? 8/22 Sebastian AMPS 289 +1 393 +2 381 +4 330 +5 352 +6 319 +7 297 +9 256 PMPS 271 +2 291 +5 228

Yesterday

AMPS 289, 11lbs 8oz, b-ohb 0.7. I just don't get it, it's like his BG is getting worse as the dose goes up.

I know people have said in the past that "too much can look like not enough" but no one ever actually explained to me what that means. Does it mean it's going to cause bouncing, which we would see, or does it generally cause higher numbers without a dip-triggered bounce?

Anyways it's been 6 cycles and with him starting at 289, I'm going to increase to 6.5u.

 

Edited the title a bit so I can hopefully get some clarification on the whole "too much can look like not enough" thing. I've done all his increases by the book, yet we're getting pretty high and not seeing any movement, if anything it looks worse, so something just feels wrong.

 

I'm just looking over his numbers for the past month and I'm starting to think I screwed up. I didn't get nearly enough PM data when we were in the 3s. Even my AM data is spottier than it should have been. I can definitely see where it's possible he was just bouncing a lot, which we know he does, and I didn't see the dips and increased right past them. I'm kind of thinking I need to reset back to 3u and try again. I'm a lot less burnt out now and it'll be easier to get more readings.

 

393@+1.

 

Glad you're feeling less burned out...however I'm not sure I'd reduce with those higher numbers and his history of DKA. Just my opinion, but I'd stay the course with the increase and hope you see some better numbers soon. Sometimes they just need that extra nudge to get those numbers down. Fingers and paws crossed that you see some better numbers soon!

Have a great day Sebastian!

 

381@+2, b-ohb 0.6. Looks like we stayed out of the reds. He's drinking a lot this morning so I'm going to keep an eye on the blood ketone meter. Looks good so far though.

 

He is such a little cuddlebug

 

293/354@+3. Took two readings, first was 293. That seemed like a big drop so I took a second and got 354. So, bit of meter variance going on probably. But, there might be a clue here that the dose is too high. If too fast of a drop will trigger a bounce, and we assume that the lower reading was closer to accurate, we have almost a 100 point drop in an hour. Can't really explain the big initial spike but this might be in indication that the dose is too high. I'm going to keep checking every hour to try and get a clear picture of what's going on.

 

Most precious!! And you get to touch him when his world is upside down! If I touched Luci when she was upside down, she'd bite me or claw me one good...

 

What a little upside down sweetie! His little toof is showing! Sometimes you have to go up before you come down but good luck with your theory, it never hurts to check.

 

Justin, thank you for that clear picture - I feel like I can almost feel Sebastian and he feels wonderful. Gorgeous obviously.
Good job on the increase. We all know every cat is different (ECID), but since most follow a fairly similar pattern, I might do exactly what you are doing, and wait for better numbers to begin showing. Then you might need to raise the dose to 7, or even higher. Then, soon, you should start being able to decrease.
What Sonia said is what I have seen in many examples.

I found this forum after I had already started with Lantus. Vet started us at 2u, and I increased to 3 on my own, then played around some. Finally started learning what I should be doing. If I hadn't started testing midday, I could have really hurt my cat. Anyway, we went up to 3 before good numbers started, then in a short amount of time, we got down to .5 units, and now back to a fat .5 (.62).

I'd also like to know how to look for "too much looks like not enough". I think it's pretty rare.

 

330@+4. Looking like maybe the 354 at +3 was probably the closer to accurate and we're getting a smoother decline. Still need to figure out why we're up in the purples all of a sudden. This definitely doesn't look like a bounce since the numbers aren't flat and are actually curving like you would expect.

 

Hoping for a continued decline and a good nadir.

 

I also have the gut feeling that too much insulin looks like not enough, but I cant prove it of course, and experience people here tell me it shouldn’t happen. But it makes sense to me!

 

The way I make sense of too much looks like too little, is that too much insulin would cause low BG, which might cause a high bounce. If the lows aren't being caught, then the caretaker thinks the high bounce numbers mean not enough insulin. But if plenty of testing is being done, the lows would be caught.

As always, I could be wrong, just trying to understand.

 

352@+5. Lunch bump.

 

He is very cute and very handsome

 

319@+6, b-ohb 0.8.

 

297@+7. And he's eating a little more so we'll be popping back into the purples.

 

Unfortunately, one of those phrases that someone says and others copy without really looking at the data. I wish people would stop using that phrase. Too many people have reduced as a result and I have seen cat on FDMB go DKA as a result. Best case the reduction means a waste of time and glucose toxicity. If a person has started at way too high a dose, or increased by too large amounts and is not testing, you can get data that looks like high and flat numbers, which is what not enough insulin can look like. How do you find out which is which? You test, numbers will come down if too much.

In mid July, you got some limes at 5.25 units. You reduced all the way back to 3 units, which was too big a reduction. Glucose toxicity set in, and now you are battling that. And yes, you did miss a whole bunch of opportunities to get before bed tests at night. And increased without seeing enough data. Put that aside for now, try to test at least twice each cycle and let the data tell you what you should do. Trade some of those daytime tests of hourly pink after pink for a spot check at night.

 

Yes, I'm going to plan on getting a +2, +5, and +10 for the PM cycle, and a +3, +6, +9 for AM at the least. If I see an opportunity to catch a peak or a nadir, I'll try to get those too. And I'll start putting dose increase threat alerts in my post titles around cycle 3-4 when we're not seeing a decrease yet to make sure I'm not missing anything.

 

Neko had a stretch of three months where she went low and earned reductions at night only, and bounced during the day. I didn’t always test throughout the night, but used the before bed test to tell me if I needed to set a later alarm. If Sebastian’s +2 or +3 is higher than preshot, you can ease off on the tests. Those early cycle tests seem to be pretty good indicators of when he’s going low. More testing if he drops early.

 

256@+9

 

PMPS 271. b-0hb 1.0. Don't like the numbers. He's most likely going to spend a lot of time in purple again. Not super sure what I should be doing because this feels like it's getting out of control on the current track. I'd like to maybe add some R into the mix but still don't have dedicated guidance.

 

Good to see the new ? Post. I am curious, and hope to learn about using R in cats. I know how to use in people, but that doesn't likely translate to cats.

 

Perhaps you might want to reach out to @Mollycat - take a look at Biscuits SS - he's on a high dose and uses 'R' to help out.

 

291@+2. Not too bad of a spike off dinner. Not sure if I'll get a +5 tonight. He's up from PS so it's probably not super necessary, I'd like to get the data, but my dad was in town and we had a few beers with dinner so I might just sleep that off.

 

Don't know what I was thinking, he's basically flat from PS and I should get a mid cycle test

 

Y.O.U are doing great, Justin. Great

 

Wait for dedicated guidance.
@Wendy&Neko, @Sandy and Black Kitty @Sienne and Gabby (GA) ...anyone else?

 

@Sue and Luci she has run into to a bit of mid understandings with R recently. See http://www.felinediabetes.com/FDMB/threads/8-17-biscuitsamps-300-9-5-272-pmps-333-3-329.218243/
Justin, see post #9...
Not the best, or successful answer from her ... for Justin and Sebastian right now... I’m just sayin’

 

228@+5