6/11 Mikan AMPS 428, +2 272, +4.5 157, +7 255, +9 335: PMPS 241, +2 198, +4.25 147, +7 261

[Mikanmama (Mikan GA)]

6/10/23 POST

A new record high

I was looking at her SS. Her preshot numbers became progressively worse as we went up on the dose. She was doing a lot better with a lower dose range of 1.5-2.5U. I wonder if I'm giving her too much insulin?
@Bandit's Mom , have you seen any cases like that?
I am just so confused. I know FD is difficult to understand. But I hate to see if her higher BG is iatrogenic.

 

[Deb and Sylvester]

6/10/23 POST

A new record high

I was looking at her SS. Her preshot numbers became progressively worse as we went up on the dose. She was doing a lot better with a lower dose range of 1.5-2.5U. I wonder if I'm giving her too much insulin?
@Bandit's Mom , have you seen any cases like that?
I am just so confused. I know FD is difficult to understand. But I hate to see if her higher BG is iatrogenic.

This is what happened with Sly until I gradually got him back up to the bigger dose.

I don't understand why at all, he did great on 4.25 for 2 weeks!

 

[Bandit's Mom]

Rubbed my eyes when I saw the AMPS on the title. Has anything changed with Mikan that could affect regulation? Any infection, pain, dental issues...? Any chance she is getting into higher carb food - human or feline (or canine!)?

She is a late nadir cat - I wonder if she is dropping lower in the PM cycle between +6 and +8?

 

[Mikanmama (Mikan GA)]

This is what happened with Sly until I gradually got him back up to the bigger dose.

I don't understand why at all, he did great on 4.25 for 2 weeks!

Mikan's numbers are progressively worse as we passed over 2.75 U. She can get down to nice blues but not much more. I think she is losing weight as well. She is a tiny cat, and I worry that I'm causing more harm than good.

 

[Mikanmama (Mikan GA)]

Rubbed my eyes when I saw the AMPS on the title. Has anything changed with Mikan that could affect regulation? Any infection, pain, dental issues...? Any chance she is getting into higher carb food - human or feline (or canine!)?

She is a late nadir cat - I wonder if she is dropping lower in the PM cycle between +6 and +8?

Thanks @Bandit's Mom for having a look. It's possible that she gets low at the later time, but all the testing I do shows modest nadir in the AM cycles - barely getting down to the 90s if that with higher dose (over 3U). She is eating, peeing and pooping fine. No sign of infection or dental issues. I've been reading up everything I can to see if I see a case like this, to no avail so far.

I am beginning to think, maybe, the increase was too hasty? Should I go back down to the last known good dose (2.75U) and see how she does and very slowly coming back up if needed?

 

[Bandit's Mom]

I am beginning to think, maybe, the increase was too hasty? Should I go back down to the last known good dose (2.75U) and see how she does and very slowly coming back up if needed?

There isn't anything to indicate the dose is too high. Hold the dose. If you can, get a +7 in the PM cycle on nights like last night to see if she is diving later.

I'm going to tag @tiffmaxee and @Wendy&Neko for dosing advice.

 

[Deb and Sylvester]

Mikan's numbers are progressively worse as we passed over 2.75 U. She can get down to nice blues but not much more. I think she is losing weight as well. She is a tiny cat, and I worry that I'm causing more harm than good.

I actually thought the same with Sly. I couldn't understand how 4.25 gave him good numbers and as I was taking it up, the numbers got worse. Once I got to 5.5 his numbers did a complete turnaround. More insulin may be the simple answer. Just hang in there, I'm sending good vibes!!

 

[Mikanmama (Mikan GA)]

There isn't anything to indicate the dose is too high. Hold the dose. If you can, get a +7 in the PM cycle on nights like last night to see if she is diving later.

I'm going to tag @tiffmaxee and @Wendy&Neko for dosing advice.

Thanks. I will try - there are nights I just can't do +7 for professional reasons but I'll see what I can.
Mikan's overall clinical picture seems worse. She was 7.1lb at the time of diagnosis. She gained in the next few months and went up to 8.5. Now she has lost some of those weight and 7.8lb.

I do wonder if the higher dose is overstimulating compensatory feedback loops to release cortisol and catecholamine, ending up with hyperglycemia.

 

[Diane Tyler's Mom GA]

Hi Kit I wish I could give you some advice, all I can do is support you , hoping soon you will see the pre shot numbers will start to come down

 

[tiffmaxee]

I also think she needs more juice. If too much you would see low numbers but the lowest is barely under 100. It’s frustrating I know. She’s clearing bounces quickly on the bright side.

 

[Mikanmama (Mikan GA)]

I actually thought the same with Sly. I couldn't understand how 4.25 gave him good numbers and as I was taking it up, the numbers got worse. Once I got to 5.5 his numbers did a complete turnaround. More insulin may be the simple answer. Just hang in there, I'm sending good vibes!!

Thanks Deb.
This is really hard. It's one thing not to see progress. But Mikan is far worse now than she was when she started. I have been using AT2 for preshot BGs (not recorded) so I could see how much worse she has been. It's hard to feel that I'm doing the right ting for her.

 

[Mikanmama (Mikan GA)]

Hi Kit I wish I could give you some advice, all I can do is support you , hoping soon you will see the pre shot numbers will start to come down

Thank you Diane.
It's been a rough week with her numbers keep climbing up to the new highs. I feel at loss - all I want to do is the right thing to help her back to health. I dearly hope that I'm not harming her....

 

[Mikanmama (Mikan GA)]

I also think she needs more juice. If too much you would see low numbers but the lowest is barely under 100. It’s frustrating I know. She’s clearing bounces quickly on the bright side.

Thanks for looking over the SS, @tiffmaxee.
It is hard to see worsening of the clinical signs as we go up on the dose. This paradoxical effect is really confusing and I just want to make sure that I'm not hurting my baby.
It is true that she has not shown much greens lately.

I think I may look through others' SSs to see if I can see similar trends in other kitties.

 

[Deb and Sylvester]

Thanks for looking over the SS, @tiffmaxee.
It is hard to see worsening of the clinical signs as we go up on the dose. This paradoxical effect is really confusing and I just want to make sure that I'm not hurting my baby.
It is true that she has not shown much greens lately.

I think I may look through others' SSs to see if I can see similar trends in other kitties.

Look at our SS around May 5th, I started taking the dose up and almost nothing happened on 4.5, 4.75 and 5.. He was getting worse and hitting reds.

 

[Wendy&Neko]

Insulin is a hormone, not a drug. You don’t always see incremental improvements with each dose increase. Also take a look at Diane’s Tyler’s spreadsheet for 2020. I had to keep getting her to increase. His numbers stayed pretty much the same until he hit his fitting dose of 2.75 units. Then the magic happened.

Milan needs more insulin. She might be seeing glucose toxicity. I would also do those late PM spot checks that Bhooma suggested. Day nadir tests don’t always tell the story. Neko once went three months giving me higher numbers during the day, and diving low (earning reductions) at night. She was doing mini bounces during the day though, not like Milan. She too was a late nadir girl, I got good at afternoon naps to prepare for night time disruption.

 

[Diane Tyler's Mom GA]

Insulin is a hormone, not a drug. You don’t always see incremental improvements with each dose increase. Also take a look at Diane’s Tyler’s spreadsheet for 2020. I had to keep getting her to increase. His numbers stayed pretty much the same until he hit his fitting dose of 2.75 units. Then the magic happened.

@Mikanmama
This is true what Wendy said about Tyler, even though his pre shots weren't as high as Mikan's I was really getting discouraged ,then bingo ,
Remember it took me 2-1/2 years to get him into remission, not saying that will be the case with Mikan , you aren't harming Mikan , sooner or later you will find the magic dose

 

[Mikanmama (Mikan GA)]

Look at our SS around May 5th, I started taking the dose up and almost nothing happened on 4.5, 4.75 and 5.. He was getting worse and hitting reds.

Ya, Sly stayed up there for a while.
Deb, I'm just so scared. Mikan never had it this high before.
But I understand. I'm scared s*!tless, but I see the logic. I'll increase her dose up to 3.5 tonight.
Thank you for your kind encouragement

 

[tiffmaxee]

Thanks for looking over the SS, @tiffmaxee[/USER

I think I may look through others' SSs to see if I can see similar trends in other kitties.

Good idea. ::bighug:

 

[Mikanmama (Mikan GA)]

Insulin is a hormone, not a drug. You don’t always see incremental improvements with each dose increase. Also take a look at Diane’s Tyler’s spreadsheet for 2020. I had to keep getting her to increase. His numbers stayed pretty much the same until he hit his fitting dose of 2.75 units. Then the magic happened.

Milan needs more insulin. She might be seeing glucose toxicity. I would also do those late PM spot checks that Bhooma suggested. Day nadir tests don’t always tell the story. Neko once went three months giving me higher numbers during the day, and diving low (earning reductions) at night. She was doing mini bounces during the day though, not like Milan. She too was a late nadir girl, I got good at afternoon naps to prepare for night time disruption.

Thank you so much @Wendy&Neko, for your kind advice.
My fear reaction to Mikan's high numbers is driving my brain to go mushy, but the precious little grey cells left up there are helping me see the logic.
There are nights I absolutely have to secure uninterrupted sleep for work reasons (so I don't end up harming others) but there are nights I could perhaps try getting late BGs. I'll see what I can.
I saw Diane/Tyler's SS and I also carefully looked at Deb/Sly's SS. I see your point.

I will go for an increase this evening. Paws firmly crossed. I just want the very best for my sweet girl. Thank you again for sharing your wisdom!

 

[Mikanmama (Mikan GA)]

@Mikanmama
This is true what Wendy said about Tyler, even though his pre shots weren't as high as Mikan's I was really getting discouraged ,then bingo ,
Remember it took me 2-1/2 years to get him into remission, not saying that will be the case with Mikan , you aren't harming Mikan , sooner or later you will find the magic dose

@Diane Tyler's Mom - I see what you mean.
This IS scary though. I hate to see these high BGs, my poor baby. Can't be good for her health. At least, she comes down somewhat in response to insulin.
But I can't let my fear drive this, right?
I got to swallow all the neurotic emotion down hard and do the right thing!
I'll go for an increase today. Until she hits the right dose, gotta get going. Wish us luck, sister!

 

[Diane Tyler's Mom GA]

@Diane Tyler's Mom - I see what you mean.
This IS scary though. I hate to see these high BGs, my poor baby. Can't be good for her health. At least, she comes down somewhat in response to insulin.
But I can't let my fear drive this, right?
I got to swallow all the neurotic emotion down hard and do the right thing!
I'll go for an increase today. Until she hits the right dose, gotta get going. Wish us luck, sister!

Kit believe me I would be like a crazy person too . I know it's scary, you're right you can't let your fear drive this , I know it's easy to say that but you have to keep going.
She will hit the right dose . I'm wishing you all the luck in the world and I'll keep Mikan in my prayers ,promise . ♥
@Mikanmama

 

[Mikanmama (Mikan GA)]

Kit believe me I would be like a crazy person too . I know it's scary, you're right you can't let your fear drive this , I know it's easy to say that but you have to keep going.
She will hit the right dose . I'm wishing you all the luck in the world and I'll keep Mikan in my prayers ,promise . ♥
@Mikanmama

Awwww. Diane. I got teary reading your kind words. Thank you for the encouragement
This is such a crazy journey! I've experience nothing like this ever before. But forward looking, that's what I am going to do!

And tomorrow is another day.

Hopefully, a better day

 

[Diane Tyler's Mom GA]

Aww I didn't want you to get teary eyed. Yes tomorrow is another day , stay string my friend ! We will get Mikan there ! ♥

 

[Mikanmama (Mikan GA)]

Aww I didn't want you to get teary eyed. Yes tomorrow is another day , stay string my friend ! We will get Mikan there ! ♥

 

[Deb and Sylvester]

Ya, Sly stayed up there for a while.
Deb, I'm just so scared. Mikan never had it this high before.
But I understand. I'm scared s*!tless, but I see the logic. I'll increase her dose up to 3.5 tonight.
Thank you for your kind encouragement

Good luck with the increase Kit

Come on Mikan, you can do it!!

 

[Mikanmama (Mikan GA)]

Good luck with the increase Kit

Come on Mikan, you can do it!!

Thanks Deb!

I was totally expecting the worst ever preshot, given that she was 335 at AM+9. She surprised me with PMPS 241 - and lifted my mood instantaneously. She's genius.

 

[Deb and Sylvester]

Thanks Deb!

I was totally expecting the worst ever preshot, given that she was 335 at AM+9. She surprised me with PMPS 241 - and lifted my mood instantaneously. She's genius.

Yay! See, she's doing it, and now with the increase I bet she starts coasting down!

 

[Mikanmama (Mikan GA)]

Yay! See, she's doing it, and now with the increase I bet she starts coasting down!

I think she is taking time but that's okay. I have a super long day tomorrow so I appreciate if I could have my sleep.
Tomorrow PM, I think I can try getting later PM BGs. Of course, FD doesn't care about our schedules Hope Sly gives you a little break

 

[Deb and Sylvester]

I think she is taking time but that's okay. I have a super long day tomorrow so I appreciate if I could have my sleep.
Tomorrow PM, I think I can try getting later PM BGs. Of course, FD doesn't care about our schedules Hope Sly gives you a little break

I hope so too, I want him to float in the 70s.. So I can get some sleep tonight

 

[Mikanmama (Mikan GA)]

 

[Diane Tyler's Mom GA]

Thanks Deb!

I was totally expecting the worst ever preshot, given that she was 335 at AM+9. She surprised me with PMPS 241 - and lifted my mood instantaneously. She's genius.

Ya see keep the faith Kit, not a bad pre shot at all and a nice blue to boot

 

[Mikanmama (Mikan GA)]

 

[Diane Tyler's Mom GA]

Kit , Mikan is having a nice cycle tonight !

 

[Mikanmama (Mikan GA)]

Kit , Mikan is having a nice cycle tonight !

I did test at PM+7. No diving last night