Re: 10/08/ Misho's AMPS 450 - what is going on?
Okay starting with the easiest to explain first.
Shooting through a bounce means that the cat has earned a dose reduction by giving a reading below 50, this caused their body to release stored sugars and force the BGs back up. So the next preshot tests are very high. So instead of giving a reduced dose on those high numbers the care giver gives the same dose that just caused the reduction to be earned then once the numbers are lower again starts the lower dose. A good example of shooting through a bounce is my Autumn. On Sunday October 6th she dropped to 35 by +6 on a .10 dose, that earned her a dose reduction by protocol but because of going so low she bounced and by that night was in the 300s again, so I stayed with the same dose of .10 that night and all day yesterday as her body cleared the bounce. Now this morning she was at 171 by amps so this morning I lowered the dose in her case to a mere needle full. That is what BJM is referring to when she said shooting through a bounce.
Okay you and I both use the same form of Levemir I also use the cartridges.
That makes it easier on me to figure out when it might be just weakening insulin rather than the dose, since I have an idea about how long one will last for you. You waste a lot more insulin with the vials because they hold more and cats just don't use it fast enough. Pens or cartridges are the way to go.
If you just opened the cartridge you're on in September its not the insulin itself, since I'm still on one that I opened in either early August or late July (would have to look at her spreadsheet to be sure), I normally get about 3-4 months out of a single cartridge before I have to start adjusting my doses because its getting weaker. As long as it's in the fridge its usually good until gone.
And yes, increasing the dose can make the numbers go up. I know that goes against logic, but then again hormones aren't terribly logical. Think back to when you were a teenager and how illogical you were back then with all those hormones racing around in your body. Insulin is a hormone that should be produced by the body itself, unlike a drug that is a foreign substance that we add to make an illness or pain go away. Since it is a native substance in the body, the body itself has checks and balances to keep it in place, but with a diabetic their body isn't either producing any on it's own or isn't producing enough on it's own to counter the food coming in. So we add a foreign insulin into the body to help out. This is even further complicated because we have cats not humans that are diabetic but the insulin we are using isn't feline rDNA based insulin but human rDNA based insulin.
But with a built in regulatory system in place if we add too much extra insulin the body reads the same as going too low and fights against it, causing it to react the same way as too little insulin. This is what makes this dance so hard to learn because TOO MUCH and TOO LITTLE insulin can look identical. Now there are two ways to go about figuring out which it is, either you keep going up in dose until you hit a break through dose that overrides the self protect mechanism and then try to chase the falling numbers down and try to stay ahead of the reductions to keep Misho safe, or if you see that the more you increase the worse the numbers get you do a reverse course and lower the dose and see if that gives you better numbers. Personally I'm about 50/50 on which way works best.
Somogyi rebound Here is a link to an article that might explain it better than I am.
Mel and The Fur Gang
:shock: Shall I shoot or wait?