The Ultramarathon Part 20

AMPS was 23.6. No surprise. Now to gradually edge him back up in dose. Glad I didn't drop back too much last night. I gave him 2.3 u this AM.

 

BG at +5 was 10.4. I like it!

 

PMPS was 26.1. Bounce! I gave 2.3 u again. Will go up a tiny bit tomorrow AM if he doesn't nose dive. I want to keep him moving or he'll get stuck and we'll lose momentum.

 

AMPS was a bouncy 23.7. I'm dosing this AM based on yesterday's +5 and I'm not holding a dose more than 2 cycles for now because he stalls too easily. I gave him 2.4 u this AM.

 

Wow, exciting times in Teasel-land again!

 

BG at +3 was 20.9 and then at +7.5 was 14.7.

 

PMPS was 18.9. I gave him 2.4 u.

 

AMPS was a lovely blue 11.1! Enjoying it while it lasts. I gave him 2.4 u.

 

Arrgh! BG at +4.5 was 18.2. Probably bouncing off a low overnight. Marching on ...

 

Come back down to blues, Teasel! It's much nicer there

 

PMPS was 22.2. I gave him 2.4 u.

 

AMPS was 21.7. I gave him 2.4 u again because I'm allowing a third day at this dose to see if the bouncing will clear. Not that I expect Teasel to follow any of the rules ...

 

BG at +5 was 14.9.

 

PMPS was 12.1. Bounce is breaking I guess. The problem is he'll go right into another one. Life with Teasel ...

I'm giving serious thought to trying him on Lantus again. The first time around I was totally clueless and followed the standard vet protocol of dose, wait a week, do curve at home, dose, week, curve ... over and over. I don't for a minute think that Lantus will be the cure all. I'm just interested in seeing whether I can make its positive attributes work to his benefit with what I know now. I've looked at a lot of SSs on the L&L forum and I still see rubber kitty syndrome over there. No easy solution.

 

Hmmm...Lantus might work better? Maybe post over there..I know you've already used it so you have some experience, but they might be able to offer stories of kitties like Teasel and what they did?

 

Hi Rachel,

I'm conflicted because I really don't see Lantus as an "easy" solution given Teasel's unpredictability and bounciness. I usually have an easy time making decisions when benefits are obvious but that isn't the case here. It really does feel like six of one, half a dozen of the other. It's mostly to satisfy the "what ifs" in my head.

 

Hi @Kris & Teasel. I know you have looked at my Rom's spreadsheet, but have a look at Frankie's too. He started on Caninsulin and swapped to Lantus in April 2015. Go back to last year August time. Before that, he was one of the bounciest cats on here, but suddenly....he just stopped. It takes patience in some cats, or others like Rom it's an immediate positive reaction.

 

Yeah I'm not sure there is an "easy" solution for Teasel! You could switch back to satisfy those what ifs...I guess I'm conflicted on advice too. We've had some switch over who made the right choice...Bubba sticks out in my head with his late nadirs (he nadirs at preshot time...Lantus allowed him to have doses at the right time and has gotten him into remission once I think). But with bouncing...I just don't know. I'm still reminded of Cass who bounced for 2 years on prozinc until remission.

 

Thanks so much for replying Sue. I'll check out Frankie's SS.

 

AMPS was 22.3. I gave him a fat 2.4 and called it 2.45 u on my SS.

Prediction:

1. he'll go too low by PMPS,
2. I'll either have to stall before shooting or use my feed/wait/retest/shoot method (that I actually like better),
3. I'll reduce the dose a tiny amount and
4. we'll repeat the last 4-5 days of numbers.

Oh well, no point getting fussed ...

 

No problem. I've replied also to your request on my post yesterday about Rom's experiences on switching.

 

BG at +6 was 16.1. PMPS was 19.6. I gave him a fat 2.4 u again.

 

Teasel says "Ha" for trying to predict him.

 

Yes, Pati, he's laughing at me today because my prediction was wrong. I should know better than to try predicting Mr. Unpredictable!

AMPS was 23.4. I gave him 2.50 u.

 

PMPS was 21.5. Gave him 2.5 u again.

 

AMPS was 24.3 so I increased very slightly to 2.6 u. He's getting stuck and needs to be shifted. He might take it as a big shove rather than a gentle nudge though.

 

I was just wondering that exact thing yesterday with Morris. Do you think slight changes might not be enough to unstick them? Referring to 2.5 to fat 2.5 vs 2.5 to 2.6 or more using Teasel's dose as an example. Do you think by slight changes that they could become sort of immune to the increases? Not sure I'm articulating my question very well. I think with Teasel you are saying he could take it as a gentle nudge or he could react strongly. Is this an ECID?

 

Yes, Pati, ECID. I've learned with Teasel that he overreacts to increases that are too big, ie., 0.2 u., most of the time ... very unpredictable.

 

So I just "experiment" with Morris until I understand him as well as you understand Teasel's responses. But do I possibly cause harm by being too conservative with my step up doses - 3.8 to 3.9 (fat 3.8, skinny 3.10) vs 3.8 to 4? Do some cats kind of become "desensitized" to the increase when it is such a small amount?

 

ECID Pati. Too conservative can keep them higher than we like for too much of the time and it can cause insulin resistance to build. That's desensitization. I'm sure I'm guilty of being too conservative with Teasel because of his extreme variability. Rock and a hard place ...

 

Hi Kris - just popping in to say Hi. I understand how difficult it is to decide whether to switch or not. Have you thought about Levemir instead of Lantus. I originally chose Levemir when I switched because @Cara and Wynken (GA) went to see a feline diabetes specialist in OSU and he recommended Levemir- so that is why I went with that. Just a thought - since you already tried Lantus - no easy answer here

 

Hi Carol,
I'm still trying to decide. I know high dose kitties might not like the sting of Lantus but Teasel isn't one of those. As you said to me a long time ago, "It's less about the insulin and more about the cat." I know that my vet is familaiir with Lantus but has no experience with Levemir. That isn't really a factor though because she didn't know ProZinc either and I do everything on my own anyway. Let the Universe unfold ... a decision will come.

 

PMPS was 15.9. Gave 2.6 u again.