Update from Andy 4/25

[Yvonne & Andy &BJ (GA)]

Mom says it's time for an update on my #'s. Mom says I am still bouncing but not quite as much lately. She still can't get a handle on my dose. I do pretty good during the day now on .8u but Mom watches me pretty closely at peak - if I am good for testing I get a treat so that's ok with me. But Mom thinks the overnight dose is wacky. So she will be bothering me probably tonight for more testing - ugh!

If I am over 300ish, the .8u brings me down well. But when Mom gets me lower, she has been guessing based on my preshot history but hasn't been hitting the correct mark yet. So we are still dosing based on bounciness! If I don't bounce, much lower doses work.

Mom asks for feedback on my current #'s and any dosage suggestions. On my chart, the numbers in .00 format are Relion human meter numbers - all others are Alphatrak. Thanks - Andy!

PS Mom wants to get rid of my trampoline but I still won't let her......

 

[Rachel]

Hi Andy! Stop bouncing all over the place...your poor mom is worn out with watching you bounce!

Tell your mom I think she's doing great! That 0.8 certainly does bring you down...and then you bounce back up! I don't have any bright ideas offhand. It would be good to see some overnight numbers from you. Your AMPS is higher than your PMPS overall...which makes me wonder what you do overnight!

I'm going to think on this some and see if I can make sense of it. I'll keep an eye on your SS for a few days to see if we can figure out what you're up to!

Be good to your mom, Andy! And let her get rid of that trampoline!

 

[BJM]

Try checking in the +9, +10, +11 time periods over the next couple of days. You might be having a duration issue.

 

[Sue and Oliver (GA)]

I think it's time to look at one of the depot insulins, Yvonne. He may still be bouncy but the cycles should be flatter and longer. Be sure to read the stickies because they are dosed very different from ProZinc. If you choose SLGS, you should be able to go slow and watch him carefully. The good news is that he goes into lovey numbers midcycle; he just bounces.

 

[Yvonne & Andy &BJ (GA)]

Try checking in the +9, +10, +11 time periods over the next couple of days. You might be having a duration issue.

Yes, I think that's what happens but just can't get his pattern. I have tried to give small dose in between to compensate but have not yet been successful. Sue and I have been thinking for a while about maybe moving to another insulin. But he was originally started on Lantis without success. I had hoped if I could just get him down overall and at preshots, the dose would last. He has been bouncing since fall when I adopted him. And they had him on 6u then!! (I think 6 units Lantis then switched to 6u PZI!) So I have been hesitant to move back to Lantis. But I think it's time to talk to my vet again.

 

[Yvonne & Andy &BJ (GA)]

I think it's time to look at one of the depot insulins, Yvonne. He may still be bouncy but the cycles should be flatter and longer. Be sure to read the stickies because they are dosed very different from ProZinc. If you choose SLGS, you should be able to go slow and watch him carefully. The good news is that he goes into lovey numbers midcycle; he just bounces.

Hi Sue - yep, I have exhausted my ideas......the more I try, the more he fools me. I plan to consult w my vet abt trying Lantis again - since I can monitor closely, maybe I can make that work. It is definitely worth trying. This is like a rollercoaster - just when you think he is down, he goes back up the next hill! My hubby is diabetic and even he is perplexed with our little guy! Will keep you updated - thanks.

 

[BJM]

If it is duration, there are several options:
1) test and shoot every 8 hours. There may be some overlap to help keep it from shooting up after 10 hours.
2) if you are diligent testing, you could split the dose in half, give the 1st half, wait 2 or 3 hours (pick an interval and be consistent), then give the 2nd half. This will double your testing costs, however it will extend the covered period.
3) Using a short term bolus insulin - NPH - which lasts about 6-8 hours. This will cause some overlap, too. Or, if you were exceptionally careful, using R insulin - which lasts 4-6 hours - in teeny tiny amounts (as in drops - it hits hard and fast!). If you use a bolus insulin, you need to do a curve on it to see how it works in your cat.
4) Switching back to a depot insulin, maybe trying Levemir this time.

 

[Yvonne & Andy &BJ (GA)]

If it is duration, there are several options:
1) test and shoot every 8 hours. There may be some overlap to help keep it from shooting up after 10 hours.
2) if you are diligent testing, you could split the dose in half, give the 1st half, wait 2 or 3 hours (pick an interval and be consistent), then give the 2nd half. This will double your testing costs, however it will extend the covered period.
3) Using a short term bolus insulin - NPH - which lasts about 6-8 hours. This will cause some overlap, too. Or, if you were exceptionally careful, using R insulin - which lasts 4-6 hours - in teeny tiny amounts (as in drops - it hits hard and fast!). If you use a bolus insulin, you need to do a curve on it to see how it works in your cat.
4) Switching back to a depot insulin, maybe trying Levemir this time.

I actually wanted to try #1 but could not figure how to make it work. If I used 6am, 2pm, 10pm - if I could not be home for the 2pm, then what? Also, would I have to split his meals up into those 3 times? I think this could work because the lower dose may keep him from bouncing etc but the 2pm time period would be a problem some days. I have been using .8u which really drops him down quickly, probably too quickly but less doesn't get him out of the yellow. I may just try this for a few days to see how it works. Maybe start with .5u x 3 ? Thx for the suggestions.