10/29 Clare AMPS 358; PMPS 342

Dear LL Friends,

Clare was diagnosed with diabetes in June and since then we've been very fortunate to have found the Board and our friends here, and have benefited from your wisdom and experience greatly.

I feel we're at a crossroads, in part because we've been hovering around the same dosage for quite awhile, and Clare continues to bounce. To be honest, since I don't have the experience that you all do, I can't tell if we're making any progress or not. She's doing quite well overall, I think, but I can see that the dives and bounces are hard on Clare.

So I was wondering if we should try another type of insulin? Or raise her dose a bit again and wait? Or is there something else that we should be doing now that we're not doing? Is Clare just one of those hard-to-regulate kitties and we just need more patience?

Any guidance you can offer would be much appreciated, as is the huge amount of encouragement we feel from all of our friends in LL. If you do see signs of progress in Clare's condition, some specific information on that would be very helpful at this point.

Thanks,

Georgette and Clare

Re: 10/29 Clare AMPS 358; PMPS 342 Question about insulin?

I don't have any answers about Clare's dose, but I can tell you that Furball used to bounce a lot and have high numbers a lot of the time when she was first diagnosed. I didn't think she would ever stop bouncing and start having blues and greens most of the time. Then suddenly she just started having better numbers. Some kitties just take a while.

I would suggest that you ask in your subject line each time you think an increase is needed so those who have more experience can help guide you. I learned if I waited too long to increase that it would take more insulin to get Furball back on track. Sometimes I still have to give her a little extra juice for a couple of days to kickstart her back into better numbers. Hopefully Clare will start seeing some more blues and greens soon.

Re: 10/29 Clare AMPS 358; PMPS 342 Question about insulin?

Ugh Clare bear - pink is not a cute color on FD kitties! Unless she sees some action on tonight's cycle, I would increase her again. It's been 6 cycles since the low and she should be over the bounce. I know she got some lower numbers on this dose, but I'm making the suggestion based on how much you test. Clare just doesn't seem to be spending much time in healing greens. One strategy for cats like this is to boost the overall carb level of their food and bump up the dose to try to bring down the highs. Or like Carla mentioned, sometimes they need a few cycles at a higher dose to get them going.

A different insulin is definitely something to think about. We suggest people give Lantus 6 months to see what it's capable of before switching. Some kitties go flatter on Levemir, and some still bounce a lot. Switching insulin is a bit of a risk because you don't know before hand how Clare will react to it and you have to learn her cycles all over again. The down side with Levemir is it's later nadir. The typical onset is around +4 and nadir around +8, but I've seen a bit earlier or later. Neko is typically around +9 to +12. I do get to shoot low a lot. The later nadir doesn't always work for people's schedule. +9 to +12 works for me because I'm always here for PS and for 8 months of the year I get up at +9 4 days a week for rowing. An up side for Lev is also it's later nadir - I have quite a few hours after shot time to feed her and bring her up before onset. I get out to a lot more dinners now. Because Neko is flatter on Lev, I'm glad I made the switch.

Re: 10/29 Clare AMPS 358; PMPS 342 Question about insulin?

I'm looking at your chart and seeing that Clare has her own private elevator.

on 10/19 and 10/23 she went from pink to green in just 3 and 4 hours.....
that says you can't just see a pink and think she's in the clear..... she may be doing it when you're asleep.
Obviously you have to sleep sometime, but it might be good if every so often you get that +8 or +9 or +10 in the pm cycle.....
see what's happening. Those random reds are responding to (bouncing from) something....

You can also start manilpulating more with the food you give when you see lows coming..... help her flatten out.
I know it's hard to be patient.... but the big picture isn't all that bad.
You are getting some greens....

Thanks very much, Carla, Wendy and Rhiannon,

I think the consensus is that we should stick with Lantus for now and raise Clare's dosage, use the food more to manage her highs and lows, and hope for fewer and shorter bounces as a result.

We've been seeing more confusing patterns like tonight's, where we had a drop at +1.5, so we gave her some 8% thinking she was going low, then getting 387 at +4. Hopefully the stronger doses will get her back to more regularity. I know she's not trying to be difficult! :roll: At least I think so ....

Rhiannon, I'll try to do some PMPSs +9s or +10s to see what's happening there. I usually wake up at about that time to check on Clare anyway.

Thanks for all of your advice. We'll keep on keepin' on,

Georgette and Clare