7/8 Kiwi -AMPS high (confused, please help!)

[Kiwi F]

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=98485


Hi all.

We could really use some help. Its been a couple weeks and Kiwi seems to still be bouncing (or for some reason having some very high readings). He also hasn't been under 200 in almost two weeks, which worries me. We raised his dose by .25 due to the high nadirs (if I'm understanding this right), but that didn't seem to help. Did I make things worse by raising his dose? (I just worry about organ damage and feel desperate to get his numbers down). It almost seems like he's worse off than before I started him on insulin! I'm very confused.

My other question is that although I've looked at the injection diagrams, I still feel unsure about my injection technique (last year I felt confident, but he's heavier now and his skin moves differently) and I'm worried that if the injection isn't ending up in the right layer, that it might be absorbing too fast and not lasting as long. Is that possible? (I found a video about the tenting technique, on the BD site, but can't get it to play). Does anyone have a different link or able to give a good description? Could this be the problem?

I would appreciate any help you all can give.

Thank you,
Kiwi and Kim

 

[Marje and Gracie]

Hi Kim

Remember when you came back and I said:

When cats are coming back from remission, you need to be more aggressive than you were the first time. If you are not seeing any movement after the first four shots, increase the dose by .25u. You want to get him back into normal numbers as quickly and safely as possible. After the first four, if he's still in yellow/pink, raise the dose. Then give him six cycles. If he's still yellow/pink, raise it again. Keep doing that until you start to see blue/green, ok? It's aggressive but you have to be if you can monitor him.

I think you've been holding doses too long and he's building up some insulin resistance. You did fine on holding the .25u while he was seeing blue, but after the fur shot, I would have increased after four cycles of no blue. So I'd increase his dose to .75u tomorrow morning. We find that cats coming back from remission almost always exceed the dose they were on before. Just keep pressing upward.....you are doing a great job testing.

This post on Testing and Shooting Tips might help you with shooting. You can also try shorter needles.

 

[Kiwi F]

Thanks for the response. The vet told us to wait until he stops bouncing to raise his dose (not that they've always told me the right thing), but he seems to keep bouncing (or am I reading his ss wrong?) If he IS bouncing, will he still stabilize if I keep raising his dose? Last time around, I had to lower his dose to finally get control (although I do understand that things will be different this time around). Or are those high numbers from the insulin being less effective?

As far as insulin resistance, can that reverse if we get him stabilized soon?

The other thing I noticed is that he peaks so early? Any idea why that is happening?

Thanks for your help.

 

[Marje and Gracie]

He is not bouncing...he is high and flat which indicates he needs more insulin. I don't think he peaks early ...sometimes maybe but I wouldn't worry about that. Siennes Gabby nadirs at +3.

I'm sorry but I'm not sure vets see enough SSs to know and for a vet to day to not take the dose up until he quits bouncing makes no sense at all. Many cats bounce and they might not bounce off low numbers. It could be off drops or any number that's lower than the liver is used to.

I think he is just needing more juice.

 

[Kiwi F]

Thank you for clearing up the bouncing issue. I see what you are saying about him being high and flat. Recognizing the difference should help us a lot. We will get him on a higher dose in the morning. Kiwi says thanks.

 

[Marje and Gracie]

Super! If he were bouncing, you'd see some blue numbers...even high blue...followed by yellow or higher.

Good luck with the increase.