Linus 4/25 - IHOP, now what?

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Dragonfly229

Dragonfly229

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Increased to 2.4u yesterday morning, have spent 2 days at IHOP. The good news is, pre-shot numbers are mostly back in the pinks, barely. I've started giving the dogs their food and asking them to finish it, so there is no dog food out.

I'll give this a few days and make a decision on my days off starting Sunday whether to increase again or possibly reboot back down. I'm pretty confused about why he goes up with increases, but the lower doses just don't get him where he needs to be either.

So something I've noticed is that some (lots?) of the cats that are micro-dosing and OTJ are ones that were overdosed dramatically by vets before coming here. Has anyone else noticed that overdoses and hypo's seem to lead to a cat that eventually needs a micro-dose? I wouldn't even know if I had the nerve to try it, but it seems like a possibility.

Wishing everyone great numbers on Thursday!
 
Your question is a very good question.
I would answer no to your question....I don't think if cat has been on high doses or had hypos that leads to OTJ or micro dosing. For example Libby & Hershey hypoed several times & he is still on insulin. Libby is currently struggling to find the right dose. She is fighting high PS's & some flat cycles.

Here is a other example Baxter. Baxter was DX in Nov. & on insulin for 3 weeks & we started to get some really great numbers with no hypos. He went OTJ for 3 weeks. Then his numbers started to rise & we started back on insulin. Baxter got sick & his numbers really rose the vet told me to increase the insulin so at that point I was giving 1.5 which didn't do anything for Baxter. It made his numbers higher he even had his first red since DX & his cycles were flat for days. This was just in January or Febuary can't remember, but it's on his SS.

Your highest chance of going into remission is the first 100 days after DX. Those are the most important days. I think consistency with shot times, feeding & diet are the biggest factors. Diet being the main one.

Your question is a good question for Carl. He would be able to answer it more into detail.
 
Hi Sue,
I undertand your feelings, sometimes I do sit back and look at the OTJ's and
wonder if it could have been because of an initial overdose..
I have also seen a pattern like that, but would never try it!
 
I know it's tempting to think it could be that easy, but like Jenn said, we've been through a couple of hypo's with Hershey but he's still liking the juice. :sad: After reading how some forum folks have lost their cats due to accidental hypo's, I'd certainly never inflict one intentionally. Wish I had a guide book to share with you to help us understand this crazy dance...I, personally, have two left feet...

Taking it one cycle at a time -

Libby (and Hershey, too!)
 
You do have something there....we're not talking hypo necessarily, but a BAM dose and then a reduction....let me see if I can find the literature, but it's kind of a "do not try this at home thing".

*Found it: http://petdiabetes.wikia.com/wiki/Glucose_toxicity

When a diabetic animal is hyperglycemic for long enough, the animal's damaged tissues may start having trouble using insulin. This in turn means that even a well-dosed animal may continue to have high blood sugar, leading to even more insulin resistance.

Various methods through this "glass floor" have been tried, to varying degrees of success. One way is to continue gradually raising insulin dosage until the tissues pick up the insulin and start absorbing glucose, then quickly back off to a lower dose. Another is to "jumpstart" the process with a fast-acting insulin or a deliberately high dose of the regular insulin, then quickly back off to a lower dose. Another is to reduce the carbohydrate content of the food further, or to eliminate dry food entirely (even low-carb dry food), thereby presenting less of an obstacle for insulin effectiveness and reducing insulin needs. Aggressive attempts to break glucose toxicity are best regarded as dangerous and should be addressed in close partnership with a diabetes-experienced veterinarian.

These methods may provide relief from glucose toxicity suddenly and unexpectedly, risking overdose and hypoglycemia once the "glass floor" is broken. Caregivers should be vigilant about watching for signs that the floor has broken, such as lower than expected blood glucose levels or a rebound event on a previously "safe" insulin dosage, and be prepared to immediately lower the dosage.
 
OK, so he was 239 at +2 last night. Quite the drop from 395. Back up to 394 this morning at +10. No dog food out overnight. It looks to me like we got an early steep drop, followed by a rise back to pre-shot numbers by +10, which, if I understand correctly, may mean the dose is still too low. It's too early to say if this is the pattern, so I'll still wait it out until Sunday and see if it continues along the same path.
 
Just to play devil's advocate....
It could also mean the dose is too high if Linus wasn't too happy with the early steep drop, and that is what caused the rise back up to high pinks.

I look at "percentage of drop", and I look at how many colors of the SS rainbow a kitty crosses during a cycle. I think a 60% drop is "good", and at most, three colors. If you start at 400+ and drop into the blues, that's red, pink, yellow and blue. That usually seems to cause bounces, because it's too much drop. I tend to think if you start red and go low to yellow, that seems to work better than going all the way down to blues, bounce-wise. Same thing with pinks to greens. 450 to 225, even though it's only 50%, is better (IMO) than 450 to 175 in terms of what happens next if the body can't deal with going that low.

Carl
 
In this specific cycle, Linus dropped 40%+ in two hours (which is weird because that is pretty fast onset on the insulin), which may have caused his body to fight back against the drop.

Carl
 
Carl, thanks, that makes sense. I was just thinking about the late nadir = high dose and translating that into early nadir = low dose. He dropped back down to the low 300's by AMPS, Pierre couldn't remember if it was 319 or 323. That's surprising given the 394 2 hours earlier, and the fact that he was fed then. I'm pretty confident in the 394 number, but it was 5:00 this morning, I could have screwed up somehow, or maybe Pierre did at AMPS and it really wasn't that low.
 
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