Hercules has gone full circle, not sure what to do next?

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Thanks, Panic. I have been looking at people's spreadsheet and I do not see patterns at all :confused:

His blue today is a good example....Nothing has changed from yesterday :confused:

I had agreed with the vet just over a week ago to go up to 1.5 and do curve..... Look where we are now! I need to send her an update. But thank you for telling me I don't need to do curves, I don't like them!
 
Hercule's mum said:
Thanks for all the previous help in sorting Hercs dosing. We have gone up with prozinc, got a few low BGscares. We have gone down with the dose, and his BG is looking really bad today (4 cycles in). Shall I go up again?
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No. Please hold the dose steady for at least 2 to 6 more cycles.

The pre-shots will stay high until the mid-cycle numbers start coming down.
Don't base the dose change on the pre-shots.

Hercule's mum said:
He doesn't seem to be responding the way I read in the books...
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Cats kind of do their own thing, and don't always read the books. It's one reason we say ECID. Every Cat is Different. Every Caregiver is Different too.

Hercule's mum said:
Thanks Daiane! I don't feel like I earned "credits" to tag people yet....
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Tags are fine. You don't have to "earn credits" in order to tag someone. But do be aware that you might not get an answer for several hours or more. Life is busy for those of us helping here too. Grocery shopping, laundry, cats and homes to take care of, goofing off in the garden, etc.
Hercule's mum said:
Yikes 31 at +10! Is Hercs going to be ok?
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Blacks = bouncing. Hercs will be fine.

Eventually, you want to see Hercules testing down in the tree green BG ranges at nadir. Not the neon green BG ranges, but those darker greens, like the color of the leaves on the trees.

Try looking at some of the threads over on the Prozinc ISG. Look at @SashaV for example, and her cat Mauer.
 
Hi @Deb & Wink i have looked at Mauer's sheet, and many more.... I look to see how the rules are being applied and how the cats have responded to changes, and I don't see it....
For example, the reason I tought I needed to go up with insulin for Hercules is because we are barely touching blue at the moment. If the goal is to be in the green zone at nadir, how would that happen if I just keep the insulin the same?
 
Hi Hercule's mom!

Kyra and I are still rather new here too and we are just going into the start of a bounce after I misunderstood what I should have done yesterday morning with such a low amps reading. I actually came across your thread trying to find out how long a bounce can last! Because, like you, I can easily panic and want to put the dose up, but I won't(!!!) because I got fantastic advice yesterday and was told to give 2units a go and to give it time to do it's thing! But I hate seeing reds and blacks after we were doing so well but hey, that's how it is! this is a huge learning curve for us newbies! :)

Anyway I thought I could post and you could have another SS to look at and you can watch us go through our bounce a few days after you and Hercule have gone through yours.
 
Hi Jemma!
I have seen Kyra's SS. You are doing something really well! Her numbers have come down! It is confusing isn't, that sometimes giving less insulin lead to lower numbers than higher insulin? It is this bounce thing, I guess, although I still dont get it....:oops:

I will sit tight on 0.5 for now, and keep an eye on you SS, thanks for getting in touch!
 
No problem! I know how lost you can feel during all of this - It can maddening at times!!

Someone explained it to me that, in some cases, you can miss the perfect dose if you go up and down the units by too much (we have also been told by the vets to do .5 units each time not .25 like the amazing support group on here tell you to) so you will see it is only these last few days that we have introduced .25 increases and decreases. They also told me that staying on a certain dose for too long can be unhelpful, our vet had us stick to doses for at least 2 weeks at a time - Now I will be working to a 7 day schedule - all depending on how Kyra reacts of course!!

With bounces, the way I explain it to myself, whilst pouring over Kyra's numbers for hours on end, is that he has almost gotten used to functioning at such a high BG level that when he gets to a great reading his body reacts and is like OH NO I NEED MORE GLUCOSE!!! and that's when we see the bounce.

I'm not gonna lie I love a good nose at a spreadsheet, not that I can really understand a lot of the time what is going on, but I would get super jealous seeing all the doses decreasing for people...but I think we are getting there...maybe....possibly...who knows haha!!
 
KyraCat said:
They also told me that staying on a certain dose for too long can be unhelpful,
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Humm, that is interesting! I haven't heard that yet, why is it? i'll snoop on your threads to find out....

You WILL get there! :) But focus on kitty health. I had gestational diabetes, and remember loosing a lot of weigth because didn't want to take much insulin. Until docs sat me down and set that providing all the nutrients for baby and me was more important, even if it meant more insulin.... So, I think keeping healthy BG is the goal!
 
Black = bouncing. Hercule was black at AMPS on 8/12/20 ( 12/8/20 in your date format).
Those high reds are bouncing too.

Patience is needed for a few more cycles, to see when Hercules clears this bounce. Bouncing keeps the BG levels higher, and you have to look and see when the bounce breaks before you decide to increase the dose again.

Yes, Hercules is only in the blues, but he is in the low blues. Not the tree greens yet, but he will get there. Give it time for his body to adjust. For his body, it thinks those low blues are too low so it dumps hormones and various sugars into the bloodstream to bring the BG numbers up to a level it considers safe. A cats body can over do it though, and that leads to higher numbers later in the cycle and for several cycles after that. Hence, the "bounce".

Patience little grasshopper, patience.
Please hold the 0.5U dose for a few more cycles, would be my recommendation.
 
Argh! We started the day with me thinking it was going to look good and calmer.... but he had another strange day! Numbers going way up, at what I would think it was around his nadir (+6). I was worried it was a wrong reading and repeated, but it gave me 20.1. Is this part of the bounce too?
 
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@Hercule's mum -

Hi Karen,

Deb & Wink said:
For his body, it thinks those low blues are too low so it dumps hormones and various sugars into the bloodstream to bring the BG numbers up to a level it considers safe.
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I hope the following analogy might be of help in understanding what's happening with bouncing BGs and the gradual nature of blood glucose regulation with insulin.

Think about what happens when you go swimming in the sea in early summer when it's a lovely hot day on land and you'd love to cool down with a nice dip, but the seawater's a tad on the parky side.

If you enter the water quickly your body freaks at the temperature differential and all it wants to make you do is run back up onto the beach because the warmth is more familiar and 'feels safer'. However, if you take time to gradually ease into the water, your body will have time to adjust and recognise that the water is not cold enough to harm it and you can slowly and surely ease yourself further into the briny, eventually having a nice refreshing swim.


Mogs
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Hi Mogs @Critter Mom ! Thanks! I *think* I understand the concept of a bounce. What I am having trouble with is recognizing, and understanding how can i tell apart from a "real" response.

After what Deb said, I tought that I could see and understand a bounce that reveal itself as Pre shots being quite high, in response from the mid cycle low induced by insulin. So, as kitty gets used to having lower BG, the smile would get less pronounced (less bouncy)

However, what I am seeing with Hercules are days that things go low, followed by days with everything being in high side. For example, in the 9th and the 10th of August his BG was always above 18, while on the 10th and 11th it was mostly bellow 19. I naively, tought that things were then settling down, but yesterday and today nubers are on the high side again. Is that a bounce?

If so, how do we ever know if it is a bounce versus all of a sudden the dose not being right?

Thanks for your patience!
 
Hmmm... He might be ready for an increase, but I'm a little worried about the blue (7.4/133) AMPS you got the other day. He probably went lower that night (no tests) and was coming up by that point; now he's likely still in his bounce phase.

I don't know that I'd increase just yet, based on that. I'd like to see you wait out the bounce for another day or two, and make sure to get some nighttime tests in to see if you catch him dropping then. On the other hand, eight days is a long time on one dose. Also, I'm not as familar with Prozinc as some other users so I might be missing some subtleties; let's see what Deb has to say about this!
 
Ah, so that blue might not have been a "true" reading. Hmmm.... I still might hold off until at least tomorrow, though.

Yes, one dip into low (or "low") numbers is enough to trigger a bounce. Even just going down fast (but not going low) can be enough. He has been high a lot but again, you're missing a lot of data in the night time, you don't really know what he's been getting up to in the wee hours...
 
Hey @Hercule's mum

I just came to have a nosey at your spreadsheet and it looks like we are in the same boat again! Kyra is barely eating too!

I hope you are both getting on OK and his appetite picks up soon xxx
 
Hello @KyraCat ! I'm glad you did, because I am awing and humming about what to do with hercs dose, and wanted to find Kyra's SS for some ideas :)

They do seem to be in a very similar pattern, indeed. Pinks and some yellows mostly..... What do we do with this? Is good that they are not bouncing to reds and blacks! But they are probably running higher then ideal, I think? What are your plans?

I have purchased U100 syringes with the hope of better managing fine dosing, and was thinking about moving to 0.4U...
 
Aww yay! glad his appetite is back!! He must have been hungry to get through the plastic too!!! I can get Kyra to eat chicken so I am trying to mix it in with this Feringa food but he is really turning his nose up at that at the moment. Typically I just bought 12 of the big cans all in one flavour - the flavour he was wolfing down last week :banghead::banghead::banghead: Got him in at the vets tonight for a check up, just to be safe. That means I'll be seeing another black on his chart tonight - but that's OK I can explain that one to myself haha!

In other news his sister is currently eating enough for several dozen cats :joyful:

With regards to his dose I'm keeping him at 2.25 until Sunday AM when it looks like he will be due an increase to 2.5. I just want him eating properly again before then so I know it's safe. It's a tight rope to not keep them on the wrong dose for too long but to not up it when their food intake probably isnt where it should be. I think a last minute dash to Pets at Home may be in order to stock up on more food that he can refuse to eat HAHA....!

Good luck to you with the .4 I struggle getting a .25 measure on the syringes I use. You are doing so well you seem to be well ahead of us for getting the good numbers - Keep it up :)
 
KyraCat said:
With regards to his dose I'm keeping him at 2.25 until Sunday AM when it looks like he will be due an increase to 2.5. I just want him eating properly again before then so I know it's safe.
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Sounds very sensible! Fingers crossed he will eat more consistently

I am sorry he is giving you trouble with the food! Hercs usually will eat anything, so I was urprised he turned his nose this week... but I chacked whether his buddy would eat, and she also turnd her nose.... so maybe there was something wrong? it was the fering veal and broccoli..... opened a new can and they both ate ok?!

KyraCat said:
I struggle getting a .25 measure on the syringes I use.
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Well, me too! That is why I got the U100. Every half unit mark on a U100 = .2 units of a u40 insulin (if that makes sense). I find the new syringes don't slide as well as the official prozinc.... so not 100% reccomending, but as small error in a U100 syringe is still a smaller error than in a U40 (I think?)
 
Ah that's good that they both turned their noses up! Good sign the food wasn't up to it's usual standards. We'll get there with Kyra I just think (hope and pray) it is that typical FD thing of getting 2 steps ahead and then dropping 3 steps back...

The syringes I use can be a little stiff when I need to get a .25 measure. I found that, before putting any insulin in the syringe I pull the plunger down then push it back up to the top again. Then I put it in to the vial and pull the insulin down. That seems to make the slider move a bit easier for me.

I'll have to trust you on the maths of all of that haha! Luckily someone shared a carb calculator on here, I think last week, because there was no way my little brain was ever gonna figure out carb content :D
 
KyraCat said:
this Feringa food but he is really turning his nose up at that at the moment. Typically I just bought 12 of the big cans all in one flavour - the flavour he was wolfing down last week
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You can get variations between batches of the same brand/variety. If your little ones won't eat them, a local cat shelter might appreciate their cast-offs. :)


KyraCat said:
The syringes I use can be a little stiff when I need to get a .25 measure. I found that, before putting any insulin in the syringe I pull the plunger down then push it back up to the top again. Then I put it in to the vial and pull the insulin down. That seems to make the slider move a bit easier for me.
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That's the trick! Sometimes moving the plunger back and forth a few times is needed. It spreads the lubricant along the inside of the syringe barrel.


Mogs
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