RUMPELTEAZER - 3-19-13

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OK. My advice for tonight.

Don't give her a shot.
Feed her dinner now.
You can leave food out or not.

Go to work.
Don't worry about your baby girl while you're at work tonight.
 
Sue and Oliver (GA) said:
Will they all have fits if you put her alone in a room with some food overnight?


Definitely....They will rip up the carpeting.....some is already tore up. :sad: :sad: :cry: :cry:
 
Carl & Bob said:
OK. My advice for tonight.

Don't give her a shot.
Feed her dinner now.
You can leave food out or not.

Go to work.
Don't worry about your baby girl while you're at work tonight.


NO SHOT....She is now finishing what the others left.

Hope all goes well.

G'night everyone.

Thank You.
 
If you skip the shot, you can feed her now and not need to put out food for later.
 
OK, here's what I think is going on with RumpelT...

Here is today's cycle:

AMPS ~ 324 (gave .25u) and fed.
+2 ~ 203 (no food) why did the BG go down before the insulin should have made it go down???
+4 ~ 185 (fed tsp or two). It would make sense for the number to be a little lower since this should be when the Prozinc is kicking in.
+6 ~ 362 (fed tsp or two). ??? where did this high number come from? The insulin should have been at peak effect at +6.
+8 ~ 435 (fed tsp or two). ??? why does it keep going up???
+10 ~ 377 (fed tsp or two). OK, the number came down a little? But it should be going up if the insulin is wearing off, right???
+12 ~ 319 (ate dinner). This number makes no sense! The number shouldn't be coming down, it should be higher. The insulin is worn off, and she's been eating all day long, even though it's been small portions...

RumpleT's pancreas is "sputtering". A .25u dose is tiny. Really tiny. Sorry, but I am not believing that a couple drops of insulin is going to drop her BG in two hours by 100 points after eating breakfast. Not when a 1u dose just a few days ago took 5 hours to drop it that far.

The majority of the fluctuations that you are seeing in her BG are from two things.
1 - food makes it go up
2 - insulin makes it go down. But not the insulin you're shooting her with. Yeah, that's doing a teeny bit. But the insulin her pancreas is putting out is what's doing the work.

After she ate breakfast, her pancreas did it's job. It dropped the BG by +2. Then her shot kicked in and helped a bit by pushing it a little lower at +4

At +6 it was higher.
So the food you gave her pushed it up. And her pancreas didn't do its job. No sputter.
She ate again, and at +8, the number was even higher. Food pushed it up. Pancreas did nothing. And the itsy bitsy .25u dose was done for the day.

Then in the next four hours, her BG dropped 120 points.
Why???
Not because the insulin you shot this morning was doing anything.
Not because she was food deprived. She'd been getting snacks all day long.

It dropped because her pancreas "woke up" again and did what nature intended it to do. It pushed her BG down as far as it dropped in the first two hours of the day or even more.

My opinion is that the dose you have been tinkering with for the past few days is doing little to nothing. I don't believe it's "kicking in" in the first couple of hours of the cycle. And it sure isn't causing her numbers to go down towards the end of the cycle. IT CAN'T DO BOTH! It can't be so high that it drops her like a rock, while at the same time lasting 12 or more hours.

And you can see from the nights where you haven't given her any insulin that her BG rises very little overnight. She might not be getting any food overnight, so that wouldn't be pushing her numbers up. But without insulin, even without food, her numbers after skipping a shot should be higher in the morning because at least in theory, she's an "unregulated diabetic". And that happened two nights ago. She ate dinner, got "1 drop" of insulin, and in the morning, her number was a lot higher. Not because she was bouncing from some unseen overnight low. But because a drop of insulin isn't going to do anything for her. And because her pancreas took the night off.

Look at the night of the 14th. No juice, but lower in the AM.
Same thing the night of the 15th. A lot lower in the AM. . She bounced from that scary 35 and the bounce disappeared overnight. You woke up the morning of the 15th to a beautiful number. You skipped again, and her BG kept dropping. It absolutely wasn't dropping because the shot she got 24 hours earlier was still doing anything to her BG. Her pancreas had gotten things under control. 14 hours after her previous shot, her BG was 130. Which is "normal" BG for a cat. Even 20 hours after that shot, her BG was still lower than it was when you gave her that shot. All pancreas.

She isn't "unregulated". Her body is trying to regulate itself. Her pancreas is trying to work. It just isn't at 100% yet. And it's working when it feels like working. Not when you want it to work.

That all might "explain" things. But it doesn't solve your problem.

When does she need a shot? How much? When is her pancreas going to help?

The best thing to try is to feed her multiple times during the day. That will stimulate her pancreas into working.
And be extremely conservative in dose. .25u at most at least short term.
And if in doubt at night? Skip the shot.

Bottom line -
YOU NEED TO SLEEP!!!

You can't keep going like this. You can't be testing 6 times a day when you should be sleeping. So you give her a tiny .25u or even less in the morning. You get a +3 OR a +6. Not both every day. The only time you need a +6 is if you see a scary low number at +3. If you don't, you sleep. Or if you see a low number in the morning? Skip the shot. Test her a couple hours later to see if the BG came down any. If it did, awesome! Then go to sleep. She won't hypo with no shot.

That's my take.
 
Carl - we were thinking the 2 days of hypo might've made her more sensitive to the insulin.
 
Possible. But I don't believe that extra sensitivity lasts beyond a cycle or two at most. The hypos may have kicked the pancreas into gear however.
Sorry, I know people sometimes believe a drop of insulin does something. I don't adhere to that belief. When the drop seems to "work", I believe any lowering of the BG level is strictly due to natural insulin, and not the shot. Ditto for fat and skinny doses or .1 dose adjustments. This isn't that exact a science. I hate to see people going sleepless believing that we have that degree of control over any of this.

Carl
 
I think any dose may have an effect, but perhaps not a measureable effect with the tools we have.

It would depend on the molar concentration, the number of receptor sites, the rate of turnover of the receptor sites, and probably a few things I haven't thought of!

I'll see if I can find or estimate the molar volume of 1 mL from Prozinc's manufacturer.
One mole is Avogadro's number of molecules (6.02214 × 10^23 <--10 to the 23rd power).
Each molecule can occupy a receptor site for a while - I don't know how fast they turn over.
I don't know how many receptor sites are estimated in a cat's body (or a human's for that matter).
 
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