? How on earth to regulate?

To start, I realize this is a lot of info, but I'm hoping it saves time as I'm pre-answering questions that always crop up during responses.

So I've been home testing Jester for a while now, although not as religiously as some due to low finances and shortage of supplies.

But my main question right now is how does one get their sugar kitty regulated?

I've been told by folks on this board to keep him on the same dosage for at least three cycles, but sometimes that doesn't seem practical.
After a curve on 29-Dec that I was told was pretty good with 1U, on 30-Dec his AMPS was 152 and I wasn't comfortable giving him a full unit so I dropped it down to .5 because of previous checks where he went low on a full unit. On 8-Dec he went down to +5 BG 53 when his AMPS had been 141 and I gave him a full unit.

So this week's numbers at a glance:
30-Dec: 152 AMPS (.5U) / 266 PMPS (1U)
31-Dec: 180 AMPS (.75U) / +6 126 / 266 PMPS / +4 142
1-Jan: 288 AMPS (.75U) / +4 166 / 287 PMPS (.75U)
2-Jan: 382 AMPS (1U) / +5 113 / 292 PMPS (1U)
3-Jan: 329 AMPS (1U) / 261 PMPS (1U)
4-Jan: 95 AMPS (0U) / +3 124 / 192 PMPS (1U) / +3 243
5-Jan: 293 AMPS (1U) / 135 PMPA (.5U) / +3 201
6-Jan: 320 AMPS (1U) / +5 98

FYI - Prior to 4-Jan, all of Jester's mid-cycles were fasting because I didn't realize that they didn't need to be.
Also, today's +5 was fasting simply because Jester hasn't eaten since this morning.

I admit some of his bouncing could be my fault - he had mostly been on 1U for a while, but sometimes he'll go down to the mid to low 100s and I'm not comfortable giving him a full unit with those numbers. And one time his BG was pretty high so I gave him 1.5U.

Sometimes it seems like I should ignore the AMPS and PMPS and just give him 1U no matter what. With a few exceptions, those seem to be the times that his BG is the least bouncy. (The most notable was between 6-Dec and 11-Dec - BG went down to below 150s and he barely needed insulin during that five day period.)

I've been keeping more detailed records on his eating habits in the "remarks" cell since 11-Dec, including which kinds of foods he's been eating (lower carb / medium carb).
On eating habits, yes it would be absolutely fantastic if he would eat lower carb all the time. But sometimes it can take forty-five minutes to an hour of what I euphemistically call "encouragement" to get him to eat more than a quarter can of low-carb food. (No, fortiflora doesn't do a thing for him and I have no other flavor enhancer to try with right now.)

For now, I'm just glad the highest carb he'll eat is medium (between 14 and 15). And even that can take forever to get him to finish half a can. So far today, he's eaten about 1/4 can of low-carb and 1/3 can of medium. Started feeding him at 9:30AM, didn't finish until around 11:00AM with encouragement.

No, auto-feeders aren't practical for a lot of reasons.

So, thoughts? Suggestions? Recommendations?

 

There are no easy answers to this, Shelagh. Some cats are much easier to regulate than others and have calmer responses to insulin doses. Bouncy cats are harder to figure out because their BG numbers are complicated by the artificial highs that bouncing creates. Some bouncers stop bouncing very quickly, within a cycle or two. Some bouncers take 6+ cycles to clear a bounce. My cat is a bouncer and I've gone through ProZinc, Lantus and am now using Levemir. He was diagnosed 2 years ago and I'm only just beginning to see some better numbers. Is he regulated yet - no.

I see that you're altering the dose to suit the PS test values. That can work well once a kitty is fairly well settled. Based on my experience with my bouncy cat I find it works better to keep him at a consistent dose AM and PM and not change dose too often. You might want to try an intermediate dose, say 0.75 u, both AM and PM for a couple of days to see what happens. So much of dosing toward a goal of regulation is trial and error. There is no set of guidelines that will work perfectly for every cat.

 

This is extremely helpful - honestly. I tend to blame myself for Jester's numbers.

I did give .75 a try, but after 4 cycles going up steadily each PS, I figured it wasn't working. Prior to that he was only hitting 300s occasionally.
Do you think I should have let it go a bit longer to see if his system got more used to that dosage?

 

Four cycles isn't very long. I'd try that dose a bit longer. You also can't assess a dose very well based only on PS. I know you're limited in how much testing you can do but you might have to stay a bit longer at a dose in order to get at least one nadir range value. Even then it might be obscured by bouncing.

 

I'll give this a try shortly. And, tbh, I'm trying to figure out if I'll be able to go on an annual trip this May with my regular cat-sitter taking on Jester's insulin dosing. (He's said in the past he'd be willing to learn.)
At the very least, by going six to eight cycles, it might give me an idea how .75U would work over a period of several days. (I tend to leave Friday morning and come home Monday night.)
Even if it doesn't wind up being an ideal permanent dose, it might work for me as a sort of "dry run."

btw, this has nothing to do with my original question, but is it possible to set up syringes in advance for such a trip? .75U, even with half unit syringes, can be difficult to judge.
Would making up the syringes with the appropriate dosings prior to leaving on a trip be a good or bad idea?

 

The general advice is not to do this because there are lubricants inside the syringe barrel that could possibly adversely affect the insulin if in contact for several days. One thing you can do is make up a reference syringe with coloured water so whoever takes over dosing has a visual guide.

 

Got it - thanks!

 

Yep, bouncy cats tend to bounce until they don't. Really that isn't your fault. If we knew how to make it stop, we would, but as Kris said...it's all trial and error. If your catsitter is willing to give insulin it should be fine...we can help you figure out a good, safe dose for while you're gone closer to time.

 

Hey, I'm on Earth too! Check my profile.