Josie 3/30

[Holly and Josie]

AMPS - 183 - we decided to bite the bullet and shoot this lower number, in the hopes that we could catch the rise. Gave about .3

I was SO nervous about shooting this low and tested every hour from hours 2+ - 6+.

2+ - 179
3+ 179
4+ 173
5+ 152 - Fed a small snack
6+ - 159

PMPS - 417. I made my husband test TWICE because I seriously didn't believe this number. I don't understand this AT ALL. She didn't go too low, so I don't think it's a liver dump. I feel like we did give her enough insulin but once again, when we give less than at least a "skinny .5" the insulin seemed to run out.

I honestly feel like I can't win. We give a skinny .5 which is probably .4 and she runs too long. We give .3 and the insulin runs out and she goes sky high. I just don't feel like there is another option here.

I am begining to question whether she is ever going to get regulated or whether she is just going to constantly bounce, crash, run long, etc. I am also beginning to wonder if ProZinc is the right insulin for her.

 

[Carl & Polly & Bob (GA)]

Re: Josie 3/31 - great AM cycle followed by HIGH PMPS

I'm beginning to wonder if the insulin at these low doses is actually doing little to nothing, and that the bulk of the activity with her BG is actually due to her pancreas working some days.
Even your AMPS cycle. All really nice numbers, but there really wasn't any movement at all in her numbers for the first six hours. All of those numbers are within 20% of each other. Just enough to hold her level. Then her numbers came back up when the tiny dose wore off.
On another day, you shoot a small dose, she goes nutz and drops a bunch. Maybe all or most of that drop is from her pancreas?

This is very confusing...

Carl

 

[Holly and Josie]

Re: Josie 3/31 - great AM cycle followed by HIGH PMPS

I'm beginning to wonder if the insulin at these low doses is actually doing little to nothing, and that the bulk of the activity with her BG is actually due to her pancreas working some days.
Even your AMPS cycle. All really nice numbers, but there really wasn't any movement at all in her numbers for the first six hours. All of those numbers are within 20% of each other. Just enough to hold her level. Then her numbers came back up when the tiny dose wore off.
On another day, you shoot a small dose, she goes nutz and drops a bunch. Maybe all or most of that drop is from her pancreas?

This is very confusing...

Carl

Yes, this is confusing to me, too. Yeah, after I wrote that the AM cycle was a "great cycle" I realized that it really wasn't. It was a flat cycle with good numbers.

I have a few theories about Josie, but they are just theories and I don't know for sure. From what I understand, Type II diabetic cats DO have working pancreases, they are just functioning at extremely low levels. My theory about Josie is that sometimes her pancreas doesn't work at all and other times, it works at almost normal levels. I think this is why she is so unpredictable. I think some of the cats who are easier to regulate are the ones whose pancreases are working at the same lowish levels all the time and then you just have to find the right dose to supplement that. That's my detached, unemotional opinion of the whole thing. My kitty mama opinion is that I want to cry my eyes out because this is SO frustrating. And if it's true, it's so disheartening because unless she goes OTJ, she will NEVER be regulated.

It's interesting that you say you think her pancreas, rather than the ProZinc, might really be doing most of the work. I think you may be right about that. Unlike when she was getting a larger dose, her nadir is no longer predictable. Sometimes she will appear to be flat, and then all of a sudden drop 100 points or so later on. And it seems like she as at her lowest point JUST before her AM shot. It's almost like the small dose isn't enough to do anything, but it is enough to remind her own pancreas to work.

Still, I'm not sure where this leaves me. Maybe I should increase her dose, so that the ProZinc can help her out? But if I do, she risks going hypo when her pancreas kicks in. I could just keep doing what I'm doing, but I worry a lot when I see the higher numbers. I'm really afraid there's not going to be an easy solution to this...

 

[Rob & Harley (GA)]

Re: Josie 3/31 - great AM cycle followed by HIGH PMPS

Why do you think these cycles aren't good? She's in the blues and green with some yellows thrown in there but there is alway some ebb and flow with the cycles and all of the other outside variables.

I think the trick is finding out how much you need to skinny up that .5u.

If you are thinking about another insulin go over and read up on their stickies to get familiar with them, that might make the choice easier for you.

 

[donnahc]

Re: Josie 3/31 - great AM cycle followed by HIGH PMPS

Does anyone think that 400 is rebound? We can get rebound from numbers in the 100s sometimes. Sorry if I am way off base, I wasn’t following along earlier. If it is indeed rebound, shouldn’t in eventually clear? (we are hoping for that ourselves :shock: )

 

[Holly and Josie]

Re: Josie 3/31 - great AM cycle followed by HIGH PMPS

Why do you think these cycles aren't good? She's in the blues and green with some yellows thrown in there but there is alway some ebb and flow with the cycles and all of the other outside variables.

I think the trick is finding out how much you need to skinny up that .5u.

If you are thinking about another insulin go over and read up on their stickies to get familiar with them, that might make the choice easier for you.

Oh, it's not that I think the cycles are bad all of the time. They're not. My original confusion was that it seems like if I give .4, she runs too long and with .2 or .3, the insulin runs out and she can get really high numbers out of nowhere. My feeling was, well then what do I give her? Plus, there's the possibility that Carl mentioned that maybe with these low doses her pancreas is doing a lot of the work, rather than the ProZinc, which I agree may be true. This could be causing some of the weird numbers.

Not really ready to abandon ProZinc yet, but it does seem that she gets some pretty harsh drops which causes me to want to give her smaller doses than she maybe should be getting. Or maybe she does need the small doses, but they need to last longer. So I thought maybe Lantus or something would keep her more stable. But again, I'm not ready to go there quite yet.

 

[Holly and Josie]

Re: Josie 3/31 - great AM cycle followed by HIGH PMPS

Does anyone think that 400 is rebound? We can get rebound from numbers in the 100s sometimes. Sorry if I am way off base, I wasn’t following along earlier. If it is indeed rebound, shouldn’t in eventually clear? (we are hoping for that ourselves :shock: )

I wish I thought it were just rebound and maybe it is, but I kind of don't think so. I really don't think she got below 150 today, which isn't super low for her. My initial thought was that the insulin simply "ran out." This doesn't usually happen with even a skinny .5 or above, but with lower doses it does. However, she's running long on the higher doses. So it's kind of a catch-22.

 

[Holly and Josie]

Re: Josie 3/30 - great AM cycle followed by HIGH PMPS

Flat again this cycle. I liked flat in the high 100's better than I like flat in the 300's!

+3.5 - 382
+5 - 315
+6.5 - 312

We gave her a skinny .5 with her PMPS (412) and I wish we'd done the full .50. We had a similar number a few days ago and gave .5 and she had a great curve. I would have done that again, but I thought maybe we could try for a lower dose and a more shootable AMPS. Pretty sure we're going to get a shootable AMPS.

 

[Catannc]

I have evidence that low doses trigger the pancreas to work, we ran NS for a few days because the vet was suspicious that the 0.2u I was giving could not be causing the curves I was getting. He was absolutely correct.....for one cycle, then her pancreas quit on me. Started the shots again after 3 days and Mr. P came right back. Check out 3/3/12 on my ss.