High pre shot numbers

[AbyResq]

Is there anything I can do to get Tuck and Oliver's preshot numbers into lower ranges? I can't figure out if their insulin wears off early or if one or both is bouncing. Both of them start in the red and are frequently in the greens at the nadir. I'm struggling to understand if this is regulation or if I can make the numbers better with an adjustment. Thoughts appreciated.

 

[Bobbie And Bubba]

Hey Kristen ~ two diabetic cats! Bless your heart for fostering them. You have gotten a good sample of numbers through both the AM and PM cycles. It looks like to me that you are getting some nice nadirs with each of them on their present doses and that they both are bouncing right after those blues and greens. I would like some other eyes on their SS and see what others think.

 

[DebG]

Kristen What a big heart you have...... 2 kitties to manage...
Fritz has been on Prozinc since March 24th 2016.
He seemed to stay in the pinks and a few reds for what seemed like forever.
While I can't advise on dosing I can share what I did. I decided to experiment with Fritz food as I was feeding him homemade raw and added 1 meal a day of the LC FF classic foods. I noticed right away that after I eliminated all the FF classic carb food his numbers went into the blues and greens till I ended up with a couple fur shots. Working our way back to the blues and greens.
Now I don't know if it was the insulin and Fritz system starting to work or if it just might be the carbs? After all sugar kitties are sensitive to carbs anyway. Could be a combo of all it....
Food for thought....
You might want to consider trying it.
Hoping others will comment on my little experiment.
Please remember it's a marathon and they take time and patience.
I saw mention of a 11/13 dosing time schedule, wonder if that could be considered?

 

[Sue and Oliver (GA)]

It is amazing how similar they look! Yes, I think they both are bouncing. Their nadirs are wonderful and they seem to
bounce for preshots. The theory is that cats bounce until they stop - until their bodies realize the greens aren't dangerous and their body doesn't need to release more glucose.

So, you can wait. Their numbers overall are great - except for those preshots. Or you can back off the dose a smidge and see if the cycles flatten out. And I would try holding the dose three cycles . Sometimes moving the dosages around too fast doesn't result in the best cycles.

Unfortunately you don't know which method will work until you try it awhile.

 

[BJM]

There may be some bouncing happening. When the glucose drops rapidly, drops to an unfamiliar number, or drops to a hypoglycemic number, compensatory hormones release stored glucose (glycogen), which raises the glucose up high for as much as 3 days. Bouncing happens until it doesn't. Aiming for a less low number, say in the hundreds, may reduce the severity while the cat becomes more accustomed to lower glucose levels.
Also, testing around +10 hours post-shot will identify if the ProZinc is wearing off before 12 hours. in that event, there are a couple of options to work around that.
- Shooting every 8 hours.
- Switching to a depot insulin - Lantus or Levemir

 

[AbyResq]

Thanks everyone. I slightly reduced their doses this morning to see if it helps lower their pre shot numbers. I'm going to try seeing what happens if I can keep the nadir somewhere between 90 and 130.

@BJM , I could manage an 8-10 hour shot interval for a few weeks but not sure I could do that long term. Would the dose amount on the 8 hour schedule remain the same or would I reduce?

@Sue and Oliver (GA) , yes their patterns are very similar! Their +4 readings were identical last night. Eerie, LOL.

@DebG, thanks for your thoughts on food. I maintain a lot of cats and raw isn't really feasible for me. Believe me, I've been intrigued by raw feeding for years. Tuck is definitely carb sensitive, I can easily raise his blood sugar with Fancy Feast classic foods. It doesn't take many carbs to get his numbers up.

In the big scheme of things they are both happy and active. Neither one is drinking or peeing too much. I have to keep reminding myself we've made great progress. In the beginning it really seemed like Tuck was going to go into remission but not anymore

 

[Sue and Oliver (GA)]

The 8 hour schedule only works if there is a clear rise at +8. The numbers you have gotten seem to suggest that the insulin is still working at +9 and the rise comes right before pmps - a pretty good indicator of a bounce.

Don't get discouraged. Some cats take months to get into remission numbers. We had a cat named Cassie who bounced off and on for 2 years and then finally went OTJ. You can find her spreadsheet under B00kworm in the Remission thread. Her bean Lisa tried everything!

 

[BJM]

You only need to worry about every 8 hours when there is evidence that the insulin is wearing off earlier than 12 hours. You're not there at this time.

If you needed to shoot every 8 hours, you would add up the total daily dose, then divide it into thirds. (Ex 1.5 +1.5 = 3.0; divided into 3 doses would be 1 unit every 8 hours, aka TID). In some cases, this could result in a little overlap, so doing this requires a very stable shot schedule.