Shaak's first shot given.

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Awesome job last night! Thank you so much @Andy & Pimp for walking Cathie through it. Great job testing, Cathie!
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Quite a response to the first shot. :)

Cathie...i think we found another member who has some N experience and I'm going to PM her today to see if she can help out with any dosing or give you some info about N and what you should be looking for.
 
I took her AMPS all by myself. My son sat next to me but I did it all alone. It was 356. I am hoping Shaak will enjoy the fact that she gets food right after her AMPS and be more willing in the mornings to get started. She has always known her eating times really well, she always starts to hang out at the food dish about thirty minutes before feeding time.
 
Fantastic!!!!! Really great job doing it by yourself!!!

If you are home today, it might be a really good idea to test every hour and run that curve so you can see if she's going to have a specific pattern on N. I don't know if it is more likely to have generally the same nadir, etc, every cycle or if the onset usually starts about the same time or not.

I've asked @Sue and Oliver (GA) to pop in and she said she can help. She has a lot of experience with PZI and ProZinc and says the action of the insulins are similar.
 
I will not be able to be home for +1 but I will be here from +2 to +5 and then back home by +7.5. I would have Braiden skip his Cal class but he has a quiz and I don't want to keep him from taking the test and there is not enough time between classes for him to take a bus from his last class at downtown campus to his Cal class at NW campus. So I know it is a crucial time to miss +6 but I can't see any way around it.

Braiden has a driver's license but insurance for under 25 yrs old is more than anyone can afford these days, so he can't take the car by himself, I wish he could.
 
Andy & Pimp said:
It's ok, it will take some time to get her dose dialed in. You did great tonight!

Get some sleep and we'll see you in the morning, if preshot test is under 300 tomorrow morning make sure to start a new thread and ask for help.
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Thank you for all you did for me through the night, I am forever grateful. It was so good to not be alone.
 
Cathie and Shaak Ti said:
I will not be able to be home for +1 but I will be here from +2 to +5 and then back home by +7.5. I would have Braiden skip his Cal class but he has a quiz and I don't want to keep him from taking the test and there is not enough time between classes for him to take a bus from his last class at downtown campus to his Cal class at NW campus. So I know it is a crucial time to miss +6 but I can't see any way around it.

Braiden has a driver's license but insurance for under 25 yrs old is more than anyone can afford these days, so he can't take the car by himself, I wish he could.
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I think with where she is, a +2 through +5 test will work but, from last night, she is probsbly onsetting by +1.
 
Hi Cathie,

I have not used N. Every few people here have, especially currently. But it is an insulin that is not a depot insulin so I sometimes try to help as it does act a little like ProZinc, which I am familiar with.

It looks like you are seeing the common response with N. It tends to have a sudden onset and does not usually last a full cycle. There are a couple things you might do to improve things. If you give a snack early in the cycle, it might keep the level a little higher when the insulin first hits and flatten out the fast drop and rise after. In fact, dividing the food into several small portions and feeding them throughout the day might help flatten things out. (You do still want to have food in her tummy before the shot also)

It looks like you are working to change her diet to wet low carb. That can lower the levels overall. It is a good idea to have some higher carb gravy foods available if you need to get the levels up - a little bit of the gravy off the higher carb foods can raise a level that seems to be dropping too fast.

Getting some data during the cycles day and night should give you a good picture of how and if N is going to work for her.
 
Sue and Oliver (GA) said:
Hi Cathie,

I have not used N. Every few people here have, especially currently. But it is an insulin that is not a depot insulin so I sometimes try to help as it does act a little like ProZinc, which I am familiar with.

It looks like you are seeing the common response with N. It tends to have a sudden onset and does not usually last a full cycle. There are a couple things you might do to improve things. If you give a snack early in the cycle, it might keep the level a little higher when the insulin first hits and flatten out the fast drop and rise after. In fact, dividing the food into several small portions and feeding them throughout the day might help flatten things out. (You do still want to have food in her tummy before the shot also)

It looks like you are working to change her diet to wet low carb. That can lower the levels overall. It is a good idea to have some higher carb gravy foods available if you need to get the levels up - a little bit of the gravy off the higher carb foods can raise a level that seems to be dropping too fast.

Getting some data during the cycles day and night should give you a good picture of how and if N is going to work for her.
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Sue....with a non-depot insulin, esp s shorter acting insulin like N, how do you tell a bounce from lack of duration and numbers just coming back up?
 
Marje and Gracie said:
Sue....with a non-depot insulin, esp s shorter acting insulin like N, how do you tell a bounce from lack of duration and numbers just coming back up?
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Good question. I don't have a good answer. I would think they would look the same basically, but I think we assume with the harsher insulin that the duration isn't there. The only time you could assume it wasn't a bounce would be if there wasn't a low enough number to bounce from....
 
Sue and Oliver (GA) said:
Good question. I don't have a good answer. I would think they would look the same basically, but I think we assume with the harsher insulin that the duration isn't there. The only time you could assume it wasn't a bounce would be if there wasn't a low enough number to bounce from....
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Thanks, Sue.

For a kitty like Shaak who has probably been in higher numbers a while, even the blue numbers last night could have triggered a bounce. Or Shaak could have dropped 131 mg/dL in one hour which could also have triggered a bounce. I find that even with Lantus and levemir, it takes a good eye to notice the difference between a bounce and lack of duration. I see members calling the lack of duration a bounce.
 
Marje and Gracie said:
Thanks, Sue.

For a kitty like Shaak who has probably been in higher numbers a while, even the blue numbers last night could have triggered a bounce. Or Shaak could have dropped 131 mg/dL in one hour which could also have triggered a bounce. I find that even with Lantus and levemir, it takes a good eye to notice the difference between a bounce and lack of duration. I see members calling the lack of duration a bounce.
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Am I correct that when bouncing, the next insulin dose (or doses...up to 6 cycles) won't have an effect- with a high, flat cycle? As opposed to a duration issue, where you would see the same drop/rise pattern on every cycle?
 
Andy & Pimp said:
Am I correct that when bouncing, the next insulin dose won't have an effect- with a high, flat cycle? As opposed to a duration issue, where you would see the same pattern on every cycle?
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Yes...exactly. If it's a duration issue, you should see the numbers come right back down with the next shot. Although some cats deal with bounces pretty quickly and can clear them in a cycle, if the pattern looked to me like they were having a u shaped curve every cycle and coming down from pink/yellow to blue/green, I would interpret that as duration.
 
Cathie and Shaak Ti said:
is there a link for the food chart to pick out a suitable dry and wet emergency food for Hypo. No, don't need it, I just want to have it. I may have already received a link for it but I can't seem to find it. I have chart for low carb foods, just not emergency hypo foods.
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When Bandit is on insulin, we keep 4 cans of Fancy Feast in the house. 2 cans of the medium carb "elegant medleys" for when he dips a little low before bed (60-80), and 2 cans of the high carb "Gravy Lovers" in case of hypo.

We didn't keep any dry on hand for hypos because it raised his BG too high and stayed in his system for too long to be very helpful. However, we used Lantus, which is much gentler than N, with flatter cycles.
 
Julia & Bandit said:
When Bandit is on insulin, we keep 4 cans of Fancy Feast in the house. 2 cans of the medium carb "elegant medleys" for when he dips a little low before bed (60-80), and 2 cans of the high carb "Gravy Lovers" in case of hypo.

We didn't keep any dry on hand for hypos because it raised his BG too high and stayed in his system for too long to be very helpful. However, we used Lantus, which is much gentler than N, with flatter cycles.
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okay, I would love to transition her to Canned food, she has never been receptive to it in the past 10 years though. I bought some gravy lovers anyway though, at the grocery store for emergency food, and then I still have her older dry food if I need to use some of that if she won't eat the canned for a Hypo situation.
 
I am attempting to understand bouncing but not sure I fully get the difference between what it and duration is. I guess bounce is where it drops low and then the next cycle bounces back up and then next cycle bounces back low. Or am I misunderstanding.
 
One of our members wrote an excellent explanation of a bounce here. (the first part about new dose wonkiness doesn't apply to your insulin)
 
should I try and talk to the vet now about the Lantus, or will she probably say I am not giving it enough time, she did not even suggest I home test so she will be unaware I even know what is going on with her BG.
 
Cathie and Shaak Ti said:
well this sucks, she is already back up to 325 at 3.5
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She is so much higher at this time in the cycle today, I wonder if she bounced. That's really fast for insulin to wear off.
Pimp didn't bounce from his first Lantus shot, but proceeded to bounce to 600's for the next month.

PS you'll want to color that +3.5 box on your spreadsheet pink...as much as we wish it was blue :bighug:
 
Andy & Pimp said:
She is so much higher at this time in the cycle today, I wonder if she bounced. That's really fast for insulin to wear off.
Pimp didn't bounce from his first Lantus shot, but proceeded to bounce to 600's for the next month.

PS you'll want to color that +3.5 box on your spreadsheet pink...as much as we wish it was blue :bighug:
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I fixed it, darn it. almost back to where she was this morning already.
 
Don't be surprised if she goes way higher...your meter might even say HI. But she's better off being too high for a day, than too low for a minute. It's all part of finding regulation.
 
Tip: keep test strips close to box in case you do catch her.

Sometimes cats will go in an empty LB. Some will go on plastic wrap if you lay it on top of litter. Sometimes if you hear them in LB there will still be a puddle you can dip the strip in. You could also replace litter with non-absorbant sand/crystals or even aquarium gravel.
 
Andy & Pimp said:
Don't be surprised if she goes way higher...your meter might even say HI. But she's better off being too high for a day, than too low for a minute. It's all part of finding regulation.
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oh wow, okay.
Andy & Pimp said:
Don't be surprised if she goes way higher...your meter might even say HI. But she's better off being too high for a day, than too low for a minute. It's all part of finding regulation.
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okay, thank you.
 
Andy & Pimp said:
Don't be surprised if she goes way higher...your meter might even say HI. But she's better off being too high for a day, than too low for a minute. It's all part of finding regulation.
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Sorry, I see how that could have been confusing. You don't need to test again until PMPS. I was preparing you for a substantially higher number at PMPS. If she has indeed bounced, it will probably last a while (days).
 
Today's numbers do look like a bounce to me. Dropping almost 50% in two hours can trigger that extra glucose from her body. It would be really unusual if her duration was only 3 hours, so I am thinking, at least today, the jump is not a duration issue. She still may have a duration issue, but the 325 looks like a bounce to me. Even with N, the insulin usually lasts 4-6 hours so we'd expect to see the rise a little later.

The problem with increasing the dose with an insulin like N is that a higher dose can mean a deeper drop, not a longer cycle. Increasing doesn't usually translate into lower overall numbers like the other insulins. The blues are nice numbers; they just come too early in the cycle. As she is very new to insulin and still eating dry, I would be reluctant to increase the dose.

While I agree that your Pmps is likely to be high, I'd hold the dose. A bounce with the shorter lasting insulin may not last as long as the longer lasting ones, so she might settle back into her usual range within another cycle.
 
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