7/12 Luna - AMPS 234, +6 334, PMPS 328

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by For_Luna, Jul 12, 2019.

  1. For_Luna

    For_Luna Member

    Joined:
    Jan 24, 2019
    Yesterday

    Luna surprised us yesterday with a PMPS 71 after a 383 AMPS. Back up to 234 this morning. With all of the bouncing, I'm not really sure what to make of her numbers on this dose yet. Guess we'll see how today goes
     
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  2. Perry & Jenn

    Perry & Jenn Member

    Joined:
    Jun 5, 2019
    Good luck to you and Luna! We are bouncing all over the place here, too. I hope I get more comfortable with this dance one of these days.
     
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  3. For_Luna

    For_Luna Member

    Joined:
    Jan 24, 2019
    Thanks. The bouncing is the most frustrating part of this whole thing.

    The dance gets easier. Eventually it just becomes part of your daily routine. Testing and data will make you worry less.
     
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  4. For_Luna

    For_Luna Member

    Joined:
    Jan 24, 2019
    +6 334
    Gradually rising since the 71 yesterday. Another bounce?
     
  5. Amy47

    Amy47 Member

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    May 30, 2019
    Hi. I'm still learning as well & found this about Insulin induced hyperglycemia:

    Hyperglycemia due to a Somogyi effect can persist for as long as 3 days after a single hypoglycemic episode. As a result, blood glucose concentrations do not always stabilize within a few days after lowering the insulin dose.
     
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  6. For_Luna

    For_Luna Member

    Joined:
    Jan 24, 2019
    Yeah, I saw that too. It's hard to tell sometimes when there's (what appears to be) back-to-back bounces. 49 on 7/9 to 397 on 7/10 was definitely a bounce. I thought she cleared it with the 168 on 7/10, but then she went back up to 383 the next morning. Then on the same day at PMPS she was down to 71, but now we're back to 334. I just don't know how long to hold a dose when she's all over the place like this.
     
  7. Amy47

    Amy47 Member

    Joined:
    May 30, 2019
    It's definitely complicated:banghead:. I'm sure someone on the board with a many years of experience will share their thoughts about what you might want to do as far as the dosing is concerned. I'd be inclined to hold the dose being that the 1.25 has resulted in such significant sudden drops & even a 43 back on 7/7. I think some cats just manage dose increases & decreases differently & for some, more time for for works better for some cats.

    I was reading some literature & there is very limited recent info with re: to felines & glycemic control, but it was interesting to see that in human medicine, they are now starting to approach glycemic control a little differently. While TR is obviously proven to be better than poor glycemic control, there is now increasing evidence that hypoglycemic events are more troublesome than thought for many reasons, including rebound hyperglycemia with consequent loss of glycemic control. So, the focus has shifted to getting good control in patients & avoiding the hypoglycemic #s.
     
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  8. carfurby

    carfurby Well-Known Member

    Joined:
    Feb 19, 2012
    There have been times when Furball would bounce, start to come back down and then have a second bounce. I hope Luna comes back down soon.
     
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  9. Amy47

    Amy47 Member

    Joined:
    May 30, 2019
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  10. J.J. and Phoebe Squeak

    J.J. and Phoebe Squeak Member

    Joined:
    Apr 28, 2019
    Thanks for finding this info, Amy! Very helpful because Phoebe Squeak is bouncing too. Luna, how about you and Phoebe Squeak hop off the trampoline and try surfing instead?
     
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  11. For_Luna

    For_Luna Member

    Joined:
    Jan 24, 2019
    Awesome. Thanks for sending that.

    I need to read through it again. Like everything else with this disease, there's no definitive answer to anything.

    Seems like we need to weigh the pros and cons of a dose that can produce 24 hrs of green but also drop her to the low 40s and cause huge bounces, and a dose that will give us an occasional green or blue and flatter curves but makes us spend too much time in yellow and pink.
     
  12. Amy47

    Amy47 Member

    Joined:
    May 30, 2019
    So true!
     
  13. Amy47

    Amy47 Member

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    May 30, 2019
    :p..I hope they stop bouncing soon for you & Dan! However, when you read the link I sent....go to post #12 from Libby & Lucy (Moderator). She talks extensively about the bouncing & states:

    "To be clear, those who suggest lowering the dose to prevent bouncing are usually not suggesting that you leave them in high numbers forever. The idea is that once the cat flattens out & gets used to yellow, you may eventually be able to increase the dose to bring them into flat blue. Some cats will even go to OTJ that way. On the other hand, some cats will need increasing amounts of insulin just to maintain the same numbers, if glucose toxicity takes hold."

    She goes on to talk about getting the cat into "healing" range as quickly & safely as possible & that bouncing is actually part of the process. "Its a GOOD thing if it means you are facilitating healing!" :cat:
     
  14. J.J. and Phoebe Squeak

    J.J. and Phoebe Squeak Member

    Joined:
    Apr 28, 2019
    Yes, I did read that, thanks. Dan, I will be interested to see what you decide for your adorable Luna. After reading over all the info in the link Amy sent, I've decided to raise Phoebe Squeak's dose for her PM shot tonight. I've got my hypo kit ready just in case. Fingers and paws crossed that we both get a good result.
     
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