4/18 Floyd AMPS Hi, +2 Hi, +4 540, PMPS 311, +2 348

Yesterday

The R trial was a failure and I am one tired mama.

I think I'm supposed to stay at 6 units another couple cycles since he didn't go down below 40 last night but @Wendy&Neko's post from last night implies I should be reducing.

ETA: shot 6 and going back to bed Lol. Waiting for advice as to what to do next. Thanks everyone.

 

Where did you get below 40 from? Was it mentioned to you before? We sometimes take reductions below 40, but it is usually reserved for cats that don’t take reductions well or cats that have been diabetic for a long time. I think Floyd almost qualifies as a long term diabetic, but since he is on 6 units and you don’t have much data as to how he takes reductions, it would be the safe thing to do to take it. He got to 49 on a 288 preshot, and you also fed a drop before that and you fed the 49 and he still went to 46. I think he’s asking for a reduction. You can always go back up if it doesn’t work out.

Hope you can catch up on some sleep at some point today.

 

Got it from the TR sticky - "If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit."

Of course, there is no definition of "long term diabetic" but I wouldn't call Floyd "newly diagnosed" either, so I went with 6. I was also thinking if the R was affecting the PM cycle, it may look like he needs a reduction when really it's just not the right timing on the R.

So, we'll see where he goes today and I am open to advice on whether to reduce and by how much.

 

Our in house definition of long term diabetic is 1 year or more, and Floyd is right there at the cusp. I know some of it is confusing and can be very open to interpretation (and it is). I don’t think it was a bad call so long as he acts himself in the 40s. The R could be in play too. You test enough and do a great job keeping him safe.

It’s been my experience that if they really want a reduction, they will make it obvious, so I’m sure Floyd will let you know soon either way what he thinks of the 6 units.

How long has Floyd been on Adequan? Have you noticed any improvements? Asia just started on it and I’m hopeful for some results. He’s a wee little lion, isn’t he? You can’t tell from his picture, I thought he was a large cat.

 

He has never shown any signs of hypo, which is another reason I felt comfortable shooting again 6 this AM, and I'll keep testing, of course.

He just started yesterday on the Adequan, no change yet.

Yes, he's only about 8.5 lbs. at his ideal weight and has always been lean. I've noticed he can't jump up like he used to and he's licking the fur off his back legs, which I think may be a sign of pain. His coat was looking rough for a long time, and just starting looking nice again after I changed his diet to the home-cooked - except on his back legs.

 

May the progress and improve together then! I hear it takes about 3 weeks to see a change, but Asia did something just yesterday that was long off of her playlist, so I’m quite hopeful.

I’m sure you already know about diabetic neuropathy. A lot of people here use and swear by Zobaline (which is methylcobalamin and folic acid). I give Asia a multi B (has folic acid) orally and shots every other week of the Methyl B12 (it is more for CKD stuff but helps with neuropathy obviously), it helped a ton with her back legs (she was splaying them when standing), although she still isn’t jumping, but I don’t think that was neuropathy so much as arthritis. Whatever is going on with him, I hope Adequan and regulation fixes it right up!

 

Because Floyd is on a larger dose with a larger depot, I would play it safe and reduce this time for going below 50. Once you learn more how he handles reductions ( bet yesterday morning you didn't think that!), you can decide if you want to change the reduction point. Even though Neko was a long term diabetic, she usually held reductions under 50. But with her it wasn't a matter of the fragile pancreas healing, but rather less growth hormone output from her tumour.

Glad you shot 6 units this morning. After reductions, one option is to do what we call shooting through the bounce. Which is to shoot the old dose one more time after the reduction is earned, then shoot the new dose It can help with the bounce. You don't want to do that more than one cycle, or you can let the depot get ahead of you. This isn't a technique for forever. Once they start clearing bounces in a cycle, it's no good anymore.

Yesterday's low may have been a delayed reaction to R, or he could have finally hit a dose that gets him to low greens. Time will tell.

 

Reduce to 5.75 u, correct?

Yay, finally did something right! LOL

 

I replied on yesterday's thread but see where Wendy and I are on the same page with shooting through the bounce.

Come on down Floyd. Last night's cycle was a good example of how R can affect the next cycle.

 

I agree that all things considered shooting one more 6u dose in Floyd’s case was fine. We know after green he was going to ride the express elevator up.

Something to keep in mind is even though we get a dx date most kitties have been diabetic for some time prior so unless you have bloodwork from 4/2017 that shows otherwise Floyd likey has been diabetic for a year.

I think in Floyd’s case the best strategy for R is to use it to try limit how high he goes. The next time you see he is setting up for a bounce, assuming you are awake alert and oriented and can monitor, try using R then. For example on 4/15 he started the day high black, sliding down to low yellow at AM+11. PMPS was high yellow and by PM+3 he was high pink. A touch of R right there may have kept the PM+9 high black away.

Since Floyd is quite the quick change artist not going more than 4 hours between tests, at least for a while could bring better focus to the whole picture and help you figure out the best strategies to keep him flatter. For example, was that 211 on 4/15/AM+11 the low for that cycle or was he on the way up from a lower number?

 

Thank you for the insights, Sandy. I agree about shooting the R as he starts to bounce, that makes sense to me. It may be hard depending on the day, but I'll try.

And more testing, check.

 

Typically we go down by the same amounts we went up, so that would mean going back to 5.5 units. At least after your first reduction. The goal is safety first. You can experiment later with smaller changes if Floyd doesn't hold the reduction. Neko was sensitive to really small changes, but many cats aren't.

I would call it more strategic testing. Today's epic bounce is expected after last night's unfamiliar numbers. I think you could easily go 4 hours to the next test.