5/12 CRYSTAL AMPS 252 +10 295 gave R PMPS 259 +2 292

[suki & crystal (GA)]

yesterday

Hi all,

I'm running out of something original to say about Crystal's performance, still frustratingly running high despite the R of 2.5u this morning. Just going to do a +11 and give her another dose of R, probably 3u in the hope of getting a head start on the rise.

Hope you are all having a better day.

Suki


@Sgans Stephanie posted this late on my previous condo:

INTERESTING! About using the different injection sites!
I just recently changed my injection site, (using Lantus) because he gets sub-q at night near his neck/shoulders - so I started shooting insulin into his flank (at a friend's suggestion) so the fluids don't interfere... maybe THAT'S why my baby's numbers were better yesterday...

I think it does have an effect using the flank shots, I've read that you can get better absorption. Unfortunately it's very difficult to do with Crystal but glad you are having success with this method for Eegie. P.S. loved the history of how he was named!

 

[Wendy&Neko]

It is hard trying to figure out why kitty's blood sugar does what it does. I try to just observe and not get emotionally involved, but it's very difficult. It's very much a waiting game.

If you don't have anything to say about the numbers, talk about Crystal - how is she today?

Good luck with the R - I hope something breaks this yellow log jam soon.

 

[suki & crystal (GA)]

@Wendy&Neko Thank you Wendy, I think you can tell by my tone I was feeling a bit fed up. But ..... I managed to get her PMPS in the flank this time, with the help of DH holding her down on a cushion, she wasn't very happy about it but I'll see if it makes a difference to her numbers, hope so. I also gave her 3.0uR at +11 rather than wait until PS.

She has been very quiet today, sleeping most of the morning and early afternoon and has now just come outside to join us and be socialable. Followed me round the garden for a little walk and was chatting away and we had numerous stops for strokes and head rubs good appy but she turned away and the dog wolfed the rest down so I'll give her a snack at about +3. bbl, hopefully with some better numbers.

 

[Peg and Toby]

Keeping fingers crossed that you and Crystal will get a break soon.

 

[Marje and Gracie]

Suki

It would be helpful to know at what dose of levemir you want to stop increasing due to cost. If you aren't there yet, I'd increase the levemir dose. If you are there, then we need to huddle up and get opinions on how much you can raise the R dose.

Sending you healing vines and paws crossed Crystal will get with the program!!!

 

[Suzanne & Cobb(GA)]

I agree with Marje. You need to decide at what point you aren't going to up the Lev anymore. That's a decision only you can make unfortunately. There will just come a time when you draw a line and say -- this is the L dose, it's what I can work with and afford - let's do our best to manage from here on out. I know what an agonizing decision that is, Suki, because you will feel like Crystal needs more but you also know you just can't afford it. You are doing such a great job!!

Honestly, the more I look at your SS, the more I see IAA. (And I used to hate it when people said stuff like that to me, so I apologize!!) But, I think that is important because I think it gives you a little more flexibility with increasing your R dose (just my opinion here).

My thoughts (since you didn't ask and all ):
I would go ahead and up your R scale, even if you up the L dose as well. I would increase your R by .5u. So if Crystal is above 200, try 2.5uR, above 250, try 3uR. I'm seeing the current doses are holding the BG steady after you give the R (which is good to know), but not necessarily bringing the BG down, which is what you want. When I say, it's good to know the dose that will keep her steady, that means you could feel confident dosing R and leaving the house, so if you know -- with a 252 preshot and you dose 52uL and 2.5uR, Crystal's BG isn't going to plummet or go down too quickly. Does that make sense? Then you can confidently give R, well I would say more regularly but you've given it every day this week...so I'll say you can give the R and not feel tied to the house for testing.

 

[suki & crystal (GA)]

Thanks for looking in Peg, and for your good wishes.

@Marje and Gracie @Suzanne & Cobb(GA) good observation Marje and Suzanne but I haven't really thought about a final figure. Can't be too far off what we have now as 2 boxes (i.e.10 pens) per month is what I'm currently using, but I certainly don't want to be in the region of +70 units bid so I have a bit to play with at the moment. Honestly, I don't know what my cut off would be, there are so many variables at play, and if it were to make a difference to Crystal's BG then obviously I wouldn't deny her that but I can't see me going with 80 or 90 units. I'm just hoping that it's not going to come down to that.

It had crossed my mind about giving her a Lev increase. I think I decided that I would try using the R more regularly for say another week and if there is no significant change, then I'll increase the Lev, probably by 5u or so.

I'm always glad to hear your thoughts Suzanne, I value your opinion so carry on. Yes I think you are right about the IAA, there just doesn't seem to be any other reason for the way she has reacted over the last copuple of weeks, my vet thought it was a strong possibility too. I agree about increasing the R scale and, as you pointed out, I know what is a safe figure for keeping her flat (antijinx!!) so I'll go with bigger doses from now on, starting tomorrow.

Well I'm off to bed now, this chest infection/coughing all night has left me pretty exhausted but I'm off to the doctor tomorrow morning for some antibiotics so I should feel better soon. Got to be in top form to look after my furbaby!

 

[Tiger(GA) and Ruth]

Suki, oops, I posted on yesterday's condo.... I just wanted to say, when I first found this forum I absolutely got depressed looking at Tiger's SS but then someone wise told me she was so much more than just her SS and a bunch of numbers. The same with Crystal- she's eating good and feeling good, that counts for a lot! Feline Diabetes is such a crapshoot, you never know what will happen day to day, most of the time there is no rhyme or reason, I guess because insulin is a hormone and not a sure thing medicine! But we're here for you, and especially now, I hope you get a good night;s sleep so you can shake that yucky virus- at least you know Crystal will be okay!

 

[suki & crystal (GA)]

@Tiger and Ruth
Thanks Ruth, I guess when you don't feel 100% there is a tendency for a bit of self pity to come in. Really, when I look at how many other cats have really serious problems, it helps me get a better perspective on Crystal's situation - you are right, she is so much more than just a set of numbers.

So, this morning's AMPS was 225 so she got 2.5u R, which is a slightly increased dose. Let's see what this does for her. Good appy this morning, looking for more breakfast, a brief wash and settled back for a nap, quite content.

 

[Bron and Sheba (GA)]

Hope the R does its work for you today and brings down the numbers for Crystal.
Vines for that nasty cold you have

 

[Sandy and Black Kitty]

Hi there

Crystal has not visited the 4th floor in 2 months !
That is some serious progress.

So many variables - with Acro comes pituitary tumor activity (or lack of) as well as a pancreas that may be fully functional. . .or maybe not. When it comes to IAA, how much insulin binds to antibodies and how much goes to metabolizing sugar at any given time is anybody's guess. And there is the potential for periods of prolonged duration due to release of bound insulin back into circulation. (If only there was a meter that measured how much unbound insulin is in circulation). These are responsible for the ups and downs.

Pressing the pause button on the Lev increases and continuing to methodically increase and fine tune the R doses is a strategy worth trying. You can always 'unpause' and increase the Lev if needed.

I too suspect Crystal is IAA . Being that IAA is self limiting, it will break one day and insulin sensitivity will return. That's important to remember.

FWIW at the time BKs IAA broke, his R doses added up to nearly half of his total combined daily insulin. At the first sign of change I just pulled the R. It was a huge reduction - and an easy one. No depot - no drama (that came later).
Let me make it clear the L to R ratio was not calculated - we were flying by the seat of our pants.
It was serendipitous.

With a high dose kitty using L you are guiding an oceanliner over waters containing dynamic undercurrents that cannot be measured or predicted but most certainly influence the picture, With study and observation and through trial and error your management of Crysals unique brand of FD will continue to evolve.

Hang in there!