3/4 Buddha

Buddha's at it again. I finally started to feel like we were getting some downward movement from the highs. Was feeling good about yesterday am when we had a +4.5 of 80, but bg bounced back up to 511 at pmps (and I would have shot early like I have been recently, if I'd been home).

Today, I thought I was being aggressive and shot 2u (.2 more than the usual 1.8u) and, nothing. It's like he didn't get a shot at all.

I suspect rebound yesterday, but a good "panicky liver" type rebound. Should I have raised the dose more? Should I have raised it last night? Should I stick with 1.8u no matter what?

We've been continuing with the Clavamox, at about day 11 for a u/a dx'd UTI.

Just got a +10 of 360. I was going to shoot early, because his numbers have been high all day, but now that it's coming down, I'm not sure.

Does anyone know what causes curves like this? Effects of yesterday's rebound? Too much insulin? I know it wasn't a fur shot, but maybe something else hindered absorption? Sometimes good numbers seem so close and then it all goes crazy again.

Grrrrr.

 

Donna, I'm no expert, but I can tell you my similar experience. I think it was last week, Blackie gave us a 55 at +6 and then proceeded to zoom over 400 at pmps. It took 2 days at a higher dose to get him to come back down again. So it may take another day for Buddha to come down again. I think that was panicky liver.

Have you noticed lower bgs' since the Clavamox? Are you going to do another u/a after it's done? I hope Buddha is feeling better and gives you some better numbers.

 

I think rebound often gives you an ucky red cycle following the cycle that triggered either acute rebound or panicky liver. People told me that when I saw that kind of pattern with Bix (nice blue cycle followed by icky red cycle). The strategy I know of is just ignore it, and hold the dose steady, and the #s should get back to normal-ish generally by the next cycle (though it can take 3 days for rebound to clear). If you suspect Somogyi you would lower the dose, but if you suspect it's liver training, you just ignore it. Of course as Ele said, if the #s don't come down you may have to raise the dose. I'd give it a cycle or two though to see before raising, unless you already know Buddha's pattern is to need more insulin.

 

Thanks Ele. This yo-yoing has been going on for so long and is so frustrating! And maybe since it has been going on so long, its going to take an extra push to get him back on track.

Boodz really does seem to be feeling better lately. Though the numbers still look high, my guess is that he's spending less time at them. Or maybe it's that spring is in the air. Or its the clavamox. But he's been happy and active and playful. Cept this afternoon, he's just zonked.

Not sure what the vet will recommend on Tuesday. She was pushing for a curve at the office and she also mentioned sending us to a specialist.

Thanks Joanna. I read someone else's post earlier about "just sitting on your hands." That's hard to do, but often is the best advice. Seems like I've always backed off in the past, maybe staying the course is the next thing to try. And if that doesn't work, then increase.

 

Don't let her talk you into an office curve! @-) It's just a waste of money IMO, you are already doing all that at home!!! If she wants specific data, maybe you could agree to a full curve at home one day if you feel the need to be agreeable. If you do head to a specialist, I'd do some research first & find one who's approach to diabetes you really like. My guess would be she's suggesting that because she doesn't know what to do next, but that doesn't mean the specialist will either, so it could also be a waste of money if they aren't more tuned in to diabetes treatment than the average vet is. I don't think it's an area where most specialists have a different perspective than most regular vets. Hopefully I'm wrong.

 

The only advantage I would see to doing a curve is to compare the vet's readings with my own. I could leave my Contour with them and they could get their number and my number at the same time. And we both could see how accurate my meter is. But the last curve performed at the office was also a straight across 400's day and I was told the perfect dose was 3u, which was way too high.

If I had a regulated cat, I'd be able to approach the vet which much more confidence.

So Buddha's day has looked like this:
amps 492 2u (.2 more than normal)
+2 HI
+7 402
+10 360
+11 346

I suppose bg could have been lower between +2 and +7, but that would be weird too.

So that's what post-rebound looks like? The 80 I recorded yesterday was +4.5 in the morning. Last night the 1.8u I shot into a 511 pmps seemed to be working (282 at +4).

 

I wouldn't attribute today to rebound--it's too similar to all the other days. Buddha isn't getting 12 hours of coverage from the PZI. Can you shoot earlier--like around +6/7?

 

Terri, I'm not sure what you are suggesting--shoot earlier at +6/7 every day, so that I start shooting 3 to 4 times a day? I could maybe swing that short term, but I would get too neurotic if it lasted very long. I'm having a hard time imagining it.

 

I shot 1.8u (the usual) at +12 pmps. At +4.5 Buddha's at 62. I had to convince him to eat. His appetite has been off tonight, but otherwise he's acting normal.