3/6 MEatball AMPS 470

[Molly]

Today's curve actually looks like a curve. It's a beautiful thing.
Isn't this what happens when insulin is working? Is my insulin working?

Going to raise the dose to 4.5. Cool?

 

[Hope and Aria]

That sure does look a whole lot more like a curve. I'm so glad you and Meatball are making progress.

 

[Ele & Blackie (GA)]

That looks like insulin working to me. I hope you continue to see some progress with Meatball off that new dose.

 

[Terri and Lucy]

I think you need to reduce the dose Molly. The drop from 470 to 150 is too steep. Hard to know if the 455 preshot tonight is rebound or BIPO (big insulin poop out). Did you get the U-100 syringes? If so, I'd knock the dose back to 3.8 tonight and see if you can't get a more reasonable drop at peak. With the preshots you're getting, I'd look for a drop to around 250. Sometimes when you manage the peak like that, it ends of extending duration.

 

[Molly]

I think you need to reduce the dose Molly. The drop from 470 to 150 is too steep.

Yes, that does seem very steep, and this am Meatballs #'s were higher than they have been. I didn't see this message until after I had already given him his shot last night, but today I tried 3.8 and it tonight his numbers are a little lower.

Other things: He's feeling good, very playful all the time lately. No ketones. He is not drinking excessive water, but whenever I feed them now I mix equal parts water and food and they drink all of that. But he is not constantly sitting around the faucets like he was doing all the time in December and January. I have not given him fluids in two days, and he's still doing very well.

Sometimes when you manage the peak like that, it ends of extending duration.

Terri - I'm not sure I understand this, can you explain? Thanks!

 

[Terri and Lucy]

It's like Goldilocks. If you give too much insulin, you get rebound. If you give too little insulin, you never see a curve or else the curve is shallow. But when you give the 'right' amount, you see a nice curve. For some PZI cats, you can see a nice curve, except that it poops out before +12. I guess it's because the body has to equilibrate or learn how to process carbs and insulin again. So when you find a dose that's about right you have to be very careful to make very small adjustments and give each dose change time to 'settle' or equilibrate.

Joanna can attest to this. When she first came to FDMB she was changing doses with every shot until we convinced her to stick with one dose for 3 days and to make small, systematic adjustments in the dose.

 

[Joanna & Bix (GA)]

Well with me it was mostly being afraid to shoot enough insulin especially on the lower PSs (due to some lengthy backstory that I will spare everyone! ;-) ) and so I was ending up with a lot of dose changes/seesawing/sliding scale that didn't work consistently, etc., til Terri finally convinced me to try being more systematic with gradual increases, and hold the dose regardless of PS, and that worked really well for Bix.

I have found with PZI that tiny dose changes - 0.1u or even less - can really make a difference. At the point when it came together and I was able to shoot pretty successfully, it felt like there was a sweet spot with the insulin dose. If I could get it right down to the drop the #s would be picture perfect, a drop of insulin too much or too little and the #s would start to shift a little off course in either direction.

Bix's #s somewhat resembled Meatball's when Bix was on dry food, though, and once we switched to LC, for the most part he stopped getting those really extreme highs that made things so tough. I feel a litle lost when I look at Meatball's #s - I see a few places that look like rebound to me, but then trying lower doses backfired, so it's a bit of a mystery to me. But hopefully things will improve for him on this dose!