Alex 7/12 - Riddle me this, Batman!

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Ginny & Alex

Ginny & Alex

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So hubby finds out at 10:00 this morning that he has to go to Philly for work. He's booked on an afternoon flight. Since we carpool :mrgreen: , I had to leave with him to come home and get him packed and to the airport. And what an excellent opportunity to get a +6.5 poke.

He's at 282 and his mid-afternoon snack had not been delivered via the Petsafe yet. How can this be????
 
Inverse curve setting up--too much insulin?

Early nadir?

I have no idea!!!!!
 
Well, when you figure it out let me know cause I sure can't figure any of this! After all these good #'s Thumper threw me a 324 this morning! confused_cat
 
Well, no brilliant ideas other than a fur shot. :dizcat Saw in your other post you were going to bite the bullet and pay for the BCP. Interested in whether that changes the picture for Alex.
 
I have been increasing Alex's dose every 3 days since I started this "experiment". With today's weird results, do you think I should increase or not?
 
I wouldn't increase the dose. Today's curve looks inverse to me, suggesting the dose is too high.

Since he came down again by PMPS it doesn't look like a fur shot either. I might go back to your last dose that gave him a regular curve.
 
Robin,
I hate to be stupid, but I don't know what dose gave Alex a "regular curve". The last time we saw a blue number was in early July on day #1 on my experiment--bascially starting over on dosage and starting with .6. Are you suggesting I go back to that dose?
 
I don't know what a real curve looks like either...seems like there's always some weird thing going on. confused_cat
 
A real curve in the reference to shape---a "U" curve. Not so much emphasis on blues, or numbers, but the shape of the curve.
 
Thanks Kim, that's what I meant.

Sorry I hadn't studied your ss before I said that and you're right you havn't had a normal U curve except maybe on that first .6u, mostly just flat days.

Since you've got the new insulin coming I would just hold steady or go back to 1u until it gets here.

I sure hope Alex likes the new insulin better than he does the PZ.
 
Hmmm, what a pain. I can't make heads or tails of it. Maybe post on Health for some fresh eyes on the numbers? They are all swimming for me, sorry not to have any good ideas for you right now. You got some better numbers around 1.6, but there's a pretty high wonk level to it all, it's hard to pick out what worked and what didn't and really correlate it to the doses. That could be a sign they are all too low, but I can't get my mind around it enough to say for sure. In the absense of anything else, I would tend to stick with a systematic approach of 0.2 increases every few days, but again I'm not super-sure. Today's could be just natural variation - all the later cycle numbers are high so it's not exactly inverse in my mind, but it sure ain't a pretty U-curve either!
 
Well inverse in my mind is if the +12 is more like the PS. So the +12 here is high. It's lower than the +9, but with meter variation and natural variation I can't say for sure if it's significant enough of a difference to call it a rebound curve. I mean I'm not saying it's a curve that I like, I just don't want to call it inverse if it's more numbers that sloped upwards all cycle, and incidental that the +12 was slightly lower. Lower doses don't seem to have worked for them, so that's why it makes me think it might be natural variation from the dose being too low and not giving the numbers any real curve. I'm not really sure.
 
Because I really didn't know what to do, I simply kept the dose the same.
I've been tracking the BG levels here, but I also need to add that urine is still fairly heavy.
Isn't that an indication that the insulin dose is too low?
 
I know you are frustrated, Ginny. Don't lose sight of the fact that he is not in horrible numbers. Prozinc just doesn't seem to be working predictable patterns for him.

On Health, you will probably get people urging you to switch to Lantus or Levemir. And as we have said before, that is certainly an option. It seems to vary with difficult cats. Sue and Samwise seem to be getting some good numbers and then some horrible ones with no pattern, just like on PZI. Darlene and Jack seem to be doing well on Levemir as does Lori and Tom.

I think a switch is possibly a good thing or the BCP, if you can get it. You might pm some of the people who were on BCP and went into remission to see who they got it from. (they are in the remission thread at the top of the age.)
 
Rob & Harley said:
I wouldn't increase the dose. Today's curve looks inverse to me, suggesting the dose is too high. Since he came down again by PMPS it doesn't look like a fur shot either. I might go back to your last dose that gave him a regular curve.
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I haven't been looking at Alex's posts but just studied his SS and this was exactly my impression too. He seemed to do better on less insulin. I'd go down on dose and keep him there for a few days. The one day he did rise, but it looked like a bounce because he saw a blue and it took a day or two to clear. By then you had increased dose again and he went flat or inverse. I saw your post on health, but I'm not sure it is the insulin that is the issue, but the dosing that needs tweaking. Of course I'm not an expert like Robin here but your SS sure looks like Shaikha's when we were giving too much.
 
Ginny & Alex said:
Are you suggesting I go back to the latest dose where we hit a BLUE? the .6 dose?
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That's the one I was looking at. I think you need more data with more days at lower doses.
 
Gosh Ginny, I of course don't have any dosing advice. We sure do have a lot of confusing kitty's over here! Is it the PZI? The problem is there are so many different things that play into this dance! :dizcat
 
That's a really nice PS tonight! No way to know though if it was a nice U-curve with a better nadir, or an inverse curve that dropped him down later to the good PS, or flattish all day even. Sorry this is proving such a mystery! Sometimes it is easier than others. :YMSIGH:

I would tend to stay at the same dose and gather data until it's clearer. If your gut is the dose is too high I would lower, but personally I'm not convinced the dose is too high. It's a puzzle to be solved I guess. A lot of regulation to me is detective work until you have enough data to have a clear picture and enough experience to react effectively, and then often things pop into place at that point. It's a pain in the a** to get there, but definitely worth the effort!

I shy away from the 0.4 trial b/c I have seen so few cats do well on doses that low, but hey who knows. If you do try something like that, you will gather data and then you will know. Just be sure to test vigilantly for ketones if you do lower the dose a lot.
 
Joanna & Bix (GA) said:
I shy away from the 0.4 trial b/c I have seen so few cats do well on doses that low, but hey who knows. If you do try something like that, you will gather data and then you will know. Just be sure to test vigilantly for ketones if you do lower the dose a lot.
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I was suggesting a 0.6U dose. It is a drop but not that much. She's been making changes so quickly between doses I'm wondering whether her cat has had sufficient time to adjust to each change.
 
Oh, okay. I didn't see that post on Health. It's all I can do sometimes to keep up with this board and with Shaikha! ;-)
 
I'm still very confused about Alex. Some say increase, some say decrease and I obviously can't do both at the same time. confused_cat I really do, however, appreciate all the input.

I've decreased back to .6 and plan to stay there for a while (longer than 3 days because I suspected early on in this game that it took him a little longer to settle into a dose) unless his numbers start going higher that they have been in the recent past. After a week or so, if that proves to be the obvious wrong dose, I'll start moving up again. In looking at his SS, it appears that both .6 and 1.4 had about the same effect. Weird, huh?

I've just about used up my first vial of ProZinc and the new stuff should be here later today or tomorrow. Wish us luck!
 
Good Luck!

I think decreasing was smart. You don't have a lot of lower doses to experiment with, so after trying the lower doses--- if they don't work, you have plenty of room for higher dose experiments.

It would be ashame to not go back to the few lower doses and miss the sweet spot while chasing the higher doses. After the experiment you will know.

Just my thoughts!
 
Don't be shy though about raising faster if you conclude it's not working. If his symptoms get worse and the numbers aren't getting better, I think you'll be able to conclude in less than a week if it's too low. A week at a dose that low, if it turns out to be too low for him, makes me really nervous nailbite_smile

The goal IMO is to conclude once & for all what direction you need to go in, so you aren't stuck going back & forth & up and down in doses. So do what you need to do and stay at any dose til you feel sure what direction to go in, but then if it is clear to you, I wouldn't wait to adjust the dose based on general principles or anything (beyond the basic 3-4 cycles that I do think it's important to wait on dose increases, barring something like ketones).
 
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