5/9 Heart AMPS 272 - still all over the place

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dodgingwrenches

dodgingwrenches

Member Since 2010
My little guy is still varying a lot. I actually decided to graph his BG and doses to confirm my suspicions - graph is in my SS. His variations are increasing and overall trend is up from when I started him on insulin again. confused_cat I did reduce his dose in case I am giving him too much, since his BGs are higher now than when we first started.
 
Morning.

I just took a look at Heart's SS, and you weren't giving him too much insulin. In fact, it was starting to show some green #s in the PMPS cycle 2 nights ago. Now, since you've decreased his amount, you're going to experience even more wonkiness with his #s, and he'll be going all over the place again, which ultimately will make you more frustrated. Regulation does not happen overnight. It takes a whole of a lot of time to get there. Some cats achieve it quicker than others. Other cats may or may never go into remission, however, will become regulated with the proper diet, and weight, and may stay on the same dose amount for a long time, or for the rest of his/her natural life. Heart may or may not be one of those cats that achieve remission quickly, and that's something that you may have to learn to accept. In order to come down in #s, you need to go up in doses. That's just the way feline diabetes is.

Try not to get too discouraged. Just follow the Protocol, and over time his #s will start to improve. Have a good day!
 
Good morning! ~O)

I know it's hard to see that wide range of numbers. Just try to remember how long it took you to find that "magic" dose the first go-round. It looks like it took about a month (after switching insulins) according to your SS. It's hard to be patient in the interim - I completely understand that!

Hang in there!
Shelly
 
I agree with the others....You got some decent numbers at 2.25 so I'm not sure why you'd think it would help to reduce

It also looks like it's very possible that on the AM cycle on 5/7 that Heart might have gone even lower than the 119 that you caught because that PM number looks a lot like a bounce

Getting a cat into a 2nd (or 3rd or 4th) remission is much more difficult than a first, and you're really just getting started. China took almost a year to get into what I'd consider "tight control" (with most of her numbers in the "normal" range) and may never go into remission, but I'm thrilled for having her tightly controlled. Sometimes we focus too much on remission and it's important to remember that the goal is to keep them as normal as possible so the damage that's done by high numbers is reduced. Remission is a wonderful goal, but not the only one.

Sounds like you need to dig into the back of your closet and find those patience pants again :lol:

Hang in there. We do understand it's frustrating to see a lot of wonky numbers, but it will get better if you just stick to the protocol!
 
Hi Angela, it's different this time around. The first time when he was newly diagnosed, I was still giving him dry food (albeit D/M) the first month. The day I switched to wet food only, he came down swiftly and was OTJ ten days after eliminating dry food.

The second time around, I was increasing until I found a dose, then he smoothly came down - no extreme variations, just mostly greens and blues

I guess what is throwing me off this time is that his numbers are pushing higher since I started giving him insulin. When I first put him back on, he was around 200. The previous times I put him back on he was much higher. So I thought I caught it early, but now the numbers are rising overall with insulin. I would have expected them, if they won't go down, to at least not be going up and swinging more than when I first started him on insulin. That is the weird part. I didn't have any pinks the first week on insulin and have had more recently

Shelly: When I try to go up, he drops to 40 though and then bounces, so 2.5 units I'm not sure I want to try again. So I was thinking I'll first try going down before I go up. I know a friend who has a cat here in Toronto that had "insulin induced" diabetes. Basically had an infection and stress drive up his BG at the vet visit (no PD, PU), vet put him on insulin, then he continued to climb - and he was not a diabetic cat! As soon as the insulin was discontinued, he was fine. That I guess left an impression on how insulin can drive up BGs.

Another option I am considering, is switching him to Levemir? Maybe Lantus isn't working so well for him this time? I am planning on driving to Buffalo to pick up a ReliOn meter and strips, so figured I could stop by Costco and get some Levemir as well.
 
Chris: Okay I'll try to find my patience pants. But the sad truth is - he has to go into remission. I cannot be home at 6pm every day and never travel again for the next few years. I have a career and this will cause me a lot of problems with it if it continues. He cannot stay on insulin. And my parents cannot look after him either when he's diabetic, so he comes back to live with me to get him under control again. :cry: When I agreed to take him (he was going to be put down by the previous owner because they didn't like him - and he is really the sweetest most affectionate cat I've ever had), I was married and in a different city and different job, so I never expected a) him to get diabetes, and b) me be alone and unable to take care of him because of it.
 
Hi again!

I'm not sure if you got Angela and I mixed up in your response. Regardless, that's interesting about how quickly he came down after making the food switch.

Like I said, I know it's frustrating. Hang in there - you'll get this figured out!

Shelly
 
I agree with the others that you should go back up to 2.25U. Heart's SS does not look like he was getting too much insulin. One of the reasons he may be getting higher numbers now is that he is also seeing lower numbers than he has for a while and is bouncing. I know how you feel, wondering if there is too much insulin, but usually the numbers then are high and flat or high and sharp drops down. Heart isn't seeing that and has had some great cycles like the night of May 6th.

Others have probably told you that when cats fall out of remission, it's best to be aggressive to get them back in good numbers as soon as possible, to increase the likelihood of going back into remission. The other thing I've seen is that many cats SS look quite different the second or third time around. If I had a dollar for every time I heard someone say "but he didn't bounce the first time around". :roll:

I see you are using the Freestyle Lite meter. It might be interesting to compare with your backup meter when you get one of those pinks. I was badly bitten by the Freestyle when we first started, it registered way under in the higher numbers. It may be better now, but I just don't trust them after our experience. You mentioned possibly going down to Buffalo soon. It's a good idea pickup a Relion Confirm or Mini and some cheap strips when you are there. The Prime is cheaper but needs a bigger blood drop. That is one thing I really liked about the Freestyle. In fact, I'm on my way across the border today!

As for Levemir - it's way cheaper in Canada. We made the switch last September but Heart is getting greens on Lantus. I think you just need a little patience.
 
Hi Wendy, I did measure a second time, other ear, on those pink numbers just to be sure. And yes, I'm going to try and get a relion micro. But if the Freestyle measures low in the high numbers, but measures normal in the normal numbers, his spikes and drops are even more dramatic. Yikes.

Wendy, since you study people's SS's quite a bit - how many points would you say a food spike is good for?
 
The amount of a "food spike" can depend on the kitty, which is why getting the odd +1 test is suggested. It can depend on how carb sensitive the kitty is.
 
we also used the Freestyle - you can see in punkin's ss in February 2011 when we switched from it to a Relion Confirm.

I agree about going back up in dose to 2.25u. You're right about it being possible for a high insulin dose to cause high numbers, but that typically happens when a person has either started with too high of a dose or the incremental adjustments were too large, ie, by 1u, or done too quickly, like 0.5u every couple of days. Even though you did that at the beginning, it wasn't overly so and when you held the dose at 2.25u you were seeing normal curves with decent nadirs.

there's nothing to suggest a situation like that with Heart. I think you're likely going to need to go up in dose until you hit that sweet spot and his numbers flatten out. then you'll be able to start reducing. Reducing before you need to just keeps him in higher numbers than he needs to be and let's his body get used to those high numbers. you want him to get back under 120 as quickly as is safe.
 
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