8/6 Gus PMPS 129, +1 98,+2 68, 2.5 57,+3 77,+4 76,+5 78, +6 85

You've got this.

 

That's fine. BTW you can just give the gravy and skip the food. That's where the carbs are. I squeeze the gravy out with the lid on the can. That way he won't get too full if not feeding causes him to drop rather than surf.

 

If all goes well Gus may just keep surfing. I have to go but I will check in later. You've got great support people and you know what you are doing.

OK Gus..keep it safe!!

 

Thank you so much for all your help this morning!

 

Just got back from the service and checking in. Gosh, I am glad you did the BCS dose. This boy is on a mission!

 

Hope you are ok
Probably not nearly as glad as I am!
Yeah, I am going to need guidance on tonight's shot!

 

+3 holding 58

 

Good. Keep surfing.

 

Gonna try our darnedest!

 

+3 58

 

+3.5 53

 

That's the same number at +3 so he is surfing along. All this time spent in green numbers is just so wonderful for him!

 

HC gravy

 

Thanks! Working to keep him there! Do you think today earns him a reduction or will we be doing this again tonight?

 

I know he would have dropped below 50 if I had not stepped in right away

 

It's so funny, my little tux cat hears the meter and comes in in waiting for me to give Gus the gravy, then she eats the food part and leaves!

 

Les, you certainly are having a couple of exciting days - you surely will need a vacation to decompress

 

Got that right! Good thing the trip I have coming up involves staring at the desert skies watching the meteor showers and nothing more demanding than eating and relaxing!
ETA: and worrying about how Gus is doing back home of course!

 

+4 55, holding there w occasional HC gravy

 

Because Gussie just got a reduction last night, the higher depot is speaking today. And he didn't go below 50 to earn the reduction. So that said, you wouldn't want to give another reduction tonight. If, today's cycle would have been difficult to keep his head above water with lots of HC food, then you would consider that in giving another reduction that wasn't really earned. But that hasn't been the case today. Let's see where he lands at PMPS time and I am sure others will weigh in.

 

Ok! Thanks! I def don't want to get ahead of the depot!

 

While the depot is in play you also gave just 2.0 this morning and are keeping him up with hc. That needs to be considered when deciding on tonight's dose I think.

 

That was my thinking too...

 

I quit giving him HC gravy at +4.5. Won't give it again to see how he's doing unless he drops again. Used Karo only once I think and tot was a dollop about the size of a dime.
Crazy cat!

 

Not even the hc and karo phased his BG much. Max would jump way up even early on. Let's see where he lands late in the cycle.

 

Ok sounds good to me! Thanks. Agree he only didn't swim with the Sharks hard and fast this morning because I intervened early as in 1 hr after that reduced dose! I am pretty certain he dropped into green overbite way late in that 1 st cycle of the reduction. He was at 148 at +6 last nite and dropped to 125 by +8.5, then 95 by AMPS and 70 a half hour after that! So he was on the move

 

+6 =75 without the boost of HC. I think we are making progress!

 

Just checking back in. Gus did not give as dramatic a performance as yesterday, but considering he started off with HC at +1 you still had to work to keep him up. Will be interesting to see his PMPS

 

Thanks for checking in! I'll be interested to see what it is too!

 

I think we are out of the woods for this cycle with him @90 now. Big sigh of relief from mama here! I am going to duck out and do a couple errands I need to get done, maybe some laundry too!
Thank you everybody for your help and support today as we learned new skills yet again! Thanks for rooting for my guy!
BBL in time for AMPS in 4!
Les

 

Hi I'm back, he just tested at 119 at +10. Any ideas what the plan for tonight might be? His spreadsheet is up to date. Thanks all, I am SO GLAD I did the BCS this morning!
Thanks again to everybody who helped and supported today!

 

I would go back to his earned 2.5U dose, provided you can monitor and have supplies. The action you saw today was not from the BCS dose you shot today, but likely from the 2.75U depot and may in fact have played out almost the same if you'd shot the 2.5U this morning. The larger depot can impact 2-4 cycles. I often saw more action 2 cycles after a reduction.

 

@Gussie's mom
Wow! What a day you've had! Nice job managing Gus' curve!

FWIW, I agree with Wendy for the reasons stated.

I hope you don't mind me borrowing your thread to help clear up any confusion which might have been caused earlier today by something I said at another time.

@Bobbie And Bubba
@Doodles & Karen
@Sienne and Gabby (GA)

Bobbie, I don't remember the particular instance or context in which I mentioned waiting to shoot 2 hours after eating, but you're right. If used, the method is usually used by newbies who may not have collected enough data to feel comfortable shooting low. There's no doubt in my mind you've heard me mention the advice to someone at one time or another.

Sienne, the method Bobbie and Karen mentioned is not urban legend. It's one of the options noted in the FDMB FAQs and the SLGS Method. I'm not sure about Karen, but I think that's where Bobbie is coming from... even if the suggestion didn't quite fit this particular situation.

How to handle a lower than normal preshot number:

In the beginning we suggest following the guidelines in the FDMB's FAQ Q4.4:

Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?

A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.

• Below 150 mg/dl (8.3 mmol/L), don't give insulin.

• Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing; b.) give a token dose (10-25% of the usual dose); c.) feed as usual, test in a couple of hours, and make a decision based on that value.

• Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.

• In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.

• Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.

​

Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.

Given the circumstances, I think this was good advice if Gussie's mom wants to follow guidelines in the TR Protocol and was prepared and available to monitor closely.

 

Thank you, Now the consensus seems to be shoot the full 2.5 dose on schedule and monitor closely? It's time now to make that decision. His PMPS is due to be read in about 10 monutes

 

Okie dokie I guess I'm going to do the whole dose unless I hear otherwise! Better put on the coffee I'm guessing!

 

PMPS 129, shooting full 2.5 units w supper.

 

Get a +1 to start then a +2 to see how the cycle will go.

 

Ok will do! Thanks!

 

You've shot full dose on lower numbers before. It's up to you if you want to do the +1, but I'd at least get a +2. Paws crossed for a gentle surf.

 

@Bobbie And Bubba
@Doodles & Karen
@tiffmaxee
@Tuxedo Mom
@Osha
@Sienne and Gabby (GA)
@Jill & Alex (GA)

Just tagging a few folks because they are all involved in the conversation from earlier.

I'd like to add my two cents worth First, Leslie...you did a great job today!!! And I want to preface my comments by saying that, generally, there is not just one way to handle numbers like today so that means there isn’t a wrong way between the options available. So, again, you did great today, Leslie!

Second, since this is a peer review board, differing opinions are always likely to come up and it’s important that they do. The CG should have the benefit of considering what is said and taking it into account when making the decision for their kitty.

Jill posted from the FAQs above, but I’d also like to provide a similar quote from Tilly’s webpage:

I bolded two sections. The first one I bolded because I think a low pre-shot is in the 50s. I don’t think 80s and 90s are particularly low if you have shot green before and Leslie has shot an 83 with a full dose before, recently, as well as a 96 yesterday. I bolded the second because I feel it is extremely important and something taught to me by Jill and Libby.....in most cases, consistent dosing is best for the cat (I am aware some other board use sliding scales with the Ls but we don't here).

Some reasons why you might want to skip, shoot a BCS, or stall include:

• new member facing blue or green for the first time
• new member (or really any member) without much data or without experience handling lower numbers
• CG is not able to or is not available to test (sick, going out, exhausted, doesn’t have supplies, etc)
• cat is sick, not eating, etc

I would also add that, if I had an acro cat or a cat with IAA, I might consider shooting the occasional BCS or skipping when the situation warrants it because one never knows when the tumor might wane or the IAA break and you don’t want that to happen with an enormous depot.

Having said all that, Wendy said above that I think is so important for members to remember is

.

So, putting a few of these thoughts together:

• Leslie has shot green and has handled low numbers
• A larger depot is still in play and so the cycle today was really most likely due to that thus shooting on time with 2.5u would have very, very likely looked the same as it did

Since I didn’t get the nickname of “the Borg Queen” for no reason, than you might know where I’m headed with this if you’ve been around awhile.

Leslie could have very, very easily shot that 95 on time, with 2.5u. Yes, she fed but she’s not brand new here and she fed LC. As I have seen happen so many times, the stalling results in numbers continuing to fall. Instead, why not shoot the 95, feeding a nice helping of LC and test at, even +0.5 but no later than +1, would have been fine.

Also remember that when we do stall, we usually shoot the full dose because stalling already has a bit of an effect on the depot (probably not until later in this cycle or the next one). In my mind, it’s a bit of a double whammy to stall and shoot a BCS.

It’s a learning process and knowing your cat is as well. But, I’m of the ilk that consistent shooting is usually best provided the CG is there to test, has supplies, is rested, etc. and the kitty is eating. But that’s just me

ETA: the other thing that worries me sometimes about giving a BCS dose is I think it can give the CG a false sense of security because they think "less insulin, higher numbers". Not always so.

Surf safely, Gussie!!! Well done, Leslie!

 

Thank you, will read your post several times tonite, thanks for the vote of confidence!
We are off and running already tonite.
+1 = 98 down from 129 at PMPS

 

Will test in 30 and break out the LC unless the consensus is I should intervene sooner given the 31 drop at +1

 

I would test in 30 and see where he is.

 

Got it! Thanks Marje, have already set the alarm! Fingers crossed!

 

Yes..fingers crossed. He and Osha seem to be on a similar mission.

 

+1.5 down to 74. My instinct is to start intervening to encourage him to surf w LC, is that smart?

 

Yes. I would definitely give him a good couple of tsp of Food....you know him so I'll let you decide what % carbs to use.

 

And I'd probably test 30 mins after he eats because he might not have onset yet.

 

Ok giving a tsp LC with some HC gravy. Will test in 20

 

Ok

 

The reason I suggest 30 is because we've found that's about the amount of time it takes to begin to see food/gravy affect the numbers. When you do use karo, it tends to work a bit faster so 15-20 mins is fine to retest in that situation.

 

Ok setting alarm for 30. That makes sense!

 

Gave a bit more LC and gravy because it was barely any the first serving I don't want him to fill up early tho

 

We are looking at a long nite

 

Possibly so. If he keeps coming down,it's often good to switch between gravy and food so he doesn't get too full and so the food helps prevent the numbers from falling when the HC wears off.

Let's see where he is next test.

 

+2 =68

 

HC gravy, new flavor, turkey, he turned his nose up at the beef from earlier

 

Ok this is different, he's now trying to hide??

 

Tired of being tested?

 

Pretty good number, though.

Is he ok? I don't want him to get too full but maybe just a little LC and lets see where he is at +2.5 and if he's steady, we can give him more time. I'm sure he's tired of the pokeys, poor boy,

 

Ok thanks, not sure what's happening tonite

 

Will keep you posted, will give LC next. Thought: I had to use a flashlight to test him just now, he's not where there's good light so maybe that bugged him. He is snarly at the ear pokes too, normally he barely cracks an eyelid open. He's got to be tender at this point,

 

I'm sure he is.

If you think it's going to be an issue and he's had enough, then give him more carbs and get the number up so you can slack off the testing a bit.

 

Ok sounds like a plan. Just let him eat more gravy..um it was more than a tsp because I put the can down while I posted so he had a good dose of gravy

 

That's ok. We don't want to dismiss that he might have just had enough. A surf might or might not be possible depending on how he's doing with the testing.

 

2.5 =57 even with all the HC

 

Not sure I understand what you mean?

 

Sorry....I meant that if he's had enough testing and is going to be difficult, you might just have to give him carbs to get him up. Therefore, a green surf might not be possible.

I'd give him a couple tsp of gravy because he's just onset and it's a long cycle to go to be at 57 already. Hate to suggest this but I think until we get him stopped and flat, you should test 30 mins after he eats. Is he doing ok?m

 

More HC gravy

 

See you in 30.

 

Thanks. Agree it's way early to be still dropping, normally he'd be surfing by now.
He is alert but not wanting to be messed with at all

 

Will keep testing at 30

 

Poor Gussie.

 

Yeah

 

+3 77, have to fess up, I put a drop of Karo in his gravy after test before this one.....

 

That's ok. Would he eat a little LC now to try and get him on a surf board and keep the numbers up a bit?

I'd give him an hour. What do,you think?

 

Gus...I think your mama's had about enough fun for one day, don't you??

Time to come up now!!

Yo Gussie!!...I'm on my way to drag you in a little close to shore!! A deputy lagoon Mistress's job is never done!! ~ China

 

Love it!! Forwarded the message to him! He's snavking on some LC

 

Got him to eat some p, haha used the LC I bought by mistake and gave him yesterday!

 

I think he and both think that's a good idea!

 

Thank you Deputy Lagoon Mistress China for the life ring, I think it's working!
+4=77 and holding

 

He's sleeping so I will get him to eat something later if he needs it. I'd like to give him a little rest. Will test in an hour.

 

Can you get an hour's sleep?

 

Probably not!

 

Ok...remember it's still possible the Karo will wear off and numbers come back down so I'd probably test in an hour or so and a little LC food is not a bad idea.

Unless you need company, I think you've got it under control and I'm going to head to bed.

Great job!

 

Ok thanks, I will do that! Thanks for your help today. I will keep pushing LC alternating with HC and will bring out the big guns, Karo if he starts dropping too far and fast. Thank you..
Les

 

Sounds good.....he's had one time that I see right off the bat that he came back down. I feel better that he's flat for a bit at a pretty decent number with not too much time to go until nadir.

Hope you get some rest! And you are welcome!

 

Ate some LC, will test at +5. I'm going to get some coffee!

 

Back at ya!

 

Sounds good. I think you've got it under control.

Ni ni!

 

+5=78, still holding pretty flat

 

Not quite at usual nadir time yet. Are you going to feed? I'm off to bed - as soon as the racoon dispute ends.

 

Haha, if I can get him to eat another bite I will!
I love raccoons! Used to have a tribe that came to visit my patio each nite. One used to lay on his side and eat like a Roman at a feast! Imagine my surprise when he looked right at me and belched! I had no idea raccoons belched! ( tho no clue why outfit think they wouldn't!)
Thanks again so much, sleep well-
Les

 

Nite. Like yr raccoons. Tae care.

 

Hi Leslie.

Just got in from a long day and a night out with friends. Looks like Gussie ran you ragged again!!! I hope he settled down and let you get some sleep. Great job today! You're getting to be a pro!

Gussie, please give the bean a break. She does need some sleep in order to take proper care of you!

 

Leslie

I see you have had another long night...you must be exhausted. You are going to need that time away from home to rest up.

Gus did a very nice green surf for you this cycle and you have done a wonderful job keeping him safe and surfing. I hope you are able to get some sleep soon.

OK Gus...keep up the nice green surf but no big drops next cycle. Your bean needs some rest!

 

Leslie, You have had quite the day and night. Hope you got some rest last night.

Thanks to Jill and Margje for using this thread to reiterate and teach; everyday I learn something new and really appreciate it.

 

Yes, thank you Marje & Jill. I've book marked the post for future reference!