Hi Becky
Sue asked me to take a look at Cali's SS and I have.
I'll get to the "rebounding thing" in a minute.
Here's what I see on the SS. Yesterday morning, you shot the normal 2.0 dose and the AMPS was 414, just like the day before. So, logically you might hope to see numbers both days that "make sense" compared to each other, right?
But that didn't happen for some reason.
On the 6th, (hard to tell because we don't know what happened between shots), but my guess is a decent curve and the PMPS was right about the same as the AMPS had been.
On the 7th, same AMPS as the 6th. Same dose as the 6th. But something "different" went on in the middle. But we don't know "what" was different. I could be he went lower one day than the other. It could be the insulin "kick in" happened later on the 7th. It could be that the insulin just lasted longer that day. But whatever happened, the PMPS was a lot lower than the day before.
OK, now compare the AM cycle of the 4th and the PM cycle last night. About the same. Same dose, each time.
Also, the same amount of "drop" from the PS to the nadir.....about 100-110 points, right?
Now look at what you got on the PMPS on the 4th, and the AMPS today. Red numbers. Those followed shots of 2.0 into numbers that were "low" compared to most days at shot time.
I think what happened was that his body saw that blue number, didn't remember having BG that low before, and his liver may have reacted by dumping "sugar" (for lack of a better word) into his system to bring his glucose back up. His liver is confused, it thinks a number that low might be "dangerous", so it compensates. This seems to be pretty common, but eventually it'll stop happening. But until it does stop, it's just something you have to put up with. You can't really make it stop. You can try to make it happen less often though.
Here's what I would do, if you could do it all over....
Keep my normal "dose" for now at 2.0u But if you see a number like that AMPS on the 4th and the PMPS last night, cut back the dose just a little bit, like to maybe 1.75. That might keep thing more consistent and avoid that liver reaction. But you don't "have to" do that. Just an idea.
Rebound - it's a word you read a lot around the board, and probably is used way too often. Another is "bounce". As Sue mentioned, Dr. P. has posted a few times lately in the PZI forum, and if you look at the last 3 or 4 threads started by "Owlgal01", you can see what she said.
Here's something that she said that I think is very important in a case like this, where you may be thinking that the dose needs to be dropped and a "new normal dose" be decided on.
carlinsc wrote:
what if it was just one wonky meter reading. What if it wasn't a 455, but maybe a pink gone bad?
This is an example of why I loathe labeling a cat X based on ONE lab value. ie....I get hundreds of people writing to me every year in a panic because their cat has been Dx'd with CKD based on only ONE blood panel. Makes me crazy....
Look for repeatability before panicking or making any important decision.
I put what I think is most important as "bold" type. If you see numbers that give you this sort of "spike" happen every time you shoot 2.0 into a mid-200 number, then you might consider adjusting the dose a bit down, but only on
those occasions. Not every time you give insulin.
If you see numbers that just keep going up, or just keep going down with the dose of 2.0 for 3 or 4 cycles in a row, then you might consider changing the "normal" dose up or down to correct things.
But try not to "react" when it's something that doesn't seem to have any pattern to it, just random events. You can drive yourself crazy doing that, and Cali will be just as confused.
Does that help any?
Carl
She's angry enough with us!