6/27 Bella AMPS 190, +6 139, PMPS 209, +3 188, +4 152 | Feline Diabetes Management Board

6/27 Bella AMPS 190, +6 139, PMPS 209, +3 188, +4 152

I saw that Chris suggested a dose increase yesterday. Perhaps Bella needs a bit more insulin to get her numbers down into more steady, healing numbers.
 
You need to increase the dose. I read back that you may or may not have had a bad box of insulin. You started the new insulin on 6/14. The depot takes 5-7 days to build, I'm going to say 5 for the lower dose you were at. The depot was back in business by the end of the 18th. You waited one more day then increased to 0.5 units which is what you needed to do. There is no more waiting for the intial depot to build once kitty has been on insulin those initial 5-7 days. Now you are just waiting for the depot for that dose to build.

When following TR, we can hold doses with green nadirs (note the plural) for 5 days, today is day 8 of this dose. Her nadirs are pretty high greens. She's overdue for that increase. Plus it's the weekend, so perfect timing.

There's a reason we push for those increases, and it's that a kitty can get glucose toxicity if they spend too much time in higher numbers. That means their body gets used to those higher numbers and it takes even more insulin to break through. I want Bella to get back to those pretty blues and greens. Lingering overly long at a dose that isn't getting her there won't do it.
 
Wendy&Neko said:
You need to increase the dose. I read back that you may or may not have had a bad box of insulin. You started the new insulin on 6/14. The depot takes 5-7 days to build, I'm going to say 5 for the lower dose you were at. The depot was back in business by the end of the 18th. You waited one more day then increased to 0.5 units which is what you needed to do. There is no more waiting for the intial depot to build once kitty has been on insulin those initial 5-7 days. Now you are just waiting for the depot for that dose to build.

When following TR, we can hold doses with green nadirs (note the plural) for 5 days, today is day 8 of this dose. Her nadirs are pretty high greens. She's overdue for that increase. Plus it's the weekend, so perfect timing.

There's a reason we push for those increases, and it's that a kitty can get glucose toxicity if they spend too much time in higher numbers. That means their body gets used to those higher numbers and it takes even more insulin to break through. I want Bella to get back to those pretty blues and greens. Lingering overly long at a dose that isn't getting her there won't do it.
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It’s just so frustrating that all this happened because of bad insulin. Now she has to take all these steps backwards when she was doing so good on the 0.15. Now you’re saying she needs 0.75. It’s like this whole year was a waste with the progress she made over something I couldn’t control. Now for every decrease I have to wait for her to go under 50.
 
Bella would be considered a long term diabetic, since it's been over a year since diagnosis. That means reductions with TR if she goes under 40, or spends a week in green. If you consider a cat that doesn't hold reductions well, you can also reduce if she goes between 40 and 49 on three separate days.

But she won't earn reductions on this dose. Doses go up and down, the numbers that matter are the blood glucose numbers. Over the almost 5 years of diabetes with Neko, she went up to 8.75 units, down to 0.75 units, back up to 7 units, back down to 0.25 units.
 
Wendy&Neko said:
Bella would be considered a long term diabetic, since it's been over a year since diagnosis. That means reductions with TR if she goes under 40, or spends a week in green. If you consider a cat that doesn't hold reductions well, you can also reduce if she goes between 40 and 49 on three separate days.

But she won't earn reductions on this dose. Doses go up and down, the numbers that matter are the blood glucose numbers. Over the almost 5 years of diabetes with Neko, she went up to 8.75 units, down to 0.75 units, back up to 7 units, back down to 0.25 units.
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My other question is if she’s getting these lower numbers like under 120 but she’s bouncing -
Wouldn’t giving her more insulin make her go even lower and bounce even more? I feel like the bouncing is what’s causing her high numbers.
 
She's bouncing because she's not used to green anymore. They are infrequent entries on the spreadsheet lately. She needs to see more green to stop the bouncing. More insulin can also help bring down some of the higher numbers.

Bouncing is not a bad thing to be avoided. It's a sign that the insulin is working and bringing her into numbers she's not yet used to.
 
Wendy&Neko said:
She's bouncing because she's not used to green anymore. They are infrequent entries on the spreadsheet lately. She needs to see more green to stop the bouncing. More insulin can also help bring down some of the higher numbers.

Bouncing is not a bad thing to be avoided. It's a sign that the insulin is working and bringing her into numbers she's not yet used to.
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I don’t want to come off like I’m fighting the advice….I’m just really frustrated and overwhelmed by everything. I’m angry this happened especially when she was so close to another reduction of 0.10 or whatever comes after 0.15. It’s like we’re back to square one and wasted a year of progress.

We did 0.75 tonight … I was reluctant but I want her to get back to greens and blues.

How long do I have to keep her on this new dose?
 
I'm hoping it'll be just a short stay and the more insulin kick starts her pancreas healing again. Doses are typically held 6-10 cycles, depending on the nadirs she gets on this dose.

Good luck.
 
Wendy&Neko said:
I'm hoping it'll be just a short stay and the more insulin kick starts her pancreas healing again. Doses are typically held 6-10 cycles, depending on the nadirs she gets on this dose.

Good luck.
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Okay so 3-5 days. I was also away since yesterday and I hope that didn’t add to her higher numbers last night and today. I feel like she’s been a little extra anxious. She’s always shown that she has anxiety but I just feel like it’s more now. With everything that’s been happening I’ve been over analyzing everything she does. I hope it’s a short stay as well. And to add to the over analyzing I’m obsessing over how her insulin looks. I will attach a picture, they just look like small bubbles to me but when I turn the pen to the other side they don’t move and with everything they happened with her insulin I’m extra worried.

I appreciate all the help ❤️IMG_8487.jpegIMG_8488.jpeg
 
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Hi Jen, You're relatively new to the forum, so I wanted to explain just a bit about the people who are on here offering guidance. We don't have "admins" on this forum (like they do on FB), other than Tim, the technical administrator. We have moderators (Wendy is one and there are a couple others) who offer all kinds of guidance but also have other forum responsibilities. And then we have what Tim has titled over on this new board, "well-known members." These are people who have been around the forum a long time, and who have considerable experience with feline diabetes. Chris, who was offering you guidance yesterday, is one of those well-known members. I would trust her advice any day--as well as the advice of the other well-known members on the forum. Over the time that I have been here, I've come to value their input. Ultimately, it is up to us (up to you) as caregivers to decide whom we will trust, of course, but if you see a well-known member, I just want you to know that they very likely are bringing the voice of experience to the discussion.
 
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