NEW Update: Josie's bouncy return

Jenna Josie

Jenna Josie

Active Member
Hi everyone.! Just wanted to check in after our trip. We got back Wednesday pm in time for Josie's shot, and her PMPS was "normal" for her (249), which was a happy surprise, actually, since she'd only been getting 1.2u for a week (a dose purposefully reduced from 1.6u since she wasn't going to be monitored).

We worked her (too?) quickly back up to 1.6u and had a green today (although I suspect there was one on the pm of the 19th as well, given her +3 that night, and which would explain her pinks on the 20th), and so now of course she's up in the 290s for PMPS.

Hoping she'll settle in . . .
 
Welcome back! How was your trip?

I don't think the move to 1.6u was too fast, but knowing Josie, you might want to hang out there for another couple of cycles now and give her a chance to settle in before the next move (if one is needed).

I hope you enjoyed your time away!
 
Well, she certainly seems to have “settled” ... essentially the same mid-yellow number all day, afaik. I’ll get a +3 in a couple of hours to see if this is one of those mysterious yellow runs that ends in a sudden drop. o_O
 
Maybe time for 1.8? If you are thinking about increasing, you might try going to 1.7 for one or two cycles and then 1.8. Kind of sneak in the increase and maybe she won't start bouncing ;)
 
Thanks, Djamila. I will do that if she doesn’t try something tricksy tonight.

I *think* I’ve noticed that when she has these pancake-flat cycles, the third day (so, the 6th cycle) ends in a low- or mid-blue PMPS, at which point I’ve always pulled the dose at set her BG going back up again. So she is due for that if that’s indeed a pattern for her. (See SS dates around Sept 9, 17, 26, for example.)

So if she tries that tonight, I may try being brave and shooting through the blues, maybe just skinnying up the 1.6. But if she’s still flat all day and into the PM, I’ll do 1.7, but probably not until the AM.

The problem with going on vacation is that you lose too much consistency in the data gathering! :banghead:

(The other problem is that there’s too much email to catch up on. :D)
 
Sadly, no. :( I tried a second one, and it was 435!

She and the civvie were having quite a growling tussle maybe about 45 minutes before, but could that do it?
 
I've heard that it can in some cats. I haven't noticed it in mine though. They seem to choose dinner time as their favorite time to get in a fight, and usually his PMPS (often done immediately after I pull him out of a wrestling match) is usually his lower PS number. But as with everything around here: ECID so maybe Josie gets riled up when she's in a tussle? I don't see any good reason for the high number, so assuming this is just a single red number, it could well be the fight.
 
I hope so! Cody was pouncing around at her pretty good (he got in trouble for it), and she got pretty riled up, but it wasn't immediately before the test, so I don't know how much to dis/count that.

I really feel devastated by this. I would have been okay with it if it had been her number right when we got back, after a week of being on a dose that we knew was too low (but given for safety reasons while we were away). The only other thing I can think of is that I gave her the run of a room this afternoon where she was staying the week we were away. I know that the cat sitter had to bribe her with a Temptation or two, and I suppose there's a very off chance that Josie found (a) stray treat(s) somewhere, but I don't really believe that neither of the cats sniffed it out in the last 7 days.

I will hope for a much better +3!
 
I know this is easier said then done, but try not to let it bother you too much. At this point it's just one number. And every once in awhile, weird numbers pop up. Especially in cats that are known to be less than consistent. Keep your eyes on the patterns, and toss out the outliers. You'll drive yourself crazy if you focus on individual numbers. :bighug::bighug::bighug:Hugs to you. Pour yourself a glass of wine/cup of tea and just enjoy your sweet furry little babies tonight.
 
Wow Josie! I'm going to go with "oh look a squirrel" syndrome. Djamila is right, until it becomes a pattern, one number is just one number. All cats throw these odd ones sometimes.
 
And now this AMPS = 112. Immediate retest = 105.

I can't even begin to think what/if anything her dose should be.

:banghead::banghead::banghead:
 
Are you home today? There are a few options:

You could try 1u as it looks like you've done that before and been okay on lower numbers
You could feed her, retest in a half hour, and decide your dose then after she's risen a little
You could stall without feeding and keep retesting. This one would probably take longer, and it would throw off your schedule since Josie isnt' known to climb quickly at the end of her cycles.
 
I carved out time to check her at +5-6, but today is otherwise awful, including an event on campus this evening. I’m going to retest her in a minute ...
 
After stalling : 92.

Okay, at least I’m laughing now rather than crying!

I fed her. I will test once more in 30 minutes and see what’s happening. If she’s climbing some, I’ll probably go with a token something, 1u or less.

Current hypothesis: last night was, as Rachel suggests, a “squirrel!” moment brought on by the fight with the civvie and/or freaking out that she was in The Room where she was the week we were gone. The high number resulted in me going past 1.7 straight to 1.8, and this AMPS is just a really long cycle/response to the “large” (for her) increase.

Too early for whisky, right? ;)
 
127 thirty minutes after feeding. Went with 0.8u, half of what has been her "normal" dose.

I left food in her timers, as usual, and am off to work with my fingers crossed but will be back to get what will now be her +4-5.

EDIT: +4 = 238
 
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Maybe she just didn't want you to go to work this morning, and that was the way she tried to keep you at home longer. ;) Her PMPS looks good considering the low dose this morning!
 
Ha! That may be, but only bc she knows that when I leave, she's going to have to stay in her room until I come back and let her out. (I have to do that bc the civvie is a grazer, and she'll scarf -- and barf -- all his food if I don't keep them separate. And then he eats her Zobaline-laced snacks, and everything's all messed up.)

Re: her PMPS: I can't believe it after only a 1/2 AM dose! And now her +3 is 193, so yay!

Maybe I should pretend the last 24 hours didn't happen?
 
I don't know how to explain this, but one pattern I've noticed is that fairly often a bean will lower the dose for whatever reason, and then the next cycle will be really good - lower than normal. And then a cycle or two later the numbers will be back up again. But that reverse effect (lower dose = better cycle) happens fairly often. Looking at Josie's AMPS, it looks like that's what happened for her too. I don't think this morning's red is the same thing as the red from the day before yesterday. I think this one is an after-effect of the reduced dose. But I think we'll have a better idea after this weekend. Hopefully the reds will go far far away and never come back!
 
Djamila said:
. I don't think this morning's red is the same thing as the red from the day before yesterday. I think this one is an after-effect of the reduced dose. But I think we'll have a better idea after this weekend!
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That’s what I was thinking/hoping, too, but I am glad to see that you think that may be the case as well: I do sometimes wonder if my “explanations” are just wishful thinking.
 
AMPS is much more her “normal,” thank goodness. I am going to do a mini-curve today and see if I can get a better picture of what’s going on with her. Hopefully yesterday was just a hangover of sorts from her odd high BG + the big drop, followed by the 1/2 dose.

I have two questions: if a liver dumps sugars when the BG goes unusually low, is there some complementary physiological response when the BG goes unusually high? It just seems like going from 427 to 105 overnight on the 24th was too big a reaction to a 0.2u increase, even for her.

Relatedly, if a BG is “stress-inflated,” is there a sense of how long it takes for that to clear vs a BG number that is high due to, say, a normal food spike?

EDIT: I guess I’m wondering ... if the 427 wasn’t “real” or was just sort of temporary bc of the fight with the civvie, then dropping down to 105 would actually not surprise me given that she has tended to go lower/have a super-long cycle after about 5 or so pancake-flat cycles in the yellows. See post#5.
 
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I think the opposite process is part of the problem with our kitites. When BG goes high, the pancreas is supposed to pump out insulin. Our cats don't do that very well, so we inject them with insulin. However, it's not that their pancreases (pancreai? ;)) don't work at all, so sometimes they kick in a little more natural insulin than others, which can result in those weird cycles where you get more of a response than expected.

For Sam, stress inflated numbers disappear pretty quickly, but ECID. Of course. It could take a couple of days to clear out the glucose dump.

Teasel is similar to Josie in that he'll hang out in steady numbers for a good long while, and then all of a sudden he'll give Kris a lime green out of nowhere. So Kris gives Teasel more time at a given dose before changing him. The other side of that though is that in some cats, too long at a dose and they start to show insulin resistance. So you have to kind of figure out through time and data if Josie just needs more time at one dose, or if that will be bad for her. From your past data, holding her longer at a dose seemed to be working pretty well.

I think right now your goal is to steady her again, and then go back to those sneaky, slow increases once she's done bouncing around so much.
 
Good morning!

Yes, I’m thinking that the “stress spike,” if that’s indeed what it was, was just extremely bad timing and derailed what would likely have been her pancake-flat-to-drop-off cycle (we should come up with a name for that!), and now she’s off bouncing, a bounce that is hopefully clearing some. We’ll see ...

Just for the record, though, I just want to say that I don’t really think our cat is truly “bouncy,” at least not in the traditional sense! ;) Rather, she is “flat-and-dropsy.” (Kris once described it as having a sticky gas pedal, lol.). I would just like her to be flat-and-dropsy in the blues and dark greens rather than in the yellows and blues.

But right now, yes, just hoping for some leveling out!

P.S. It’s also occurred to me that all of this multi-colored nuttiness/bounciness, although certainly more dramatic in the last few days, also seems to have begun with the new ProZinc vial. With the week away (i.e., low dose, no data), though, I can’t do anything with that other than say, hmmm, that’s interesting.
 
Alrighty! So Josie has definitely leveled out, spending about 44 hours in the mid to low yellows.

Her +10 is 170. Yay for blue!

If she comes up by shot time, I think it’s time for a sneaky dose increase to 1.8 (we’ve given 1.7 for 5 cycles). If she is still around 170, I’m thinking to hold the 1.7 for one more cycle.

But if she drops further — yes, I realize she should be rising between +10 and +12, but this is Josie :rolleyes: — I’m thinking 1.6, but I don’t want to mess her up again by giving her a chicken shot!

Thoughts? Shot time will be about 7:15 CTD.
 
Woohoo for a blue! :cool:

I like your plan. I think an increase if she's gone up would be good and sticking to it if she sticks around where she is is good.

Hopefully she won't drop further...yes I think the best thing to do is a tiny decrease if she does since we know how she tends to react when that happens usually!
 
PMPS = 134. She has decided to be tricksy!

I fed her and am going to retest in 20 or so minutes to be sure she is going up.

Then, assuming she is at least 150, I will shoot 1.6.

EDIT: I decided to shoot the 1.6. +20'ish minutes was essentially the same number -- 141 -- but that is also essentially the same number as the 150 I set for a 1.6 dose. I am nervous but have everything on hand and know what to do if she drops, and I will certainly get a +2 to see where she may be headed . . .

Thanks, @Rachel, and @Djamila, too.

EDIT #2: +2 is a surprisingly high 232.
 
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She is certainly bouncing this morning, back into the pinks for AMPS! Hopefully she’ll clear it in a cycle or two.

I don’t know that we’ve shot through the blues successfully before. I usually lose my nerve and pull the dose. (I’m not counting last night’s 0.1u reduction against myself, lol.). I will be curious to see what happens, especially to see if she goes quickly back to flat-and-dropsy and, if so, if her pancake numbers are higher or lower than they were the last couple of days ...
 
Hey -- look at that! Two consecutive blue pre-shots! Looks like she cleared a bounce and may be settling in for some pancake numbers in the high blues/low yellows. Hopefully she'll settle in here for a couple of cycles before giving us one of her marathons that ends in a confoundingly low PS number. :rolleyes:
 
Yay! I was just going to suggest sneaking in just a teeny bit more insulin to see if you can get her to make a smile curve instead of these pancake flats, but maybe those are just Josie's way :cat:
 
I upped her to 1.9u yesterday morning, and she's been fairly high (yellows), including right at 200 at nadir last night. (EDIT: Make at ~200 at +6, since who knows when her nadir is!)

AMPS = 126! <--- this is truly +13.25 because of daily savings/time change.

This is her little trick! (See posts #14 and #28) I'm thinking to hold the dose or maybe to skinny it up just a little bit to 1.8. Will test again and see . . .

Thoughts, if anyone's up?

EDIT: 2nd test (+ 20 minutes) unchanged at 127. I am feeding her now and will get one more test in about 20 minutes (7:15 CDT), and decide on her dose then.
 
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Jenna Josie said:
I upped her to 1.9u yesterday morning, and she's been fairly high (yellows), including right at 200 at nadir last night. (EDIT: Make at ~200 at +6, since who knows when her nadir is!)

AMPS = 126! <--- this is truly +13.25 because of daily savings/time change.

This is her little trick! (See posts #14 and #28) I'm thinking to hold the dose or maybe to skinny it up just a little bit to 1.8. Will test again and see . . .

Thoughts, if anyone's up?

EDIT: 2nd test (+ 20 minutes) unchanged at 127. I am feeding her now and will get one more test in about 20 minutes (7:15 CDT), and decide on her dose then.
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Maybe try 1.9 u again after feeding her and retesting (number permitting)?
 
Hi! Do you think “number permitting” would be pretty much anything higher than what’s she’s got now; I.e., something showing she’s on her way up, even it it is with food on board?

EDIT: 179, so we're shooting the 1.9u.

Thank you, Kris! Clearly not time-sensitive now, but I am curious to know your thoughts about the above since I'm still getting used to the idea of using food to raise the BG to a shootable number.
 
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Jenna Josie said:
Hi! Do you think “number permitting” would be pretty much anything higher than what’s she’s got now; I.e., something showing she’s on her way up, even it it is with food on board?
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I did this stall/feed thing with Teasel when he was on ProZinc. He was usually higher after eating and waiting a bit. Sometimes I gave the full dose, sometimes a hair less. It depended on the other numbers preceding the stall. There are no hard and fast rules unfortunately. It's always an experiment.
 
Given that Josie has established this as a fairly typical response, and that you are able to test pretty regularly, I think the stall-with-food method could be good to help keep her dose consistent, and maybe even get the dose high enough that she could have some better nadirs....or any nadir really ;) She really does use prozinc like a slow release insulin, doesn't she? It's like she has a levemir nadir o_O
 
She's doing it again, only this time feed/stall didn't work: 155 and then 154. And her so-called "curve" yesterday had an apex rather than a nadir!

I am worried that she's on her way *up* from something low overnight (and that the same thing happened overnight Sat/Sun . . . and that yesterday's mid-day pinks were actually a bounce from having a low number that I didn't know about overnight). I don't know that I really think that's true -- it seems pretty unlikely that she went from a 206 at +6 all the way down to, say, 50, and then back up to the 120s in the last half of the cycle over Saturday night/Sunday morning, but that's what I'm worried about. :(
 
It's not impossible, but it does seem unlikely given the rest of your data. She could probably bounce just from hitting a green of any kind since it doesn't look like she's seen one in a while. But again you have enough data that I'm more inclined to think she just holds onto the insulin and has a very late nadir. There was another cat a few years back that did this with Prozinc. Certainly doesn't make it easy on you!

Do you get the PM +4 before you go to bed? Or do you wake up for that? I'm wondering if you could get a couple of +8's or +9's instead just to make sure?
 
It’s the before bed test. I do think I’ll set an alarm to try to get +8 or +9 a few times. Hey, I’m already sleep deprived anyway, right? ;)

I wish she’d get some greens! Looking at her SS, it appears she only ever had them when she was on 1.5/1.6, so I don’t know. :confused:

One interesting thing: yesterday AM, when we were trying the patented Teasel feed-and-stall reverse technique, we can her some of the civvie’s food, which is 6 carbs vs Josie’s usual varieties of 3 or 4 carbs. She certainly came up more quickly on that, which is worth thinking about — is she really that carb sensitive? — but then, I can’t remember if yesterday I gave her 1/2 can or 1/4 can during feed-and-stall (did I mention sleep-deprivation?). I definitely gave her 1/4 this am. If I gave 1/2 can yesterday, I would think that would be the difference in her coming up more quickly before I think it would be the carb content.
 
So 1.9u was interesting for awhile: 4 of 5 blue pre-shot, including three in a row! And then she bounced (I guess), and then instead of clearing it, after two days she hit a red, and so I snuck her up to 2u.

And here we are, with her still going down -- now at 140 -- at +11. I felt good learning to shoot through the blues @ 1.9, but I am nervous b/c the last time I shot 2 on a blue (which was waaaaay back in August!), she ended up in the limes.

Anyway, I'm going to get another test at her normal PS time -- about 7:00pm CST -- but if anyone has any ideas or advice in the meantime, that would be most welcome. :D

EDIT: still haven’t shot ... she’s in the 120s, and so we’re trying the “Teasel Reverse”; aka, feed-then-test. So far no movement, so we’ll reassess in another 20 minutes.
 
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Sorry no one was around last night. I was out at the ballet having a lovely evening away from FD :joyful: and away from worrying about my sick kitty :oops:.

FWIW, I would have probably told you that if you can handle a little sleep deprivation, go for it. Give the dose, monitor, and see what happens. If you were tired and needed sleep, then the reduction was the way to go. She did have that big drop you mentioned, and those are always possible on Prozinc, but it's equally possible that she'll surf along just fine, and maybe even get some time in better numbers.

Again though, sleep is important and it was a PM cycle, so the reduction was understandable. :)
 
Yep, I should have and even, I think, would have except that she didn't come up *at all* in 90 minutes, 60 of which were after eating. I thought she might actually still be going down and was only staying in the 120s b/c of feeding.

Oh, well. Here's hoping she clears this soon, and I can try shooting through the blues this pm or tomorrow am.

The ballet -- jealous! Was in PNB, by chance?
 
@Djamila @Kris & Teasel

Hi. If you are around, do you think you could weigh in on Josie this AM? Gave her 2.2 last night, and she was 103 at AMPS. Trying the Teasel Reverse, gave 1/2 can of food, but after 30 minutes = 108. Just gave another 1/4 can, and will wait till top of the hour to test again. (Top of the hour will be +13.)
 
Any chance you're home today? My hunch is she's not going to come up fast enough for you to get to work, so probably start thinking about reducing the dose again. :confused:
 
I want her to do this on a day when you're home and can just go ahead and shoot. I have a hunch Josie is just a late nadir cat and uses Prozinc like it's Levemir. IF that's true, then in theory you can shoot her regular dose and she'll rise for awhile and then lower again late in the cycle. But it's definitely not something to try when you're leaving because she could end up in margarita land ;) (get it? limes? :smuggrin:)
 
I agree with Djamila. She's holding flat so a reduction is in order. The eternal question ... how much? You dropped to 1 u on the evening of Nov 10 with a PS of 127. Maybe try that?
 
Djamila said:
I want her to do this on a day when you're home and can just go ahead and shoot. I have a hunch Josie is just a late nadir cat and uses Prozinc like it's Levemir. IF that's true, then in theory you can shoot her regular dose and she'll rise for awhile and then lower again late in the cycle. But it's definitely not something to try when you're leaving because she could end up in margarita land ;) (get it? limes? :smuggrin:)
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Beware of late nadirs. Teasel is fond of them. Sometimes he rises afterward and sometimes he doesn't. He's on Lantus and still tricks me. o_O
 
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That's what I'm afraid of....that it would work until it didn't. It would sure be nice to have full-time caregivers for our tricky cats who could just watch over them and steer as needed.
 
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