2/24 Eddie AMBG 160, +6= 409, PMPS = 342

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Jen&Eddie

Member Since 2013
Yesterday: http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=114297

Good morning all!

Last night was pretty much a high flat cycle after clearing that wicked bounce of 447 for PMPS. That's the highest pre-shot he's had in several weeks. Yicko.

Nadir appeared to be around PM +7 of 177.

+12 this AM = 160 :shock: His AMPS is less than what looked to be nadir last night.
+18 = 409 :cry:
PMPS = 342 (2.2u)

Stalled and tested every 30 minutes and got 160/166/162/166, so he's not rising very fast, if he is in fact rising. After our 18 hour cycle on Saturday, I don't know if this is a repeat of a super-long cycle, and the PM shot is still going, or what.

Had this been in the evening or on a weekend where I could have monitored, and if I could clearly see that there was a lower number at some point prior to AMPS, and if I could see that he's going up, and not down, I may have shot a slightly reduced dose to try and catch him on the way back up. I had one unit all drawn up to give a chicken-sh*t shot, since I can't be home to check on him, and then I chickened out.

Any ideas what is going on here? Could I have shot something, even a CS dose?

Eddie needs to stop hanging out with that rule-breaker Lucian... ;-)
 
Re: 2/24 Eddie AMBG 160

I really do wonder if his pancreas isn't joining the party for these long cycles. A chicken $&@! Dose might have been okay, but if you're not there and he continued down instead of up....
 
Re: 2/24 Eddie AMBG 160

Sue and Oliver (GA) said:
A chicken $&@! Dose might have been okay, but if you're not there and he continued down instead of up....

That was what the voice in the back of my mind was saying when I put away the insulin and chickened out on shooting.
 
Re: 2/24 Eddie AMBG 160

With the rather steep dive he took in the AM cycle yesterday and the huge bounce after, my gut is telling me that we need to scale back a bit. Maybe Eddie does need a hair less insulin. I guess we can experiment and if we don't get the results we want, we can always bring him right back up. I hate to lose progress, but I also don't want to hold a dose that's too high, if in fact Eddie wants to go down.

I do hope Carl chimes in on the "sputtering pancreas" versus/and/or/plus reduced insulin resistance issue. Maybe Eddie's cells are processing the insulin and glucose more efficiently, which is allowing his pancreas to keep up with the glucose for longer periods of time. :smile: That said, is this supposed to happen with kitties that are still up in the dose range that Eddie currently is?
 
Re: 2/24 Eddie AMBG 160

While I think it is generally true that it happens when cats are on lower doses, I am not sure there is any supposed to with feline diabetes. :mrgreen:

You could send Carl a PM and ask him.
 
Re: 2/24 Eddie AMBG 160

Yeah yeah, Lucian's a bad influence, I know. But he stretched out to +10 this morning, maybe they had it planned.

You know I have no advice, but I gotcha back. :-D 18 hr cycles may be all well and good but it doesn't free you up, you still have to be there testing and able to shoot when they do get to the right point. I'd much rather have something I could count on.

I do think if Lucian got to that point, I would reduce his dose, that's my first thought, with it happening repeatedly. Unless someone could tell me why I shouldn't.

PM Carl, he'll get back with you and come take a look. When I first came I PM'd him and Sue so they could take a look. :-D
 
Re: 2/24 Eddie AMBG 160

+18 = 409

Well, coulda, woulda, shoulda shot this AM. The cycle must have petered out shortly after I left. His nadir must have been much later than +7, and he was on his way back up. You'd think I'm testing enough, I could tell whether he's going up or down in a cycle. :YMSIGH: I did look at the ProZinc field study, and if I read correctly, it indicated that nadir could (uncommonly) happen at up to +12, and that duration could span up to 24 hours before BG returns to normal. It sure would be nice if Eddie liked SID shots, but ranging between 12-18 is making things a challenge. I hate seeing him sit in high numbers for half the day because I'm too chicken to shoot. :cry:
 
Re: 2/24 Eddie AMBG 160

I've been successful in dosing about 1/2 a normal dose when Cass throws me one of those weird lows. Better than skipping altogether (which doesn't work for him) and maybe worth a shot (pun not intended).
 
Re: 2/24 Eddie AMBG 160

Hon, I would have done the same. No way I would have shot even a CS dose if I was going to be gone, on that 160. That's something you have to do when you're home and can monitor.

Hopefully, he'll give you the chance to do that soon, so you can add that to your data and know what kind of dose to shoot when he's hanging in the mid 100's at preshot.

Lucian is so erratic, I'm so glad I don't work any more. Being the way he is, I couldn't take care of him if I wasn't here.

Although he's had some long cycles lately, Eddie is MUCH more stable. Just need a little tweaking. ;-)
 
Re: 2/24 Eddie AMBG 160, +6= 409, PMPS = 342 - DOSE HELP

Thanks for the input guys. :smile:

PMPS = 342

Eddie came down a little for PMPS, although it's probably within meter variance of the 409 at +6. My current scale is 2.4u for 250-350. I reduced from 2.6u for 300-350 about a week ago. In the last several days, on pre-shots in this range we've either had long cycles that I've had to stall till at least +14 to shoot a blue rising number, or like yesterday AM, a big steep drop, and a huge bounce. Time to reduce to 2.2 for this range??
 
Re: 2/24 Eddie AMBG 160, +6= 409, PMPS = 342 - DOSE HELP

If you don't like the way he responds, you can always increase it. I'd try it and see if it smooths him out some. Give it a few cycles with lowered doses and see.
 
Re: 2/24 Eddie AMBG 160, +6= 409, PMPS = 342 - DOSE HELP

Shot a reduced 2.2u. Fingers crossed for a good cycle! Thanks for your input Deb. :smile:
 
Looking at your SS...
On prior preshots, when you've stalled, and then shot at 180 or so, you've given sizeable doses like 2u or more. That said, I think you might have been able to do what Lisa said - like half a dose this morning?
What I find interesting is that he was flat or fell between +6 and PMPS. Did he eat after +6?

As far as the "sputtering pancreas" goes, I am not sure. I've seen it stated a lot, but I can't find a scientific explanation. I'm reading up on the difference between types 1 and 2 human diabetes, but also know that feline diabetes doesn't fit either mold exactly. It's supposed to be closer to type 2.

In type 1, the pancreas doesn't produce insulin. In type 2, it does, but the failure is the cells' inability to absorb/use the insulin, and the issue is more "insulin resistance" than lack of pancreatic insulin. I think we just have to add insulin to overcome the resistance? So maybe what we call a sputtering pancreas is actually some random periods where for some reason we are overcoming insulin resistance better than "normal"?

I dunno, I think maybe a "think tank" topic?
 
Carl & Bob (GA) said:
On prior preshots, when you've stalled, and then shot at 180 or so, you've given sizeable doses like 2u or more. That said, I think you might have been able to do what Lisa said - like half a dose this morning?
What I find interesting is that he was flat or fell between +6 and PMPS. Did he eat after +6?

I really appreciate you looking Carl. Had I been confident that he was rising on that 160 this AM, I probably would have shot close to a full dose. What made me second guess was that it looked like AMPS was lower than nadir, so I wasn't positive he was actually going up, rather than still going down from that flat PM cycle.

I'm not sure if you're referring to last night's PM cycle regarding eating after +6, but last night during the PM, he had his 2 Tbsp. FF "midnight" snack at +6, and is then a bit lower at +7 before going back up again, and that's what I thought was nadir. If you're looking at today, he had his 2 Tbsp. FF "lunch" at +6, but nothing other than that.

Carl & Bob (GA) said:
As far as the "sputtering pancreas" goes, I am not sure. I've seen it stated a lot, but I can't find a scientific explanation. I'm reading up on the difference between types 1 and 2 human diabetes, but also know that feline diabetes doesn't fit either mold exactly. It's supposed to be closer to type 2.

In type 1, the pancreas doesn't produce insulin. In type 2, it does, but the failure is the cells' inability to absorb/use the insulin, and the issue is more "insulin resistance" than lack of pancreatic insulin. I think we just have to add insulin to overcome the resistance? So maybe what we call a sputtering pancreas is actually some random periods where for some reason we are overcoming insulin resistance better than "normal"?

I dunno, I think maybe a "think tank" topic?

Think Tank is a bit intimidating for me to dip my toes in yet, I think LOL. That said, I thinking the sputtering pancreas thing might be as much about waking up the glucose receptors of the cells, in that they are more efficient at using both the insulin and the glucose, as it is about a pancreas that's waking up. More probably it's some sort of combination of the two. It would be interesting to see a discussion of how those things relate to a remission in cats. :smile:
 
Hey MommaBean. I don't have any input (gee, what a shock lol) but I just wanted to give you an internet hug and an internet boop on Wispy Rice Crispy's nose.
 
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