Tigger 3/5 AMPS 501 Frustrated Peaking at +4?

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mdmelvin1128

mdmelvin1128

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So, Tigger is still feeling well, but Mom is getting frustrated. When I first got him home from the vet, he was getting way better numbers with the Prozinc. Since getting home, he just seems to be getting worse. Still getting high preshots, and also not very good numbers during the day. I know ecid, but most peak at +6-+8 correct? It looks to me like he is peaking around 4 or 5. Could he be a cat that needs 3 doses a day, or have we just not found the right dose? Another possibility is switching to Lantus. I have some, but last time we put him on that he ended up at the vet for a week with ketones. Probably just coincidence, or could be because I was using short needles which don't seem to work well with us. This is a very frustrating disease, and I'm an over analyzer lol. @-)
 
I've had a hard time telling where Cody's nadir is, and I test a lot! Some days it's +4, some days it's much later. Part of our trouble is that he snacks after +4 or +5 and I think that messes it up. If I withhold the snack, his bg soars because he's P***ed off.

I just looked at your ss and noticed the dog food- I think you just need to ignore every wacky number for the next 3 days until that works its way thru and out. Sorry
 
Right now we are at +8 and he's already 492. He has been eating all day. If I only feed 2 meals a day, he gets very mad lol. He's lost so much weight that I feel bad only feeding twice a day, so I leave food out all day.
 
I'd like others to chime in here on your sheet.

On the food, yes with PZI free feeding is the best policy [or the closest possible approximate]. So leaving food out is the best thing to do. Also, while they are not regulated they do need all the food so don't hold back [unless your cat is overweight which is not the issue here].
 
Hungry cat?
Does he sneak around and steal dog food, stuff left in the sink, trash, counters? Cody did all that, and it really makes getting him regulated tough. Its especially tough when you have a busy household with lots of people coming and going.

It seems like Tigger bounces up and down a lot. Has anybody thought that maybe this is too much insulin? As an acro mom, I'm totally out of my league on doses under 1u :lol: Maybe some one else could take a look.

Also check out the info I just posted elsewhere on timed feeders. Maybe it would help you:

Timed feeder to the rescue!

There are 2 that I know of, both from PetSafe (yes they make the underground dog fences) Here is the link to their online store: http://petsafe.thepetstoreonline.com/ca ... eders.html

The price online is actually cheaper/same than what I have seen in the pet stores, but I don't know about shipping.

Cody has the 2 meal feeder which I liked, but he is crazy and he was able to break into it .
The 5 meal feeder is much larger, $47 online, $60 at Petsmart. I haven't gotten it yet, but they are sending me the 5 meal feeder, soon I hope. Others on the FDMB who have have it (5 meal) really like it. The 2 meal uses 1 AA battery and ticks quite loudly. The 5 meal uses a whole bunch of C or D batteries, but is quiet. The ticking is annoying.
 
The idea of too much insulin has been discussed, it just seems that I don't see much of a change when lowering the dose. Maybe it just takes time and I am too impatient :-D
 
Darn--it happened again. I wrote a long post and it got lost when I hit Submit.

Food--I hate to disagree with Gator, but there's no reason to give him more calories than he should be getting for his ideal body weight. An unregulated cat's brain thinks it needs more calories, but if you give in, you make it harder to regulate. There was an excellent explanation of the neurological issue on the old board by a physiologist. So if you are feeding him more, you might try to scale his calories back over a few days to where he should be.

Insulin--it looks like he was doing pretty well until you raised the dose to 1.5 and then started experimenting with lower doses. If I were you, I would increase the dose to 1.2 tonight and stick with it for a couple of days. Then I'd use that data to help me decide if I needed to shoot early. You can shoot early as long as it's past +6 and his levels are on the way up. A couple of days of shooting early might just be the motivation his body needs to adjust to the insulin.
 
Insulin--it looks like he was doing pretty well until you raised the dose to 1.5 and then started experimenting with lower doses. If I were you, I would increase the dose to 1.2 tonight and stick with it for a couple of days. Then I'd use that data to help me decide if I needed to shoot early. You can shoot early as long as it's past +6 and his levels are on the way up. A couple of days of shooting early might just be the motivation his body needs to adjust to the insulin.[/quote]
You really think I need to increase? Also if I shoot early with his pm shot, then at regular time with the am shot is that OK?
 
Gator & H said:
Please disagree with me :smile:
Click to expand...

Ah, you just want a fight to rev you up for the slopes!


You really think I need to increase? Also if I shoot early with his pm shot, then at regular time with the am shot is that OK?
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Yes, I really to think you need an increase. You're experiment with lower doses didn't make any positive change. But the 1.50 was (maybe) too much. When you have a dose that looks good, but not great, like the 1.0, and another that is too much, you have bracketed the range you want to be in. That's when you make the best use of the U-100 syringes by making very small dose changes and sticking with each change for around 3 days.

When you shoot early, you have too keep shooting early until you are back at a time you can shoot BID on. So let's say you shot at 7 am and again and 2 pm. Your next shot would be at 9 or 10 pm. And the next shot would be around 6 or 7am again--then you could wait until +12. If you shoot early, you absolutely do not want to get into the position of having to shoot at something later than +12. So if you can't hang with the early shots for a day or two, you shouldn't try it.
 
Ok, so I shot 1.2U. His ps was 383, now at +4 he is 426. Going up I guess. I'm afraid if I don't get his numbers down, we will run into problems with ketones again.
 
Nice to see he came down at +6. It's interesting that the insulin had started to work at +2 but then he went up at +4. Did he eat then?
 
mandy looking at your SS i also thought of increasing...probably out of fear of those highs and the looks of 1 unit not doing much.
i certainly can understand your frustration with him going up at +4
tom is also an early peaker, +4-+5
looking back to our first time around he was about the same way.
i'm gonna go 'over analyze' again but right now i'm thinking up the dose.
 
ok from what i see mandy did'nt raise her dose to 1.5 until she got her 2nd ps in the 500's and i think it was a totally appropriate call, at least it's what i would have done. i see your dosing as being pretty conservative and i certainly don't see rebounding.
i stand by my call to raise the dose, even to 1.5.
does anyone see rebound here as a reason for keeping the dose at 1u with those very high #'s?
 
Lori and Tom, I am in agreement of raising the dose at this point...I had to do just that to get Puttz out of high numbers, if you look at our SS, he went from 3U BID, and holding good at 4.25U BID currently...
 
Yeah, some of those drops have been so steep I thought a hair less insulin might help, but it didn't seem to. :sad: I might be tempted to shoot early as Terri mentioned for a few days to try to get a better ride in some blue/green numbers & at the same time try to avoid the sharp drops Tigger sometimes gets, but I don't feel comfortable advising on how to figure out the dosing if you do want to try that route. Sometimes if you can shoot early like that for a few days it helps their duration on the insulin & you can go back to BID and get better results, but I don't know how to tell if that is likely to be the case or not ahead of time... and frankly, shooting early is a pain! But I have seen some cats get really good results from it.
 
I'm late to the party but wanted to weigh in on your mention of Lantus. When you switched before and Tigger ended up with ketones, it could have been that he spent so much time in high #s while adjusting to the new insulin that he developed them. He spent so much time in high numbers (and I am only hypothesizing here; I don't know what his numbers were) because Lantus (and Levemir) work differently than PZI in that the shed has to build up. It can take anywhere from a few days to a few weeks + for this to happen. If a kitty is ketone-prone (or you are worried about high #s), some supplement with R (type of insulin) during the transition.

I'm not advocating that you switch, so please don't take it as that. I just wanted to offer you a possible explanation for Tigger's lack of success with Lantus.
 
Just peeked at the #s and am wondering if it's time to raise to 1.4u? Are you checking for ketones daily? Sorry, I have lost sight of who is testing regularly already & who hasn't started doing that.

If it isn't already in your spreadsheet (if it's there I am officially going blind!!!), it's good to put "no ketones" or something in the notes when you do a test, and you might also want to note somewhere more prominantly (I just saw it in your Profile, but had missed it before :oops: ) that he has had ketones in the past. Maybe in the SS, or in big bold red letters or something in the profile, or even in your signature. Just a thought :) but it helps people (like me) remember that you may need to be more aggressive with dosing than some other beans (I had totally missed out that he has a ketone history, sorry about that!!!). I'm not sure it is true, but my assumption is that if a cat has ever had ketones, they are considered "ketone prone" and may be at higher risk than other kitties (though it can happen to any of them of course).

p.s. just saw you shot early tonight, so hoping you get good results off that!!! I would probably try to get in a couple early cycle spot checks if you can - maybe a +2 or so for starters - you may get a good drop off this since it is early, hard to say for sure, but good to keep an eye on the #s just in case... normally when I shoot early I would lower the dose, but since it looks like the dose was too low I'm not sure it would be an issue in this case... others can help you more with the dosing stuff!
 
That's a good idea for noting that he has no ketones, I hadn't thought of that. I actually went ahead and shot 1.5 tonight since I haven't been seeing anything under 200 in several days. I missed getting a check at +2, but I just got a +4 of 252. I'm not sure why he's not responding to the insulin like he used to, it seems that we are going the opposite direction we should be @-) Crazy cat is going to drive me to drink lol. Since I'm new to shooting early, when should I shoot again?
 
mdmelvin1128 said:
I actually went ahead and shot 1.5 tonight since I haven't been seeing anything under 200 in several days.
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Frustration is the trap that so many people fall into. Been there myself, so I'm speaking from experience. But with diabetes, you are going to be better off if you persist in being systematic and ignoring the frustration.

I can't read your spreadsheet to know how you are shooting early--so ignore this is you already knew it. If you shoot at +9 one day, you have a new +12 time. If you wait until the old +12 time, you've gone 15 hours without a shot and undercut any value of the +9 shot. It might help if you put "shot" in the column with the preshot number if you are going to shoot early so it makes it clearer for others.

The goal is to build up overlap--when two shots are working simultaneously. That's the way you build up duration.
 
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