2/8 Smudge AMPS 730 +2.5 Hi +4 706 +7 535 +10 447

Astexcat

Astexcat

Member Since 2019
http://www.felinediabetes.com/FDMB/...11-5-313-pm-2-381-pm-6-246-wow-so-low.225326/

Good morning everyone, apologies for my continuous freaking out, but I have always been far more comfortable with the unknown when I understand the theory behind it or know there are equations/formulas/easy to see relations but other than insulin = blood sugar affects, the diabetes is throwing me for a loop.

So, after last nights 246 reading, I didn't expect to be at 730 this morning. That's one heck of a bounce, right? Her body has dumped a lot of sugar to get there from the low last night. The blood test isn't lying is it (I've thought that before but...). I'm guessing once the depot is built things should level out, yes?

Questions I have floating around about depot insulins hat I've thought of:
1. If they're based on a depot build up, why do they have initial effect pre-depot build up (like the in/out insulins)
2. Is the rate at which the body uses the depot varied based on what's going on in the body (sickness, stress, etc...), or is it always steady no matter what

I'm sure I'll think of more once we get further along this journey. I'll probably freak out again Monday when I won't be home all day to monitor, but I'm hoping by then I'll have a little more trust in what it's doing to her daily.
 
First the AT2 meter always reads higher than human meters - so the first thing I'd suggest is to get a human meter.

All the protocols are written using human meters - which protocol are you choosing to use? SLGS or TR

I'd suggest reading the stickies thoroughly - they will answer many of your questions :)
 
Sue and Luci said:
First the AT2 meter always reads higher than human meters - so the first thing I'd suggest is to get a human meter.

All the protocols are written using human meters - which protocol are you choosing to use? SLGS or TR

I'd suggest reading the stickies thoroughly - they will answer many of your questions :)
Click to expand...
Agree with Sue and the test strips are wayyyyyyy cheaper
 
I have a human meter, but they top out at 600, and there are several tests every day prior to yesterday where the numbers were above that. The intent is to switch to a human meter as soon as her numbers are consistently lower enough to register and not just read a bunch of "Hi" when testing. I am fortunate that short term, the crazy expensive test strips are feasible for me and accept that it's not going to be as feasible long term.
 
And yes, I have read and re-read everything multiple times and have a few older threads discussing most things. Unfortunately, a lot of how depot insulins work is still just not clicking. I think I've reached the point where the explanations here are all phrased the same way, and it's not clicking for me. I need someone to phrase it a different way or come from a different angle for the explanation, at least, I hope that's all it is. Then again, I didn't go into the life sciences for a reason.

Diagnosed early December, she was already at a good weight and eating mostly low carb foods so the common risk factors were not present and the diagnosis was a bit shocking.

Protocol I'm using is probably SLGS, except we started at 3U after consultation with the moderators on this board based on the dosage of the Vetsulin/Prozinc and resulting numbers I was seeing on the spreadsheet.
 
So how did she come to be diagnosed? Was she somehow symptomatic?

There comes a point in the journey (sometimes more than once) where what is required is a leap of faith.

None of us know how things will ultimately play out. My BK is a prime example. Back in our day (FDMB class of 2009) BK was the last cat anyone ever imagined would be regulated much less go OTJ. But after 21 months he did just that. He remained OTJ for 6.5 years, which was the rest of his life.

No one can predict anything really. However one thing is for sure and that is there is no better place for a diabetic kitty to be than right here.

Hang in there and hang in here :cool:
 
I'll do my best with your questions.

1. If they're based on a depot build up, why do they have initial effect pre-depot build up (like the in/out insulins)
Click to expand...
I'm not entirely sure I understand your question but I'll give it a try. What I think you're asking is why do some cats have an initial, marked response to a depot-type of insulin. In the case of a cat that is a new diabetic and started on a depot insulin, it may be the initial "shock" of having insulin in the cat's system given that the kitty's pancreas hasn't been supplying the necessary insulin. I would think of it as being really hot and thirsty and chugging icy cold water. It's a shock to your system. As you keep drinking, the shock wears off.
2. Is the rate at which the body uses the depot varied based on what's going on in the body (sickness, stress, etc...), or is it always steady no matter what
Click to expand...
My best answer is that I don't know. Lantus forms microcrystals which gradually dissolve. Levemir binds to albumin (a protein). Ultimately, the bond between the insulin and albumin begin to break apart and the insulin is released. The duration of the insulin can be consistent but the other factors which you noted will influence the action of insulin. Any source of stress (e.g., illness, a loud noise, another animal in the back yard) will cause stress hormones to be released which, in turn, raise BG levels. Likewise, activity may increase metabolism which may use up more of the available insulin. When the pharmacokinetics and pharmacodynamics of a drug are discussed, the active period is referred to as a half-life -- the time it takes for the concentration of the drug in the plasma to be reduced by 50%. The other 50% then is being gradually released and by the time you give the next shot, not all of the insulin is fully used up. The same happens for the next cycle. So, there's always some insulin in "storage." The variation in numbers may be more a reflection of the insulin that is immediately available having been used versus what is in the depot since you can't force the crystals to dissolve or the protein bond to release.
 
So early blood tests only good to prove that her sugars are rising as they should. Next up +4

Sienne, thanks for the try at an explanation, it actually does make a little more sense. It may be like long term pain management, it's harder to get relief from the initial pain than to keep it away once it's under control.

Working on the leap of faith. Right now at least I know the 3U won't push her too low if her body could rebound into the 700+ range.
 
That bounce, while impressive, is not unexpected. Smudge's body is not used to yellow. The more she gets used to better numbers, the less she'll bounce. Neko threw me several "Hi" numbers when she first started seeing blues. She got over it, eventually.

Looks like onset is close to +4. Do you know what "Hi" means on the AT?

It helps to remember that insulin is a hormone, not a drug. It takes their bodies a while to get used to new hormones. Reactions may not be as expected (think of teenagers :p). As for why there can be an initial reaction, there are several variables. Here is one example. With my girl, she had insulin auto antibodies, as did Sandy's BK. Think of the antibodies as a reaction to foreign injected insulin. Antibodies work by binding to the insulin. At first they don't react to the new insulin, then they learn to bind with it. We don't know how common these antibodies are. I have seen two studies on very small numbers of subjects, one says common, the other says not. There is very little research done on antibodies in cats. This is just another example on top of what Sienne mentioned. Bottom line, there are lots of variables that can impact what a cycle will look like.
Astexcat said:
Right now at least I know the 3U won't push her too low if her body could rebound into the 700+ range.
Click to expand...
Not entirely true, though in this particular case, I think you are safe. We have seen cats start the cycle in black numbers, drop down to below 50, and back up to black at the end of the cycle. Which is why we suggest people not be complacent with testing if they see high preshot values. And as the depot builds, you will hopefully start to see better numbers. Once the bounce is over of course.:rolleyes:
 
I'll probably try to get an extra reading tomorrow around expected onset just to see if 4 holds.

I'm hoping once a depot holds that things smooth out a bit more. I figured I was in for a bounce with that sub 300 reading last night.
 
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