Mr B's tilt a whirl

well its been an interesting day. http://www.felinediabetes.com/FDMB/...-little-scare-but-ok-now.169929/#post-1847169


Mr b likes to cover all his bases, so he decided to go as low as at least 99 at +3 to a 'hi' reading at +12 tonight.



Old thread http://www.felinediabetes.com/FDMB/threads/mr-bs-rollercoaster.167968/page-2#post-1847429

 

Already commented on your older thread. This isn't surprising. It'll be interesting to see how long this bounce lasts. Welcome to trampoline kitty world!

 

Thanks kris
Do younthink the little bit of high carb food would be partly responsible for this high reading, or would that have worn off hours ago-?

And to confuse things more, we had started a little pumpkin today to help his gi motility. But that certainly should not raise bg, right?

Funny he is acting more comfortable with a high than with that green this morning. Its like his body was tired from fighting off relatively (or actual) low numbers. He is peeing less drinking less and is more relaxed. Aint that a kicker!?

Even with the slow increasing it got out of hand. Goes to show when i was being more aggressive there was no waaaay that would have worked.

 

I really don't know. You'd think it would have worn off but who knows? Do you have any sense of how Mr. B. reacts to carbs from past experiences? I also don't know about the pumpkin. Many people here use it and don't seem to find it to be a problem. If it helps his elimination problems I'd keep giving it and dose around that.

It might be that the low was so atypical that he couldn't cope. More things for you to watch for going ahead. As stressful as this was you've learned new things about his reactions.

Your slow increases were fine. I think you finally hit his "breakthrough" range. Notice I didn't say "dose". This is just the beginning because the target is still moving. You're still doing the dance - one step forward, one step back.

I know you've been recording info all along but today was an eye opener for you. You've learned that he reacts a certain way to low BG and that his BG dropped earlier than expected. I speculated on why that happened but who knows for sure? It's something to watch for now.

 

Please post your evening tests Jen. It will be interesting to see whether he's still high from the bounce or not.

 

I just did a before bed test. Black but lower. Got a number instead of a 'hi'.

he's been off carbs for so long that no i had no idea how they may affect him. Not sure if he wouldve bounced up this high, or if giving him carbs before he got even lower mightve helped prevent an even worse bounce. Who knows? Someone else mentioned in another thread maybe he had gone lower than 99 and i was catching him on the uptick, setting up one heck of a bounce.

Anyhoo its been a day. I've been up since 2am worried about him so i'm going to go collapse now.

 

Busy night with the bouncing kitties tonight! Hope you sleep well!

 

Wow, I missed an exciting day with Mr B! I'm glad Mogs was around to help you through it - that's the awesome thing about this board, there's always someone to help

Still it's great that he visited the greens, even if it was a steep plunge and ricochet back up instead of a gentle smiley curve. Hopefully this is the start of better times for you both!

 

Still bouncing this AM, Jen. The events like yesterday's can happen sporadically when you're near the edge of the glass floor so don't be surprised if you have a run of higher numbers or other weirdness. What you know now without a doubt is that he CAN respond to the insulin.

 

thanks everyone!
got some sleep. mr b was up and down all night with lots of peeing and drinking of course, but it appeared that he felt better. and at least our amps was out of the black.

 

And the fun continues. 562 pmps. I dont know what to dose. I guess i was stupid with the 4u.

Thoughts anyone? @Kris & Teasel ?

 

He's still bouncing, Jen. You should raise the dose methodically but you don't want to jump in and dose according to the size of a bounce number. It would be too much and it would perpetuate the bouncing. You got a yellow PMPS on 12/17, you gave him 4.8 u and then he bounced causing you to raise the dose because you didn't know it was bouncing. Those 5 u doses kept him bouncing until he ran out of "bounce fuel" (liver glycogen reserves to mobilize in order to counteract BG drops you didn't know about) and dropped into the green that scared you. This is all 20/20 hind sight.

How about being careful and only giving 4.2 u tonight. You had to drop his dose a fair bit after the greens. It's always a guessing game to know how much. Now you have to carefully work your way back up. Mores testing is needed, not full curves but some strategic times like +3, +5, +7, +9 (some or all of these) to see what's going on.

 

Thank u. 'Bounce fuel' lol i like that. I needed an opinin because of course the temptation is to increase dose a good bit, but i know thats not right.

I gave him 4.2. Will check before bedtime.

 

Sounds good! Be prepared for weirdness because they can go up and down, back and forth and drive you to distraction. The goal is to crash through the built up resistance but not get into hypo situations. Somewhat tense greens like yesterday will happen and are OK because they increase insulin sensitivity.

 

Thanks again kris. Went down a good bit. I hope he sees some pink tonight at least.

 

Got overnoc readings. Thank u insomnia.
Amps pink. I bumped down to 4u, afraid to push him too hard with this lower range of readings. If that was stupid please tell me.

 

No, not stupid, Jen. You can always go up again once you see how this plays out. They can be a bit more unpredictable in the aftermath of low numbers. He will be wonky and you will see more of his stuck in pink/red behaviour. They don't change into different cats. Your most important piece of info is that he CAN drop.

 

Yup. +5 is 455 this is awful

 

Bounce.

 

+6 398
Thankful not going into black. I hope.

 

Stayed in reds but i am a little confused about this episode.

How can i tell if maybe now this dose is too high? And we're maybe still in somogyi or whatever.

He is now in the tub! This is crazy.

 

Maybe he wants a bath?

I'd say stay the course for now Jen. As Kris said, they can be unpredictable after low numbers and you may be seeing that. It looks to me like you worked your way up fairly steadily. Considering that the insulin did move him a few days ago, I wouldn't think automatically that the dose is too high.

I have been absent for a bit due to a course I was taking, so I haven't been keeping up with history as much. I'll try to look over SS some this weekend and see if I get anything different, but it seems to me you're probably seeing a bounce right now.

 

Thanks rachel. I get confused no matter how many times i'm told about this bouncing thing. Then i get paranoid maybe a lower dose is better. He would get into the blues briefly on lower doses. He is SO thirsty and his legs get really bad in this range and it breaks my heart.

 

Just keep doing the slow increasing, Jen. Who knows - you might end up at 5 u again before you get action. Your green the other day wasn't a hypo just totally unexpected. He might need 5 u and his system will need to adjust to that.

 

Right no i know it wasnt a hypo. The concern was such an early drastic drop that he mightve become hypo by the usual time of nadir. ok i'm still confused. If he was dropping relatively low just even if it was that one time, which now i dont think was the case judging by how he was acting, why wouldnt he drop that low again at 5u? I was thinking that dose would probably be too much based on that.

 

You won't know until you get there or almost there again. Or he'll surprise you at a slightly lower dose. That's what I mean about the wonkiness that can happen at this stage.

 

He might drop that low again on that dose...but if you slowly and steadily work your way up, it's not as likely. You'll have data at each point to see if he's dropping low enough...and if these lower doses help drop him some, even if it's not enough, that can help his body get used to the drop. So then when you get back up to 5, he might drop more steadily and not as suddenly. As Kris says, he might very well surprise you and drop at a lower dose. That's how you start to hit regulation or OTJ...you get a lower number than you should, you drop the amount of insulin back and then work your way back up if needed and find what dose works then...usually lower than before.

 

That's why it's a dance ...

 

Tanked again! 911 in main forum
+2 is 122 from 449!

I think this dose IS too high! Gah! This is what all that crazy drinking was about. I had a feeling something was up...silly monkey!

 

Hi Jen,

I see on your SS that you lowered his dose to 3.2 u this AM. I'm glad you did what you are comfortable with. We can give feedback based on what we've experienced but you're the final gate keeper. It's always hard to know how far to backtrack when they surprise us like this. Not enough and you might have some stressful time ahead, too much and they can get stuck again.

What we know for sure is that Mr. B. is in a transitional phase between being stuck high and resistant and beginning to respond but in a spotty, crazy-making way. You're also learning that he shows you signs when something is going on.

Are you off to monitor him today?

 

You might want to get a +2 and/or +3 this AM given what he's put you through. These can sometimes give a heads up for a more "active" cycle.

 

I had to go out but i'm home now. Yeah i cant risk him dropping early when i'm not home. Gut said to lower so i did. Might regret it, but sooner or later i have to leave the house and i cant function if i'm worrying about him.

 

Your gut should be a major player in decision making...sometimes we just know something without knowing how we know it. In the end you hold the syringe...take advice for what it's worth but you absolutely have to be comfortable.

I do think we've reached a breakthrough with Mr. B. When you'll be gone is good to play it safe...when you're home is time enough to be more daring.

 

Guts can be good. Yesterday before the dive i had an inkling and was questioning the dos might be too high. Without guidance and experience of others here, i would not have been able to develop a sort of sense of what is going on. So thankful to have this site!

 

Those bounce numbers aren't surprising.

 

Not surprising, no. not bothering me either because he is acting so much better than he was last night when he was fighting off that fast drop. Learned a lot from this week!

 

Trial by fire learning - painful but it sticks.

 

Still bouncing, Jen. Now you have signs to watch for if he dives.

 

The bounce is over. Look at that yellow, Jen! Exciting times ...

 

Its crazy. I was so late with his dose last night. That yellow was a surprise this morning. Wasnt sure how to dose him so i took a guess. I no longer pretend to believe there is much rhyme or reason to his BG, and i'm just glad to see a good number when i see it. No sense in hoping to get a handle on this but its good to appreciate a few hours of better numbers. Thanks kris!

 

Am I correct that you gave him 3U? Should be fine.

This! Good for your sanity. I know the feeling.

 

back up again. see why I cant get excited about yellows?
I have no idea if these reds could've been prevented. if I gave too little, or too much.

 

Your last blues were at 4 u. I think I'd hold off on sliding scale for now and continue the gradual rise back toward 4 u territory.

 

Remember it's a process. When you first start to get those lower numbers it's likely they won't last...because we don't know how much to reduce. We have no data for that cat on lower doses. BUT it means something is working and as we get more data we can more effectively handle lower numbers.

 

i got the best xmas pressie this morning. mr b started up his purring machine full blast after about 2 weeks or so of no purrs.

he even talked back to me, telling me his tales of woe and lamentations. i got an earful and told him he's such a good boy.

amps was yellow i forgot to log into ss. the past 36 hours or so he has been drinking less, peeing less. yesterday he slept solid for hours, not having to get up repeatedly to quench thirst and empty bladder. SUCH A RELIEF!!!!

whew. at least we're having a little respite.

 

Fantastic present, Jen!! Enjoy!

 

What a great present! Hopefully this is only the beginning of better times

 

well we've had a nice reprieve of symptoms for a day or so. numbers might not look the greatest, but lots less peeing and drinking, and not overly hungry. more restful and the purrfests are a gift.

today's numbers look odd. i'm not sure what is happening but if the trend continues he might be really high for pmps. I don't know if I dosed too much today, or too little, or if its another damn bounce. I even waited this am to be sure I wasn't pressing him too hard. In the past, dosing with a preshot in that range gets tricky.

anyways at least for a little bit he seemed to feel better.

 

Sort of odd but it's a run of yellows, not pink or red. It'll be interesting to see PMPS. Teasel is surprising me today - maybe some weird moon cycle or planetary alignment??!

 

I like that yellow today at +3. It'll be interesting to see if Mr. B. is like Teasel: if Teasel drops early he usually gives me a lower nadir and PMPS.

 

No rhyme or reason here lol and i've given up hoping for it. The best i can aim for is to at least keep him out of the reds.

 

More yellow and less red is progress!

 

This is true!

 

Oh that's looking much nicer Jen! Here's hoping this new year brings continued better numbers

 

Thank u!

 

Nice yellow AMPS! Moving forward - yes, on a bumpy road but moving forward nonetheless.

 

Lol i love your optimism kris, but i dont think for a second that i'm onto something. His numbers will go off the rails again for whatever mysterious reason. i cant account for this yellow amps.

 

Don't try to account for it, Jen just enjoy it. Your SS tells the story in the scattering of colours over time. Yes, I try to be optimistic because Teasel's responses would drive me bonkers otherwise. Let me reassure you, though, that I'm no Pollyanna! I see what I see.

 

W

well i'd love to be able to account for it so that i could repeat it lol. Yeah our babies like to keep us on our toes!

 

There are just some unpredictable kitties, Jen, and it is good to celebrate the good numbers when you see them. Someone explained insulin to me once this way: it is a hormone, not a medication. So it impacts every cat differently. Not like an aspirin - take one, your headache goes away. More like a teenager. One day, he (or she) is reasonable and happy. The next day is a disaster from sunrise to sunset. Some teenagers (and women in menopause) are a mess for several years with hormonal changes; some just wade through with little changes. So it is with cats. Insulin impacts some cats with daily -hourly- changes. Some have predictable cycles and don't bounce much.

 

You'll get there Jen. I really do believe that.

 

Hurray for yellow and blue!!!

 

I am seriously shocked. I really dont believe it.

 

Believe it, Jen! They might not be here to stay but they're a good sign.

 

Very nice - celebrate those lovely colors!

 

Looks like 3.6 u might be good tomorrow AM, Jen. I see you have Mr.B. booked for an appointment with a new vet.

 

Hi kris. I've got mixed feelings about dragging mr b to yet another vet, and its much further away which stinks. I just want a fresh pair of eyes, to make sure i'm doing everything i can. I dont feel great about this but if they can help at all it'll be worth it. Its not even so much the diabetes, its what looks like worsening arthritis, his thyroid, and whether or not his kidneys are in early failure. I feel a little left in the lurch by our current vet. so i'll pack the litter box in the car and get out mr b"s carrier and go for a bit of a drive next week. Cross fingers for us please!

 

Crossing fingers now!

 

Fingers crossed for you!

 

Fingers and paws crossed!

 

Fingers crossed here too!

 

Thanks all i hope i'm not being stupid but i have postponed the appt for now. I had been on the fence about it from the start. I dont want to put mr b through long drives and more stressful visits and tests unless i have something a bit more solid to base it on. I can call and rebook anytime.

 

You have to go according to how you feel about it, Jen. Meanwhile, continue the systematic increases. Don't forget - you're only at 3.6 u and had been as high as 5+ u.

 

It's your decision Jen. You know Mr. B best and you'll know if you need to go. You have to do what you think is best, and as you say, the stress of the card ride and vet visit might not be worth it.

 

I like yesterday's two yellow PSs!

 

Nice to see, i agree!

 

Look at the nice yellows!

And I agree that waiting to visit the new vet isn't a bad thing, especially if the car ride will make Mr. B stressed out.

 

LOVE all those yellows, Jen!

 

Maybe you just need to suggest (out loud when Mr. B is around) a vet visit and then you get these nice yellows.

 

Are you thinking 3.8 u for tomorrow?

 

Fur shots come and fur shots go ... you'll get there.

 

Well, would you look at that blue!!?? The bigger increase to 4 u seems to have jolted him back into responding.

 

Life has been whacky lately. Mr b having nice numbers today has been a treat. Trouble is i know its just trmporary and the bouncing will be coming.

Unless his pmps is similar to his amps, i dont think i'd do 4u tonight. What do you think?

 

Fantastic numbers! I'd wait to see what PMPS is before deciding on the dose and it's worth getting a +10 and/or +11 to follow the numbers. Yes, there will be bouncing but you know he can come down.

 

Look at that, blue AND greens! Go Mr B!

 

Not sure how to proceed. New territory. Thinking about dosing maybe at +13which based on the curve he may then be between 200 and 250. I certainly would not give him 4u like i did this morning but i really dont know what dose to give, presuming i catc h him before 250. 3u? Really no idea -any input appreciated.

 

Well son of a gun! Look at Mr. B. go! I suggest you stall to see if he gets above 200. You can stall in 20 minute increments instead of waiting an hour and you'd be more likely to catch him before he hits 250. If you had data in this BG range it would be easier to suggest a dose. Considering that you bumped him up to 4 u just this AM and have no history at this dose and because you got those lovely greens, I'd be a little more cautious. Maybe try 2.5 u? You don't want to lose too much momentum but you don't have data to show his reactions at these numbers.

 

Wow, look at that! What a wonderful change, so long in coming! Now that you've gotten him here once it's just about gathering the data to keep him there

 

Thanks, all! Hoping for the best, and keeping my expectations low lol.

Hope i didnt screw up this dosing tonight.

 

Gathering data, Jen ...

 

I'll never understand how a dose one day puts him in blues and greens but the same exact dose the following days only gets him into the yellows. Why? Can anyone explain it to me? Three days ago it really had an impact. Why just that one day? How can it work such magic for one day only? How is it physically possible? Really frustrating. His legs have been so bad for months, and he still drinks and pees a lot.

 

The biggest possibility is that he bounced the next two cycles after some lower numbers.

The yellows aren't bad - under the renal threshold. So we can be glad he doesn't bounce too high.

And remember that insulin is a hormone. It won't have the same result each time. (Think if that teenager who is a sweetheart one day and a snot the next)

We have another annoying saying: It's just one cycle. Don't despair. He will get lower on other cycle.

 

Confused with increased bg at +3 today.

Vet appt later. Probably a waste of time. I'm not even getting into diabetes with her. Done flogging that subject. Overall he hasnt been a happy camper and i'm not sure if he's in pain or not.

 

Could be a bounce number from a possible lower BG during the night.

 

My little goober is constipated. His xray showed all kinds of poop backed up in his rectum. Intestines were clear. We're on miralax.

 

Sorry! I hope the miralax helps!

 

I've heard others on here say that constipation can affect their kitty's BG levels. Any other helpful feedback from the vet?

 

She thinks the constipation is defiitely uncomfortable for him, which is prob what i've been picking up on. He had been pooping regularly so i had no idea! I saw the xrays. Lots o poop.

She wants me to lower his insulin by 1/2 u and do a curve to see if we're hitting somogyi again.

 

Well i'm confused again. Its beeen a few days and we have not seen the good numbers we had initially when we did this last increase. why good numbers the day of increase and since then we have not seen that range again? Too much insulin now or too little?

I dont know if we should go up or down. I dont know if this is somogyi or if he is stuck again. Suggestions?

I dont understand why today with a relatively nice amps he has gone up quite a bit. What do you think?

14 months of diabetes and i still dont know whats going on.

 

Stuck and needs a small dose increase I think. Somgyi or not, staying in high numbers for many cycles gets them stuck there. I'd try upping to 4.2 u.