12/27 Silver AMPS 315 PMPS 126 +2=308 +5=374 bye bye blues

http://www.felinediabetes.com/FDMB/...-418-4-365-6-337-8-356-pmps-380-5-347.188576/

Think he is coming out of the bounce and will definitely be in yellows when I'm at work today but I went for the increase anyways. Let's see what this new dose does for him. Three days at work then I will be home for the next three and can monitor.

 

Good luck with the doserease.

 

Hope the dosecrease brings Silver back into the blues soon.

 

Thanks. I really hope it takes him down to greens but whenever he does get to blues he bounces the next four days!

 

Ok so I knew Silver would do this the day I am back at work. He got his dose increase to 2u this am. However, now I am thinking he shouldn't have had the dose increase because the low PMPS can't be off this am's shot right?

Sooo, because I am home tonight and I didn't want to mess up his depot, I gave the full 2u. What do I watch for and how often and for how long do I need to test tonight to make sure he is okay?

@Tracey&Jones
@Marje and Gracie
@Stacy & Asia
@Dyana
@Chris & China


Please advise - and should I have increased? Should I revert back to 1.75 as he has only had two doses now (today) of the 2u.

 

My rule of thumb is that if you're not sure if numbers are going to head down, test early and often. Get a +1 if you're feeling uncertain but definitely get a +2. Lantus onset is usually at +2 but it can vary depending on the cat.

In Alley's condo, you said:

If a cat has gingivitis or any kind of inflammation, it's the inflammation that causes numbers to be higher than desirable. The dental cleaning will rectify the problem and numbers may then drop. In addition, anesthesia can have the property of dropping numbers. If a cat's in pain, that will cause number to be higher than expected and pain meds will help with that issue. I'd like to know what "too bad" means? It's very hard to get a good look at a cat's teeth just by visual inspection. I hope you're not giving your cats the dental food. (I'm sort of assuming by your comment that you're not.) On the off chance you are using the dry dental food, someone pointed out that feeding a cat dry food under the pretense that it will clean a cat's teeth is like saying we won't need our teeth cleaned if we just eat biscotti.

 

Ooh no I’m not giving the dry. It didn’t make sense that chomping on set food would clean teeth!

What do you think re the dose? Should I revert to the 1.75 he was on yesterday? I think I shouldn’t have increased? The dose he got this am can’t be what’s brought him into blue right?

 

Awesome job shooting tonight Juliet! I would reduce if he goes below 90, not before.

 

Thanks. Wouldn’t have been so confident if this was an AMPS so hope he won’t throw me a low tomorrow.

 

@Wendy&Neko do I reduce to 1.5 or 1.75 if he goes below 90 - bearing in mind he only went up to 2u at AMPS today and the 126 at PMPS must be him coming out of the bounce right? Not as a result of the 2u dose that morning?

 

Let's see what his +2 is. Juliet, I would set an alarm to make sure you get a +6, if you can.

 

I don’t think that will be possible. His +6 is quarter to one in the morning and I am up at 5:30am. I can’t lose sleep as my health is not good. I’ll try my best to get a +5 if I’m still awake.

 

It could be a combination of both.
If you reduce, we normally making dosing adjustments, in 0.25 increments. If he earns a reduction tonight, I would only go to 1.75. You have plenty of room for a dose adjustment, in my opinion.

 

Ok. Thanks.

 

When a cycle came up like this for me, I would try to sleep in increments. I would have my alarm set, and actually sleep on the couch, because if I went to bed, I may not wake up enough to get out of bed, to test. Can you try to relax and sleep for a bit? Maybe, depending upon the numbers on on the next tes.., you could even set the alarm for 2 hours.

 

Unfortunately no. I’m recovering from brain surgery and I can’t keep getting up. Once I’m down for sleep I need to stay in bed.

 

Okay, I understand. My boyfriend had brain surgery. Try to get a +2, and a +4 or a +5. Let us know what the number is. I go to sleep in 30 minutes, but others will be available to you. Post your numbers and ask for help it you need it. You can always feed MC or HC if needed. I'm sorry he didn't give you this PS number on a nice daytime cycle when you were home all day to test. Cats will be cats. I hope he surfs along nicely, for you.

 

Thanks.

 

Never known him jump so high at +2 from PMPS. Can he be bouncing already? Onset hasn't started yet. Dont tell me I get a nice blue then see next few days in pink and red again. This is crazy. How are we ever going to get him regulated?

 

Yes, it's likely he's bouncing. Could have gone a bit lower than that 126 today. The first time I shot low blues were similarly anti-climatic. Good thing you shot tonight.

It's a process, it takes time. If you look at the SS, I'm seeing a touch more blue overall. That's progress.

 

No idea if he went low - I cant test on working days. He could have gone below 90 and earned a reduction. Its so frustrating. He does not usually bounce that quickly though. If he goes low, I usually dont see the bounce until the next day. Basically if I am not home, we have no clue what is going on with Silver and are just guessing right? How am I going to get this right.... I dont think I can. If he is low in the am there is no way I can shoot. Will have to follow SLGS guidelines on no shoot numbers and reduced doses.

 

I know you can't. All we can do is speculate and follow SLGS, using the data you do have. It has a certain safety margin built in. It's also possible that Silver just isn't used to low blue and is bouncing because of that.

 

Yeah, I dont understand. He's had a few low blues the past couple weeks but as soon as he hits one he spends the next four days back in pinks. It is getting so annoying. I follow SLGS and don't shoot or shoot a lower dose according to its guidelines, then folks say I have messed up his depot by following those guidelines. I cant seem to win whatever I do.

 

Juliet, you are doing what you can, and more than the majority of caregivers of diabetic cats. Give yourself a pat on the back for that. Having a very bouncy cat is just plain hard - I know all about that.

 

Does it get better?

 

Hi Juliet!

Great job on shooting the 2.0u on that PMPS. I agree with Wendy on keeping on course with that dose.

You can't keep beating yourself up for what you can't do and can't change. That is the definition of insanity girlfriend! So yes, we guess a bit. Gather data when you can. Look at that PM cycle on the 22nd. You shot a 9.3 and he basically stayed there the next 5 hours! Just because you shoot low doesn't mean you will see a dramatic drop in numbers as you see now with all these pinks and bounces!

Like Wendy, I see progress. He gets more blues, more often and hopefully soon we see less bouncing and just a gently lowing of the numbers.

And we didn't say you messed up....it is just a fact that the depot gets disrupted when things like that happens - fur shots, missed shots, BCS - it happens to everyone. It is just an explanation of what was going on, to help you understand his numbers and patterns.

 

I hear you. But nothing is making any sense. I don’t understand any of these numbers. It feels like a guessing game every day. And he doesn’t seem to have any sort of pattern.

 

It will, eventually. Bouncing makes it hard because it is more a reflection of Silver's body reaction than a reaction of what the insulin is doing for him. It fuzzy's the picture.

 

Yes, unfortunately part of the cure is time. Part of the solution is Silver's body, and you are doing what you can to help him. The rest is up to him. I used to go crazy trying to analyze numbers too, until I realized I was doing what I could and just let it happen.

 

I’m worried the toll this is taking on him. He looks so much thinner.

 

Until Silver gets better regulated, it may not hurt to give him more to eat. This is especially the case if he looks think to you. Remember, when numbers are high, glucose isn't getting into the cells. Silver may be hungrier than usual but since glucose isn't getting into the cells, he's not getting as many calories as he may need. Feeding him more is a good way to address this.

 

You probably missed conversation already had on this in previous condo. He gets two meals a day with his sister. I can’t free feed and I can’t use feeders.

 

It's not a matter of when you're able to feed. Can you give Silver more food and try to supervise when you're feeding your cats. The other possibility is to look for a food that's higher in calories. For example, a can of Wellness is much higher in calories than the same size can of Fancy Feast.

 

I wish I could but I can’t no. I feed and immediately leave the house. My schedule is extremely tight and not changeable I’m any way. I can’t stay up late to test or set alarms to wake up. I can’t stall and wait to feed. I can’t separate them in different rooms. My life is a strict immovable schedule. It doesn’t matter how much I feed him he is constantly hungry which is why I am trying so hard in the impossible task of trying to regulate him. I am at the end of my rope here. I cannot do any more or any different than I am doing.

 

I’m very sorry if I contributed to you feeling this way as that would never be my intention.

Many times, I’ll tell a caregiver what might have been another way to go but that’s never meant as a critique. It’s just so the next time it happens, they will have an other option to consider.

I agree with Wendy and Stacy that you are doing the best you can do. No one thinks you have messed up or you can’t win. We are here to help you interpret the patterns.

Hang in there....progress is progress.

 

Thanks. I know I sound frustrated tonight. I was so pleased to see a low blue and now I am almost in reds again and certainly will be by AMPS. Its so disappointing. I am good at following instructions but SLGS is not meant to be followed apparently, but tailored to each cat. That's the hard part.

 

For new members still building data and learning about their cat, it helps for them to stick closer to the guidelines.

But the SLGS guidelines do state that the guidelines should be personalized to take into account your cat’s patterns.

I know it’s hard when you have to work such long hours.

 

I know. And my brain just doesn’t work that way. I can get as much data and test every day for a year but I just don’t see patterns. Never could. He’s a happy kitty tho and right now is snuggled in bed with me. There’s no symptoms anymore - no extra peeing or water drinking. He’s lost weight but he was a huge cat to begin with. His gait is normal and he still chases his sister round the house. If not for the numbers you’d not know anything was wrong. Sometimes I think I dreamt the occasional blue I get.

 

You are focusing on the right things....how well he feels and is doing.

As I said, we will always be happy to help you spot patterns.

 

Juliet -

Re-read what you said to Marje. Those observations tell you a great deal about what’s going on with Silver. Your cat is more than numbers on a page. Getting a cat regulated takes time and can be tougher the second time around. I also think it helps to remember that we’re not the ones leading this sugar dance — our cats are in charge and they do things in their own way and in their own time.

Not everyone is equally good at reading a SS. We’re here to help.