12/28 Meowzi PMPS 273, +3~137

[WCF and Meowzi]

arrrgggghhhh!

be back in a bit with yesterday's thread/responses.

 

[Jen and Oreo (GA)]

Her picture looks great

 

[Libby and Lucy]

yes, if you're able to link yesterday's condo I would like to read it (otherwise I'll find it again later). I saw it but didn't have a chance to study it yesterday.

 

[Cassandra and Sasha]

Here it is: http://www.felinediabetes.com/phorum5/r ... 22,1968184

 

[WCF and Meowzi]

Yesterday's post

12/27 Meowzi AMPS 258, PMPS 258
Posted by: WCF and Meowzi (IP Logged)
Date: December 27, 2009 10:33PM

Previous thread 12/23

WCR: She seems to be feeling pretty good. Going out into the LR and getting on her steps to look outside, playing with her new Hot Cats links. Even climbing onto the kitty tower (not seen in weeks, if not months!). Eating decent amounts. But BGs have been bouncing. I think.

I think this latest round of bouncies started yesterday morning when she dropped 41% in 2 hours. Anything more than 15% per hour sets her off. Here's a summary of the last couple of days:

12/26
AMPS ~ 256
+2 ~ 150 (-41%, or -20.5% per hour on average)
+5.25 ~ 113 (-8% per hour on avg)
PMPS ~ 199
+3 ~ 200
+5 ~ 162

12/27
AMPS ~ 258
+1 ~ 261
+2.25 ~ 192 (-21% per hour on avg)
+4 ~ 128 (-22% per hour on avg)
PMPS ~ 258

I did feed her breakfast late by an hour yesterday, but didn't think it was a factor. I fed on time this morning and still saw that sharp 20% drop; that confirmed to me that food wasn't a factor.

Looking back, I think similar bounces may have been happening even a month ago, around 11/26:
AMPS ~ 239
+3.25 ~ 76 (-21% per hr on avg)
...
PMPS ~ 221
+3 ~ 99 (-18% pr hr on avg)
That set her off on bouncies for the next few days. Some were mini-bouncies, not very noticeable unless I'm looking for it (or imagining it!)

Dosing team, am I imagining the bouncies?

If they are real bouncies, I'm wondering if it's foolhardy to consider shaving her dose to even out the bouncies before bringing her dose back up again. We did something similar after switching to Lev on 1/19/09 - the dose we started on was too high and just sent her on a bouncing marathon. Had to lower dose to level her out before we started working on bringing the curve down.

I had been reluctant to shave her dose; thought she'd just have to learn to ride this out, but she's now been above her r/t for three consecutive cycles. I got two positive urine glucose readings tonight. That makes me kind of antsy. Should I just stick with this dose or shave? Or raise, except that would set off even more violent bouncies?

That she's been able to hit the sub-150s pretty consistently, and sometimes even the greens, on this dose is suggesting to me that her dose is not insufficient. Or am I wrong?

eta: just wanted to add about her appy. DH thinks it's reliable now, but I'm not as sure as he is. I do think it's almost, but not quite, back to where she was at September where she would reliably eat on days 1 and 2 of mirtz. We're still handfeeding her 1/2 to 2/3 of her calories most days.

 

[WCF and Meowzi]

Responses to couple of posts

Cassandra and Sasha Wrote:
-------------------------------------------------------
> I'm not seeing bouncies like what you saw when you
> first switched to Lev. Had lots of pink back then
> as well as green - much more up and down. She's
> pretty flat now comparatively.

~ No, it's certainly not as volatile now as back then. She was getting twice as much insulin as she needed back then, IIRC. We started at 1.5u and had to drop very quickly to 0.75u. I'd always thought that was why the bouncies were so extreme then. *If* she's getting too much insulin now, it's probably only a drop or two too much. Shouldn't cause as extreme bouncies, no?

But it is a real possibility she may not be getting enough insulin. Now that she's getting more consistent calories, she may indeed need more exo. insulin help. I just wish there was a definite way to find out. The greens and light blues are throwing me off. Am I suffering from a case of can't-see-the-forest-for-the-trees?

If she has food on
> board at PS or +1, those drops could just be the
> food spike wearing off coupled with onset.

~ She does have food on board for most of the morning PS. She gets her small snack (1/8 oz) and Azodyl at PM+11, and I try to start feeding her breakfast by +11.5 or +11.75. Shoot around +12 of course.

But most evening PS she doesn't have food on board, save for the small 1/8 oz snack + azodyl + norvasc she gets at AM+11. Like tonight, I'm pretty sure she didn't have food on board for PMPS. (We get home at +11, give her the usual small snack.) I don't think we have ever caught her eating after AM+8. Assuming no food spike tonight.

I'm not so sure about sharp drops being caused by food spike wearing off coupled with onset though? I was thinking more along the lines of, her insulin onset is early and sharp, and food on board helps to soften it.

12/26
AM fed at +1 or +1.25 ==> could she have been dropping already at +1, b/c there was no food on board at AMPS?
+2 is 41% lower than AMPS ==> is +2 a combo of food spike from +1 wearing off, and onset?
but she was fed only an hour before +2. but let's assume it is indeed a combo of food spike wearing off, + onset.

12/27 fed at AMPS
+1 is flat ==> possibly could have dropped if there was no food on board, but since she was fed, that food spike from AMPS is countering onset to keep +1 flat?
+2 is 26% lower than AMPS ==> +2 drop is softer, less drastic b/c the food spike countered onset.

I'm driving myself crazy with all this. Doesn't help that my brain is fried; I was stuck in a 2.5 hr call with attorneys, blech.

> I would probably be inclined to fatten the dose a
> little just to see if the PS could come down a bit
> and keep her below renal - try and flatten the
> range out to mostly blue if that would happen,
> perhaps with a touch of green. Would probably
> start with literally just a small drop and
> increase verra slowly in hopes of easing her down.
> I understand why you may not want to do that,
> though, especially if her appy isn't what you
> consider to be back to normal.

I dunno - after tonight's PMPS, I was game. How much? But just got her +3 - arrrgghhh! I'm thinking if she hits even a touch of green, it will send her bouncing even worse. But if it doesn't, then a drop more could indeed extend her duration to get to a blue PS. (And yes, I'm still worried that she won't eat when she drops too sharply. I'm still not seeing consistent eating). Oh what to do, what to do ...

Another piece of the puzzle - she used to have early onset/nadirs, at around +3, to +5 at the very latest. Now her nadir has moved out to +6 or so. She's still nadiring in the light blues, same as before, but it's now moved out. And on the same dose too. This does puzzle me.

> Think the others will weigh in tomorrow with more
> ideas too.

Tomorrow's here

Cheryl and Winnie Wrote:
-------------------------------------------------------
> where is the mirtz in her cycle?
> both day and time ?

Every 72 hours, at AM+11 (5:30 pm). Latest dose was yesterday.

> *civie* wolf who has been getting some abynormal
> bg numbers, was highest on mirtz day.
> possibly a coincidence. haven't given again yet...
> cause had to f.fed anyways and fasting tonight for
> f/u bw am.

>

I had *thought* mirtz raised her numbers last year, but not significantly enough to warrant pursuing it further. Just something to keep in back of mind and shrug. But didn't diligently collect data to prove or disprove it.

> just wondering if you ever noticed any pattern --
> esp since she does have a strong reaction to the
> dose.

>

I can try and study her ss tomorrow. Brain fried today.

> Wolf's repsonses have also gotten increasingly
> stronger in a neg way to the mirtz on day 1. what
> about meowzi?

No, not too negative, I think. She's more anxious, sometimes takes close to 6 hours to get ravenous, and she can pace a bit, sometimes yowly, but she doesn't seem too distressed. Have you considered shaving Wolfie's dose? Not by a full 1/4, but just take a butter knife and shave a little powder off?

> give the princess and her pal callie a pat for me.

Did Meowzi purred and Cali tried to swat me LOL. She doesn't like physical contact unless it's on her terms.

Hope the cysto and blood draw went well today.

 

[Jill & Alex (GA)]

choy-foong, something's wrong with the link to her ss.
i can't open it...

 

[WCF and Meowzi]

oops. sorry, jill. it's fixed now.

 

[Jill & Alex (GA)]

thank you!

i dunno. looks to me like a classic case of insulin needs changing. i think i'd increase the dose rather than decrease.

 

[WCF and Meowzi]

she's now at 0.75u. we can raise in morning. raise to fat 0.75u (skinny 1.0), or straight to 1u?

you don't mean change her cartridge, right? we just changed it on christmas eve.

 

[Jill & Alex (GA)]

no, didn't mean to change a cartridge. sorry!
because meowzi's appetite changes from day to day, i think i'd start sneaking the dose up every 3 - 4 days.
i'd try a fat 0.75u first...

 

[WCF and Meowzi]

okie dokie, one sneakcrease coming up in the morning

thanks, jill, cassandra, cheryl and libby (who's probably still working on my book :lol: )

 

[WCF and Meowzi]

Re: 12/28 Meowzi +5~172

and up she goes again ...
at least UG is negative at +5
UG was positive at +0.75

ni ni, all!

eta - do we add link to today's condo to tomorrow's thread?

 

[Cheryl and Winnie]

mirtz issues reply

Responses to couple of posts

Cheryl and Winnie Wrote:
-------------------------------------------------------

I had *thought* mirtz raised her numbers last year, but not significantly enough to warrant pursuing it further. Just something to keep in back of mind and shrug. But didn't diligently collect data to prove or disprove


No, not too negative, I think. She's more anxious, sometimes takes close to 6 hours to get ravenous, and she can pace a bit, sometimes yowly, but she doesn't seem too distressed. Have you considered shaving Wolfie's dose? Not by a full 1/4, but just take a butter knife and shave a little powder off?

was a thought... just a little observation on limted tests for my wolf. last dose he was really pacing and yowling seemed to last long time, but prob. in time frame you mention. plus he wasn't eating on it. well not enough and had to Force. so stopped and force fed for a week no mirtz. today after the fast he has eaten the most in long time on own no mirtz. still needed bup. so wondering if build up tolerence to long term mirtz . but meowzi has been eating better lately.
his numbers were higher (mid 200s) the mirtz dose day. but then I have not been testing so much as you.

will post re his bw on community if i can find it lol
thanks for well wishes.
if you find any pattern w/ mirtz pls let me know. am curious.