6/11 Lucky AMPS 345 PMPS 272

[Luckyducky]

Hello again everyone! Last time I posted, Lucky seemed to possibly be going through a bounce, so I waited these past two days to see if it would break (it seems like it might have, but then it went into another bounce...?). Here's his spreadsheet for reference, and today's numbers:

AMPS 345
+5 261
PMPS 272
+3 280

Yesterday evening I caught Lucky at a low of 138 at PM +6 (I'm guessing it may have been lower prior to the reading), and it seems like he might have gone into another bounce today. I'm wondering if I should wait it out again because of the bounces, or if I should just increase his dose to 1.75u bid, since his numbers have been hovering in the 200's/300's for a while now that he's been on 1.5u. Any help would be greatly appreciated, thanks very much!

 

[Sienne and Gabby (GA)]

Re: 6/11 Lucky AMPS 345 PMPS 272 Dosing Advice?

I think if you're getting mostly yellows and a yellow pre-shot, you're OK to increase. Basically, you don't want to increase on a bounce if the nadirs you're seeing are low. If they are, and you increase during a bounce, you could be putting Lucky over what's a good dose.

 

[Luckyducky]

Re: 6/11 Lucky AMPS 345 PMPS 272 Dosing Advice?

Thanks again for the fast reply, Sienne. :smile: I decided to increase the dose to 1.75u, which I hope will be alright. I was mostly concerned because it reminded me of the last time he was at 1.5u --- he was also lingering around the 200's/300's with occasional dips into the 100's, and I sensed at that time that he might be continually bouncing (with dips that I wasn't catching), and as a result I prolonged the dose longer than might have been necessary.

I guess it makes me wonder: are bounces followed by bounces followed by bounces normal to see? And if that's what's happening here, how would a person go about normalizing the situation?

I'm starting to get a bit antsy about the tight protocol of late, since it's starting to seem a lot more variable than I expected. :-| I'll keep with it though, and thanks much again for your help so far, and any other insight you or others might be able to provide.

 

[Sienne and Gabby (GA)]

Re: 6/11 Lucky AMPS 345 PMPS 272 Dosing Advice?

The bounciness is not uncommon for some cats. It truly is a matter of ECID. If you look at people's spreadsheets, you'll see that many cats bounce -- until they stop.

There are 2 approaches to bouncing that predominate on FDMB. One approach suggests lowering the dose. The other, and the one we use here, is to increase the dose. Jill recently addressed this in on the PZI board:

...however, there's one thing i have observed after studying many spreadsheets of kitties whose doses have been lowered to prevent a cat from bouncing... in almost every case (not all), weeks or even months later the caregiver eventually ends up taking the dose back up until they're right back where they started or they have to surpass that dose if glucose toxicity has set in. just looks like a whole lot of wasted time and effort to me. according to research, there's a golden opportunity to get newly diagnosed kitties OTJ when their BG numbers are brought down into the normal range as quickly as possible... allowing their pancreas' to heal before more damage is done from remaining in unnecessary and unhealthy hyperglycemia. if that's the case, it just kind of makes sense to work towards tight regulation and ignore the fluctuations caused by bouncing, but that's just a personal opinion.

So, I would encourage you to stick with the protocol even though the bounces are frustrating. As long as the nadirs aren't dropping Lucky into a low range, you are OK to increase the dose providing you are able to get spot checks.

If you scroll back through your SS, it looks to me like you are beginning to see some movement. When you were at 2.0u, you were seeing more green. It may be that you need to get closer to that range.

 

[Luckyducky]

Thanks so much again Sienna for the advice and the information. Jill's observations sound very similar to Lucky's situation prior to sticking with Tight Regulation (in my case, fear of hypoglycemia was holding me back from increasing the dose faster), so I hope I don't reach a point where I'm all the way back to the originally prescribed 2u dosage. I'll stick with the protocol and check back in in a few days (hopefully with better numbers, we'll see). Anyways, thanks again, it's much appreciated!

 

[Marje and Gracie]

Good luck with the dosecrease. One thing I'd like to encourage you on is don't get married to a dose. Don't worry about how far up you might need to go to get a breakthrough dose. If Lucky needs more insulin, he does

Libby's Lucy was at 4.25u at her highest dose, came down the dosing scale fast and to a very low dose, then stalled and Libby had to take her all the way back up to 4.25u to get the breakthrough dose again. Lucy came down again shortly after and went OTJ. Sometimes we just have to go up to come back down.

 

[Luckyducky]

Thanks for the encouraging words Marjorie, and also for Lucy's story, it gives me hope that Lucky's upwards crawl could just be a temporary setback. Here's to hoping for the best :smile: