2/14 Paul-Kyle

Finally got SS updated after a week without power/internet service....

PK hung in the 200's on the .75u long enough to start getting 100's PS's ( also peak value). He is much more active, attentive and annoying to the old lady kitties in the 200 hammock flatness he is getting on the lower dose. I think it agreeed with him, though most of you told me to raise the dose.

I wasn't not listening to you, in fact I weighed your input carefully, but sometimes you gotta go with the gut and the gut said lower dose, no raise.

We got a low 118 PS/peak a few days ago followed by some unusual higher numbers so I took that as a hint to lower the dose yet again.

No, it isn't the greens ( 50's ) that Tilly suggests lowering on, but PK has never been a by the book kitty, even when I tired to make him one for a few months there by sticking to Tilly against my gut feeling, so I am trying to listen to PK in particular and see what happens.

I can say today I am not pleased with the 230 ish PS we got, but I was not initially pleased with the values on the lower .75u either. After I let it settle and ride on, we got some great numbers.

Take note that PK raised less than 80 points at food spike from PS yesterday...THAT was VERY pleasing for me to see! ( compare to the 60's to 300's we were getting on the higher doses)

With the new lower dose, I am seeing the red 3rd eyelid at PS time and some mopeing about in between right now, but I got that initially on the .75u until it settled further.

All in all I think we are making positive progress. ( fingers crossed)

PK is still getting 2.6 oz raw/canned mix BID at shot time and no snacks in between...predictability seems to work for my sugarpea.

In a few days after more settle time I will get a full curve and see whats going on.

Does anyone find it odd that his numbers have not seemed to vary that much from the 1.25u, 1u, .75u, .5u dose? ...nothing has changed, cart is new, food is same, routine is same, no illness, not time for dental... :?

Also a thought- wondeirng if PK was getting too much insulin when he was spiking in the 300's after food, could it be that there was P action mixing with exogenous insulin and it made the bgs spike? Just a thought milling abou tin my head.

 

Melissa, go with your gut. It isn't very scientific, but it works for you - and it has worked for me when my "not by the book" Beau was throwing out confusing signals. I will be interested to see how this dose settles out in a few days.

If he has pancreas action, I would think that it is lagging the spike, kicks in about the same time as the insulin does and them, Wham! That would make the spike a food/rebound combo. So lower dose would even that out on by preventing the rebound and letting the pancreas handle the lower BG increase better. Pancreas just can't handle a big food/rebound spike - its like feeding him cake.

Does any of that make sense?

 

Sheesh...I had a response all written up and flooey it went into cyberspace...ergh.

I think our theory might be that if there is pancreas helping here, then when PK eats the body is releasing some endogenous insulin at the same time PK is getting a dose or riding the last dose of exogenous insulin ( bottle) and together it may amount to too much insulin creating somogyi effect and therfore the higher food spike numbers?

With the lower amounts of exo insulin, IF endo IS being released, he isn't getting such a sock of insulin and keeping all the numbers even at food spike time? ( in essence and *insulin* spike, rather than food spike?!)

I wish I could do something about the rest of the days 250's, but that is MY impatience talking...PK is doing better right now than he has for months. He is more alert and "among us" than he has been in a long time, more active even with the wether keeping them in, it seems every time I pass the cat room he is up, where he used to be curled tight in a ball sound asleep ALL DAY.

As far as food spikes, though it is too early in the dose change to be reliable, even last night and hour and 20 mins after eating he was less than 60 points different from PS. Compare that to the higher doses taking him from 90 to 300 in the same hour.

I am confident we are on the right track here...we'll see as it plays out.

 

Well, basically I am saying he needs a little assist from the exo insulin instead of a charge in and take over and start smashing things with a hammer assist.

Clearly, riding the highs and lows makes PK feel crappy and being steady - even in the 200s is more comfy right now.

 

JUST as I was giving up and thinking that I made a mistake lowering the dose to .5u and I should go back to .75u, PK gave me 184 for AMPS/Peak value!!!! YEEEEHAAA!

And, just as always- Day 6 today...My boy just takes longer to settle- always has, and someday I'll realize that! :lol:

So, looking good, pleased and we shall see what we shall see!

Is anyone elses cat shedding gobs of hair right now? Seems like I have 2 more cats worth of hair to vacuum every day- gobs and fistfuls escape the cat door when I open to delivery breakfast. @-) Yesterday such a big hairball blew out, that I put my foot out to stop a cat from escaping- thinking it was a whole cat, not just a pound of fur!

Gads!

 

He just needs more time - I knew that because YOU keep telling me that! Maybe you should embroider a pillow with that on it, or something....

No massive shedding yet. But I expect it will start soon enough. Maybe you are a lower latitude than we are so sunlight triggers it earlier?

 

BEWARE: Sheila's threatening to embroider pillows again :lol:

 

No, I'm telling other people to embroider pillows...

What was the other one that I suggested? I can't remember. Maybe I should start a business...

 

thinking of going back to the .75u so doing a curve today just to make sure that is what I want to do and no suprises hidden anywhere...

Thing is- I don't get why, on the .75u, PK seemed to bounce from the 118 to the 300's....that bothers me.

When he bounces, which he basically has done since he started Lev, he sleeps ALL day, is inactive, has 3rd eyelids up and just seems to feel icky.

The last few weeks I have had him on the lower does and flat curve he has been brilliant! Shiny coat, bright eyes, interactive, attentive, WAY less sleeping- it seems 8 out of 10 times I walk by the cat room, he is up and walking or at least on the floor looking around. 3rd eyelids I have seen twice, both at meal time...?

Anywho- we seemed to have more blue PS/peak's on the .75u and PK was seemingly better than any other dose on Lev, just I didn't care for the bounce from that low 118 to the 300...

anyway...just FYI if anybody even cares.

 

OK, I wasn't going to say anything further, but I'm feeling wild and crazy today.

PK is spending 100% of his time above the renal threshold on .5 and more than 80% of his time above the renal threshold on .75 units. If you measure a successful dose on external behavior only, I understand your decision to stick with the lower dose. But if you consider long-term side effects, I don't think external behavior is a sufficient measurement tool. Obviously the goal should be to reinforce happy external behavior while still protecting against long-term deterioration.

At 1.25 his kidneys got a small measure of relief. But like you have pointed out, the ups and downs are disconcerting and his behavior reinforces that. You choose to modify based on external behavior only. Why not give some consideration to the recommendation that he needed more than 1.25 units in order to get both happy behavior and long-term health for his kidneys and other internal organs?

 

Thanks for your feedback Terri.

I'd believe I am dosing with both bg AND bx in consideration.

I've already been to the higher doses ( look back to December/November ), spent 3 months following Tilly to the word, switched food times and amounts 4 ways from Sunday and PK still spent 80% of his time MUCH further above renal than he does now in addition he looked and acted like he felt like crap.

With the .5 and .75 he is MUCH closer to renal 100% of the time, doesn't have the wild swings AND acts MUCH better than I have seen him in a LONG time.

I'd already decided to go back to the .75u but did the mini curve FIRST to make sure I wasn't missing anything.

 

What happened on the 10th to make you put unusual bx? What was he doing?

If 118 is his nadir number, it was not low enough to decrease on. I say stick with the .75U.
Also please consider fine tuning your doses more.

Once we get near/below 1U the percentage changes between .5U and .75U are too large and increments should be in tenths of units. That could be one reason why it seems to take him so many days to react to a dose change. You are increasing dose by 50% by going from .5U to .75U! I dose in tenths even above 1U because the differences I see in nadirs between 1U and 1.2U are remarkable.

Melissa, you use tools - micrometers are cheap and very helpful for the measuring challenged!

It needs to be this kind: http://cgi.ebay.com/6-inch-LCD-Digital- ... 5d263a85dd

Not the more popular C shaped kind.

 

Vicky, what I don't get about using that device is how you SEE where the tips are pointing at? And is there some way of calibrating it so it "knows" that a certain distance is equal to 1u?

I'm just not sure that it would make things any easier for me.

The really ironic thing here is that I learned about the "bead" method from Melissa. Maybe I "perfected" it by practicing getting 10 beads from 1u and 5 from .5u., but the point is that I know Melissa can "do" 10ths of a unit. :mrgreen:

 

Ahhhhh,

Well, I have to see to line it up with the start of the barrel and line it up with the top of the plunger, but because the ends of the calipers are so sharp, it's easier to tell than trying to line up plunger at a certain point between markings.

I use a 1:1 scale - 1mm = 1U now. Which is why my doses seem a little higher than they were as it used to be a 1.2mm= 1U scale. It is digital, so it gives you the measurement as you adjust it.

Last night I discovered I can see it really good in front of my kitchen TV!! Yippee! Much better than the CFL bulbs which glare too much.