Assuming his numbers are rising before every shot....
A curve "should" look like this.
AMPS
+1 to +2 BG should rise due to food at shot time
+3 to +6 BG should drop due to insulin taking effect and peaking
+7 t0 PMPS BG should gradually rise, first slowly, then more rapidly as the insulin tapers off. There may be some surf in the +6 to +9 range.
The nadir can happen between +5 and +7. The duration can be anywhere between 10 and 14 hours depending on the cat (according to the Prozinc website)
Any time food is fed during the cycle, you would see a "food spike" within the first two hours after eating. It may not show as a rising number. It may just not allow the BG to go as low as it might have if food had not been eaten.
Copper seems to have long duration some days, while on other days he might have "normal" duration. No idea why that happens, but it obviously does.
Excessive duration can indicate a dose that is too high. Super low numbers can indicate a dose that is too high. Conversely a dose that is too small can cause a shallow curve, or it might show a shorter duration. Nothing about this is logical or simple it seems. It just "is".
So you have:
Long duration
Short duration
Deep curve
Shallow curve.
Here's the kicker. All 4 of these things can happen on the same dose! Four different patterns all on one dose. We have all seen it happen, and not just with Copper. With every kitty.
Here's where I'm going with this....
Given that all these different things can happen without making any adjustments to dosage, now throw changing doses into the mix. The simple reality is that you don't know if the different results are happening "just because", or because of the changes to dose. No way to tell for sure.
Something that Dr. Lisa said several weeks ago keeps tugging at my brain.
Copper had been on that dosage for 6 days before he dropped low and there was no obvious reason to suspect that kind of a drop. (I see 2.6 as not statistically different than 2.8 and even IF you could measure a 0.2 dosage with great accuracy, we are only talking about a 7% difference. I see this as close-to-negligible which I know others will disagree with.)
Given that there are MANY things going on in the body that influence the BG level, it is my opinion that we all get too caught up in thinking that the dosage we give is so critical down to the 0.1 or 0.2 unit….and that the *only* reason a hypo occurs is because of an overdose. Exogenous insulin is only one piece of the puzzle. This is why there is always going to be a risk of hypo because what if the pancreas just decides to wake up that day and join the party…adding to the exogenous insulin? What if some infection/inflammation subsided….or stress was reduced….or the patient lost some body fat…..any of which would render the patient more insulin sensitive? (Again, I know I am preaching to the choir here but am just 'talking out loud'.)
Now, remember, that was when Copper was getting 2.6 or 2.8, so the difference was only 7% in the amount of insulin. Today, Copper is fluctuating between .8 and 1.0, which is a 20% difference. So with that much more of a difference, we would expect to see some sort of "real" difference in the BG numbers. But I don't think we do, not consistently anyway. So that just leaves me (and others) even more confused.
I think that perhaps the big factor in how his BGs act is that some days it looks like his pancreas decides to help, and some days it doesn't. I think I have seen that referred to a "sputtering pancreas". What is scary is that you never know when the pancreas is going to decide to work well, or when it isn't, if that is actually what is causing the confusion with his numbers.
Look back at the period of 1/5 thru 1/10. There were cycles, like the AM cycle on 1/7 that show a perfectly shaped curve on a dose of 1.8. But on the 6th and the 8th, exact same dose, but the curves are not good. On the 6th, he was flat. On the 8th, there is no curve. It just drops from AMPS to PMPS. All on the same dose. On the PM cycles, each day, he got a fat 1.6 (now I will agree with Dr. Lisa here....the difference between 1.8 and a fat 1.6? I don't think there really is a difference, not one that matters anyway.) But for some unexplained reason, the shot on the PMPS on the 10th caused a "no shoot" AMPS on the 11th. Why? Pancreas? I have no idea. The same thing had happened just two days earlier. 1.6 at night caused a "no shoot" AMPS the morning of the 9th.
On the 11th, Lori had to wait until +19 to shoot a small dose of .8, and then it looks like his pancreas decided to take a vacation. The next day, AMPS he got 1.0. Nothing happened all day on the 12th. Flatness. That night, he got .8.
OK. Look at the total insulin given on the 10th. It was 2.6u. Two days later, on the 12th, he got a total of 1.8 units. Why? Because on the night of the 10th, it looks like his pancreas woke up again. Then it went back to sleep. The morning of the 13th, he had the highest AMPS he'd had in a while, got only 1u, and lo and behold, Mr. Pancreas woke up again! But late in the cycle it looks like, because once again, Lori was forced to withhold shooting due to the low PMPS. The morning of the 14th, he had an expected high AMPS due to no insulin for 23 hours. That day, his cycle was not all that great. Small curve, higher PMPS.
Yesterday, on .8, the curve looks inverse? No clue why. Today, flat or slightly inverse on .8? What? Why? No clue.
OK, my logical mind says "Copper is not getting enough insulin". Because his dose has gone all the way down to .8, and it was 2.8 a month ago, and 1.8 two weeks ago. But looking at his curves, that logic is shot all to hell.
I have no clue at all what is going on inside Copper's body. As frustrating as that is to me, I can't imagine how frustrating it is to Lori (or to Copper for that matter!).
I can't sit here and say "up the dose", and the major reason for that is because I keep seeing these cycles where is AMPS is higher than his PMPS, and there's no "dip" in between. Just a slanted line downward all day long. The exact pattern he was showing prior to his first "hypo" on Dec. 18th. I don't know if it is too much insulin, but it is showing what looks like "long duration". I don't want to tell you to reduce the dose either, because I don't want to see high numbers.
I am totally confused and at a loss here.
this dance always keeps us on our toes I think you are doing wonderful cat_pet_icon dancing_cat