1/13 Muffin +2 / 84, +3 / 45, +3.5/72, +4/133, +5/195, +6 /183, +7/173, +9/174, PMPS +1.5 431

Yesterday

This AM after eating about 2.5 oz of FF classic, his BG was 150.

 

moved from old thread:
i know lower numbers can be scary but hypo range is generally under 50 so he's stayed safe, if left untreated yesterday he may have dropped down under 50 but we are still dialing in the dose. It is more work but the numbers do speak for themselves. since hes begun the new protocol he hasnt had a single high number (black purple or red). these are the first days on your spread sheet he hasnt had high numbers. He is playing ball finally and seems to want to stabilize, we just need to dial the dose in, for such a large kitty its a great sign that he is working the dose down and not up. Running the protocols here can be alot more challenging then doing what the vet recommends but when the numbers speak for themselves you will hopefully find it worthwhile.

As for this mornings dose i would wait a half hour and see what his reading is then and in the meantime post and a new thread maybe and see what people think about another reduction based on last nights numbers. you didnt technically get a reading under 90 but if you believe he went under 90 then i would think another reduction would be ok.

 

I can't give you any dosing advice but wanted to say that he's looking good! Someone more experienced with dosing info will weigh in soon. Glad you are going to let the experienced peeps here help you. They are so knowledgeable and know lots more about FD than the vets do.

 

@Lukewithcats -

It looks to me like yesterday's AM +2 and +4 were both below 90. Since Marilyn is following SLGS, then Muffin met the guidelines for a dose reduction.

 

she did reduce for the evening shot from 3 to 2.75 but then with that reduction it looks like she may have dropped to 90 or lower during the night but its a guess so i just am not sure if the dose should be held because we didnt see it hit 90 or if it should be lowered on suspicion it hit 90

 

Marilyn when exactly did you feed the 2.5oz of FFclassic, was it @+11? Have you shot yet? or are you stalling?

If it was @ +11 I think you will need to delay shooting till @ least +13 so we can see a preshot number that isn't influenced by his food? Is that correct @Sienne and Gabby (GA) ?

Are you in today? can you monitor? Muffin, have you got supplies?

Sorry so many questions and no answers for you.

 

I fed him right before his shot after the 134 and 150 readings.

 

thats fine. that makes it easier on us too afraid to post dose suggestions lol. I just don't have the experience to suggest much so i just try to point things out instead.

You should do what you are comfortable with and you know your cat better then anyone so your opinion does matter. Its tough when we think a reduction is right but we missed the readings that prove it. you can always go back up though if need be, we are still in early days and he is doing very well. i think you made the right decission to come here, his numbers are really looking great compared to the rest of his spread sheet. hopefully you will get some breathing room today.

due to the lower then norm AMPS you should certainly keep your eye on him in the early hours especially since hes been diving early.

 

Marilyn could you please clarify what you have done to make things easier going forward

as I understand this is the morning so far please confirm or correct
+11 134 then fed 2.5oz ff pate
amps 15o fed 2.5oz ff pate then shot a reduced dose of 2.50u

Is that correct?

 

Oh yes, I forgot get a +1 test in as that will give us a better idea of which way Muffin is heading for this mornings cycle.

 

+11 134 then fed 2.5oz ff pate
amps 15o then shot a reduced dose of 2.50u
+1.5 test at 121

 

thats a decent +1.5, so far so good. hopefully we will see some professional surfing today.

 

i'm curious Marilyn, was it your vets idea to home test? What about the spread sheet? If your vet was supportive of these things then I think you can probably let him know at this point what is going on and that something has changed with Muffin and hes reacting MUCH better to the insulin then he was. If you are lucky enough to have a caring vet that gave you good advice then it can't hurt to keep him informed especially when you have great news.

 

Great job monitoring Marilyn…. Muffin looks like she is responding very well to your care. The experts here are amazing … and it looks like your getting the hang of this much quicker than I did! I understand about those lower numbers and… I am no longer afraid of them as I have enough data to know what my boy will do and when I should intervene…. you are in good hands

 

Just as an FYI...

It's best to not feed at +11 unless you are seeing numbers below 90 (since you're following SLGS). You don't know if Muffin's numbers will rise spontaneously given that it's late in the cycle and the previous dose of insulin is wearing off. Feeding that late in the cycle can give you false confidence with regard to the pre-shot number.

Since you reduced last night, I would not have reduced again this morning. An alternative, might have been to delay Muffin's shot by 30 min and not feed her in order to see if numbers were rising. Ultimately, you want to be able to shoot lower numbers since this will often result in a flat curve that's in good numbers. However, if you are going to shoot progressively lower numbers, you need to be available to monitor so you learn how Muffin responds and have plenty of strips and HC food on hand in case you need it.

 

Darn - here we go again - +2 / 84

 

its ok Marilyn, just test again in 30 mins so we can see how fast he is dropping. I guess since its below 90 you could maybe try to feed and add in a quarter/half teaspoon of gravy or a few drops of syrup but take it easy, anything above 50 is ok, it is early in the cycle though so you just need to keep testing and keep your eye on him.

 

My guy drops fast too--I have been working with trying to flatten the cycle with food--maybe some expert eyes will check in to help you with getting "ahead" of the drop--I am not experienced to offer advice to someone else. As long as you know your cats cycle I will say it has been really helping us-
Drevon was 170 amps=+1/103…. I intervened with food (regular low carb and a little HC) but don't want to "abort" the cycle… it is a balancing act. I would test in 20 if this was Dre-

 

don't panic--you got this

 

test ???

 

It was my idea to home test. Muffin is a VERY HIGH STRESS cat and taking him to the vet to check his BG was getting old - fast. He will not go into a carrier, so I have to put him into the car and he was starting to catch on to what was happening when I picked him up. I stumbled across this site when I was searching for information about FD. I needed help keeping track of Muffin's numbers, thus the spreadsheet. The vet is fine with me home testing and he even suggested doing a test right before I brought him in to see how the BG at home vs. the office compared. The numbers were almost dead on. I was chastised once by one of his assistants for changing the dosage right before bringing him in for another check, which is why I am hesitating about telling him.

 

+2.5 / 54

give food??

 

I think that's low enough to treat somewhat agressivly. I would give around a table spoon of gravy if you have it. that will raise it for an hour or 2. You should keep testing every half hour just incase.

It looks like that decrease this morning was a good thing. Muffin is certainly far more sensitive to insulin now then he was a few weeks ago which is great.

 

I agree --if this was my kitty I would give regular low carb and a tsp high carb-if your kitty is not carb sensitive I would give a table spoon of HC with regular low carb--

 

He's carb sensitive. Gave him the low with tsp of HC. Testing in 30.

 

I would be testing every 20 min at this point until he get above 60.

it is early in the cycle and he has dropped quite quickly.

 

Looking at your ss it is similar to Drevon--seems the drops slow at about +4
the food should keep Muffin safe/still good numbers and hopefully she will surf after the +4 but monitor if you can-fro Drevon at +4-5-6 he stays with in 10 and then he goes up-
I have been giving him a little HC at shot time to slow that drop and test more in the early hours to see if I should add more HC-(today at +1 he got a tsp)

 

I would test in 20-

 

please post next test-

 

You are doing a great job monitoring him Marilyn,

Getting that 121 @ +1.5 was an indication, based on passed performance that Muffin was going for a fast slide, it can be helpful to try to slow them, by feeding some food then, right as the start to drop, I have found that this works for George, and Jayla has also had that experience.

For when you have a similar situation I'm going to Quote Chris and Chinas post last night:
When you see a fast drop like that so early, it may help to feed a little food that's higher carb than her "usual" food and see if you can slow down those big drops and once you slow it down, go back to just feeding whatever low carb you usually feed. ECID though and it will just take some experimenting to see what carb percentage works best for Muffin!! Keeping good notes on your spreadsheet as to what you feed and when will help later on when you're faced with the same kind of situation.

You may just need to use some food that is still LC but higher than his usual, for example for me I use a 7-9%LC that is higher than Georges usual 2%, and usually that slows him up. I have 14% on hand and 30%(for when it gets hairy)

Waiting for that next test, I hope he comes up for you.

One other thing you may want to think about recording the feed times on the remarks on your SS as amps +1 +2 etc, over time you may change the time you shoot or if you stall and end up shooting at a different time, it will become difficult to tell where you fed in relation to the cycle which is really what you will want to know if you are ever looking back. Also it's easier when we are trying to help you you have people helpping in different time zones. Just a thought.

 

+3 / 45

gave him Karo syrup & HC food

 

well done test again in 20

 

seems like Drevon is on the same page--+2/42 AT!
he is eating now-
looks like we will both be monitoring ...

 

how is Muffin doing Marilyn? you doing ok?

 

+3.5 / 72 whew

test again in 20

 

It's noon. Time for a glass of wine!!

 

You could go to 30 min now but that's your call.

LOL you probably feel like you need one!

 

GREAT JOB!!--72 is a great number--testing in 20 is perfect! Hopefully your out of the woods
30 is good too since your at 72….like @GTS says--your call

 

It is a good number, but, it's still early in the cycle and based on yesterdays performance he may need monitoring and tweaking with food for a while yet.

 

there you go and we are nearly at +4 when the insulins effect starts slowing down so I would just stick to normal food for now unless you get another low number (55 or less). Since we are starting to clear the big drop period the HC will have more effect if he needs it.

The good news is muffin gets another dose decrease tonight! He's really working that insulin hard. It is really great how well muffin is reacting to the medications. I know this is hard on you but this is really great news for Muffin. Its hard to believe he was getting 5U shots just a few days ago. It looks like you picked the perfect time to come here.

Just keep testing every half hour for now and hopefully he will start surfing. Enjoy your wine you earned it.

 

Sorry to disagree @Lukewithcats ECID and I don't think there's enough data to say that Muffin will stop dropping by +4, some cats can be all over the place with their Nadirs, I would remain vigilant at least Up until +6 and then some.

 

Sorry if I got something wrong, I said to keep testing every 30 mins and if the readings drop below 55 to take action. If it came off as I was saying NADIR was +4 then that's my bad, I certainly didn't mean to imply that, I was just trying to reassure her the large drop after dose should be hopefully slowing down.

 

No worries Luke, I read it as the latter, just wanted to make sure Marilyn kept eyes on Muffin.

You are right the longer into the cycle the better for the numbers.

 

that's fine I wouldn't want her thinking that, if something can be read in several different ways then it wasn't written well so that's my fault. I would say nadir is still quite along way off especially when dealing with low numbers it can seem like eternity, checkers nadir was generally +8/+9 but ecid as you said.

I'm hoping muffin will stop these large reactions to dosing. Perhaps he will be a good candidate for increased carbs if he is on a low carb diet. A few extra percent could maybe help with the drops, Nayla mentioned something similar she is trying. I'm really hoping muffin is just on too high of a dose for now and just working his way down and these large drops won't be the norm once the dose gets to where it wants to be. Paws crossed anyway.

 

+4.5 / 139

Yes, Muffin is on a low carb diet. He get very little kibble and what he does get it's supposed to be zero carb. I've cut out the treats he was getting and now give him dried chicken, which he likes. He was very overweight at 28 lbs (the vet called him obese) this past summer, which could be why he wound up with FD. Now he has trimmed down to about 20 - 21 lbs.

 

I think you could go to one hour test now.

Looking at your ss you last fed HC and syrup @ +3 is that correct? no more food/syrop since then?

 

Correct, no more food/syrup since +3

 

its looking good Marilyn, you are doing a phenomenal job. His reactions to his new dosing schedule has been incredible. Some low numbers and alittle hair pulling will pay off if he can keep this up. I'm not sure if you realize but his SS is filling out really well now. I can't stress enough how good you are doing and how good of an impact this is going to have on Muffin!

 

Hi. You are doing great. It looks like Muffin is carb sensitive like my Max and either the carbs are bringing him up quickly. Next time you might want to experiment with feedin a little lc at +1 and +2. I don't know if you did. It might slow the drop. Another thought would be to feed a little mc at +2 if you see green.

 

+5 / 195.

Thank you for all the great advice!!

 

Looks like he is on his way up I think you would be alright getting a +7 But by all means sooner if you are not comfortable with that.

From this post I gather that you did not feed just prior to shooting?? (guessing you are trying not to overfeed him by way of managing his weight)

We would normally test AMPS, feed and then shoot. (all withen 10minutes or so), he might have run out of food by +2 (Idon't think he was fed anything in those 2 hours, correct me if I am wrong) and that could have been responsible for the drop you saw @+2, (onset of insulin is considered to be between +2 and +3, ECID some onset earlier others later, with time you will figure Muffin out)
It would probably been better to hold off feeding at +11 and fed him his FF 2.5oz at amps.

You managed the situation beautifully, and as Luke said he is in much better numbers, and thats good for his body.

I hope he doesn't bounce to high.

He has earned his reduction, but I am going to put a call out to get some of the experienced folk to take a look and see what they think about that, because
1) the history coming into this dose
2) the back to back reductions

Hi ladies I am putting a call out to you on behalf of Muffin, he has earned another reduction in this mornings cycle, would you ladies still agree that it should be 0.25 U or given the activity that Muffin has been having in these cycles would you recommend more of a reduction, given the history coming into this dose I wasn't sure if you guys would feel the guidelines still apply thanking you in advance for your input @Sienne and Gabby (GA) @Marje and Gracie @Wendy&Neko @julie & punkin (ga)

 

The reason I took the 150 reading after he ate was because I was waiting to hear from someone about the AM dosage. I just wanted to know what his BG was when I gave him the shot. He drops so low so fast, I was seriously considering skipping the shot this AM. Also, I gave him food about 7:45 AM because it takes him FOREVER to eat (he has a major under bite, so he laps it out of the bowl and I scoop it back in) and I wanted to try to move the injection schedule a little earlier (I understand that you can do this in 15 minute increments) so I have more time at night for tests, but that didn't happen this AM.

PLEASE I look forward to advise on the dosage tonight.

 

+6 / 183

 

I agree with what Sienne said earlier...I wouldn't have reduced the dose again this morning. I also wouldn't reduce it again tonight. You could still be dealing with depot from 3u.

If it were my cat, even following SLGS, I'd leave the dose at 2.5u (since you already reduced) and see what it does. In a perfect world, you would have shot 2.75u again this morning and just held the dose while we see if the depot drains a bit but since you already reduced, just leave it and give the depot a chance to drain to this dose. Who knows....2.5u might work just fine.

You just want to be cautious about taking back to back reductions. It will seem as if it's working fine and then, all of a sudden when the depot catches up, you can end up with higher numbers and have to go back up the dosing scale.

 

I understand, poor little guy. At least he likes his food even if it takes him a while to tuck in.
Looks like Muffin is surfing, in blue, that's good let's hope he remains flat for what's left of this cycle.

Please don't think I was critisising I just wanted clarification, it's nerve racking when you are seeing numbers that are lower than you are used to and you are afraid of them dropping and you are not hearing back. I'll try and watch out for you in the mornings, it's my lunch time

And I see Marje has responded with the dosing query.

I had a feeling that might be the response.



Thanks for responding Marje

 

+7 / 173

 

So what I do - stay up all night testing?

 

How do you feel about that +7?
If you are worried he is dropping you could feed a couple of tsp of LC to help him surf along.

In light of the cycle you have had and the depot, even if you reduced this evening you would probably not see the effect of the reduction for another few cycles (with George it takes 2 cycles, but others report 3 ECID) realistically you may still not be seeing the full effect of the dose reduction that you took last night.

That is, I believe, what Marje is concerned about(hope I have interpreted you correctly @Marje and Gracie ), that by the time you start to see the full effect of all the reductions you would have gone past that sweet dose for Muffin, and then you'll have to slowly start working back up the scale, all the while muffin will be having to deal with high numbers.

If you are tired and it's just too much at the moment there maybe other better options for you.

It's hard when they are bouncy like this,it gets easier when their cycles flatten out, you've had quite a couple of days, it was the same for me just a couple of months ago, I was grabbing sleep when I could, afternoon nap etc, basically whenever Georges numbers were up, if it was me I would give Muffin a little LC now and catch an afternoon nap for a couple of hours, but hey, that's just me.

 

i was going to post with that concern. It is a little early to be worrying about that though. This morning the AMBG was low which certainly didnt help with the low numbers. I would recommend we wait and see what pmps is. Also you need to stay safe and sane so if tonight you just need some extra sleep and to play it extra safe or something then post that then so people can take that into account.

Please try to remember not to feed until you are giving the shot. Ideally you wont have fed for around 2hours before testing and then if the number is low we would wait up to one hour to see if the numbers rise naturally without food. muffin certainly needs food to be in his system during those first 4 hours after dosing. Perhaps tonight if you are concerned you could try giving some higher carb food along with the shot. we can discuss it then when the numbers are in I know this is frustrating and scary at times but i assume those high numbers in the morning were also scary and frustrating which is why you came here. I hope you see that this is leading somewhere good, these are the best numbers you've recorded even if they are a little scary at the time.

 

Understood about the reduction - I'm just getting a little tired and cranky.

Muffin is yowling at me right now so I will give him a little to eat.

Oh, what does ECID stand for?

 

ecid every cat is different

 

I'm going to give you an alternative for tonight if you are feeling the need for some catch up sleep. Been there done that. The larger 3 unit depot can influence 4-6 cycles later. It could be that's what you are seeing today. One way to help reduce the larger depot is to do a much smaller dose tonight, maybe half dose, then go back to your 2.5 U dose tomorrow morning. Due to the depot the first couple of hours of the cycle may still be active, also because Muffin likes to do that, but the rest of the cycle should be quieter, letting you get some sleep.

I don't like suggesting jumping around in dose like this as Lantus does like consistent dosing. However, Muffin was not started at an appropriate dose nor increased in a safe manner as we do in SLGS or TR. It could be that we have to "break a few rules" to get him back to a good dose.

 

I agree with Marje. I would leave the dose at 2.5u.

There are a couple of tweeks to the process I'd like to point out. When you have a chance, please read over the sticky on Shooting & Handling Low Numbers.While this was written with Tight Regulation in mind, the principles are the same when it comes to managing low numbers in the cycle. Basically, I'm encouraging you to test every 20 - 30 min rather than letting an hour between tests elapse. You have far greater control over the cycle if you test more often. (If you look at either Gabby's SS or Marje's Gracie's SS you'll see how often we test especially when we were both new at this.)

As far as staying up all night, I don't know that will be necessary. First, it looks like Muffin's numbers are heading up. In fact, she may be bouncing. Second, you've reduced the dose by 0.5u within one day. That's a big reduction and the depot will be starting to catch up with the reduced dose. However, there's no guarantee that numbers won't come back down. Again, if you look at our SSs, you'll understand why I mentioned to another member quite some time ago that sleep was vastly overrated. There are instances where in order to keep your cat safe, you learn how to "sleep test" (set the alarm, test and sometimes feed the kitty, go back to sleep -- and repeat as often as necessary) or you stay up.

ECID = Every Cat Is Different. In other words, what works for your cat may not hold true for anyone else's kitty.

 

Every Cat Is Different (sorry)
I think feeding him is a good idea.

I'm not surprised by the crankiness, neither will anyone else be, we have all been there!
My George is 'fluffy' now, he was also classed as obese weighing in at 20 pounds at his heaviest he's now 16 pounds and still has a couple of pounds to loose to get him to his ideal weight.

I have found that over the last couple of weeks he has a more normal appetite, he still likes his food, but he is not constantly begging, I believe his blood sugars leveling out are partly responsible for that that and cutting out the diet food I was getting from the vet.

 

+5 / 174
Fed 1 oz FF classic pate around 4:30 PM.

 

Wow - PMPS +1.5 / 431

Maybe I didn't get the insulin injected right?? He did eat some FF classic chicken at about 8:15 PM.

 

It's more than likely a really wicked bounce. His body is not used to those low greens and is reacting appropriately. On the up side - I think you'll be able to get to sleep early tonight. Just get a before bed test and if he's still really high, pleasant dreams.

 

I seems like Muffin bounced last night, and you got some sleep.

I hope the bounce clears soon, but bear in mind that bounces can take up to 6 cycles to clear, but they don't always last the full 6 cycles.
Waiting for them to clear can be frustrating (Been there) but we just have to be patient.
Gill

 

everything ok Marilyn? Did you give the 2.5U this morning?

 

Yes, I gave the 2.5 this AM. Waiting for +2 to take a reading. Stay tuned

 

start a new thread marilyn when you are ready keeping paws crossed for a good number.