Beau - 8/6 Rebound or too little insulin?

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alicia.1771

alicia.1771

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Hey all -- can someone take a look at his SS for the past few days and let me know their thoughts?

His PS#'s are higher than I'm comfortable with right now and I don't know if he is either going through a chronic rebound (from 7/29 AM low nadir at the vet, 7/30 PM hypo +/- 7/31 PM possible dip) or getting too little insulin? I have been reading posts on rebound vs. too little insulin and know that it can be difficult to tell the difference. Here are some additional info I have:

Appetite is better that he is seeking to be fed and will finish 1 can of Fancy Feast on his own whereas for the last 1.5 weeks I have to hand-feed the 2nd half of his food. His appetite right now is similar to when we first started insulin, but it dropped off during the 2nd week of treatment and now it's back up again. I'm not sure how much appetite can tell us since my other civie is always seeking food and will eat pretty much anything offered (I tested her last week before feeding and she's at a comfy 55).

Water consumption is actually less. Before insulin he was about 400ml/day, then dropped to about 200ml since insulin and now in the 100's these past few days.

Urination frequency and volume are both less than when we started insulin. Ketones have been negative even this AM.

Behavior is about the same, the only odd ball is on 8/4 he did not greet me at the door during AM+5 checkup (his AMPS was also lower that day at 276). But we have been having constructions in the house this past week and that day was pretty loud, so not quite sure how much of that factors in.

He is getting 1.0U BID now on his 5th cycle (we are trying to hold ia dose for a few days to see a pattern). I am a little discouraged now since he was doing so well and we were getting really nice curves and good nadir #'s :cry: I will be doing his BG curve today at home and post the #'s here.

AMPS - 509
+2 - 326 (big drop from AMPS)
+4 - 166 (seems to hid nadir early in the cycle)
+6 - 186 (# is creeping up already before mid-cycle)
+8 - 297 (and up...)
+10 - 411 (argh...)
PMPS - 460
 
Hi Alicia! Boy, you are a good tester!

Beau doesn't seem to be getting any oomph from the 1u anymore, I would go back to 1.25u only because he can go so low! I don't see rebound but it could be .... although you are using less insulin than before. When you gave 1.25-1.5, you got some really nice nadirs. When you started going down on the dose, the #'s started going up, which to me is not rebound.

You have a second option because he has no ketones .... you could drop his dose more, if it is rebound it will level him off. It is really hard to say with only a few weeks of #'s but our worry now is him not going too low.

You may want to post on health to see if you can get more eyes on your SS ..... you are doing a really good job!

Nancy and Payne
 
Thanks Nancy for your input. I will go ahead and post on Health as well.

He is really good about being tested (I love him :-D ), and I'm getting better on gauging the depth to go with the lancet and using neosporin, which seemed to help.
 
Isn't it strange the love we have with our sugar cats? we love all of our animals but these babies, they become so special to us .... good thing too, because this dance can get really crazy sometimes! ohmygod_smile
 
+2 looks good. Maybe after today's curve then will seem clearer.

Good Luck!

You are doing Great!
 
In health you are competing with other posts .... sad but true. You need to catch eyes with your subject, maybe, just a suggestion, Kitty can go low .... need eyes on SS .... or something where people want to look at your post. Remember you do that by going into your first post and hitting edit, then change. Only if you want.
 
Nancy and Payne said:
Hi Alicia! Boy, you are a good tester!

Beau doesn't seem to be getting any oomph from the 1u anymore, I would go back to 1.25u only because he can go so low! I don't see rebound but it could be .... although you are using less insulin than before. When you gave 1.25-1.5, you got some really nice nadirs. When you started going down on the dose, the #'s started going up, which to me is not rebound.

You have a second option because he has no ketones .... you could drop his dose more, if it is rebound it will level him off. It is really hard to say with only a few weeks of #'s but our worry now is him not going too low.

You may want to post on health to see if you can get more eyes on your SS ..... you are doing a really good job!

Nancy and Payne
Click to expand...
Nancy,
I responded in Health, but I don't think anyone else has yet. Beau is getting a pretty steep drop from ps to +4, would you agree? 75% maybe? I was thinking a lower dose for the same reason you said. It almost seems like he's getting a big boost early on, then the insulin sort of peters out. Instead of a nice U shape curve, he's more like a V. That 500 this morning would have concerned me too, but so would a real low +6. If he goes single digits (70's or lower) at nadir, then I'd be more worried about upping the dose than trying a .75 and seeing if that made his curve more gentle without raising his PS readings.

Carl
 
I think the #'s are where he goes, an early nadir, than back again quickly .... it is one of the hardest to sometimes regulate because you are always fearful of going too low.

With no ketones and being tested well, maybe start with a reduction and see if it is indeed rebound, it is the safer way to go.
 
His +6 is slowly creeping up to 186...

I can see reasoning for both cases. I read that rebound doesn't always need to be due to too low a nadir#, but like Carl said, it can also be due to too sharp a drop in glucose. Beau may be sensitive to insulin as his #'s had dropped quite a bit a few times after his shots. Also his PS#'s are much higher than when we first started insulin so that makes me wonder if rebound is in play.

On the other hand, he is showing a pretty good curve (I think) but it's not going low enough so it creeps back up. This makes me think we are not giving him enough insulin to keep the BG low and long enough to the next shot.

Any thoughts so far?
 
Interesting---test the cycle out, before we pass judgement!

It will be real interesting to see how fast he goes up---or, if he will surf for awhile in lower numbers and then shoot up.

Keep testing!
 
I am with Kim...
keep testing..and hang in there
I am sorry but I am not an advice giver on amounts of insulin to give
Hang in there and just keep testing...and always trust your gut!

Dneise and Shakes
 
alicia.1771 said:
On the other hand, he is showing a pretty good curve (I think) but it's not going low enough so it creeps back up. This makes me think we are not giving him enough insulin to keep the BG low and long enough to the next shot.
Click to expand...

I think you hit the nail on the head with this idea right here. You were seeing better numbers at a slightly higher dose, which tells me this isn't rebound. Tonight will be your third day at 1u. What do you think about fattening up the dose just a smidge tomorrow morning? Say 1.2u?
 
Hi Kelly -- I am really on the fence about whether to increase or decrease his dosage tonight. I see that Beau had a good curve and nadir when he got the 1.25U last week for the vet's BG curve, but things hasn't been the same since that stressful visit.

It almost seemed he was doing pretty good on the skinny 0.8U and was starting to show good curve on 7/31PM when I gave him gravy food. His # where also quite promising with a skinny 1.0U on 8/3PM dose getting a 276 AMPS before I gave him a steady solid 1.0U.

If I choose to adjust his dose tonight, how many cycles should I hold it to see whether or not it's in the right direction??? If he happens to be in rebound and I up the dose, won't that put him a few more days in higher #'s?

Anyone know if cats in rebound still show curves like Beau does or are mostly flats? Has there been cases here that a rebound was identified based on readings after reducing a dose? Can someone point me to the cat's SS so I can take a look and compare?
 
I don't have spreadsheets to point you to. Rebound numbers are usually high and flat, which is why I don't think you have a rebound case. You are talking about such a small difference in dose, that it wouldn't hurt to try either up or down depending on what your gut is telling you. Regarding lowering the dose, I'd say you should notice a difference within 3 cycles if the lower dose is going to work better. When raising the dose, it can sometimes take up to 3 cycles for a dose to settle in with some cats, so either way, I'd say sit on your hands for 3 cycles to see what it is going to do. If you do lower the dose and you see horribly high numbers, you don't have to wait 3 cycles though. The 3 cycle waiting time is if you are seeing similar numbers.
 
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