? Very high number out of the blue!

Hi, everyone--

I'm looking for advice again--so confused. We've been making progress with Misha--we finally started getting some blue and green consistently. But that has been mostly at night--and he has dropped below 50 several times (below 40 a couple of times). Because of that, we've been reducing the dose pretty rapidly, in increments of .25; we went from 2 units to 1 in the course of 10 days.

This morning, totally out of the blue, I got a 389! Tested again and got 379, so I don't think it was just a wildly defective strip.

I don't see how he could've eaten anything inappropriate; we don't even have high-carb food around any more (outside of the hypo kit), let alone out where he could get it. We did introduce some raw food during the last few days, for some of his meals--he had been getting freeze-dried for various reasons and we are trying regular--but otherwise nothing has changed.

What could be happening??? Is this some kind of epic bounce? Does it mean we should have reduced further/faster? And the daytime numbers are so different from night (though I don't have as much +8 to +11 daytime data as I want, because of work). [The raw food is ground rabbit and rabbit organs from Hare Today, with the eggshell calcium Alnutrin supplement added as directed--no vegetables, nothing that should be carb-y.]

I really have no idea what to do. We went ahead with 1 unit this morning. I can test him at +2, and I guess maybe I can come home from work really early and catch him around +7, though I've been out sick a lot recently and am way behind on things--but what should we do tonight, if the preshot number is still high--or if it's under 100 again?

Any advice? Has anyone seen this kind of pattern before?

 

I'll leave it to the more experienced member to chime in, but just wondering, if you are following TR, why the reduction on the 18th?

 

Yeah, that was a judgment call rather than a TR-dictated move--possibly the wrong call. I was concerned about giving the regular dose based on the lower-than-usual pre-shot number and the recent dives into the 30s/40s. I had been wondering if the dives might mean we were actually giving too much insulin and creating some kind of "crash and spike" pattern. I thought that a lower dose might give us some information about that, and might also spare me from spending the night doling out medium carb food--I've been sick a lot lately and really wanted to be able to sleep. So much for that theory, I guess, because we still got a 42, and then this really out-of-character 380-ish one; if that's information, I don't know what to do with it!

 

She's been giving you a run for the money. With those 30's you have to take the reductions as you have been. Looks like mini bounces during the day from the lows at night. Many kitties run lower at night There was no choice but to take a few reductions very close together which means the depot may have been influencing some of the following low numbers. See what she does the next few cycles and if the numbers don't come down take her back up to 1.25u.

 

Thank you!!!!!! I hadn't thought about how the depot might be continuing to have that kind of influence even with the reductions, but that makes sense. They really do like to keep us on our toes, don't they? I guess if he has to go ultra-low, I'd rather that he do it at night, when I'm at least in the house--but if things would flatten out a little, that sure would be appreciated.

 

Don't wait too long to bring her back to 1.25u but would give her at least a few cycles so the depot stabilizes.

 

Maybe I'll go ahead with the lower dose tonight and tomorrow morning and then re-evaluate tomorrow evening...

 

Human contraband? Something dropped on the floor? It happened here. We are super careful but it was a crazy evening and I know that had to be it. Shot Gizmo to black.

Just being a cat?

I think that sounds like a plan.

 

So scary, Gizmo! Oh my!!!

Whatever happened with Misha, he is now back at a reasonable (for him, lately) preshot number in the mid 200's--went ahead with the 1 unit and will see what that nets us tonight. Cats are such a mystery!

 

For what it's worth, we are usually more aggressive with kitties coming back from remission, and going for either an under 40 or one week in normal numbers before earning a reduction.

The larger depots can influence 4-6 cycles after a reduction. The 1.5 u depot should have been out of the system by last night. You also have to get used to shooting full dose on green preshots with TR.

 

He hasn't ever had a whole day of normal numbers yet, poor guy. The below 40s were what freaked me out. But I guess he hasn't actually had one of those since we went below 1.75--just things in the 40s. So I guess I should have stayed at 1.5? I'm ok with shooting something when he's in the green; I was just afraid to do the whole dose, in the context of the repeated lows. But I know I'm not supposed to alter the dose out of cowardice or go up and down with it I repeat to myself the "you're not shooting where the cat is now; you're shooting where he'll be in a few hours" mantra, but it doesn't always work.

Maybe I'm too chicken to be doing TR--I worry that we'll miss something when we're at work, and being up with him every night is hard. I do want to do everything I can to try to get him back into remission, though.

So should I not be as afraid of things in the 40s as I currently am? When he's had them, I've been "steering" with medium carb food, so I don't know how low he might've gone without that...no way to know, I guess, except to keep testing frequently and not do the feeding until he actually does hit something in the 30s? Right now I've been thinking of it like "Well, ok, kitty, you're staying in the 50s, so we're good here...uh-oh, you hit the 40s--time to turn you around! This is bad!" Maybe it should be more like "Hmm, you hit the 40s--we need to keep an eye on you and make sure you don't go into the 30s, which would be bad."

I have got to learn more about how the depot works. And I wish I were better at interpreting his spreadsheet...then I might feel less dismayed next time there's a green preshot number...

 

Think of it like a time release pill. You get some when you take it and then it slow releases - but it is the body doing it and it isn't a pill it is a hormone.

Duration of the shot is different than the depot. When the AM shot is wearing off you get the rise at the end of the cycle. When you shoot it takes a bit for it to start working. The depot is the reserve the body holds on to despite the duration.

Lantus & Levemir - What is the Insulin Depot?

 

Ah--so the depot is releasing insulin at a fairly constant rate? More like a time-release pill and less like, say, a gas tank? I guess I was thinking of it that way--like just a tank of extra insulin that would be released only as needed, rather than something that was sort of continuously being released. Interesting! Thank you!

I'm pleased to say that he's at 154 at +3--maybe not quite where I'd like him to be, but he's definitely backing off from the 380s, thank goodness! I'll check him again in a couple of hours. I really appreciate everyone's help! I'll post updates if anyone is curious!

 

I was saying he didn't earn a reduction to 1.0 units. If you want to stick to it, that's fine, just be ready to go back up if he doesn't hold the reduction.

 

Went back up this morning since my husband is home to keep an eye on him--haven't yet heard how that is going!