Rocky- NEEDS an 8hr Insulin/Shot Cycle?

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Tina & Rocky

Member Since 2013
In the past few days I have been moving Rocky's shot time backs EARLIER by small increments. I have not seen a supreme adverse affect from doing this, even when increasing his dose of insulin. I strongly suspect that Rocky *may be* a cat that does better on an 8 hour insulin shot cycle.

I think the only reason that Rocky has not visited as many BGs in the black, red, and pink for the past many days is because of the insulin overlap.

I am wondering if Rocky might do BETTER with an 8 hour insulin cycle to even out and make his cycle more flat... In other words, maybe Rocky would stop visiting those outer-space high BGs and those bottom-dweller lows if he had insulin in his system for every 8 hours rather than very 12 hours..

I do believe that he might be using his insulin fairly quickly.

To do that 8 hour cycle shot cycle it might involve giving a smaller amount of insulin, I just don't know.

Can someone please advise about this because I REALLY want to do this for Rocky. I think it will help him, a lot.

If there is someone who is doing the 8 hour cycle, can you please post in this condo so that I can take a look at your before and after SS?

Thank you! :YMHUG:
 
just curious - what's making you think 8 hrs? there's a pretty big difference between giving a shot 15 minutes early and going to 4 hrs earlier.

it's not impossible and could have some advantages - i don't think anyone is doing it with Lantus because it's so hard on the people. Consider what the testing would be like with that, Tina. There have been a lot of times when you've said you were simply too exhausted to test more already with the 12 hrs cycles. And yes, you would have to have a smaller dose.

It's not something I have experience in, so i wouldn't be able to advise on how to do it. I think if, after considering what the testing requirements would be, you still wanted to do it, sending a pm to Jill or Libby to get their thoughts would probably be a good first step.

Another option might be to try Levemir. Some cats' cycles are different on Lev, and it's not an option you've tried yet.
 
Thank you Julie. I am going to email Jill and Libby about help with it. I will also take a look at the PZI forum to see what results/problems that people are having there.

You are right, 15 minutes is a lot shorter time than every 8 hours. What makes me think that he would do better on Lantus with the 8 hr cycle is that when I did shot the 15 minutes early his BG would come down faster, not in the same cycle, but the bounce wouldn't be so long. I don't believe it had to do with the amount of insulin given. I believe it had to do with the insulin overlap.

I don't believe that I am EVER going to get Rocky's natural cycle to accept a 12/12 schedule. I think I need to switch Rocky to an 8 hr cycle for him to finally have a flat cycle of blues and greens, minus the outer-space numbers. I will do whatever it takes for his pancreas to begin the healing process. It's not likely it's done any healing in the past six months.

I don't believe that the 8 hr cycle is going to be any more stressful or exhausting on me than what I am already doing because I already test so much. If you look at my SS I think I Sienne might be the only person who tests more than I already do.

In addition, I have already tried the no carb/low carb/high carb methods of trying to regulate his cycle and it just does not work for him. The ONLY THING so far that has worked to stop him from a prolonged, sky-high bounce, (WITHOUT adverse effects), is a shot of insulin BEFORE the time of his regularly scheduled dose.

What I'm saying is that I believe Rocky needs that insulin overlap and I don't think he is getting it with the 12 hour cycle.

We CANNOT increase his insulin amount to try to achieve an insulin overlap. It's just not working that way for his body. What happens with an increased insulin dose is that his body just freaks out and does the New Dose Wonkiness. It doesn't help Rocky to heal at all when he gets those BGs in the 400 and 500 hundreds right after an increase in insulin!

Ok.. for example, let's say you give me two glasses of wine to drink and you want me to stay drunk for 8 hours. But let's say my body doesn't do what you want it to do, and I only stay drunk for 4 hours instead of 8 hours.

Now, I need to be drunk for 8 hours or I'm going to go into a really bad alcohol withdraw. You wouldn't then want to the next day give me 3, 4, or 5 glasses of wine to drink, all at the same time, to keep me drunk for 8 hours..I'm probably going to barf it all up. My body is REALLY going to overreact to that increase in booze.. @-) @-)

Instead, to keep me drunk for a total of 8 hours, you'd want to give me two more glasses of wine to drink at the 4th hour so that the alcohol wouldn't have any adverse affect on me.


I think a smaller amount of a long acting insulin, more often, would help him the best.
 
I just saw that you've got another post for today - you don't need to open a new condo to ask a question. it's easier if a cat's information is all in one post per day - that way people can see what other people have said, and if you link the condos from one day to the next, it really helps those of us trying to help people.

One of the things you need to be able to do when you're considering shooting other than 12/12 intervals (and this should be true no matter what, even shooting 12 hr intervals) - you really ought to be able to articulate how the Lantus works in Rocky's body. What's the length of his duration? When does he typically onset? When in the cycle does he typically nadir?

Have you read the sticky called "What is the Insulin Depot?"
 
Sorry about the double posting. You are right, I should have just deleted his BG information and written my question in the subject line. I'll make sure that I do that next time.

As far as knowing the nadirs, etc., frankly, I don't think I'll ever be able to understand that.. but what I can understand and what I can see is that Rocky's body is not doing well with dose increases, and he is not doing well with the duration of a dose.

He ALWAYS has NDW when I increase his dose, and he ALWAYS has mega-long, too long, of bounces. You folks here don't like people to increase during a bounce so that means Rocky will go for days on end while his depot is draining and body trying to figure out what to do next..When he does get a dose increase, he see numbers in the 400s, then in the pinks for a long while.

The thing that I notice the most is that when I SHOOT EARLY if he's in a pink number, his BG comes down into a normal range right away without any adverse effects. But when I increase his dose, I GET HIGH NUMBERS RIGHT AWAY FOR DAYS!! That's just not right....

I'm not patient and I don't think that there is any reason that I should have to wait a year to try the 8hr cycle with him to see if it works better for him.

The 12 hour cycle is not work..and dose increases seem to not work either to level him out. I am already feeding him LC mini-meals so that is not the answer either.

I'm going to give him his shot 15 minutes early tonight *if* he is still in a pink number at his PMBG. If not, I'll stick with 9:15pm. If that's the case I bet he will not make it back to a green number tonight. If he does I will be highly surprised.
 
I don't think any if the things you mentioned are issues.

Rocky was doing really well on 2u and clearing his bounces quickly. And he also looked pretty good on 1.75u. But then there was a BCS, some large dose reductions, and skipped shots so he went from 2u to f1u in 9 days with not a lot of consistency in dosing. He was given two reductions in one day on 4/26 followed by a skipped shot. He's had late shots. I understand that some skipped or BCS shots were for safety because you had rescue work to do.

Feeding experiments take time. I think It literally took months for Sienne to see an improvement for Gabby when she started front loading her cycles.

I agree with Julie that if a CG does not understand how the insulin works, TID dosing is not a good idea. You have to have a basic understanding of onset, nadir, and duration. When Rocky was at a good dose for him, he had plenty of duration.

I just think he had too many dose reductions too quickly and now you have to go back up. I wouldn't be surprised if you have to go above 2u to see a breakthrough again.

Mike and I are home most of the time and I would have a difficult time doing TID dosing. I have no idea how that could be integrated into your rescue work. If you want to consider TID dosing, I think you should consider using PZI or Prozinc so you don't have to deal with a depot like Lantus and levemir have. PZI/Prozinc can have long durations and you can have more variability with dosing.

IMHO.
 
It's true there has been a lot of variation in his shot time, but I still think that it's not just a matter of his dosage, but that Rocky is also metabolizing the insulin faster than 12 hours, so he needs more sooner than 12 hours.

His BG did not drop to any green numbers at all yesterday, he didn't see any green at all today either, and it doesn't look like he's going to see any green at all tonight.

That will actually be 7 cycles on 2.u with only one small streak of blue and green numbers. Is it time to raise him up to 2.25?
 
I'm going to reiterate:
Marje & Gracie said:
I agree with Julie that if a CG does not understand how the insulin works, TID dosing is not a good idea. You have to have a basic understanding of onset, nadir, and duration. When Rocky was at a good dose for him, he had plenty of duration.

If you don't know about onset, nadir, and duration, concluding that Rocky is a fast metabolizer is premature. Drawing conclusions based on skipped shots, back-to-back reductions, and inconsistent dosing also clouds any interpretation of Rocky's SS. I would not want your impatience to have a negative impact on Rocky's health. With Lantus, you get the best results when dosing and shot times are consistent. If the kind of consistency that's necessary isn't possible for you, Marje's suggestion of using a different insulin may have merit.

The bottom line, though, is it's your call and you can do what you want -- you're the one holding the syringe.
 
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