? Fell off a cliff!

Hi there. I'd stopped by originally to introduce us, then Monkey settled in to some nice numbers at 0.5u or no insulin at all. I kept telling myself to update you and thank those who greeted us ... but I waited too long and now she's doing poorly on her insulin.

She seems to feel good, actually, except recently when she went over 400 bc of a fur shot. But she's always giving PS numbers in the 300s now, and I've been very worried to keep cranking up the dose because her pancreas may reawaken at any point. Aargh. So I am going to increase to 1.5u tomorrow AM (I don't like to increase at night) and then do a curve on the weekend.

She's active, affectionate, she's gained back all the weight she'd lost, she still slap fights her elderly littermate and gets the zoomies. Her urine glucose is high but ketones always negative. But she seems to be peaking early on the PZI, from what I can tell, and I don't know if that means we should switch to Lantus.

I'd appreciate any insight ... just scroll past our beautiful numbers and find us at the bottom of the cliff at the end :(
 
Hi Brian! I'm glad you mentioned you'd posted before...I was like "I recognize that name" but I might have thought I was crazy if you didn't confirm it!

Looks to me like Monkey does need more insulin. I'm not convinced she's peaking early...she has in the past, but I also see her hitting nadir around +5 which is normal. A curve this weekend would be really helpful to see what's going on for sure. Why don't we put off the switching discussion until after the curve? Lantus is a great insulin, but let's see what's going on on Prozinc first. Trust me, we won't hesitate to suggest switching if we think it's best!

I have some guesses about what's going on. It could be some light bouncing (those few times you've gotten pinks mid cycle look like classic bounce cycles to me but could be furshots or something else too). It also could just be that Monkey has a bit of glucose toxicity and needs more insulin to break through. Either way, I'd probably suggest increasing more often than you have. Waiting over a week is just a long time and if Monkey has any toxicity going on (and don't let that word scare you...it just means the insulin isn't enough and she kind of got 'stuck' in higher numbers) the way to break through is more frequent increases. But again...let's have that discussion after the curve I think!
 
Thank you Rachel. Yeah I dragged my feet because she was doing so well on a much lower dose so I thought that would just start again.

We increased today and will give it a few days, then curve. I'll keep you posted.
 
Hi Rachel. So, tomorrow I can either do a curve or just increase. Since I'm sure 1.25u is too little insulin, I don't know if I need to check for rebound at 1.5u by doing a curve at that dose. Should I just go to 1.75u? I think 1.5u has got to be too little insulin as well.

Also, do I keep adding to the same spreadsheet? It's a lot of scrolling. Do people break it into tabs at some point? Thank you.

I don't like to increase at night so I gave 1.5u tonight. I'd appreciate advice. Thank you.
 
You could surely increase tomorrow morning. I would still make sure to get as many tests as you can this weekend. Anything you can get will help us see what's going on so we can help you get Monkey into good numbers!
 
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