8/21 Ebby AMPS 369 +3 169 Try something else?

[MelissaEbby]

I've been trying to slow these drops at onset, but even with a lot of food and increasing carbs slightly she still likes to take these dives. Glad she's out of the 300's but just wish she'd do it more gradual.

I'm considering trying out Levemir. I know there may be no magic solution to this, but I also don't want to look back and feel I didn't try everything to gain regulation. I understand Levemir has a later onset. Does anyone know if the onset is also more gradual?

Another thing I'm considering is splitting the lantus dose...giving half her normal dose at normal shot time, and the other half at +2. This, of course complicates the shooting schedule a little, and I do worry about some amount of unpredictability.

Well, I know I'm not alone in having one of these bouncy kitties, and that it just may be how it is, but figured there are still a few things I could try. Any feedback is welcomed.

Yesterday's condo:
viewtopic.php?f=9&t=102678

 

[rhiannon and shadow (GA)]

I don't think you should split the dose.
I think you should wait for Marje to get back from her staycation with family visiting and see what she has to say. She has vast experience with both issues.

Generally bouncy kitties need beans with patience pants....
Maybe experiment with some other foods.... find one that gets a little more rising action. Deborah and Shasta might be a condo to watch.... during the school year.... she often has to frontload the cycle because she has to go off to work and can't monitor.

 

[Sienne and Gabby (GA)]

The biggest difference with Lev is that the nadir is later. Lev was a good choice for Marje/Gracie. OTOH, it didn't make much of a difference for Barb/Checkers. You'll need to factor in how well a nadir at around +8 (give or take) will work for your schedule.

I would strongly advise against splitting the dose. It's not how Lantus works best. You will end up with 2 nadirs each cycle. You could certainly PM Jill/Alex to ask if this strategy has been used in the past but I don't recall anyone doing it. Having 2 potentially overlapping nadirs, in my mind, is asking for twice the problems.

I also have a slightly different spin on what you're calling drops. I think this is where a bounce is breaking. The last couple of days, it looks like things are flattening out a bit.

 

[MelissaEbby]

Thanks for the feedback! I will check out that condo you mentioned, Rhiannon. I don't think I've seen them before. Ebby gave me a decent PMPS, so she must know I'm getting frustrated.

I wasn't planning any changes yet, just thinking about options. I have two weeks off at the end of September, so just thinking ahead in case I want to take advantage of this time to do any switches or try anything new.

I had been wondering if splitting the dose would help, and then saw someone mentioned doing this in a thread on ThinkTank. I think it was Kpassa?? I'll have to look again, could be wrong. The overlapping nadirs is a concern, and the nadir of lantus probably does work better with my schedule. Sienne, I see what you mean about the bounce breaking....shooting a falling number would appear like a fast drop I guess.

I will keep experimenting with the foods....I have some new 9% to try. Maybe slightly higher carbs at the beginning of the cycle will help.

 

[Sienne and Gabby (GA)]

I would front load the cycle with food (i.e., feeding over the first several hours). I'd also not expect to see a quick, radical change. It took Gabby a couple of weeks to respond although she can still dive early. I have thought about switching her to Lev but it would be a nightmare for my schedule, as well.

We've seen a couple of new members try to split doses more out of not understanding than anything else. It's a great way to court difficult to control low numbers. If you find the thread, let me know. I'd be curious to read it.

 

[Marje and Gracie]

Hi Melissa

I'm just getting back to condos after my DSS left.

I agree with Sienne that I would not split the dose. I really don't know how that would address the diving issue. I still think sticking with your front loading is the option for now; as Sienne said, it takes time.

Bounce clearing cycles can be challenging because numbers tend to come down fast. Once a caregiver has the experience and dat (and you do), shooting dropping numbers (when it is safe) allows you to take advantage of overlap and carryover.

I had Gracie on lantus a year before I switched her because she was doing what Ebby is doing (diving) and, while the frontloading helped alot, she was also constantly giving me dropping numbers at shot time (which Ebby is not doing so much). Ebby tends to dive fast and bounce back up. You may find with Ebby, as I have with Gracie, that the dives cause her to bounce harder than the low numbers.

I love levemir for Gracie and wish I had switched her after six months on lantus. Sienne is right, though, that some cats that have switched like Barb's Checkers and Ann's Tess, still have alot of bouncing issues. Gracie does still bounce but her cycles are just so much flatter, in general, than they ever were on lantus and she just seems to feel better. Most of the time, I've been able to keep her pretty well regulated.

But....until you try levemir, you won't know what Ebby will do. Gracie often gets really great duration from lev (and it is known for it's great duration) so she often nadirs around +15 and if she nadirs a bit earlier, she gets a second dip around +15. that means I am usually shooting a dropping number but it's different than shooting a lantus dropping number because I know I can give her some higher low carb food and get her up just a little bit before she onsets somewhere around +4/+5. Her lev cycles have never been "typical" but we pretty much understand her patterns.

Since you have another month before the end of Sept, then see how Ebby does. I do want to be clear, though, that cats can still bounce on levemir.

 

[MelissaEbby]

Ok, just now getting some time to post today...Thanks for the responses! Marje, I hope you had a good time with the family, and thanks for stopping in.

I will keep with lantus for now, and continue experimenting with food and maybe reassess before my break in September.

But....until you try levemir, you won't know what Ebby will do. Gracie often gets really great duration from lev (and it is known for it's great duration) so she often nadirs around +15 and if she nadirs a bit earlier, she gets a second dip around +15. that means I am usually shooting a dropping number but it's different than shooting a lantus dropping number because I know I can give her some higher low carb food and get her up just a little bit before she onsets somewhere around +4/+5.

So Marje, Gracie nadirs at +15? Is that common for levemir, or does she just have more of a slanted drop than a curve?

Since you have another month before the end of Sept, then see how Ebby does. I do want to be clear, though, that cats can still bounce on levemir.

Can't they just make an anti-bounce insulin? It would be so much easier. Yeah, chances are Ebby would have a similar reaction to levemir and still bounce.

 

[Marje and Gracie]

So Marje, Gracie nadirs at +15? Is that common for levemir, or does she just have more of a slanted drop than a curve?

Yes, when the dose is perfect, she will nadir at +14/+15 and then her next shot onsets and she has a nice, flat curve. Sometimes, she will come up just a tad and then drop back down. She often has a really flat cycle....ESP when the dose is perfect.

Can't they just make an anti-bounce insulin? It would be so much easier. Yeah, chances are Ebby would have a similar reaction to levemir and still bounce.

:lol: :lol: :lol: :lol: it would be easier if they made a anti-bounce liver.