Please help me with Taco, if you can please :)

I havent been back here in almost 1 year and I'm having problems with Tacos BG, he started out on Prozinc and I was not testing like I should have because like many others I wasnt told to do that, after Taco being on Prozinc for almost 1 year and things not getting better I searched for a group that would be easier to use and found one on FB. I received and continue to receive help there but, I feel I've hit a brick wall. Taco is now on levemir since the end of this July, and I was sure he would be well on his way to getting better control,especially after a dental, that I had long suspected to be a cause of him not eating well. His numbers are all over the place and aren't good at all. Or I should say I'm totally disgusted and scared that he will not get better. Taco does have a Spread sheet that can show you more,Can I get suggestions on what to do at this point? Please and thank you

https://docs.google.com/spreadsheet...QOe5-XVXI75xl-T1A1OjLHh730/edit#gid=361360320

 

@Marje and Gracie this is a friend from FB. Would you take a look at her post and maybe tag others that might be able to guide her. Thank you soooo much!

 

I can't help with Prozinc. I can offer

 

Taco is no longer on Prozinc, he is on Levemir as of the end of July. Thanks for the hugs

 

Welcome to FDMB! You’ve done a great job of testing and keeping records.

What I see are doses that are often held too long and just when he starts to respond, the dose is dropped back or you shoot a reduced dose for a cycle or so. If he’s held at doses too long, that aren’t the fitting dose for him, then he builds some resistance.

You are testing enough to follow Tight Regulation and that would allow you to increase the dose faster when warranted. He needs to be on a low carb canned or raw diet to do TR.

If you want to follow Start Low Go Slow, you would hold doses longer and the reduction BG is higher. It’s a more conservative method which normally requires you to reduce when a dose might be working for him. For example, the reduction BG on a human meter for TR is 50 but it’s 90 for SLGS. Cats might eventually see much better numbers on SLGS but it takes more time and patience, generally.

 

Taco has definately been on low carb pates, usually 1-4 carbs at the highest. I was going over the TR protocol again a few minutes ago, and I will try the 2.50 units in the AM. will see how that goes. I was told this evening that it may be food related, giving him so many choices and try 1 food at a time, I really don't believe that is the problem, but willing to try that if I dont see results increasing his dose. It was also mentioned that it could be some kind of infection or inflammation driving his numbers up, but, that doesnt make sense to me either as his numbers have been crazy for ever. I'm going to try this TR and see what happens. Of course I'm scared, yet, something has to change, Thank you will keep you updated.

 

Please only raise his dose to 2.25u. He has nadirs in the range of 100-200 so you only want to increase by 0.25u.

Food consistency can definitely help but that doesn’t mean you can only feed him one flavor of food. I’d try to stay with flavors in the same brand, if possible, and about the same carbs. Bottom line is the best food for a cat is the one it will eat.

TR has built in safety measures and you are testing plenty to catch any lows. If you get a number that worries you, post here.

Reading the stickys at the top of the forum will also help immensely and ask questions. We are here to help.

 

OK I guess it's been so long since I've seen a range of 100-200 ,that I thought I was doing the right thing, Thanks so much for guiding me or suggesting I should say Taco is a very picky eater. He has a tendency to get addicted to one food and then won't eat, so I've been trying to give him a variety. He's gotten to the point that he won't eat friskies, but he may again in a few days, that's the reason I'm mixing, because he's hooked on the Beyond, and they are very hard for me to get. Thanks again

 

Welcome to FDMB L&L! You've done a great job testing...keep posting, reading condos - you'll get Taco down - just gotta keep adjusting that dose, feeding the right foods (looks like you're already working a lot of this)...hang in there - this is quite a ride! Lots of great support/advice/wisdom provided on this forum. Lifesaving - literally! I can't say enough good things about this group of folks - wonderful!! Each and every one of them!! I find it's very information/helpful to read what others are struggling with too...not just what your issues are at the moment...what they're doing - what their results are - all information and helpful. Try to read as much as you can here - terrific information!

 

With TR, we dose on the nadir which is the peak action of the insulin and where you see the lowest number in the cycle. He’s been in the 100-200 range of nadirs on the 2u dose a few times. However, unless a cat is high dose or has nadirs over 300, we only raise the dose by 0.25u at a time.

With that in mind, he’s well within the nadir range for 0.25u vs 0.5u dose increases.

I understand on the food. When you say “mixing” do you mean two foods together at one meal or do you mean you might serve one brand one meal and another brand another meal? If it’s the latter, then I’d do what you have to so he eats but see if you can keep the %carbs in a fairly consistent range of 4-10%.

If it’s the former, it makes it harder to know what the composition in carbs is of each meal you fed him. For some cats in this forum, not only what the caregiver feeds but when it is fed is very important for controlling their BG. Others seem to do well with feee feeding and variety as long as it is low carb.

Good luck with the increase. One sage piece of advice: don’t get attached to a dose. If he needs more insulin, he just does and as long as you are increasing it based on TR, since that’s what you’ve chosen, then it is safe to do.

As a favor, could you please add “TR” in your signature block so members will tailor their advice to your needs.

Thank you!

 

@Marje and Gracie - thank you so much for your dedication and guidance. xx

 

You’re welcome

 

@Marje and Gracie A whole new problem today, I'm so confused, he is steadily dropping which is good in a way, but, surely it cant be from the increase, because he started his drop at 6A EST. Could all that pink be a bounce? but, why? for so long. We shave Taco on both shoulders so hairshots are out, food is the same, any idea what I should do if he keeps dropping as he is? His NADIR has always been VERY late, almost right at shot time. Please advise. Ok, just got a rise to 167.

 

We use 3 foods, from Dr. Piersons food list, friskies pates (most, but, no beef) Beyond Char&spinach and Beyond Salmon&spinach, Sheba savory chicken in own juice and Sheba Salmon in own juice. A lot of times i mix in some Beyond because he's addicted to it and I mix it with friskies because that's the only way he'll eat friskies lately. He quit eating Fancy Feast a few weeks ago . Everything I believe is under 4 carbs.

 

Very nice today. Are you using anything for his ears with all the testing?

 

This is excellent!!!

He was clearing a bounce last night and settled down by AMPS today. Then he came up just a bit before onsetting. Without any tests before +3, we don’t know if he went up a bit more than 192 and then onset by +3 or whether he onset a little later than +3.

Sometimes a dose increase can give them a little kick in the pants even on the first cycle of it. He might stick with it and continue to do well, he might decide in a cycle or two that he wants a reduction, or he might fizzle.

On the evening cycle of 9/21, he started clearing bounce and dropped from 306 to 179 in just a few hours. That’s a big drop; big and/or fast drops can start a new bounce which he did yesterday and cleared last night. It’s good he is clearing the bounces quickly.

Many of the cycles,when you see him lowest at shot time, it’s because he’s clearing a bounce but his nadir will tend to be late because you are using Levemir.

Make sense?

 

I understand most of it except where you say "he might decide in a cycle or two that he wants a reduction, or he might fizzle.". Explain a little more, like is he likely to drop low? would that be the reduction, correct? and the fizzle would be if he decides to climb back up? Correct ? @Olive & Paula , yes, Taco gets a dab of triple antibiotic cream rubbed in every few days. His ears are fine and he doesnt mind testing at all

 

Yes...he might drop below 50 on your Relion meter so you would take the dose back down to 2u.

Otherwise, we give him six cycles at 2.25u and see where his nadirs are. If he’s seeing nice blue or green numbers in between bounces, we hold the dose 8-10 cycles and reassess. If he’s all yellow or more, we increase the dose.

 

He has dropped again 37 points in 1 hour, will there be someone here to help me at around 9:45 PM EST? I'm getting a little nervous I feel like he will keep dropping, because his nadir being so late in the cycle.

 

He’s doing great. Is he currently at 172 @ +9? If you are past that and it’s not past +10, you can feed him a tsp of low carb food.

I’ll check in. See you at 9:45 EDT.

 

Standing by. If he’s flat around 150 or above, go ahead and shoot the current dose. You’ve shot lower numbers

If he’s lower, don’t feed him. Post and I’ll watch for you.

 

I had to get off a while (family) he was 170 @ +11, I'm waiting a few more minutes to take his 10P reading. At +9 he had dropped 37 points, he was 130 @ +9. Be back in a few minutes Thanks

 

See above but I’m still here.

 

It's 5 minutes before shot time and we have a 161, SS is up to date except shot, Shoot 2.25 u of Levemir?

 

Go for it or as we say here... shooooooooooot!

Feed a good meal. I’ll post more in a minute.

 

OK took 6 eyes and 2 different magnifying glasses to get 2.25. I HATE those .25s. I have the half mark , but that doesnt help with 25.
I'll be testing every hour for a while, he ate his 2 sheba chicken portions, and will get another at 12A. Thank you

 

Just so you know I have an emergency kit, I have 13 carb, 17 carb, 25 carb, and honey. I was telling Cynthia ,the first time I used it, I gave him a full can of 25 carb I panicked , but it worked LOL. So am I correct that if he goes below 50, I feed small amount of his regular low carb and test in 20 minutes? If I cant get it up to a better number I do honey,? Explain to me please a short version or direct me to a file if you can,please

 

You’re welcome.

Well....we’ve all overreacted to the numbers at least one time but likely, lots more so no worries I do remember one member who gave her cat something like 2 tbsp of honey

The goal is to learn how to feed with low carb (LC) so that the numbers come down gradually instead of the bottom dropping out fast. It’s going to happen that he’ll go below 50 at some time and that’s fine. We aren’t trying to feed to keep him from earning reductions but just trying to flatten the curve a bit as we see it dropping. As you deal with lower numbers, you’ll find out how carb sensitive he might be and it will be different during different parts of the cycle.

For example, after he onsets, you will likely need more carbs or more food for lower numbers than you will at the end of the cycle when the insulin is waning. Yes, if he drops below 50, try his regular food first and give him a couple of good tsp of it. Retest in 20-30 minutes (it usually takes 30 minutes from when they eat it for the first effects of the food on the BG to show). Obviously, if he gives you a really low number in the 40s or 30s, you’ll want to give honey or syrup and retest in 15 minutes as they will bring the BG up much faster than food and we want them up fast if they are really low.

Does that help?

Here is a post on How to Handle Low Numbers but remember that every cat is different. I found that high carb (HC) food did not work for Gracie....it stopped her duration cold so I had to stick with foods no more than 13% (usually 10%) and if she dropped lower than 40, I used a drop of karo.

I’d like to toss out some info to you about Levemir and what those cycles look like.

Typically, onset is about +4 and nadir is anywhere from +8 to +12 or even after if the dose is good. Levemir can give some great duration. What you might expect to see, then, is a lower preshot number and then numbers climb until +3 or +4. Onset occurs and numbers come down to nadir. Of course, all of this is assuming it’s not a bounce clearing cycle (today is not).

The wonderful thing about levemir that I always loved when I was using it was that I could shoot those lower numbers knowing that I had time to feed and see the BG rise before onset. With Lantus, my Gracie would give me a low number at preshot and then it was a scramble to get enough food into her before she onset at +2. It’s one of the reasons I switched to levemir.

I only see one cycle with a blue or green PS where Taco came down by +2 so, if it were me, because he was flat going into preshot, I’d likely not test again until at least +2.

You’ll want to study his spreadsheet and see if you can identify these really important times of his cycle because it will help you know when to test. Normally, I have to ask members to test more but I don’t see a reason to test him hourly when he’s in pinks and yellows and, depending on how fast he’s dropping, there might be cycles of blue where you can spread it out a little more.

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle
• Duration - the length of time insulin continues to lower blood glucose

Also, here is some information about Making the Most of your Lantus, Baslagar, Levemir ISG Experience which will tell you how we post each day. We do one thread (we call them “condos” per cat per day with all of your questions in it). The subject each morning is started as (example based on today’s cycles):

9/23 Taco AMPS 140 +4 192 +5 184 +6 185 +7 147 +8 168 +9 130 +10 170 +11 171

Starting with PMPS, you would edit the title (go back to the first post of the day, click on “thread tools” on the right upper corner and “edit title”, delete everything after “AMPS” and start over with PMPS so it would look like:
9/23 Taco PMPS 161

Finally, if you’d like, I can add a column for you for what you feed after his shot because you might need the +1 column for numbers at some point.

 

Take a look at Cameron's SS and you'll see where he wanted reductions He may not ACTUALLY want those reductions in the long run, but once he stopped bouncing, we had 2 very quick reductions due to low numbers (and one Big Chicken **** shot of 0.5 hahah). When I say he may not actually want those reductions in the long run, it's because they were each very fast, less than a full 6 cycles, so the old depot was still in play.

If you look further back (up) on his SS, you'll see him bouncing as well.

 

@Leah thanks for chiming in! But for some reason, I cannot access Cameron’s SS; it’s not a link.

 

Ah poop...I bet it was broken when I was checking it earlier for the color issues. be right back!

/ETA - all fixed, I hope!

 

WOW! Your guy is doing awsome! Can't wait to get there

 

It'll happen! Look at the sea of blue Taco had today! That's huge!

But, do you see on Cam's SS that we had to take him up and up and up and then he finally started to break through the bounce and he quickly came down in the dose? That's what Cynthia was talking about.

 

So, holy guacamole on the condo thing, I'm really going to need some help with that one, I've read and done so much today, I'm pretty burned out, but, I will try , one of the reasons I left this group last year was I had a hard time navigating it, I couldnt do a SS and well this old lady takes a while to learn something but once I get it I get it, something like testing Taco Give me a little time on this condo thing, please I would love to add you to my SS if you tell me how to, but, I really don't need another column, but, sometimes I get glitches and I can't fix them. How do I add you? Please, oh and I'm usually on more in the evening and not mornings, my daughter, Tacos real Mom does him in the am as I sleep, because I'm usually up all night with my 43 yo ,24/7 care son. So I sleep in the daytime when I can

 

I’ll send you a private message regarding the SS. When you see a number by the inbox, upper right corner, you have messages.

Looks like he’s reached the end of duration for the a.m. cycle.