I was looking at Emmett's SS - my goodness you've had an interesting July and August! Shooting all those greens!! Do you find it nerve wracking? I find it very stressful - it's like I'm walking a tightrope because at any minute Luci will take a dive and then she gets a reducie...but I feel like I have to test her constantly -that's when I need one of those sub-dural testers she needs to wear so I don't chase her and poke her ears every half hour or at the very least hourly...I'm just not there yet as far as catching my breath when she goes green. Looks like Emmett however is doing great on his continually dropping dosage. So how do you decide it's time to decrease without that dip (lower than 50?) I never know when to increase, but she gives me the lime green warning that she's ready for a decrease....after all these months still trying to figure this out.
Hmm...good questions. Haha. Well, I have dosed a few times with really low preshot numbers. ...I thought it would be fine, and it was but never again will I do that. I think he was at like 45 or 47 or something. I wouldn't advice that.
However, I have done a lot of reading on this from multiple sources (not only this site). I can tell you that in all cases, the cat must stay within the range of a normal cat continuously throughout the day...with a few blips above (that's okay...you'll see maybe 10 blues in Emmett's chart since the end of June).
Now that said, when he was up at 7 units or 6.5 units (read -- "higher dose") shooting a low number was very nerve wracking. If I saw a lime green, I'd reduce immediately at the next dose time. If above 5 units - 0.5 unit reduction -- so 5.5 units to 5.0, etc...); if below 5 units -- 0.25 unit reduction, so 4.5 units -- reduce to 4.25 units. Like you're doing.
When to increase...honestly, Emmett had a lot of bouncing around, just like Luci, he had a few green runs...sometimes for a few days, even longer. But then he'd go back to higher numbers...or not constant green (below 120 I think the protocol says). FYI, right now, Emmett seems to hover between 65-85 most of the time...fingers crossed this continues.
So, in Luci's case her numbers are still bouncy, and she seems to get some lime greens (a few quite low); but if the reduction happens too soon she wont stay in the green range, she'll bounce back up. THe whole idea is to tell the pancreas that these numbers are good (I believe...lol -- pretty sure that's the insulin engine...). If the cat doesn't stay low, then the pancreas just keeps making glucose when it thinks it should. IMO, if corn syrup is given or super high carb food, then this "learning" never happens. When super high carb is given, BG goes way back above 120, and then glucose is all wacky again. I am no trained vet and I just speak from how I've dealt with Emmett -- some people may not agree with me too (I have made mistakes as well...like I speak above...too low -- don't dose). I use to test like crazy (since June - max history for contour application, I have 656 readings lol -- and that's me doing less readings) -- I'm probably up to 1500-2000 readings at least, contour app doesn't store my older readings.
Anyway, I'm usually dosing above 60. I have dosed and would continue to dose between 50-60 (and do a +2 or +3 reading). I mostly always do a +3 or +4 even to this day.
Don't dose below 50 (like I did once -- very nerve wracking) ...if below 50, wait 20 mins, check BG, if above, I'd personally give normal dose. I have done this waiting thing and I honestly don't think it's beneficial. From my experience this only delays the insulin injection, allowing the numbers to rise too much. Lantus injection doesn't start on-setting for at least 2+ hours, so if you wait to inject the curve and carry-over from the last dose diminishes and this onset happens too late allowing the BG to rise between the two.
I know it's nerve wracking, but imo, a dose when low is what needs to happen to get the cat on track. When Emmett was low and high dose, I'd inject, feed, wait an hour (time for work), do a reading...if his BG's had risen, thank god, I'd go to work, if they were close to the same or lower, I'd have to work from home. No choice. 100% of these times, Emmett managed to level out for the day. And a lot of times, wound up having super high numbers...but if that happened and he didn't stabalize to green, another increase in units was required.
So, with any increase you want to hold for 8-10 cycles, but I would say if cat is still getting high numbers or sporatic numbers at 8 cycles, another increase is in order (0.5 above 5 units -- 0.25 if below 5 units). I've even upped after 6 cycles...but that's not required...slow is better than risky moves.
At any rate, they advise on here to wait AT LEAST 4 cycles for the previous dose to level out and into the higher/lower dose. Lantus (from my research) actually builds up crystals in the blood stream or crystalline depots from what I understand, so I believe what happens is after 4 cycles this depot is established. If you wait too long for the next dose ooooor you decrease the dose but the cat still needs x units of insulin the depot starts depleting and once gone (ie cat using the insulin shot PLUS depot) the cat starts having crazy high numbers again.
When Emmett started getting lime greens when he was up with the high doses (+5 units) I'd feed medium carb and test 30 mins, 1hr, 2 hrs...or more depending on the numbers. And reduce immediately at the next dose. You can see my unit chart, how the dose dropped really quick from 7 units to about 4 or 5 (I can't remember when he started leveling out).
Anyway, I wrote a lot of mumbo jumbo...hopefully some of it makes sense. The bottom line is, must shoot low to stay low. But be safe, if you're not comfy, give your high carb food, or medium carb and test. I'm not there with Luci, so I can't observe her behaviour or anything. If she's getting all crazy and meowing alot, in my experience this means one of 2 things -- BG's are quite low (Emmett does this usually with BG's below 50) or BG's are really high (Emmett did this for months with his sporatic times).
Now just as a side note and for some comforting numbers. I my family has multiple cats, they all get to visit each other mostly on the weekends. I also have multiple BG meters (cause I got them all free lol -- it's silly -- I have like 4 contour meters). Anyway, I have tested most of the cats.
Clara (Emmett's blood sister -- also 9 years old): her BG readings range from 60 (3.3 mmol) to 74 (4.1 mmol) -- I have read her 4 or 5 times and have never got anything lower or higher than this. ...the 60 was first thing in the morning last weekend.
Marty (Albino kitteh -- 2 years old): his BG seems to range from 70 (3.9 mmol) to 76 (4.2 mmol)
Bruce (14 year old): only one reading here - but he was 100 (5.6 mmol) -- he has some health issues though, like IBD and unknown problems, so I'd say 100 is pretty good for him.
Anyway, all I'm saying is the blood relative of Emmett, most of the time, gets lower readings than Emmett's lows you see in that chart. So shooting at the low numbers is simply to maintain those numbers, NOT to reduce further...the insulin curve must be smooth and stay low...
Okay, I think that's enough lol. If you have questions, or none of this makes any sense (I didn't proof read it haha), just respond and I can hopefully clear it up. And for others with experience greater than mine, if anything I wrote is against protocol, please say so and correct me...I don't wanna give bad advice. I've simply outlined what works for Emmett and myself.
R
I was broken hearted about that diagnosis and his recommendation! Just couldn't accept it...so here we are...with a fine group of people - all with the same objective - trying to save our FD cats from that fate...totally unnecessary...when are the vets going to catch on? Maybe attend some seminars? FD is not a killer...doesn't have to be...but it is a ton of work...and home testing is an absolute requirement - they should offer to teach their patient's parents how to test...not offer an immediate 'out' of euthanasia