Re: 12/3/11 Marilyn AMPS:327 +5:214 PMPS:488 +2:601 +3:601
Barn Cats R Us said:
I've looked at several kitty's SS's, as suggested, and although they may be helpful if I had more experience, or possibly more sleep...I am just not finding a correlation to Marilyn's numbers. Marilyn is showing a glaring, and consistent, difference between AM & PM cycles. The term "bounce" is used often, and I am trying to wrap my head around this concept, regarding Marilyn's numbers. I've heard that a bounce, or rebound (assuming they are one in the same), "can" take days to clear. So assuming this is her liver causing a bounce, and knowing that ECID, can there be a consistent predictability of this PM "bounce", that happens every day, for the same length of time, then clears, and repeats? Does anyone have firsthand experience, or knowledge regarding "this" pattern?
Bounces
can take days to clear, but some cats clear them much faster. In fact, most cats' bounces get shorter and shorter until they go away. It's not unusual for cats to go through a phase where they are on kind of a 24 hour schedule like this. Also, we often see that cats coming off of a shorter-acting insulin, like Humulin or Vetsulin, can sometimes bounce more than cats that start right off on Lantus. Their bodies become accustomed to that fast up-and-down of those insulins and sometimes it takes a while to condition that response out of them. Breathe! It has only been a week and Marilyn is still adjusting to Lantus.
I must say, I switched to Lantus since the folks over in Health were concerned with her high pre-shot numbers on Humulin. What I'm seeing now seems much worse, and more concerning, than just high pre-shots. My untrained eyes have looked at the Humulin data, and I'm not seeing this "bounce" from lower BG's. All I can see, again, with untrained eyes, is the Humulin acting the way "it just does" in cats. I'm not seeing her body fighting the lower numbers...just the Humulin wearing off...as it's known to do in felines. I'm finding her PM Lantus data troubling to say the least; her SS is hurting my eyes. Maybe it will "clear", as you say, and by tomorrow, it will be smooth sailing from there, on. However, why would her liver, in such a regimented fashion, fight the low BGs on Lantus, but not on Humulin?
It was fighting the lower numbers on Humulin too. Her highs were in the daytime more than at night on Humulin. One thing about Humulin is that it is good at bringing down high numbers quickly. That is why you don't notice the highs as much, because the Humulin DID pull them back down (until she bounced back up again). Lantus doesn't pull down high numbers as well because it is more cumulative in nature, but when it is working well at a good dose it will help smooth out the ups and downs so she will stay more steady. That doesn't happen overnight, though. Please don't be looking for immediate improvement. It will take some time.
I'm going to point out one other very important point:
please, please, please get some sleep! Take care of yourself. When Marilyn is that high, get a before bed test and then go to bed and don't get up until morning. There will be plenty of time for sleepless nights once she starts getting low numbers. ;-)
One of the things that is most frustrating about Lantus at first is that most people expect to see the insulin doing something. With Humulin, you inject the insulin and the numbers go down. If you inject more Humulin, the numbers go down more. Lantus doesn't work that way. In almost every case, what we see is a whole lot of nothing, dose increase after dose increase, until one day BAM. There is a breakthrough, all of a sudden. Then usually the cat starts earning dose reductions pretty quickly.
Most (not all) cats end up needing a higher dose of Lantus than they needed on whatever their previous insulin was. Just keep working the dose up systematically until you get that breakthrough. Of course, if ketones increase then we'll need a more aggressive strategy, but for now I think you are doing a great job.
Oh, and what Sienne suggested about Marilyn not feeling as well when she is low because she is used to being in high numbers? That is probably true. I had a diabetic friend tell me that. Later she started feeling GREAT when she was low, but it was an adjustment.
So breathe, and sleep, ok? :YMHUG: I-)
