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Vicky & Gandalf (GA) & Murrlin
Member Since 2009
Re: BUD's numbers dropping . . .
Hi Beth,
I knew I would be sorry I said that. I'm sorry if it upsets you.
It is known among us old timers here that if a long time diabetic's insulin needs begin to decrease, it can mean certain types of cancer. It just comes from board experience. Certain cancers "eat" glucose. Therefore less insulin will be needed by the body to lower BGs, just as in good regulation. Regulation can lead to lower numbers/less insulin required, that is the path of OTJ. I don't want anyone whose cat is experiencing lessening insulin needs to immediately think cancer. That is thankfully rarely the case.
Please understand I knew Gandalf and his BGs and how his body used Levemir very well after over 3 years on it. Although we have had cats go OTJ after a number of years on insulin I knew that was not going to happen for him, even on Levemir. My board experience told me the likely cause of lessening insulin needs in his case was a cancer.
And I'm not sure I understand where you are seeing lower BGs for Bud? She is still in the 300s. Her BGs don't look any different than they were in November. While it's true that too much insulin can cause high, flat BGs, I am not convinced that Bud's BGs indicate that type of rebound. You should have seen an indicator such as a low or fast drop and she is not getting that. Yes, she's had lows and the 500 which makes me think rebound, but I also wonder if there's not some food issue such as not eating (which has been indicted on SS at times when she has gone low) which has caused her to have low numbers on occasion.
Her BGs at this point look more like glucose toxicity has set in. I don't know if this definition will help, but here is the wiki page on that: http://petdiabetes.wikia.com/wiki/Glucose_toxicity
I know you are gone for a while, but since they are testing, I'm wondering if anyone else here concurs that you should consider revisiting the Tilly Protocol for Bud. That would involve getting BGs at least once mid-cycle, such as seems to be done fairly regularly even while you're away, and doing increases in .25U increments based on that mid-cycle test. I would have them wait at least 5 days between increases.
The important thing about Tilly protocol is to be methodical. Increase the doses by .25U if they are needed based on the nadir, and evaluate every 5 days. It takes patience, but lots of people on the Lantus section have done it, so it works! And I don't believe you have to have BG results every 2 hours to get there. Sure the more data the better, but for those who can't, you do the best you can.
If you haven't read the Tilly protocol for a while, it may help you understand once you re-read it. http://www.tillydiabetes.net/en_6_protocol2.htm The way Tilly works, it can break glucose toxicity and I think that's one of the reasons it works so well - because more cats are experiencing glucose toxicity than we realize. And as evidenced from Bud's current high but level numbers it's hard to determine whether it's too much insulin or not enough. I just am not seeing anything in her BGs now which says .4U is too much.
Sorry to be so long-winded about this. I hope you're not thoroughly confused now. Hopefully someone else will be along who can take a look at Bud's spreadsheet and weigh in.
eeraby said:
Hi Beth,
I knew I would be sorry I said that. I'm sorry if it upsets you.
It is known among us old timers here that if a long time diabetic's insulin needs begin to decrease, it can mean certain types of cancer. It just comes from board experience. Certain cancers "eat" glucose. Therefore less insulin will be needed by the body to lower BGs, just as in good regulation. Regulation can lead to lower numbers/less insulin required, that is the path of OTJ. I don't want anyone whose cat is experiencing lessening insulin needs to immediately think cancer. That is thankfully rarely the case.
Please understand I knew Gandalf and his BGs and how his body used Levemir very well after over 3 years on it. Although we have had cats go OTJ after a number of years on insulin I knew that was not going to happen for him, even on Levemir. My board experience told me the likely cause of lessening insulin needs in his case was a cancer.
And I'm not sure I understand where you are seeing lower BGs for Bud? She is still in the 300s. Her BGs don't look any different than they were in November. While it's true that too much insulin can cause high, flat BGs, I am not convinced that Bud's BGs indicate that type of rebound. You should have seen an indicator such as a low or fast drop and she is not getting that. Yes, she's had lows and the 500 which makes me think rebound, but I also wonder if there's not some food issue such as not eating (which has been indicted on SS at times when she has gone low) which has caused her to have low numbers on occasion.
Her BGs at this point look more like glucose toxicity has set in. I don't know if this definition will help, but here is the wiki page on that: http://petdiabetes.wikia.com/wiki/Glucose_toxicity
I know you are gone for a while, but since they are testing, I'm wondering if anyone else here concurs that you should consider revisiting the Tilly Protocol for Bud. That would involve getting BGs at least once mid-cycle, such as seems to be done fairly regularly even while you're away, and doing increases in .25U increments based on that mid-cycle test. I would have them wait at least 5 days between increases.
The important thing about Tilly protocol is to be methodical. Increase the doses by .25U if they are needed based on the nadir, and evaluate every 5 days. It takes patience, but lots of people on the Lantus section have done it, so it works! And I don't believe you have to have BG results every 2 hours to get there. Sure the more data the better, but for those who can't, you do the best you can.
If you haven't read the Tilly protocol for a while, it may help you understand once you re-read it. http://www.tillydiabetes.net/en_6_protocol2.htm The way Tilly works, it can break glucose toxicity and I think that's one of the reasons it works so well - because more cats are experiencing glucose toxicity than we realize. And as evidenced from Bud's current high but level numbers it's hard to determine whether it's too much insulin or not enough. I just am not seeing anything in her BGs now which says .4U is too much.
Sorry to be so long-winded about this. I hope you're not thoroughly confused now. Hopefully someone else will be along who can take a look at Bud's spreadsheet and weigh in.
pamela and tigger
Member Since 2009
Re: BUD's numbers dropping . . .
I agree with Vicky that decreasing the dose isn't getting you where you want to be here with Bud. I think her idea of revisiting the Tilly protocol is a good one. It is a very slow and methodical way to increase the dose and hopefully break through that glucose toxicity she is referring to.
I agree with Vicky that decreasing the dose isn't getting you where you want to be here with Bud. I think her idea of revisiting the Tilly protocol is a good one. It is a very slow and methodical way to increase the dose and hopefully break through that glucose toxicity she is referring to.
Lana & Yoyo
Member Since 2010
Re: BUD's numbers dropping . . .
I agree also. The renal threshold for sugar being dumped into the kidneys is 180 BG. Sugar dumped into the kidneys causes dehydration. It can also lead to kidney damage. I think Bud needs more insulin. With as many health problems as Bud has, I think you can expect a fluctuation in her insulin needs and you have to respond accordingly. I know how frustrating it can be, believe me.
Good luck!
Lana
pamela and tigger said:
I agree also. The renal threshold for sugar being dumped into the kidneys is 180 BG. Sugar dumped into the kidneys causes dehydration. It can also lead to kidney damage. I think Bud needs more insulin. With as many health problems as Bud has, I think you can expect a fluctuation in her insulin needs and you have to respond accordingly. I know how frustrating it can be, believe me.
Good luck!
Lana
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