? 12/28 Zeke crazy numbers needing advice.

Status
Not open for further replies.
Meridith and Zeke

Meridith and Zeke

Member Since 2017
Prior Thread

We haven't posted in awhile but figured it was some time for some advice. Zeke's numbers are really doing crazy right now. We are on day 4 of this dose and he should have leveled out, but he went so high at +2 that it took him until +6 to get back to his amps and he is already raising back up. Is it getting time to start thinking about changing insulins? We have been on this dance since April, end of May if you don't count the time we were following the Vet's advice.
 
He will be getting an increase the day after tomorrow. My question is on the crazy numbers. He should be settling in to this dose and flattening out since he has been on this dose for 4 days now but he is still getting crazy numbers.
 
Numbers bobble around a bit during a bounce. Could be today's he's going to go a little higher before breaking the bounce and going lower tonight.

Good thing the increase is on the way. I think he hasn't hit his breakthrough dose yet. I'm not sure what ECID reasons are for holding the dose longer, but it looks like glucose toxicity is developing due to holding the doses too long but even more importantly, from going back in dose to 1 unit. It's been almost a month since he last saw green. What was the reason for going back to 1 unit? With Neko, I had to keep chasing greens and be a bit aggressive about it cause she would easily develop glucose toxicity.
 
Bronx's dad said:
The numbers don't seem so out of whack, new pen was shipped/stored as normal?
Click to expand...

This pen is #4 out of a 5 pack and has been stored as all the others.

Wendy&Neko said:
Numbers bobble around a bit during a bounce. Could be today's he's going to go a little higher before breaking the bounce and going lower tonight.
Click to expand...

Thought new dose wonkiness only lasted 3 days at the most? Was expecting a little bit more "normal" starting today.

Wendy&Neko said:
I'm not sure what ECID reasons are for holding the dose longer,
Click to expand...

Because of his bouncing, he needs a little longer to settle into a dose. Can't know if he has hit his dosing or not if he is still bouncing all over the place at the end of the 3 days. Just wasn't expecting numbers to still be this crazy at the end of his am cycle.

Wendy&Neko said:
What was the reason for going back to 1 unit?
Click to expand...

Was a safety call because he had some dental done at the first of the month. He broke a tooth and then had to have the root dug out surgically. Since the tooth was bad and there was a good chance he had elevated numbers due to pain etc, I lowered him so there was no chance in him taking a dive.

I have talked with Robyn (Penny's mom) some over this on the phone and she did help me make some sense of all this.
 
Meridith and Zeke said:
Thought new dose wonkiness only lasted 3 days at the most? Was expecting a little bit more "normal" starting today.
Click to expand...
New dose wonkiness lasts less than 2 days. I was talking bounce - he's bouncing off the blues.
Meridith and Zeke said:
Because of his bouncing, he needs a little longer to settle into a dose. Can't know if he has hit his dosing or not if he is still bouncing all over the place at the end of the 3 days. Just wasn't expecting numbers to still be this crazy at the end of his am cycle.
Click to expand...
TR timing takes into account bouncing. If he's bouncing from blues, it's not enough insulin and he needs an increase. He now seems to be taking 5 cycles to clear a bounce. This post by Libby is a good explanation of the timing and why it's OK to increase during a bounce.
Meridith and Zeke said:
Was a safety call because he had some dental done at the first of the month. He broke a tooth and then had to have the root dug out surgically. Since the tooth was bad and there was a good chance he had elevated numbers due to pain etc, I lowered him so there was no chance in him taking a dive.
Click to expand...
But having elevated levels due to pain and inflammation is why you should increase (to lower the BG), not decrease the dose. Neko had a growth on her jaw that was removed (dental vet thought it was cancerous, thankfully not), but that work meant quite a bit of inflammation during the healing process and earned an increase, until she told me she was healing by going lower. And she got buprenorphone to help with the pain.
Meridith and Zeke said:
I have talked with Robyn (Penny's mom) some over this on the phone and she did help me make some sense of all this.
Click to expand...
One of the beauties of FDMB is that it's an open forum, where all can read and comment on dosing suggestions if we don't agree with what is said. Dosing discussions via PM or phone/email go around that. Of course it's your job to sort through all that you hear and decide what's best for your cat.
 
Wendy&Neko said:
But having elevated levels due to pain and inflammation is why you should increase (to lower the BG), not decrease the dose.
Click to expand...

I did the decrease after his surgical procedure, the small dose the night before was because most were saying no insulin before the procedure though for that night do a small amount so he wasn't too long without any. Afterwards, since the tooth was gone, was figuring his pain would be less so therefore his numbers would be naturally lowering so needing less insulin.

As for for the phone call, she was explaining to me insulin resistance and how that could be what it is with Zeke right now since it seems that he is getting higher numbers even though his dose is increasing. And I started talking to her on FB, not here.
 
Glucose toxicity is a type of insulin resistance.

I wasn't talking about the descrease around the day of the procedure, but rather going back down to 1 unit from 2.25, starting December 11th. It's too hard for us to guess what less pain means in terms of lowering the dose, best to just let the cat tell you by earning a reduction. As an example of glucose toxicity, take a look at Boomer's SS, starting July 7th he had a dental. Judy lowered his dose from 1.25 to 0.25 for the same reason, thought he'd need less insulin. It took almost three months and up to 3.0 units before he turned around.
 
Meridith and Zeke said:
What numbers are considered under "renal threshold"?
Click to expand...
ECID of course, but generally in the upper blue to lower yellow range. Neko's was around 220. You can test with ketodiastix, but I would do a BG test before taking her in for a urinalysis, so I could see at what BG she was spilling sugar into her urine, or not.
 
Status
Not open for further replies.
Back
Top