09/15 Ivana AMPS=362, +2=349, +4=288, +6=277, +8=239, +10=310, PMPS=248, +2=70, +2.25=63

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Oh yeah, she's working it. She worked it so hard she needed a nap. Poor thing could hardly lift her head up to eat her post +4 test treat ;-)
2015-09-15 09.53.21.jpg
 
I know I haven't finished Ivana's curve yet, but looking at her spreadsheet has me wondering if she isn't doing as well on the 1.25u dose as she was on the 1.5u dose. I'm still doing SLGS as I don't want to start TR until the automatic feeder arrives incase she needs carbs through the day. So, looking at the SLGS protocol, her nadir is definitely >8.3/150, so should we increase 0.25u to be back at 1.5u?

Also, there's a part in the SLGS protocol that says "rushing towards regulation will cost you time in the long run, because you may shoot past the right dose" - that to me seems to go against the TR protocol, which is to get regulated as soon as possible, is that right?
 
Tara & Ivana said:
"rushing towards regulation will cost you time in the long run, because you may shoot past the right dose"
Click to expand...

You have to read the sentence right before it "Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is!"

The same sentence could be used in the TR protocol too...if you try to increase the dose too often or by too much, you could go past what might be the best dose for your cat.

Although the strict SLGS protocol says to hold the dose for a week, I think you could go back to 1.5 if you're able to continue testing as often as you have been, but let's see what other opinions are out there @Wendy&Neko @Marje and Gracie @Sienne and Gabby @Jill & Alex (GA) @julie & punkin (ga)
 
I can't see from your signature line what glucometer you're using? Is it a human glucometer? I think so, so all this below assumes that's what you're using.

Here's the reference from SLGS:

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours
Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.

  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
  • As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but do decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change). Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.
Lather, Rinse, and Repeat!
​
I think it's a little ambiguous in your situation. For choosing to adjust the dose, I'd go by the lowest point in the past few days on this dose, which was 149. Right on the border between the "hold the dose" and "increase the dose." Overall, I agree with you - i think she looked better at 1.5u.

If you didn't test so much, I might suggest holding the dose. Most people use SLGS because they are feeding their cat dry food, or because they can only test occasionally. In your case, it's pretty clear what's going on in Ivana's body and you can see nicely how she's doing with the dose.

When you decrease the dose, the idea is that the good nadirs continue - in Ivana's case, it looks like the dose reduction has taken her out of green numbers. So based on that, I'd go back up to 1.5u immediately. When you've taken a dose decrease because the cat dropped below the reduction point, and then the cat's blood sugar trends up, you don't wait x number of cycles to increase. That's considered a failed reduction, and as soon as you determine that the reduction failed, you can go right back up to the last good dose.

When you're initially increasing the cat's insulin dose, it's important to hold the dose the appropriate length of time (and not rush things) before increasing the dose again. That's the time to not hurry things and make sure you don't overshoot a good dose.

Does that make sense?
 
Thanks so much Julie, yes we're using a human glucometer, I've added the details to my signature.

We will go back to 1.5u as of tonight's shot, now that two other people think so as well as us. We can always go down again if we need to, and hopefully that will be the case.

I'll finish today's curve and will continue testing past 12 hrs for as long as I can stay awake. I'd really like to pull an all-nighter sometime to get a full PM curve, we don't have much data for that and I've heard it can be a bit lower than the AM curve.
 
Talked to hubby about switching to TR and he's all for it - yeah!! Now hurry up and arrive, auto-feeder!

I'll be sending Ivana's spreadsheet to the vet today after today's curve is finished, and letting her know what we're doing - hopefully she's ok with us doing TR.
 
From a PMPS of 248/13.8 to a +2 of 70/3.9 - I'll check her again in 15mins, if she's dropped again I'll give her some carbs. On a possibly related note, she didn't eat as much dinner as usual, probably because of treats from all the tests. She's still very interested in the treats so I'm not worried that she's lost her appetite.

ETA: 15mins later and she was at 63 so I gave her 1tsp of carb food. Will test again shortly.
 
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That is a big drop in 2 hours......9.9 or 178. And then a further drop to 63 in 15 minutes.
I would give her some high carb food as it is still early in the cycle. And don't leave it too long between tests at this point.
 
Last test was 1.3. Turns out our honey had crystallised (!) so we gave her condensed milk and more 22 carb food. Testing again very shortly. Stressing out! She has no signs though.
 
Ok you need to give more honey on the gums. You need to get her up to over 50 or 2.9 so still a way to go.
Put the honey on the gums now please
 
You are lucky she has not shown any symptoms......but we are not out of the woods yet and she still could show symptoms.
I am not trying to frighten you....just give you the facts.
Keep up the good work
 
Yeah I know, that's why I'm freaking out... but she's coming up which is such a relief. I don't think I'm going to get any sleep tonight!
 
Hugs breath your doing very well I was a total basket my first dance... huggles breath and give sugar kitty honey
 
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