7/16 Philly AM 147 (NS), +1 154, +2 145, +3 173, +4 198

Recent

I give up. Yesterday I did a curve at my vet's request because Philly has been in falling numbers at shot time. She wanted to see when nadir is and asked me to skip the evening shot. Yesterday he was beautiful. He went from pink to blue within two hours and raised as it got closer to shot time.

My vet said since he was climbing, if he was in the 300s at shot time, go ahead and shoot, so we did.

I tested at +6 and he was still in the 300s. I fed him this morning and tested at AMPS fully expecting 300s. Nope. 147. What the heck is happening? I couldn't do a true stall since he ate while I tested him. He had a tiny rise at +1 from the food and back to AMPS level at +2. He's now up a bit at +3. I expect he'll skyrocket through the day with no insulin.

Normally I would've shot the 147, but I wanted to try to get meaningful info for the vet. I'm not sure what is meaningful at this point.

 

The depot is a wonderful thing. Continues to give you some nice numbers for a while, even after a missed shot. Starting pink overnight and ending up blue in the AM was Neko’s favourite type of cycle for the longest time. Looks like Philly has done the slide to blue a few times overnight now.

If you are comfy shooting a 147 and around to monitor, no need to stall, unless you want to see where he’s trending. But now you have some good data which will help you next time.

 

Thanks. The vet wants to see when he hits nadir on a day when his preshot number is lower than a mid cycle number. I keep thinking that would work on a non-depot insulin, but I don't know how to get meaningful data when he has a depot. Yesterday he was at his lowest at +2 and at +4 before raising slowly. Overnight he was at his lowest at +12.

Is it possible to find a reliable nadir or do a meaningful curve with a cat that uses a depot insulin and is literally different day to day (and night)?

 

What is the reason for the curve or finding the nadir in such specific circumstances? Here we decide on changing doses primarily based on how it takes the cat, regardless of when it is. Neko’s Lantus nadir was reliably between +3.5 and +13. The former when angling for a reduction, the latter when breaking a bounce or really good duration. If you look at spreadsheets for cats on non depot insulins, you will also see “variability”.

 

She wants to understand how his body is using the insulin, whether he continues to drop over the course of 12+ hours or if he hits nadir, goes back up, a d drops again. She has said a few times that she thinks something else is going on with him to cause the fluctuations in numbers, but we've done bloodwork, xrays, echo, and EKG.