Maggie's perplexing progress

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Today isn't looking bad - she dropped 50%. She might need a smidge more insulin or she might be bouncing. Will you get the rest of the numbers today? Might be nice to see when, and how fast, she starts up.

Could also be the vial petering out...
 
Yep, I'm home all day so I can complete the curve. Just added a +8 number, she's headed back up.

I guess it isn't so bad when you look at it that way. It just isn't typical for her. She's always had the black/red PS and the blue/green nadir. Which I guess wasn't that great either, if her body was still reacting with those big bounces.

I think I'll try the new vial tonight and set my alarm for some mid cycle tests. Otherwise have to wait until the weekend.
 
New vial did no good. I upped her to 3u today. I probably won't be able to tell by her PMPS if she bounced or stayed high, but maybe it will at least get her in some better mid-cycle numbers.
 
She seems to be entering a phase of wanting a higher dose. It took me a while to absorb the concept that the dose is a moving target and that there will be ups and downs over time. And that goes double for tricky, bouncy cats.
 
I think you're right Kris. I was complaining about it to my husband, who isn't following all of this closely but has gotten bits and pieces from me. He said, "If she's staying high, doesn't that mean she needs more insulin?" I was like... duh... why didn't I make that connection? I've been so focused on this idea that "less is more" when trying to avoid bounces, that I forgot the most basic mechanism of how this all works! :D
 
No progress so far with 3u. How long do you think I should hold it? She's currently in the third cycle.
Hard to say. Maybe again tonight and then go up tomorrow if there's no progress. Teasel, Maggie and Hermione (rubber kitties all!) are all in a phase of needing a higher dose.
 
Haaaaaaahahaha. I give up, you guys. I am not even going to try to predict her anymore.

I gave her 3.2u this morning -- the most she has ever had. Then I was unexpectedly gone most of the day, but managed one mid-cycle test. Same old story, she'd gone down but not under 300. When I tested for PMPS, I was expecting high 500s. Instead she was 308! I had to test again just to make sure.

I didn't want to give that kind of dose again on so (relatively) low of a reading, so I gave her 2.6, which was working well when she was in good numbers a couple weeks back. I just tested her again at +3/+4 (can't remember exact shot time). She's 400.

Maggie, you win.
 
Haaaaaaahahaha. I give up, you guys. I am not even going to try to predict her anymore.

I gave her 3.2u this morning -- the most she has ever had. Then I was unexpectedly gone most of the day, but managed one mid-cycle test. Same old story, she'd gone down but not under 300. When I tested for PMPS, I was expecting high 500s. Instead she was 308! I had to test again just to make sure.

I didn't want to give that kind of dose again on so (relatively) low of a reading, so I gave her 2.6, which was working well when she was in good numbers a couple weeks back. I just tested her again at +3/+4 (can't remember exact shot time). She's 400.

Maggie, you win.
Been there, done that! Teasel is the same - a dose that worked in the past won't work later after a spell of higher numbers. They get stuck. I regard it as some degree of insulin resistance developing. Kitties like these are variable in their response to insulin dose to dose and variable in their systemic sensitivity over time. That's why we get stuck in "the dance". Two steps forward, one step back ...

I'm slowly learning not to react emotionally to this and think that I've failed somehow because I need to up Teasel's dose. I find it helpful to just look dispassionately at his numbers and ask myself, "What dose is he telling me he needs?". It's like monitoring some industrial process... o_O
 
Have you heard the saying, Molly, that it is a sugar dance and you are trying to lead, but only the cat hears the music?

Just mutter data gathering...data gathering.... So the 3.2 looked pretty good, but maybe next time a little more than 2.6 for the 300s? Data to use next time.
 
I'm slowly learning not to react emotionally to this and think that I've failed somehow because I need to up Teasel's dose. I find it helpful to just look dispassionately at his numbers and ask myself, "What dose is he telling me he needs?". It's like monitoring some industrial process... o_O

Thanks Kris. It is hard not to take it personally! When she surprises me like this, I feel like I'm never going to figure out how to treat her properly. The higher dose itself doesn't bother me as much as the unpredictability.

Speaking of which... she had 308 again for AMPS this morning :rolleyes: So I'm thinking that 400 could have just been the tail end of a food spike. I really intended to get a nadir overnight but couldn't get myself out of bed. I'm curious what she will be at this afternoon.
 
The last few days have been interesting. Trying so hard not to have any expectations when I'm waiting for that number to pop up! But at the risk of upsetting the jinx gods, I will say it looks like that 3.2 dose gets her from black to pink and then she hangs out there. It's worked twice now. Tomorrow I'll be able to tell if she's coming down at all or if she's staying in the 300s all day. I really don't understand this pattern, but I'm liking it for now!

Oh, and I didn't mean to up her dose last night -- I thought I had given her 3 for AM too... oops... luckily it didn't seem to make a difference.
 
Yes, abandon all expectations but keep on keeping on ... ;) It's a process, isn't it! Her recent high numbers might have created some level of insulin resistance and you'll have to move up in dose until you break through that. I think that's what's going on with teasel right now.
 
More of the same today. Last night I dropped my daughter at home and then left to go vote (I don't want to talk about it!). My husband gave the cats their dry food while I was gone, so I'm pretty sure Maggie was in the middle of a food spike when I tested her. I don't think that accounts for the full 300pt rise, but hopefully some of it.

She just will not drop below 250. Now I wish I had gone higher today so I could see what would happen. This weekend we're going back up to the cabin so I'm sure that will have an effect one way or the other.

What I don't understand is how 3.2 can get her from 625 to 325 but then 3.0 barely budges her from the 300s. Is it something to do with 250 being the renal threshold? I've heard that term but don't know a lot about what it means.
 
More of the same today. Last night I dropped my daughter at home and then left to go vote (I don't want to talk about it!). My husband gave the cats their dry food while I was gone, so I'm pretty sure Maggie was in the middle of a food spike when I tested her. I don't think that accounts for the full 300pt rise, but hopefully some of it.

She just will not drop below 250. Now I wish I had gone higher today so I could see what would happen. This weekend we're going back up to the cabin so I'm sure that will have an effect one way or the other.

What I don't understand is how 3.2 can get her from 625 to 325 but then 3.0 barely budges her from the 300s. Is it something to do with 250 being the renal threshold? I've heard that term but don't know a lot about what it means.
I think it's possible that when they're stuck in high numbers for several days, their response to insulin changes and is even less predictable - I regard it as a degree of insulin resistance. I'm there with Teasel right now and past experience tells me I'm going to have to keep raising his dose until I hit a breakthrough. When that happens, I think they become more insulin sensitive and then the challenge is to keep at them with enough insulin to help BG stay low enough but not to hypo. My experience is that backing off too much just sets up another go around of increasing numbers, new resistance, etc.
 
I don't think the renal threshold has anything to do with it. It is the level we think when the kidney can start to level. Some people think lower than 250; some tend to be lower than 280.

I'd suggest being a little more aggressive with dosing when you have the time to monitor. Try a fat 3 or 3.25 on a lower preshot than usual?
 
WELL. Today has been interesting. So we ran out of Evo and had to give the other 3 cats a mix of Evo and Nature's Valley. We gave Maggie her wet food, let the other 3 eat for a bit, then put all the food away and left for work. Maggie got 3.4u since we're being aggressive!

When I got home, she was 101!! Of course I didn't give any shot. In the meantime the replacement bag of Evo had arrived so we gave all of them their evening serving. I offered Maggie wet food, but she wanted the kibble.

I took another reading 3 hrs after the first. She had skyrocketed up to 530! So I gave her new normal dose then.

Now there are a couple possibilities. My husband was giving one of the others cats a little more NV in the afternoon and Maggie snuck sone. He isn't sure how much she ate. So it's either that, or the Evo is really affecting her. If you remember she also went up to 630 on Tuesday after having some.

I'm going to need to do some more experimenting to figure it out. And naturally I just bought a big bag of Evo! So hoping it isn't that.
 
Thanks for checking in Kris. I'm still not sure if the food is keeping her numbers up or not. Things have been hectic around here and I haven't gotten a chance to figure out how to keep her out of the dry food while making sure the other cats get enough to eat. We only have about an hour in the morning which makes it tougher.

Yesterday it seemed she may have started bouncing again, which I was actually happy to see because that meant she must have been dropping down into lower numbers. I tried to drop her dose, but that didn't get the result I was hoping for. I ended up being home unexpectedly today because my daughter's daycare had to close due to a power outage. It doesn't look like she is going to drop at all today, unless she had a very early nadir while we were gone this morning.

We have been so busy, I haven't been very on top of her testing lately. We went back up to the cabin last weekend and she's been laying low since we got back. It's so heartbreaking to see. She is SO happy when we are up there, and so sad when we get home. What's worse is that her mood at home isn't any different than it has been for the last few years -- it's just that now I've been reminded what she is like when she's happy! I didn't realize how sad she was at home. I think she just misses the attention she used to get before all the other cats.

I'll bring her back to 3.4 tonight. I need to do some thinking on how we can feed the other cats separately so I can get a few solid days of no dry food for her and see what kind of difference that makes.
 
Is there any way to give her one on one time with you? Like letting her sleep in your room at night? Or spending some one on one time with you in a room alone?
 
The cats have always been welcome in our room, and usually Maggie and one other cat sleep on the bed with us. Maggie hasn't been joining us lately. She used to sit with me on the couch too after the baby went to sleep and we sat down to watch TV. She hasn't done that in a while either. But it's getting cold now so I'm hoping the addition of blankets on my lap will make it more appealing! I guess I just need to make an effort to go get her when I am able to give her attention. She tends to find a spot to sleep and camp out there. She won't come to seek us out.
 
I'm sorry that Maggie hasn't been herself, Kelly. I know you're very busy but if you can squeeze in some extra one on one time with her she might enjoy that.

It looks like she's bouncing quite a bit the last few days. It might be helpful to look more at the middle third of the cycle's numbers rather than the high (bounced up) ends when deciding on a dose. If I look at those numbers it seems she needs to go up, maybe back to 3.4 u then 3.6 u. That recent evening blue wasn't all that low.
 
I think she could use a tweak upward also, on a cycle you can monitor. Until you are seeing some lower blues (in the low hundreds) for nadir, she has room to drop. Have you been getting rid of the EVo for her?
 
Hi Kelly,

I see that you've stopped dry food most of the time. Looks like it had a positive effect on her numbers. Wise move. :)
 
Hi everyone; sorry, I must have only read Kris's last message in email and not on the board so I wasn't getting notifications from the recent posts. Thank you for continuing to check in!

Maggie has been responding really well to the food changes, though from a coordination standpoint it's been challenging. Before Thanksgiving, we brought Maggie up to the cabin for 3 days and I only brought wet food. She did great, though I was only getting one shootable number so I knew her dose was still too high. When we got home, I started a routine of feeding Maggie in one room with the wet food and then putting out dry food for the other 3. I had to leave it out for about an hour because we have one very shy cat who won't come in the room when I put out the food. They are also used to being able to graze throughout the day so I wanted to make sure they had a good amount of time to get some food in. We did this for about a week and it was pretty tough to do. I was doing a morning, afternoon, and evening feeding. Once I went back to work this week, it became clear that morning and evening feedings only were not going to work. Maggie was dropping into dangerous numbers without food available to level her out. The other cats were not getting enough food and were very upset by the time feeding time came around. One of them kept throwing up his food because he was so hungry that he was eating it way too fast.

Tuesday night I started feeding Young Again Zero, which I've had a bag of for about a month but hadn't started feeding it because I was afraid of the poop issues. But I didn't really have much of a choice; they all needed to have food available throughout the day, and unless I kept Maggie locked up in a room by herself, that wasn't going to be possible. As you can see from her chart yesterday, Maggie is doing great! I'm still giving her a serving of wet food before shots, and then leaving the YAZ kibble out at all times. I know we've only just started, but she's had a really positive reaction so far. Two of the cats are having some loose stools from the YAZ but I'm hoping their bodies can adjust quickly. They definitely don't like this kibble as much -- they all went crazy for the EVO, and they aren't excited about this stuff at all. I've got tons of EVO to go through, so we'll still feed it to them when we go out of town with Maggie. They are funny cats; they're picky, but somehow always in agreement!
 
No kidding! I don't think she's eating much overnight. I've been stepping her dose down gradually but I'm wondering if I need to go faster. Maybe I will drop to 1.4 tonight. I can't believe she could need that little!
 
No kidding! I don't think she's eating much overnight. I've been stepping her dose down gradually but I'm wondering if I need to go faster. Maybe I will drop to 1.4 tonight. I can't believe she could need that little!
You could try 11/13 dosing because her PMPSs are high and AMPSs are lower recently. By that I mean give her the PM dose at +11 to catch her before she goes higher. Dose in the AM at the usual time which would then be +13. That extra hour before AM dose might get her BG up a bit more. Something to think about. She might be needing less insulin if her pancreas decides to wake up. Dosing can be trickier then so you might want to post and ask for advice. :)
 
At this point I just want to get off the 24h dosing! Lol. She hasn't had an AM shot all week, so the PM numbers reflect a day without insulin. I do think she's going to end up needing a lower dose overnight than during the day, but I need to find one low enough that she has a shootable number in the AM.
 
At this point I just want to get off the 24h dosing! Lol. She hasn't had an AM shot all week, so the PM numbers reflect a day without insulin. I do think she's going to end up needing a lower dose overnight than during the day, but I need to find one low enough that she has a shootable number in the AM.
Twice a day dosing works best with kitty metabolism. Here's something to try: take what ever average dose you've given in the PM, divide it in two and give one half in the AM and one half in the PM.

Pardon my fuzzy brain; I did see those NSs for the AM and then went ahead to suggest 11/13.
 
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