat - a tiny adjustment means an immediate result. Lantus is the barge, not the speedboat.

I still would wait for the data at night to decide on whether or not to increase. If she's getting low overnight you may make the situation worse by increasing the dose. That +3 looks like a bounce number to me.
 
Hi Julie, thank you for your quick response. I really appreciate it. :)

I totally get that analogy but it just seems worse each day. I am also pretty darn impatient, and when I review her SS, it seems that 0.75 (or just shy of 1u) is her sweet spot, so why wouldn't I just move there now? This is kind of a rhetorical question. So, really, I'm thinking I'm definitely shooting low. She's done more inappropriate pee recently than before. All points to high BG and an earned increase.

So for now, I just let her ride it out until her next shot? I will definitely get a +2 after her PMPS but getting a +6 is going to be difficult.

and how do you all handle the pinks and reds? I thought we were doing so well... and now a set back.
 
there is nothing you can do except wait for the next shot. But realistically I would wait and get some evening test in. Its up to you what you do but I think you don't have the data to know for certain that she isn't going low at night.

you don't need to get a plus 6 in the PM cycle. Just get a test before you go to bed.
 
It is easy to panic when we see those high numbers, but Julie is right that the dosing needs to be based on the nadir. With Furball I get up a little early so I can get a +10ish test before her AMPS. Then I can get an in the door test when I get home from work about +10ish. After PMPS, I get a +2ish test. If is seems like she is going to go low, I can grab a test at +3ish before I go to bed. I only get up during mid-cycles at night during the work week if she is heading really low. On the weekends when I can go back to bed I get the extra night tests in.

I think I read somewhere that the high numbers from bouncing aren't as hard on them as just being high all the time. It usually doesn't bother Furball when she bounces high.
 
hi Amanda
my Tibbs is a notorious trampoline boy. he bounces like crazy but i have to agree the high numbers that are bounces don't seem to bother him at all. his 5p's are great. how is Lee Lu acting. sorry if u already answered this. are her 5 p's good?
 
Well, this kitty mama feels a helluva lot better, +6 gave us 197!!! Blue!!!! I'll take it! :)
Thanks so much for your comments and encouragement. I would be in a world of panic without you all.

Nadine - Her P's are great, other than a more than average liquid intake/output, and the occasional inappropriate box behavior. Otherwise, you wouldn't be able to tell she has DB or any ailment.

Will test again PMPS and +2 after. I really feel like getting a +8 or +9 just to make sure I'm not crazy but I almost don't want to know if the 197 is a false read. LOL

How long does it take to steer your sugar barge? 2 doses? 4 doses? Just curious if there's a standard waiting period before truly assessing? 6?
 
I don't think the 197 is false - I think you're seeing a bounce clearing. I'd get the +8/9 or so to see what she's doing.

It takes 6 cycles most of the time, with those mid-cycle tests, to be able to see what a dose is doing. Depends on the cat - some cats show a response right away, some have the response on a later cycle. I want to say the Wendy/Neko has said that she can see what Neko's doing with a dose on the 4th or 5th cycle.

Has anyone given you this post on New Dose Wonkiness, Failed Reductions and Bouncing?
http://felinediabetes.com/FDMB/threads/new-dose-wonkiness-ndw-and-failed-reductions.46012/

That may help you understand some of what's going on with Lee Lu's cycles.
 
One thing to note in what you're seeing right now, Amanda, is that Lee Lu dropped about 208 points in thos 3 hours from the peak of the bounce high til the +6. When a cat drops too fast, their body perceives it as dangerous and a hypo, and will release MORE sugar/hormones to bring the blood sugar back up. The outcome is that a fast drop creates another bounce.

I'll be curious what happens in the next few hours and how fast she gets started in the next bounce. That's going to help us understand what's been happening in the past few days.

You're welcome Nadine!
 
Reporting back, +10 yielded 311. I would say she's bouncing LOL
But, she's fine otherwise... Will get a PMPS in 2 hours and another in +1.5 hours and report in.
Thanks everyone!
 
So here we are at the end of the day:
AMPS 359, +3 408, +6 197, +10 311, PMPS 325, +2 322
Julie - you weren't kidding re: bounce, see 12/29's AMPS, le sigh.
 
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