3/23 Minner PMPS 94 +1.6 59 fighting the dive

Prior Post

Hi, we haven’t posted in a while (since 3/9) and things have been stable. But we need some help tonight because Minner is having the most active cycle I’ve ever seen and I’m fighting it at +1.6 with medium carb, and the real action hasn’t even hit yet.

Brief recent history: Suspected lipohypertrophy in shoulder/upper side areas where she has been injected since the beginning (july 2024). Started feeling more fatty and in past 3-4 weeks her action has been more and more inconsistent. Many days I feed only 0 and 1% and don’t get below 90. Other days have solid action with nadir in 50s or 60s and feeding 3-5%.

So … 3 days ago I decided to try injecting her in hip area. Since then she has had noticeable solid action and I’ve had to feed even more to avoid the 50s.

Tonight I dropped her dose to 6.625 (reminder I use calipers for precision). I also fed immediately post shot … didn’t matter, she dropped to 59 by 1.6 so I panicked and started feeding medium carbs. By +2 she inched up to 70 and 89 at +2.5. Whew. I just took the +2.5 reading, thank goodness. But I know I’ll need to test hourly since that carb load might not get her through.

Help Needed: Does anyone have experience shooting insulin in the hip and is it different? Or is the difference I’m seeing likely proving out she has fatty buildup in her regular injection areas which is interfering with absorption?

Does her IAA increase her likelihood of responding with fatty buildup in injection areas? I’m very concerned that this will start happening in hip area too.

I have no way of knowing how much the fatty buildup is interfering other than based on the strong action witnessed these past 5 cycles since moving to the hip …. I’ve had to feed her alot more, including using higher carb (still LC until tonight’s cycle when I grabbed MC and then bisque which is HC). I’m tempted to drop her dose down to 6.0 in the morning as a “safer” way to try to recalibrate, vs letting her drop below 50 by not feeding so much at current dose. This is a high dose and there is simultaneously the possibility that we could be seeing antibodies starting to break or behave more erratically.

This is a lot and she has multiple factors at play … I’m hoping there are some suggestions to help us, otherwise I’ll probably keep shooting the hip area and keep reducing her dose more proactively until the pendulum swings.

Thank you.

 

Hi Laura! You've got a good question here, and I hope someone can offer insight for you and precious Minner. Just saying hello--and bumping up your post.

 

Nope. I pretty much shot Neko below her shoulder blades, in a square on either side, for all her almost 5 years as a diabetic. I did shoot sides a very few times, but she didn't like. I did have to do that when I gave fluids, to have a bit of data on it. I never had problems with fatty buildup. Nor did I notice a difference when I did shoot her in the shoulder. I only tried the hip once, that was a clear "NO GO" zone.

At Minner's size of dose, I'd call 0.25 unit changes "tweaking" the dose. I'd stay away from the even smaller changes until her overall dose gets quite a bit lower. You've also shot different doses AM and PM the last three days, muddying the dosing waters. The 6.875 unit dose may be still influencing tonight? The larger depot can last up to 6 cycles after a reduction. How about 6.25 units as her new dose. Reducing by 0.75 units seems a lot.

Note, what ever change you made to the dose tonight won't have an impact until the later part of the cycle, due to the depot influence.

 

Thanks so much for responding Wendy. It’s very nice to hear from you and to have some Neko experience wisdom shared. I recognize ECID but I did have a hunch that fatty buildup could possibly have higher probability in cats with higher antibody reaction, so I like knowing not the case with Neko. The NO GO comment about her hips made me laugh. I’m actually stunned that Minner lets me, but thank goodness she does b/c I’ve pretty much used up the shoulder/side area. I am going to take her to see her doc soon and see if he can tell clinically in some way if this is indeed lipohypertrophy. I would bet money in vegas that it is, but they don’t offer that bet (bad joke).

Fair point on the size of the dose changes. I’ll adjust. And now that she’s in the 90s at +4 and +5, I think I overreacted, although I was truly extremely scared looking at 59 at 1.6 when she was 94 pmps and had eaten some 5% after her shot. That made no sense, but it was staring me in the face. I felt like I had to throw a lot at it since once we get to +2 then the insulin action truly begins. Eeeeeek.

Now that she’s in the 90s at +4 and +5, I’m not sure if I should drop her further to 6.25 in the morning. But I also want no part of another 30+ point decline from pre shot before even getting to +2 (when the insulin action actually kicks in for real) and all with having food already onboard !! Will see what she does overnight.

THANK YOU!!!

 

Thank you Marielle! I hope you and Jude are doing well!

 

Another tip - often you'll see them nadir earlier if they are planning to dive low. Meaning she's probably done - get thee to bed!