Well the (kinda) good #'s didn't last long...

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Cherish Gallagher

Cherish Gallagher

Member Since 2017
Any ideas why Angel's #'s are so all over the place? Been a month and a half on insulin and she is still frequently seeing 400's. TIA
 
Numbers like that, especially at the beginning, aren't really unusual. It takes awhile, and sometimes a long while, for a kitty to get regulated. Food can play a big role for many of our kitties. You may find that the lower carb foods give you some improvement. But again, it takes awhile.

Hopefully someone with experience in Vetsulin can take a look at your dosing and see if there's anything in there to adjust.
 
Vetsulin is a fast acting insulin that can pull BG down fast and low. It'll rebound high at the end of the cycle either because of the relatively short duration of the insulin (8 to 10 hours in many cats) or from an overreaction we call bouncing. Angel started on a high dose and it's been increased twice in a week by 0.5 u increments. There are various possible things going on:
  • the 3 u dose was too high to begin with and the pinks are bounce numbers (not sure if this is the case)
  • the dose has been increased too quickly (possible - new diabetics might need more time to adjust)
  • the dose has been increased by increments that are too large and you've bypassed the good dose (we recommend 0.25 u increments - eyeballed on the syringe)
  • she could be dropping quite low in the middle part of her cycle and it's causing rebound.
The only way to sort this out is by getting more test data. If you're away at work, aim for a test the minute you come home at night as well as at least a bedtime test every night. Fill in the data gaps as much as you can on weekends. It doessn't have to be a full curve but numbers scattered between +3 and +7 would help a lot.
 
Kris & Teasel said:
Vetsulin is a fast acting insulin that can pull BG down fast and low. It'll rebound high at the end of the cycle either because of the relatively short duration of the insulin (8 to 10 hours in many cats) or from an overreaction we call bouncing. Angel started on a high dose and it's been increased twice in a week by 0.5 u increments. There are various possible things going on:
  • the 3 u dose was too high to begin with and the pinks are bounce numbers (not sure if this is the case)
  • the dose has been increased too quickly (possible - new diabetics might need more time to adjust)
  • the dose has been increased by increments that are too large and you've bypassed the good dose (we recommend 0.25 u increments - eyeballed on the syringe)
  • she could be dropping quite low in the middle part of her cycle and it's causing rebound.
The only way to sort this out is by getting more test data. If you're away at work, aim for a test the minute you come home at night as well as at least a bedtime test every night. Fill in the data gaps as much as you can on weekends. It doessn't have to be a full curve but numbers scattered between +3 and +7 would help a lot.
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Thanks so much for the input. I think I'm relatively an impatient person so I just want the numbers down and for her to be healthy again.

Will get several more reading today.

Do you think it would be ok to keep her at current dose (4u) for a couple more days to see if she comes down at all and then decrease to 3.75 if needed?
 
Cherish Gallagher said:
Thanks so much for the input. I think I'm relatively an impatient person so I just want the numbers down and for her to be healthy again.

Will get several more reading today.

Do you think it would be ok to keep her at current dose (4u) for a couple more days to see if she comes down at all and then decrease to 3.75 if needed?
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You could try that. Can you do a curve on the weekend? That would be very helpful in sorting out what's going on with her.

Unfortunately, FD requires a lot of patience. You'll have much more peace of mind if you cultivate that as much as you can. It bears repeating: this is a marathon, not a sprint.
 
Kris & Teasel said:
You could try that. Can you do a curve on the weekend? That would be very helpful in sorting out what's going on with her.

Unfortunately, FD requires a lot of patience. You'll have much more peace of mind if you cultivate that as much as you can. It bears repeating: this is a marathon, not a sprint.
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I did a curve Monday. I'm off today so going to shoot for at least 4 more tests plus PMPS
 
Kris & Teasel said:
You could try that. Can you do a curve on the weekend? That would be very helpful in sorting out what's going on with her.

Unfortunately, FD requires a lot of patience. You'll have much more peace of mind if you cultivate that as much as you can. It bears repeating: this is a marathon, not a sprint.
Click to expand...
Can you point me in the right direction to read about bounces?
 
Cherish Gallagher said:
Can you point me in the right direction to read about bounces?
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Here's something I wrote that others found useful:

Here's how it works:
  1. BG goes low OR lower than usual OR drops too quickly.
  2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
  3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
  4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
  5. Bounce prone kitty repeats this until his/her body learns that healthy low numbers are safe. Some kitties are slow learners.
  6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
  7. Many vets have little/no understanding of the bouncing phenomenon.
 
Now that you're armed with Kris' awesome explanation of bouncing, don't be surprised if her PMPS is a bounce :). That is a very nice +6 though :cat:
 
Possibly closer to her AMPS. Her body has to get used to the lower numbers again so it bounces her back up again. I detected a pattern with Maury and it might work with Angel. If nadir (lowest point in cycle) is 50% or less PS value, then you might see a bounce. So, AMPS was 463. Since +6 was 105 (more than a 50% drop), PMPS might bounce back to a 400 number. It may be a 350 number because I think the AMPS might be a slight bounce from last night's cycle and still working it's way off the trampoline. :D
You can look at Maury's first blue's and see that he bounced back to red and black :facepalm:
 
Yong said:
Possibly closer to her AMPS. Her body has to get used to the lower numbers again so it bounces her back up again. I detected a pattern with Maury and it might work with Angel. If nadir (lowest point in cycle) is 50% or less PS value, then you might see a bounce. So, AMPS was 463. Since +6 was 105 (more than a 50% drop), PMPS might bounce back to a 400 number. It may be a 350 number because I think the AMPS might be a slight bounce from last night's cycle and still working it's way off the trampoline. :D
You can look at Maury's first blue's and see that he bounced back to red and black :facepalm:
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I just got 56 as her +8 .... nervous as heck.
 
Can also test in 20 minutes to be sure she's ok since it is your first double digit :). Sorry if I got gender wrong, I think you said Angel is a boy... *checking previous posts*

No. I was wrong. Fixing! Must have been another kitty that the name could go either way :D Bad memory here :p
 
Advice... because of the huge drop today I'm not sure what I should do about her PM shot. Will be giving it at 6pm. I could monitor her until 8-9pm but then need sleep to get up at 5am.
 
Kris & Teasel said:
Vetsulin is a fast acting insulin that can pull BG down fast and low. It'll rebound high at the end of the cycle either because of the relatively short duration of the insulin (8 to 10 hours in many cats) or from an overreaction we call bouncing. Angel started on a high dose and it's been increased twice in a week by 0.5 u increments. There are various possible things going on:
  • the 3 u dose was too high to begin with and the pinks are bounce numbers (not sure if this is the case)
  • the dose has been increased too quickly (possible - new diabetics might need more time to adjust)
  • the dose has been increased by increments that are too large and you've bypassed the good dose (we recommend 0.25 u increments - eyeballed on the syringe)
  • she could be dropping quite low in the middle part of her cycle and it's causing rebound.
The only way to sort this out is by getting more test data. If you're away at work, aim for a test the minute you come home at night as well as at least a bedtime test every night. Fill in the data gaps as much as you can on weekends. It doessn't have to be a full curve but numbers scattered between +3 and +7 would help a lot.
Click to expand...
Thank you for the info! I'm so overwhelmed by the support and kindness shown around here. Feeling very lucky to have found this community! In such a short time I feel like I've learned So much and it's definitely the Most visited thing on my phone as of lately. Lol.
 
Yong said:
Can also test in 20 minutes to be sure she's ok since it is your first double digit :). Sorry if I got gender wrong, I think you said Angel is a boy... *checking previous posts*

No. I was wrong. Fixing! Must have been another kitty that the name could go either way :D Bad memory here :p
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She is my perfect girl :)
 
Cherish Gallagher said:
I have been doing a test and within 5 minutes I put her meal down and give her the shot as she's eating.... is this wrong?
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That's fine if you are using a long-acting insulin, but with Vetsulin you should wait 20-30 minutes after she eats and then give the shot. Because Vetsulin does tend to cause, sharp, fast drops, you need to have food on board to act as a buffer.
 
Lol...I just graphed a bounce I found on someone's spreadsheet:

upload_2017-4-7_16-54-56.png


Of course, you just lived through one, so you probably don't need the visual anymore ;)
 

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Well, it's a little hard to say right now. Yesterday during the AM cycle, you got a really nice response. Although I'm curious that your nadir is so late since I thought Vetsulin usually has an earlier nadir? Sometimes that means the dose is too strong, but it would take more data to know if that's right or not. It looks like Angel hit nadir around +8 yesterday. Would you be able to set an alarm and get a test later in the cycle?

Also, numbers-all-over-the-place is pretty common. Try not to stress too much.
 
Djamila said:
Well, it's a little hard to say right now. Yesterday during the AM cycle, you got a really nice response. Although I'm curious that your nadir is so late since I thought Vetsulin usually has an earlier nadir? Sometimes that means the dose is too strong, but it would take more data to know if that's right or not. It looks like Angel hit nadir around +8 yesterday. Would you be able to set an alarm and get a test later in the cycle?

Also, numbers-all-over-the-place is pretty common. Try not to stress too much.
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From what i can tell so far her nadir is between +6 - +8
 
80 at #6. Bf is keeping an eye on her and will wake me if needed. We did just give her a small low calorie snack though and I hope she's ok tonight. It just makes me nervous to have such high numbers and then perfect numbers that might be headed too low because of too much insulin. But then again why is she still so high so frequently if she's getting enough insulin #stressedmama
 
Wow! You are getting really great responses during your mid-cycles. Is your BF going to get a +7 or +8 test? I think giving her a snack was a really good idea, as well as keeping an eye on her for the next couple of hours until she starts to rise. 80 is still a very safe number, but have you read the info about hypos? Whenever a cat is hitting greens, it's a good idea to know what to do just in case.
 
Djamila said:
Wow! You are getting really great responses during your mid-cycles. Is your BF going to get a +7 or +8 test? I think giving her a snack was a really good idea, as well as keeping an eye on her for the next couple of hours until she starts to rise. 80 is still a very safe number, but have you read the info about hypos? Whenever a cat is hitting greens, it's a good idea to know what to do just in case.
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She doesn't trust him yet. We are working on it. And yep! I have my kit all. Ready Just in case. That's something we have talked about in length. He works from home so I needed to make sure he can help her if needed.

I'm thinking this dose might be too much. What do you think? How many more days should I stay at 4u?
 
Cherish Gallagher said:
80 at #6. Bf is keeping an eye on her and will wake me if needed. We did just give her a small low calorie snack though and I hope she's ok tonight. It just makes me nervous to have such high numbers and then perfect numbers that might be headed too low because of too much insulin. But then again why is she still so high so frequently if she's getting enough insulin #stressedmama
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The highs at the end of the cycle are a typical response for many cats on Vetsulin. It drops them fast to a low nadir and then they overreact by bouncing up high at the end of the cycle. Another factor that can also lack of duration of the insulin. It lasts only 8 to 10 hours in many cats so it might be all used up before the end of the 12 hour dose cycle.
 
Kris & Teasel said:
The highs at the end of the cycle are a typical response for many cats on Vetsulin. It drops them fast to a low nadir and then they overreact by bouncing up high at the end of the cycle. Another factor that can also lack of duration of the insulin. It lasts only 8 to 10 hours in many cats so it might be all used up before the end of the 12 hour dose cycle.
Click to expand...
So think could be what it's like for her on vetsulin moving forward? Or could she stabilize?
 
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