7/6 Loudogg AMPS 376 +8 41 +8.5 82 after HC PMPS 112 +2.5 175

July 5, 2018 Condo

Good morning everyone!

I am still absolutely floored at how beautiful Lou's cycle was yesterday. He spent 5 hours at essentially the same number! Lovely! While the numbers were still below 200 in the PM cycle, I felt it was obvious he was heading for a bounce. Interestingly enough, I've found that his appetite will show up before his BGs go out of control. He started looking for food already at +1, when he was just over 100. He ate normally yesterday during his super surfing. He wasn't ravenous, which is fantastic. I'll take that as a sign that he's getting used to lower numbers, slowly but surely.

Hoping this bounce will be short lived! I hope you all have a wonderful day today and I hope your kitties surf safely!

 

Hi Amanda. Wendy tagged me the other day with Loudogg's IAA dx since my Doodles was another IAA only kitty. He tested at 78% originally and I had him retested when his dose came down a bit and it was higher at 84% Doodles also had advanced HCM and recurring CHF. IAA showed up over a year after starting insulin. Doodles was down to 1u and we climbed to 12u after the IAA dx.

Lovely stretch of greens yesterday! When Doodles hit green he'd also spend many hours in them. Looks like Loudogg is starting a bounce. Remember it can take 6 cycles for the bounce to clear so be patient before wanting to increase. I'm not sure if you've seen this information on IAA that @Sandy and Black Kitty explained but it's very informative on "what's going on".

Some very important information on IAA to keep in mind:

• IAA is idiopathic. It just shows up spontaneously for unknown reasons.
• IAA is self limiting and generally resolves in about a year.
• The way it works when IAAs are present is that injected insulin first gets bound to the antibodies. Any insulin that does not get bound goes toward metabolizing sugars. How much goes to antibodies and how much goes to metabolizing sugars is anybody’s guess and a moving target
• IAA can retard the initial rise of available insulin after an injection.
• IAA can lead to an increase in the half-life of free (unbound) insulin in circulation because some bound insulin gets released into circulation.
• The increase in half-life can lead to prolongation of action.
• The release of insulin from the antibodies can happen at inopportune times

 

Beautiful cycles yesterday Lou!!

 

Hi Karen! Thank you so much for stopping by! While part of me is still reeling from the IAA diagnosis, part of me is thankful to have a reason why it felt like Lou's numbers kept trying to stay higher, despite his previous insulin needs at the time. At the end of the day, at least I know what we're dealing with. Thank you for the information, it's great to have everything in one place. I also appreciate hearing Doodles' story, especially being able to see his spreadsheet. It's crazy how long he was on insulin before it's like a switch flipped. While I'm hopeful that perhaps Lou's IAA has broken, despite the fact his insulin doses didn't sharply increase, hearing Doodles' story will ensure I do not take my eye on the ball. I'll be ready if the IAA starts ramping up.

Thank you again for taking the time and leaving me such valuable information. I appreciate it more than I can express! And may I say, your Doodles was such a beautifully stunning kitty!

 

Thank you, he was the sweetest boy.

Knowing when to be cautious is just as important as ramping it up I do lurk often so will check in from time to time. Feel free to tag me if needed.

 

+6 = 68

He's getting right back in the saddle, no easing into things today! Hoping he stays steady on that surfboard!

 

Nice to see Lou head back to green today.

 

Look at that boy today! We're feeling proud that he's back at the lagoon - hope he'll do some more surfing for you today...yesterday was IMPRESSIVE! I'm trying to show Luci his SS - but she's too sleepy to look...trying to get her to find her way back to the lagoon..she's too sleepy for that too...maybe it was all the sugar high from yesterday? Has just worn her to a frazzle...she's over in the corner by the doorwall...stretched out and snoozing the afternoon away...ah...she looks so relaxed...

 

I wish there was a wolf whistle icon.

Neko also used to surf like that sometimes. During the night if course.

 

+8 = 41 His first ever lime green!

Extremely skittish and ravenous. Gave a dot of Karo just in case (weirded out by the skittishness and worried he wouldn't eat); gave 1.5 tsp (about 1/4 can?) of 20% HC food, which he scarfed down, of course. Will test again in 10 minutes (20 mins after first test).

 

Whatcha doing down there with them bad ol sharks, get back to the lagoon, silly kitty, kitties don’t play with fish

 

Deep breathe. You got this Amanda. Test again in 20. If you are worried about him eating, next time try just feeding the gravy so you don't fill him up.

 

Thankfully the HC was a gravy food and it was literally mostly gravy. Rechecking in a couple of minutes!

 

+8.5 = 82

 

Ok, the karo might have bit more than he needed, but it worked. I would test again in 1/2 hour. If still up you can go longer the next time. The HC can wear off in a couple hours, so you donhabe to keep testing for a bit yet. A spoon or two of LC may help him surf at this point, as long as he's not full.

 

Sounds good! I kind of knew right after I gave him the Karo that he probably didn't need it (that it was overkill with the HC), but what do you do, haha. I'll definitely recheck in a half an hour. Thanks Wendy!

 

+9 = 104

Definitely overkill with trying to bring him up. My bad. Good to know for next time, though. So as far as TR, since he didn't technically go below 40, I do continue to hold this dose. Is that correct? Or since he was close enough would I lower to 3u? It just seems so weird to lower since he wasn't doing overmuch with the 3u before the increase. It is the 5th cycle at 3.25u.

 

Today is try it and learn day. Cats differ in how carb sensitive they are. Being cautious at first is OK. Just take good notes on how much extra food/karo you gave and use it to guide you next time. I could save karo for the 30's, but ECID. You can probably wait an hour now to test.

Also good question on the reduction. For a normal cat that has been diabetic over a year, they do have to go under 40, though some people use the three under 50 rule, especially if their cat isn't good at holding reductions. With Neko, I just reduced at under 50. She held her reductions. With IAA in play, or maybe not if it's broken, it could be different. If you are around to monitor the next few days, you could try holding the dose. That would get him more used to green and potentially help out the bouncing. If you want to be cautious, or cannot monitor, take the reduction and see how he handles it. With "high dose" conditions, you even more so have to learn how Lou responds.

 

We all overkill the first few times, then we become to cautious the next time and not give enough. We beans just can't win.

 

Poor Lou...fell off the darn board...Luci does it all the time...and then roars back to the beach...Next time he'll do better..he's familiar with what he needs to do...just gotta keep adjusting the food...the insulin..your hair...you know...up/down, back/forth...we'll figure it out...eventually...

 

Luci is in the 3 x under 50 category Amanda...just in case you were wondering...1 x under 40...she's not very good at holding anything...increases...decreases....you name it... Just sayin' it happens...

 

Thanks everyone for making me feel better about my overreaction, haha.

Thanks Wendy. Karo in the 30s is a good game plan. I do have the next couple of days off, so I think I will hold this dose to see what he does with it. I think if he goes under 50 again, I will likely decrease, as that's cutting it a bit too fine with me going back to work next week. But if today was just a fluke (I wondered about the possibility of antibodies releasing insulin to amplify the dose), I'd like give it another chance.

 

Always keep that front of mind.

FWIW I did not know for certain how long BK was diabetic - he came to us off the streets with FD (he was about 5yrs old).
We joined in late January 2008 so by Jan 2009 he was definitely diabetic for 1yr. Still, I took reductions after 1 drop below 50 or if I was having to really fight to keep him above 50.

Since BK was the 1st cat here to be diagnosed with IAA and no one had any idea what exactly to do, we were all flying by the seat of our pants.
One thing we did know was that he was a big gulper with a depot to match.

 

That is a really good point. Thanks for commenting Sandy! I'll see what this does does tomorrow (if he breaks the bounce). The markings on these U100 syringes are so much more scrunched together than the U40s. It was a breeze to estimate 0.5s and even fattening and/or skinnying doses up. These U100 syringes are almost impossible for me to dose consistently when he's not on full or half unit does. I'm wondering if I possibly dosed up 3.5 without realizing it or something and it's just now kicking in. I think I might look into calipers, even though they don't look quite as slick as I was hoping.

 

Which brand syringes are you using? Some have fatter barrels and the lines are closer together. I loved using calipers.

 

I agree with @Wendy&Neko on the calipers. We ordered a nice one from Amazon - has the digital numbers to display very precise measurements...those darn syringes are the worst for fine doses...I never could make heads or tails of them...and they were all DIFFERENT! Sheesh...if you want the Amazon link, let me know...I'll add to my next note...gotta head out now. Have a wonderful day!