Sammy: looking for feedback on recent numbers

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TokyoKitty

TokyoKitty

Member Since 2013
(reposted from Health forum)

Sammy's been in the yellows consistently for the last week or so (before that in the pinks). Then this morning her AMPS was about 100 points lower than usual (127). I retested every 30 minutes and she continued dropping: 121, 112, 108. At this point I freaked out and fed her, and skipped her morning dose (see posting below on levemir forum).

She seemed to feel great; peeing and pooping are normal, she was playing with her toys for the first time in months. After eating she zonked out and is still sleeping. Her +2.5 and +4.5 numbers are up (157, 265). I'll keep testing through the day.

But I'm mystified as to what caused this sudden >100 point drop in her numbers. I had increased her dose yesterday from 1.0 to 1.1. I wouldn't expect such a small increase to have such a big impact. This has shattered my expectations. Now I'm wondering what to do tonight or tomorrow morning if her numbers drop again like this.

I know that skipping her shot will drain her depot, and the sudden drop in her numbers will likely lead to rebound. So what to do tonight? (my 9pm is PST 5am, so probably not many eyes on the board). Any feedback/suggestions on how to interpret her numbers and/or what tests/data to focus on gathering? Thanks so much for your help.

previous post to levemir forum
 
Susan

Sammy is adorable!! It's not unusual for the I131 treatment to result in subsequent CKD if the kidneys were showing a little decompensation prior to the treatment. But...the I131 should make it easier to regulate her because hyperT cats can be a challenge to regulate.

My baby girl, Gracie, is on lev and lev is known for its really nice duration. It's not unusual for lev cats to nadir at +12 and perhaps get a second dip after +12 although it looks to me like Sammy is just clearing a bounce. There are alot of cycles where you have no tests after PS for quite some time and so she might be coming down to +2 after the current shot before she heads up. It would be nice to gather some spot tests to see when she starts back up.

I would have suggested you shoot tonight because she would likely head back up before she onset at +4 or after. Once you learn to deal with low numbers and learn Sammy's cycle patterns, you might be comfortable shooting in the 50s. That's one of the great things I love about lev is being able to shoot low knowing that she won't onset for a while.

ECID but, yes, some cats (and Gracie is one) respond to very small dose changes. Also, because lev, like Lantus is a depot insulin, it has the same cumulative action where one shot builds upon the previous.

I would leave the dose...these are nice numbers. I would concentrate on trying to identify her onset, nadir, and duration do you get a better idea of her patterns.

Please let me know if you have questions.
 
Hi Marje,

Ok, I will focus on getting more tests just before and after PS. It does feel like her nadir is around +12/+13, so I will try to confirm. I can understand how to figure out the nadir (lowest point) and onset (where the numbers start to do down), but how do you tell what the duration is? Is that where the numbers start to go up again?

Thanks so much for your feedback! I have to run off now to pick up a prescription for my Mom. I'll keep posting test results.
 
Duration is the length of time the insulin works to lower the BG.

And nadirs can shift so she might nadir at +13 one cycle and +8 the next.
 
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