1/21 Cobb AMBG 41 +1 79 +2 93 +9 137 +11 165 PMPS 197

Discussion in 'Lantus / Levemir / Biosimilars' started by Suzanne & Cobb(GA), Jan 21, 2015.

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  1. Suzanne & Cobb(GA)

    Suzanne & Cobb(GA) Well-Known Member

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    Nov 24, 2013
    Yesterday's Condo

    Neither Matt nor I could stay home this morning, so we are carbing Cobb up. I did not shoot, obviously. I told Matt to leave him with some HC food and some low carb with karo on it -- we are almost out of our HC...we will have to do better on stocking up on it, there just hasn't been a lot of reasons to keep a lot of cans of it around in the past. Matt is getting a +2 before he leaves for work.

    However...I am at a loss. I have no idea what is safe to shoot anymore. I get we are on this rollercoaster and really holding on for dear life, but I have to be able to be confident in my decision to shoot Cobb and leave for work. I don't mind him running a bit higher -- not necessarily in green. I think, for my peace of mind, I have to do that on days I know there is no one there to watch him.

    So help me please. I know he'll be higher tonight -- with the skipped shot and the carbs. Should I drop his dose by a whole unit? I know I can always then go up to 4.5u if I need to. I just don't know what to do!!!

    ~A Frustrated Suzanne
     
  2. Angela & Blackie & 3 Others

    Angela & Blackie & 3 Others Well-Known Member

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    Mar 15, 2010
    That's a very interesting, and rather low # this morning, Mr. Cobb! What gives, huh? Can you surf nicely for your parent beans, please?

    Suzanne, I wish I had an answer for you with regards to dosing advice. All I know is that when I skipped a shot with Blackie as I felt a tad uncomfortable shooting a 60's a time or 2, I went straight back to the regular dose she was getting before I skipped the next shot time. I hope that someone can swing by to help you with it. Good luck, and hang in there.:bighug:
     
  3. Suzanne & Cobb(GA)

    Suzanne & Cobb(GA) Well-Known Member

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    Nov 24, 2013
    Thanks Angela! It's been a stressful few days! I don't want him surfing in the 30s all day like he did on Monday. I just can't figure out what is a good dose these days! Obviously 5u is not it! Or is the dip still from 5.5u Monday morning. Who knows anymore?!
     
  4. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    I have no idea what dose you need but with the acro Wendy or Julie will know more. I certainly would think that you need a reduction and one possibly more than you have been giving as it looks to these not very experienced eyes like he might be needing less insulin more quickly now. I don't know how you people that work can do this when the trends change. At least you know that you will be safe today and that is what matters most. Have a nice day!
     
  5. suki & crystal (GA)

    suki & crystal (GA) Well-Known Member

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    May 4, 2014
    thanks for taking the time Suzanne for looking at my recent post - with all you have going on in your own life I really appreciate it. Good luck with Cobb's dosing and hope Matty is now fully recovered. Take care
    Suki & Crystal
     
  6. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Last night, Cobb's +2.5 before onset was again lower than his PS. That seems to be a clue that he's planning something and a time to set that early morning alarm.

    I think dropping to 4.0 sounds like a good plan. Cobb's going down dose for different reasons, but when Neko was rushing down the dosing scale after SRT, there were many a time I took a extra reduction and said "I'll go back up if I need to" and didn't. This advice is only for caregivers with cats with high dose conditions, even if Cobb's no longer on a high dose. Things can change suddenly and unexpectedly. Play it safe.
     
  7. Suzanne & Cobb(GA)

    Suzanne & Cobb(GA) Well-Known Member

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    Nov 24, 2013
    I think you're right, Wendy. I did notice that, but didn't think to set an alarm. I'll keep an eye on that. That before bed test didn't used to yield any real information for me. It appears that is no longer the case. I'll have to make a concerted effort to make sure that test is gotten every night.

    That's exactly what I said to Matt this morning. I said, I'll drop his dose. I can always add more, but I can't take the insulin out once I've put it in him. So...we'll see what 4 units does. It's interesting to see how .5 unit decreases were working at larger numbers, but now (it appears) he requires a full unit decrease. My mind is boggled right now!
     
  8. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Cobb spent a long time in the 30's the other day. Sometimes kitties that have gone close to hypo can be more sensitive to insulin. Dunno if that's it, just throwing out another theory. Something's sure changed in Cobb. :) That plus your comments that he's thinner and more active are clues that he's regaining his inner kittenhood.:cool:
     
  9. KeikosHuman

    KeikosHuman Member

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    Aug 29, 2014
    Suzanne,
    I know what you're talking about, I have run into the same dilemma when Keiko was in low numbers and what to do in terms of a dose. I spent 7 months raising Keiko's dose which I thought was stressful, yet lowering seems in some ways more so, although it should be a time to celebrate less need for insulin. I think for me K suddenly needed less insulin, he has never been on a steady dose for any long period of time so I went from raising it all the time to suddenly getting low numbers and then starting to lower it Maybe that's normal but I expected him to be on a plateau for longer time. Hang in there. Help is right here in this group.
     
  10. Suzanne & Cobb(GA)

    Suzanne & Cobb(GA) Well-Known Member

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    Nov 24, 2013
    Well, he's not as high as I expected him to be -- which makes me think the food spike at +2 probably wore off.

    I'll plan on shooting 4 units tonight. We're about 3 hours from shot time now.
     
  11. Suzanne & Cobb(GA)

    Suzanne & Cobb(GA) Well-Known Member

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    Nov 24, 2013
    I hope someone is online who feels comfortable answering!

    At +11 Cobb is 165. I don't forsee him climbing too much more in the next hour. Do you still agree with the 4 units tonight? No lie...I'm a little trigger shy right now.
     
  12. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    I think it would be perfectly ok to give a 2u shot tonight, Suzanne. I think that's what I'd do, unless he passes 200 by +12. For him on Lev it seems like often his nadir is around preshot time, so maybe 165 is ok. But . . . i feel your anxiety and I'd be feeling it too. You have to sleep tonight, you have to work tomorrow. I don't want to set him back, but . . .

    that's what I'd do anyway.
     
  13. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    just one more thought: it does seem like when a kitty is on a mission, they don't really get derailed by skipped shots or reduced shots here and there. I would worry less about that than about him being so hard to bring up the other day when you were carbing him and he wanted to hang in the 30's. Don't want that to happen again.

    We'd like you to be able to remain sane and all! ;)
     
  14. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Trying an even lower dose as Julie suggests is also fine. With Neko on Levemir, I find that the cycle after a fur shot (or skip) looks pretty good and I've seen her get to mid blues for the following PS. The higher numbers don't start until the cycle after that. But given you are rightfully feeling trigger shy, a 2 or 3 U dose could work. As we've both said, you can always take him back up if you need to.
     
  15. Suzanne & Cobb(GA)

    Suzanne & Cobb(GA) Well-Known Member

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    Nov 24, 2013
    Thanks Julie and Wendy! My gut tells me we'll be going with 2 units...but what to shoot in the morning? I feel like I'll be just guessing!

    A random thought I had this morning...I know Sandy has said multiple times that the antibodies can release the insulin at any, and usually an inopportune, time. How long do you think those antibodies stick around? Could they be releasing very old insulin...like insulin before we switched to Lev? And that might explain some of the early, pre-onset dips? Or am I over thinking that?
     
  16. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    As I recall the insulin antibodies have a lifespan that's weeks-long, not months-long. I'll try to find the reference on it, but it might take me a while.

    but yes, the antibodies can die and release the insulin they have bound up. I'm just not remembering how long that bound-up time can be.
     
  17. Suzanne & Cobb(GA)

    Suzanne & Cobb(GA) Well-Known Member

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    Nov 24, 2013
    Cobb was 197 at +24.5. I gave him 2 units.

    The first day we gave him the new food he gobbled it up. He's now taking a few bites and walking away. Not sure what that is about. But I'll keep an eye on it.

    He has lost weight. He weighs 15.8 lbs, according to my scale at home. That is about 1.5 lbs less than what he weighed when he was diagnosed in April 2013 - 2 years ago.
     
  18. Sandy and Black Kitty

    Sandy and Black Kitty Well-Known Member

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    Dec 31, 2009
    Well well. . . . .
    Looks like a crazy spell . . .
    Good call on the skip. . .

    Going to read up on Cobbs most recent adventures in BG land. . . .
    BBL :cool:
     
  19. Marilyn and Polly

    Marilyn and Polly Well-Known Member

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    Apr 2, 2014
    This is the part I hate. Making decisions in unfamiliar territory. (I always get lost on road trips, too. Turn right? Turn left? Go straight? I choose wrong.)

    Thank goodness we have people here who have the experience to help!

    Sending light for some relaxation for you and your family...

    Marilyn and Polly
     
  20. Shelly & Jersey (GA)

    Shelly & Jersey (GA) Well-Known Member

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    Feb 1, 2014
    No dosing advice from me, of course. Just lots of moral support.

    Cobb really is looking fantastic, even if he's scaring the life out of you in the process. I still can't believe how much it's all changed over the past year (less than, actually) - down from 31 u. Amazing! :)
     
  21. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    So, here's my $0.02 on dosing tomorrow. And remember that's Canadian, and worth even less now after the Bank of Canada move today. :rolleyes: I'd stick to the 2 units for at least 4 doses. Cobb may well go higher tonight and tomorrow, but you've got a skip and low that's going to affect the numbers. My rationale for sticking to the dose is that if you dose hop, it'll be difficult for the depot to settle, and we'll have a hard time figuring out what's the right dose. So, build a known depot, then follow the protocol to get back to a better dose if you need to, or down if he goes there. I'm not betting anything at this point. Remember, at these much smaller doses, that a 0.5 U change is a much larger percentage of the overall dose.

    Losing 10% in a year and a half is good. A wet food diet probably contributes to that. Did you go out and buy a bunch of the tall cans of Wellness? That's a sure fire way for them to decide they want to be picky. :p
     
  22. donaleen and Ozy

    donaleen and Ozy Well-Known Member

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    Jul 19, 2013
    It's so exciting and amazing. Yeah, Suzanne and Matt. Yeah Cobb!!
     
  23. Sandy and Black Kitty

    Sandy and Black Kitty Well-Known Member

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    Dec 31, 2009
    Well I took a look at Cobbs ss - Wowza Wowza Wowza !
    Big change in progress!
    Flying down the dosing ladder is emotionally challenging for anyone.
    Having a high dose IAA kitty makes it even more so. After all, it's a looong way down.
    ;)
    With a high dose kitty at times like this erring on the side of extreme caution is always the best choice.
    You don't want to find out whats safe to shoot by way of finding out whats not.

    The times they are a changin' :cat:
    Funny, I remember being in the same boat.
    Similarly I had times when I shot a BCS and it ended up being the new dose.
    I think it's like 2 weeks. .
    What we don't know is if some antibodies to Lev developed and could be responsible. It may just be a matter of Cobb regaining overall good health to the point were all the gears are meshing and all systems are once again go. I believe that for some kitties healing just takes longer. And who really knows what more, besides pancreas has healing to do.

    I don't know if it is typical of IAA or not but BK tumbled and stumbled as he flew down :
    BK insulin graph (600x337).jpg
    BK had a similarly particularly crazy 2 week period in February of 2009. He was on 5.5u on 02/09 and by 02/22 he was down to 3u. Out of those 28 cycles, I stalled for 9 of them and skipped shots for 3.
    That was February.
    We zig-zagged our way back up in dose and by April pink and red were back on the scene and I was calling upon our old friend R .
    By the 3rd week of May were back up to 5.25u. . . I was completely mystified. . .and seriously bummed.
    Then came the day when he yawned a big yawn - like this:
    big toofuses close.jpg
    and I saw redness around a tooth way in the back. Mystery solved. Back to the dental specialist (twice in 6 months ). Then back down he went.. . . :cool:


    Nobody can predict where Cobb may be headed. Nobody knows. What we do know is he is way different than he was a year ago.

    Trust your instincts and when you have another morning like today remember-
    'better a day too high than an hour to low'

    As far as what to dose in the morning I can't say - it depends on how this cycle plays out and how that fits in the context of the last few days. and past 2 weeks.

    One thing I'm sure of is that you will make a good call.:cool:
     
    julie & punkin (ga) likes this.
  24. Vyktors Mum

    Vyktors Mum Well-Known Member

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    Nov 15, 2011
    Cobb you are a champion look at you go :D and so is your bean - go Suzanne :)

    Black Kitty you so cute!
     
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