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Re: BUD 6.10 amps 79 +13 95 shot 0.25

Nope. I just happened to stay up.

Looks like i'm going to be staying up for many a night to come.

She's cleaning herself this mornging. thoroughly.

This is really scary. 0.25u is like IMPOSSIBLE to draw up. How in the world do you do 0.1u???
 
Re: BUD 6.10 amps 79 +13 95 shot 0.25

ouhf - really good catch!!!
In the Sticky - Lev 101 Basic User Info - under the Starting Dose section there is a link to drop method pictures and drop method instructions that may help you. It looks like you're heading in that direction.
 
Re: BUD 6.10 amps 79 +13 95 shot 0.25

I'm pretty sure the picture are the same as on the sticky, but the explanation link might be different.
 
Re: BUD 6.10 amps 79 +13 95 shot 0.25

Now that I have some more time to reply.

We now know where the 300s are coming from.

Sometimes or maybe even more often than not, catching a low is accidental. It takes a great deal of testing and even overnight to catch a number that calls for a dose reduction.
I know that I missed several good opportunities with Lev in the beginning of using it and did not understand it enough to know what was going on or to try to reproduce it to know for sure.

So this is pretty clear evidence that even .5U is too much. This also explains all the 400s on 1U. The only reason the 32 would not call for a dose reduction would be if she had eaten nothing since her PM shot.

I hope the photos and explanation of the drop method of dosing below .5U help you. She may be higher for 2 or 3 cycles though on .25U because that was a pretty fast drop to 32. But they are no reason to raise dose.

Very good that you lowered to .25U. And even better that you caught the 32. Way to go, Bud Bud.
 
Re: BUD 6.10 amps 79 +13 95 shot 0.25

Marcy & Klinger said:
I'm pretty sure the picture are the same as on the sticky, but the explanation link might be different.
Click to expand...

:dizcat :dizcat

My brain is old.....I had already fixed the links in sticky. Wow. Somewhere my brain did not get the message - "been there, done that."

Maybe I need some ginseng....

Thanks Marcy!!!!
 
Re: BUD 6.10 amps 79 +13 95 shot 0.25

Great that you got that number because it is a big piece of the puzzle. confused_cat

That's the pattern of rebound on the long-acting insulins: high, flat numbers "punctuated" by very low numbers. But those lows don't always happen, or we don't always "catch" them in a test and they aren't necessarily consistent. What you are seeing, numbers-wise, is almost exactly what the petdiabeteswiki page on Somogyi says:
A typical rebound pattern, most often seen with long-acting insulins, is a high, flat, unresponsive blood sugar over a period of days. Sometimes, often when raising dosage, this high flat curve will be punctuated by sudden drops to very low values, (with possible hypoglycemic events) followed by a fast return to high unresponsive numbers. (It's the sudden dip that distinguishes this pattern from inadequate insulin, but it doesn't always happen.) http://petdiabetes.wikia.com/wiki/Somogyi_rebound
Click to expand...

And that is what I experienced with Beau. It was that description (above) that made the light bulb go off for me with him. I started decreasing and just kept decreasing. I think I decreased when I saw 300+ and/or those very low numbers.

You will do fine getting .25u once you have a method of doing it that is comfortable. I had Beau down to .05u at the end! That was fun (not), but it worked for him. :thumbup
 
Re: BUD 6.10 amps 79 +13 95 shot 0.25

Looks like Bud might be close to going into remission. I don't want to congratulate you too soon .... because you need to get some more gorgeous days like today. Then you could see if she might stay between 50 & 150 without a shot.

Lana
 
Re: BUD 6.10 amps 79 +13 95 shot 0.25

Thanks Lana.... was typing and didn't see your post until after I posted.

"Is it due to too much insulin? or too little eating? or both? Is this a 'good'thing? an indication that she might be coming off or getting regulated or is it that it's just so out of whack that she's going to keep bouncing around?" nailbite_smile
 
Re: BUD 6.10 amps 79 +13 95 shot 0.25

"Is it due to too much insulin? or too little eating? or both? Is this a 'good'thing? an indication that she might be coming off or getting regulated or is it that it's just so out of whack that she's going to keep bouncing around?". . . and the 90% drop from 308 to 32 in 7 hours last night!"
Click to expand...

A couple or 3 points...

First, a BG in the 40's or 50's is not an abnormal number for a non-diabetic cat. After Yoyo went into remission the first time and I did a lot of testing to make sure that he really was OK without insulin. I would occasionally get low numbers like that.

Secondly, my new vet told me that BG meters are not that accurate at low numbers and that the actual BG is higher than what the meter is reporting.

Third, when Yoyo was diabetic the first time, on Vetsulin, I very rarely tested for nadirs because the vet I was seeing then was shocked that I would test at all and certainly discouraged inter-day testing. (He told me at one point that Yoyo's ears were going to rot and fall off.) There were several occasions when I know Yoyo had a severe hypo. His eyes would be glassy, he would look weak and shaken, his fur would look weird, he looked like death warmed over. I don't know what his blood sugar had fallen too. I would call him for his 12hr injection and his BG might be 52 and he would look like a cat who had been to hell and back. Now, if I get a 32 and Yoyo looks like he is feeling fine, I give him some HC food not because I think he is having a hypo but because I want the direction of his BG to be up, not down --- I want to prevent a possible hypo. It would be nice if 2 + 2 always = 4 in diabetes, but it just ain't so! Ask any human diabetic and they will tell you they get crazy BG results sometimes that defy explanation. The thing that is important is that the direction of Bud's BG and insulin requirements is "down" over the past three months and that is a good thing. I do think Bud's SS indicates that she is a prime candidate for remission.

Lana
 
Re: BUD 6.10 amps 79 +13 95 shot 0.25

eeraby said:
"Is it due to too much insulin? or too little eating? or both? Is this a 'good'thing? an indication that she might be coming off or getting regulated or is it that it's just so out of whack that she's going to keep bouncing around?" nailbite_smile
Click to expand...

It looks like you and Bud have been busy! When you get a chance can you fix your spreadsheet. It looks like you gave .25 units at preshot and then again at +13. Nice set of blue numbers today. :)

Adding on to what Lana said, I think the consensus is that Bud was getting too much insulin. The fact that you started off with .5 units and changed it to one unit after only one dose could be a factor. Although that is hard to say in that sometimes you have to go up in dose before you can back down, but usually it is recommended to start off .5 units of Levemir.

As far as the food being a factor that is hard to say when there is more than one cat in the home. Ideally if we knew exactly how much food (and when) Bud was getting on her own each day it would eliminate that one variable but that is hard with more than one cat. Do the dogs ever help themselves to their food?

As far as sprinkling something on top of her food to help get her to eat. You can use Parmesan Cheese (in the green shaker can), Liv-A-Little's by Halo, or Fortiflora is good too. Also, Sheila likes a product called Prime Taste Feline treats which is also freeze dried chicken like the Liv-A-Little's.

When you get a chance Beth can you do a Profile on Bud? It makes it easier to see at a glance her age, medical history, etc. Here are the instructions:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=36698
 
Re: BUD 6.10 amps 79 +13 95 shot 0.25

One thing that I wish was different about the section I quoted is that comment on "often when raising the dose". Its confusing in that it can happen ANY time, even when the dose has been the same. And a cat going off insulin will repeat the pattern as each dose decrease settles. I would decrease and Beau would stop having swings for a few days, then he would have high flat numbers and a sudden low. That was usually preceded by a slightly lower PS. And would lower again.

Regarding her appetite, is she eating too little or just less? Can you make a guess on how much in ounces? Beau eats less now, more like the civvies while Jeddie can still pack it away. Maybe that is a factor of needing less exogenous insulin? Now sure, just putting that out there.
 
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