? Curve day PMPS 4.4, stalled one hour then 4.0 (NS), Caninsulin

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Alexi

Alexi

Member Since 2016
So, today was curve day, and having not read the manual Cappuccino has decided today is the day she does a gentle slide towards PMPS and gives me a green number, and continues dropping. I have just fed her as it is now 13 hours since she last ate and will check again in an hour. She has been giving me odd numbers for the past 4 weeks with pre-shot numbers in the blues and leading me a merry dance with dosing.

I am really not sure what to think of this other than that she has recovering pancreatic function and am now completely stumped about what to do about insulin this evening, she clearly needed some this morning so I will just have to wait and see what effect food has. It is now six weeks since I changed her food. This is quite exciting but worrying at the same time.

@Elizabeth and Bertie @MrWorfMen's Mom - have you seen this happen before?
 
I am anything but an expert with Caninsulin (or any other insulin for that matter) but Cappuccino is indeed having some very strange cycles compared to what I would expect with Caninsulin. If her pancreas is recovering, it's possible that it's sputtering back into action and producing some insulin at intervals. You gave her 1u last night on a PMPS of 6.3. Thinking out loud......Is it possible that the AMPS of 22 this morning was a bounce from going very low last night and then she put out another surge of glucagon today after the 2.25u this morning as a further protective reaction and now her reserves are petering out? Just speculation on my part but I really can't think of what else could cause that kind of reaction. Hopefully Elizabeth will pop by and provide her input because she is much more experienced than me!
 
With food on board she has just tested at 11.4, so I'm going to check again in an hour and hold off on insulin for now, if she has a significant rise at +3 I might give her a small dose - I'm thinking 0.25 or 0.5 units. She did dip into hypo numbers about 2 1/2 weeks ago at +4 when I did give 2.25 units on a AMPS of 14.2, but I knew I could be around to monitor and was curious how low she would go, she was completely asymptomatic. Thank goodness it is a weekend so I could pull an all nighter!
 
That sounds like a good plan for today. Might give you a little more insight into what's going on. It doesn't look like she normally has that much of a food spike but she may be bouncing again because of that unfamiliar low reading at PMPS. Lower numbers often cause the liver to panic and pump out regulatory hormones but right now, she seems to be on a bit of a roller coaster ride. I'd definitely try a lower dose as you've suggested and see what happens if she continues to rise.
 
Well she now has a +2 of 24.2 so that will be the food kicking in, so I'll wait another hour and see which direction she is headed.
 
How long ago did she eat? That would be a huge food spike....from 4 all the way to 24.2! Even from 11.4 to 24.2 is a big jump. Yikes! My kibble addict (15% carbs) doesn't spike like that. :eek: I don't see anywhere else on her spreadsheet where there is anything approaching a huge jump like that although granted the other readings have obviously been tempered down by the insulin she's been given but that still seems like a lot to me given she is on low carb wet food. She's got me stymied!
 
Wow!
What that looks like to me (given that she's on Caninsulin and not something longer-acting) is that there is some pancreas activity going on there; it's as though her pancreas has 'picked up the ball and run with it', so to speak...
Sometimes, when the insulin drops the blood glucose into decent levels the body is able to hold them there, or even to drop them further.
The sudden rise in numbers you're seeing may be due to food, or to the fact that pancreas could pulse out insulin for a little while but has now run out of steam; or it could be a combination of both those things. Either way, I would take this to be an interesting and positive sign.....
With Caninsulin, because of it's relatively short action, if there are decent numbers late into the cycle then that usually means that something else has caused those low numbers; and pancreas activity would seem to be the most likely cause... But that subsequent jump is pretty huge! Wowsy!
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She hasn't had any insulin as yet - so she clearly does need some, and she generally does get a food spike even with insulin on board, if she does have pancreatic activity then I am hoping the +3 may be a little lower. At the moment I am just fascinated to see what she does next. I will give some insulin at +3 just not sure how much yet.
 
2 hours after the 0.5 and she has dropped to 20.9. I am hoping she will be ok until the morning now, six hours away.
 
16.3 this morning, I was expecting it to be higher so I have given 1.5 units and will monitor again today to see if she does it again.
 
@Ruby&Baco I have been looking at Baco's spreadsheet and wanted to ask if you had any ideas based on your experience with Baco, I appreciate you were using ProZinc and had steadier numbers but wondered if Cappuccino was starting to show the same sort of pattern you saw.
 
Alexi said:
16.3 this morning, I was expecting it to be higher
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Alexi - It's interesting that her blood glucose spiked shortly after PMBG last night and then drifted back down on it's own...

Alexi said:
..she generally does get a food spike even with insulin on board
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I wonder if Cappuccino has an intolerance to one (or more) of the ingredients in the Purina DM, and maybe that could be causing the spike...?

Eliz
 
Elizabeth and Bertie said:
wonder if Cappuccino has an intolerance to one (or more) of the ingredients in the Purina DM, and maybe that could be causing the spike...?
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I was also wondering the same thing. In Canada and the US I believe the main source of protein is liver, but they do not say what type of liver..it could be from many different sources. I don't know what formula Purina DM has in the UK but not all kitties tolerate liver as well as others.


ETA I feed one of my kitties small bits of raw grassfed liver as a snack. If I give pork or lamb liver it can cause a food spike, but if I use chicken or beef liver it does not seem to have any effect.
 
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She is definitely a lot better since she started eating it - she doesn't always spike but mostly she does. She had a big liver which has shrunk, she no longer vomits and produces normal poops - a huge difference to before she started it. I think it may just be her. Today she seems to have resumed normal service with her results and has been sleeping a lot - however, having reviewed her spreadsheet she does seem to need less insulin now so I am going to give it another push to get her levels down and see if I can get more pre-shot levels in the blue.
 
Just found this online (is there any further info on the food label, @Alexi ?)
Composition: Pork kidney, liver, lung, greaves and plasma, turkey, salmon, minerals, corn starch.

My understanding is that corn is quite a common allergen for cats. The greaves meal may be beef-based, and beef is one of the commonest allergens for cats. Salmon is an allergen for some cats. The plasma could have come from a number of different species...
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She was on Felix pouches with jelly, I have checked the ingredients on the tin and it is not very enlightening, meat and fish derivatives as the primary ingredient, it looks and smells like oily liver pate, quite yucky to my nose, but she loves it. It was recommended by the specialist (and it is the only 'veterinary food' he does recommend) mainly for her digestive issues rather than her glucose levels. Last night she had 0.5 units at +3 as she had continued to rise, I was expecting a much higher number this morning after such a small dose, and was quite conservative on dosing this morning as I want to get a decent number to shoot this evening to get her timings back on track.
 
So her PMPS today (at +10) was 19.2, no more greens for me :(, she is back on track with her timings, so I'll keep trying to push her down again. What I have noticed since I changed her food is that her curves are shallower with less of a dramatic drop mid cycle. She used to drop like a stone.
 
Alexi said:
So her PMPS today (at +10) was 19.2, no more greens for me :(
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Aw, chin up, Alexi. :bighug:
...Those greens yesterday may be just the beginning of good things to come.
When the cat's pancreas starts producing more insulin it can sometimes be extremely erratic at first, pulsing out a little insulin here and there, getting tired, then sitting down and putting it's feet up with a nice cup of tea and a biscuit... :coffee:

Alexi said:
What I have noticed since I changed her food is that her curves are shallower with less of a dramatic drop mid cycle. She used to drop like a stone.
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So, it looks like there is something in her current food that is preventing the steep drop?
I guess in a way, with Caninsulin, that's a positive thing in that steep drops are not nice for the kitty (or the caregiver sometimes! :nailbiting: )
.
 
Elizabeth and Bertie said:
Aw, chin up, Alexi. :bighug:
...Those greens yesterday may be just the beginning of good things to come.
When the cat's pancreas starts producing more insulin it can sometimes be extremely erratic at first, pulsing out a little insulin here and there, getting tired, then sitting down and putting it's feet up with a nice cup of tea and a biscuit... :coffee:


So, it looks like there is something in her current food that is preventing the steep drop?
I guess in a way, with Caninsulin, that's a positive thing in that steep drops are not nice for the kitty (or the caregiver sometimes! :nailbiting: )
.
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If she is needing less exogenous insulin then the rest should be coming from somewhere :).
Protein is digested more slowly than carbohydrate and the conversion to glucose is more complicated, so high protein low carb diet in theory should give a shallower curve, so she is doing something right, even if she hasn't read the manual...
 
Alexi said:
..so she is doing something right, even if she hasn't read the manual...
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Ha-ha!

Here's a little inspiration for her...;)

upload_2016-7-24_20-24-42.jpeg
 
Another blue APMS, 6.5, still strange happenings. Tonights shot will have to be given late because of work so will be interested to see what number she comes up with at PMPS.
 
Nice start to the day but very interesting that she seems to be having a very late nadir for Caninsulin. Just wondering how feasible it would be for you to get a reading at +8 or +9 (or even +10) during the night cycle for a night or two just to see where she's going later on those night cycles. :)
 
I'm sleep deprived as it is! Tomorrow she is booked in for a fructosamine test so will see what that shows, also will be discussing a change of insulin as I think I have given caninsulin a good go with her and she may just need a push with a longer acting insulin.
 
Well she is still doing it! I don't have her fructosamine result yet as the vet's machine wasn't working so it had to be sent off. She has overshoot her target weight - oops, so she is now on less food, I thought I was conservative with her dosing last night but she was 6.6 this morning so I skipped her shot thinking she would have shot up by this evening, I did manage to get a +1 and she was still in the blues - I wasn't around to monitor her today. Her PMPS is lower than I expected so she got a lower dose than I would normally shoot due to the food reduction. No change in insulin as yet. My vet agrees her issue is she hasn't read the manual but is watching with interest. Overall her need for insulin seems to be reducing.
 
8.6 this morning and another skipped shot, no +1 today because after breakfast she escaped from the house and returned 8 1/2 hours later, vomited some food that was not hers, and promptly demanded more food. She has been visiting somewhere and stealing, probably through someone's cat flap. When she was a kitten she would regularly bring me presents, a bread roll, a large fish from next doors pond (sadly an ex fish by then and I couldn't confess to it for months because I thought it might have been a koi carp but it was actually a very big goldfish) and a large carrot! Not as bad as another cat who once appeared with a joint of meat but she has got her mojo back and turned into the energizer bunny this week. Another reduced dose this evening. She went walkies last week as well and was found in a neighbours garden down the road. She hadn't been out of my garden since diagnosis before then. Less welcome is the 4.30 am wake up calls from a very bouncy cat. I think she may be trying to tell me something...
 
Well it seems all's well in the Cappuccino camp! Sounds like you have a bit of a kleptocat on your hands. LOL! Keep working that juice Cappuccino! How about some lower night time numbers too?! :cat:
 
Alexi said:
@Ruby&Baco I have been looking at Baco's spreadsheet and wanted to ask if you had any ideas based on your experience with Baco, I appreciate you were using ProZinc and had steadier numbers but wondered if Cappuccino was starting to show the same sort of pattern you saw.
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Alexi, i've never noticed this tag! Omg i'm so sorry! Well it doesn't matter anymore I guess because you switch to prozinc since 4 days right? If you need me it's better to send a private message and say that you need me somewere to be because those tags sometimes work and sometimes don't! The one you did today did work! But if I don't reply in like 1 hour than please send me a message.
 
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