Help with maddie's curve

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Sarah Beers

Sarah Beers

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I'm doing her curve today. Can someone check it out? I'll try to do another on Thursday when I'm
Off work. I just don't think it makes sense if you compare this to the numbers two days ago. She's just never consistent and it makes me so nervous giving her insulin. Thanks!
 
Sarah Beers said:
I'm doing her curve today. Can someone check it out? I'll try to do another on Thursday when I'm
Off work. I just don't think it makes sense if you compare this to the numbers two days ago. She's just never consistent and it makes me so nervous giving her insulin. Thanks!
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Sarah

It is very possible that Maddie is bouncing. She had that 80 a couple of days ago and without a preshot or early cycle test last night, it is hard to say if she went lower last night as well. When a kitty has lower numbers ( or lower than they are used to) the body produces counter-regulatory hormones that cause stored glucose (glucogen) to be released which brings up the glucose levels. It can take 2 or 3 days for the bounce to clear the system. Today's numbers are higher and fairly flat which often happens with a bounce.
 
She was being very difficult last night and wasn't letting me check her so I didn't give her any but typically in the evening she is around 180 so I didn't want to give her insulin without knowing what she was. I'm assuming it was going up because she is always very grouchy when she is high but I didn't want to risk it. I have lots of battle wounds from last night lol. Shockingly today's curve isn't really bothering her.
 
oh the other thing...Shes been wanting to eat nonstop. She always does that when she is high and that did start last night. Is that normal?
 
Sarah Beers said:
She was being very difficult last night and wasn't letting me check her so I didn't give her any but typically in the evening she is around 180 so I didn't want to give her insulin without knowing what she was. I'm assuming it was going up because she is always very grouchy when she is high but I didn't want to risk it. I have lots of battle wounds from last night lol. Shockingly today's curve isn't really bothering her.
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So sorry Maddie has to be difficult from time to time. If you can find a really special treat for her it might encourage her to be more co-operative at test/shot time.

OK..so if you did not shoot last night, then that will contribute the the higher numbers. As well as I said above that 80 two days ago could very well have triggered a bounce which can take up to 72 hours to clear. So with those two factors it is not surprising to see the sort of curve you got today. Higher glucose numbers do tend to make many kitties more hungry, since they are not able to process the energy from food as well when the numbers are high. At this point I wouldn't bother any more with the curve, since it si not giving a good indication of what the insulin is doing. Hopefully you will be able to get a prehot test tonight.

Did @Sue and Oliver (GA) give you any ideas on a sliding scale for Maddie depending on what her numbers were?


EDIT This might be a clearer explanation of how bouncing works:

http://www.sugarpet.net/glossary.html

"If blood glucose levels drop too low or too suddenly, the body panics, thinking it’s being starved. Stored glucose is released to end this “starvation” and the body is flooded with glucose. This causes the blood glucose levels to bounce rapidly from next to zero to really high. "
 
Sarah Beers said:
it is very rare for her to get insulin at night. She normally doesn't need it.
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Many kitties do run lower at night, but it is a good idea to test and give small doses IF needed. This will help keep the glucose levels stable throughout the whole 24 hour period.
 
Sarah Beers said:
I will redo another curve on Thursday and compare the two. Tomorrow I would be able to get a +2 and +4.
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Sounds like a plan. The more data you have the clearer the picture becomes on how Maddie is responding to Prozinc. If the results are still not what she needs then you may consider a different insulin such as Levemir or Lantus. But in defence of Prozinc, it is a good insulin for kitties...but not all kitties respond the same to different types on insulin, so it is a matter of finding what works best for Maddie.
 
I do if she needs it. It's just that she's normally around 180 at night and there have been a few times were even a half unit with make her drop a lot very quickly so my vet recommended no insulin if she's under 250.
 
Sarah Beers said:
I do if she needs it. It's just that she's normally around 180 at night and there have been a few times were even a half unit with make her drop a lot very quickly so my vet recommended no insulin if she's under 250.
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Definitely you want to keep Maddie safe at all times. A bit more data with the Prozinc and maybe you can ask your vet about using a different insulin
 
Have you considered using U100 syringes so you can accurately dose in smaller increments? It might help you give her .2 of a unit when she's in the low 200's AND you're home to monitor her. This was something I really resisted for too long. I think using the U100's has made all the difference for Tuck and Oliver. With more data I think you may be able to start shooting her when she's lower than 200. She looks like she's flirting with remission but still needs the support of some insulin.
 
Sarah, if she is too low to shoot at night, then you need to reduce the dose a bit. You want to give two shots a day. If you don't and consistently skip, she will be going up from pmps on and be high by amps. Then she gets a little too much insulin for amps and it lasts longer than normal and gives you a pmps you are not comfortable shooting. Consistently skipping the pm dose is not going to work with any insulin.

Hope you could get a test tonight. - it looks like she would be high enough to shoot, even if a little less than 1.5. I would be glad to set up a sliding scale but would really like more data. Maybe Thursday will help.I wonder if she went low with the one unit on the 298. She did the cycle before in that same range. That may have meant this cycle was a bouncy one with elevated numbers.

I think you have two issues - giving a little too much insulin (the move from one unit to 1.5 was likely too much of a jump) causing bouncing, and skipping doses. If you could post daily with your numbers and let us try to interpret them, we might be able to get her on a even keel.
 
Sue and Oliver (GA) said:
Sarah, if she is too low to shoot at night, then you need to reduce the dose a bit. You want to give two shots a day. If you don't and consistently skip, she will be going up from pmps on and be high by amps. Then she gets a little too much insulin for amps and it lasts longer than normal and gives you a pmps you are not comfortable shooting. Consistently skipping the pm dose is not going to work with any insulin.

Hope you could get a test tonight. - it looks like she would be high enough to shoot, even if a little less than 1.5. I would be glad to set up a sliding scale but would really like more data. Maybe Thursday will help.I wonder if she went low with the one unit on the 298. She did the cycle before in that same range. That may have meant this cycle was a bouncy one with elevated numbers.

I think you have two issues - giving a little too much insulin (the move from one unit to 1.5 was likely too much of a jump) causing bouncing, and skipping doses. If you could post daily with your numbers and let us try to interpret them, we might be able to get her on a even keel.
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Sure! I'll keep her chart updated and post tomorrow. I will give her 1 unit tonight.
 
Sarah Beers said:
Will my vet give me those it she's on prozinc?
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You can get them at Walmart. You want to make sure you get the ones with 1/2 unit markings. In many states you don't need a prescription. I'm in PA and the Walmart pharmacists have been very helpful.

My vet thought I was crazy to test so much and she scoffed when I said I was giving fractional units. She also told me Tuck probably wouldn't go into remission. If I'd stayed on her program he probably wouldn't be in remission. I would've only tested at preshot times and I would've misinterpreted his bouncy numbers as not enough insulin. I make her sound horrible but I have a very good relationship with her. I'm there all the time with my foster cats so she trusts me and knows I'm only doing things I've thoroughly researched. Vets are more accustomed to the people who don't want to test and want to be told what to do. At least that's my take on the situation.
 
@Sue and Oliver (GA) can you checkout her spreadsheet and tell me what you think? Knowing her pattern im surprised she's still in the 300's. My vet has been saying this whole time her body just can't decide if it wants to be full diabetic or not so maybe it officially decided to be a full diabetic.
 
I like your choices. The one unit looks pretty good for now and the .5 for the yellow worked well. I think I'd stick with those doses a few cycles and see if she gives you a little lower numbers.
 
Glad she looked better this morning. How did you handle the 193? Did you stall, test a bit later then re-test, feed and shoot? I think you are at a point where you need to begin shooting small amounts when she's under 200. Only try this when you're home to monitor and have the U100 syringes so you can accurately draw up a small dose. What do you think?
 
I didn't because I had to work and won't be home til 7 tonight. I will test her again tonight but normally when this happens she will stay around 180 for a week or so and then back to the 300s. I'll go to Walmart tomorrow and ask if I can buy u100s.
 
This is why I truly believe she has been diabetic the whole 4 years I've had her. She's always had symptoms but Everytime she was checked her results were normal but I think it must have just been her good weeks. In February she got a UTI and that prompted them to recheck. She had been checked a couple months before (I think December) and the BG was normal.
 
Sue and Oliver (GA) said:
So maybe you just need to stick with those lower does, vary then to fit her preshot/nadirs and see if she flattens out?
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I will get u100's tomorrow. I'm going to do another curve if I'm able to give her insulin in the morning. Do you think my theory could be correct about her being diabetic for a long time but it just went undetected? I think someone probably dumped her because of it. She just showed up in my car one day when I had the window down. She was extremely skinny. I took her to the vet and everything was normal. She started gaining weight like crazy and drinking nonstop. I probably had her checked 5-6 times over the past 3-4 years. Each time she was normal until this past Feb.
 
It's possible that she was diabetic for quite while. So each time she was checked out, did they check her blood glucose levels? Is so, it would be odd that she wouldn't be in diabetic levels. But if not, maybe it was just missed.
 
Sue and Oliver (GA) said:
It's possible that she was diabetic for quite while. So each time she was checked out, did they check her blood glucose levels? Is so, it would be odd that she wouldn't be in diabetic levels. But if not, maybe it was just missed.
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Yep they did but always normal until this past Feb. but I'm thinking it was always done on her good days. She would always drink nonstop and her coat was awful. Now she doesn't sit and want the faucet turned on anymore and her coat is MUCH better.
 
Hmmm....well it's possible that she was diabetic all this time and they never noticed. Usually, even on a good day the vet stress will raise the BG enough for them to suspect. BUT it's possible that your vet assumed the higher BG was all from the vet stress and it wasn't high enough for the vet to assume it meant more.
 
Rachel said:
Hmmm....well it's possible that she was diabetic all this time and they never noticed. Usually, even on a good day the vet stress will raise the BG enough for them to suspect. BUT it's possible that your vet assumed the higher BG was all from the vet stress and it wasn't high enough for the vet to assume it meant more.
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That is what I am thinking because she was tested in Dec and they said she was fine. This was a new vet though because I moved. Then in Feb when she got the UTI and was peeing straight blood I called that vet and they said they couldn't do anything without a urine sample. This was at like 1pm. Poor maddie was crying in the litter box and there was blood smeared everywhere. I flipped out and fired that vet. They said they had openings but since I didn't have a sample there was no point in bringing her in. I called my old vet that she had seen for years and they said bring her in immediately. I put her in the car and we made the drive because it was far but not as far is the ER vet. That's when they found out she was indeed diabetic. The next day I had called the vet I fired to ask what her BG was back in Dec and they said it was 180 (roughly...i don't remember the exact number) but that was normal for her because she was extremely stressed out (they even had to sedate her to draw her blood because she was so mad).

We are doing another curve today and she needs a bath. It's going to be a very fun filled day. I'm going to wait to bath her until a few hours after we finish the curve.
 
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