Sept 9 Felix AMPS=359, +3=328, +8=108, +9=89, +10=121, PMPS=255, +3=334

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Susan&Felix(GA)

Susan&Felix(GA)

Member Since 2017
Felix's curve seems to have flattened out. He's keeping to himself today, which isn't unusual for him, but he had been more social the last few weeks.

Do I understand right that the SLGS protocol would be to hold at 6.25 units a couple more days and then do an every-two-hours curve? Would I then just go off that curve to decide the dose, or do those bounces get factored in?

I'm getting antsy to increase back to 6.5 units!

But I'm also haunted that I could've passed his ideal dose a while back. His first fructosamine test three weeks after coming home from the ER for DKA was 590 and the vet said to increase from 2 units to 3 units. Three weeks later, his fructosamine was 807, but he'd been on a cortisone cream for ear issues, and the vet said to increase from 3 units to 4 units. Felix didn't seem to feel as well the first couple days of that, so I backed off to 3.5 units for a week. Then when I began some home testing in early July, I went back up to 4 units.
 
It looks like he bounces from the blues. He saw blue on the 6th preshot after the greens. So based on that you might see blues in the 5th or 6th cycle after his last blue.
Are you doing SLGS because of the dry food diet?
 
StephG said:
Are you doing SLGS because of the dry food diet?
Click to expand...

I guess going slow felt safer to me. But maybe faster would be better at least while he tends to be high? Or is that the recipe for bounce-bounce-bounce? Sorry--I've been reading a lot here, but I just don't have it all sorted out in my mind yet.

It sure would be nice to see those blues again! Or even if he'd just hang out in yellow for awhile.
 
My cat did the same thing. He would bounce from yellows!
If I remember correctly, tight regulation isn't recommended for cats on dry food.
I personally don't agree with that but stopped the couple teaspoons of zero carb dry food my cat was getting so we could follow TR. We switched from another insulin so I was comfortable moving right along and going up the dosing scale.
Kibble addicts are a hard switch. My civvie was a hard switch but we finally got him eating wet. He now gets some of the young again dry since I don't feed it to Chuck.
It frustrating seeing them in higher numbers when you know they have seen better. I was impatient when he was higher then dragging my feet once he saw better numbers. One end of the scale to the other. Chuck had to get use to being in better numbers and then his bounces started to get lower. Pinks vs red. Then yellow vs pink.
I think you're right that increasing while he's high might just give you bounce after bounce. Sometimes you can shoot through the bounce if they earn a reduction but that's something a guru would have to look at and see if it was a good idea.
Do you free feed? Chuck couldn't have food past +6 when he was higher numbers. Now that he's a bit less bouncy he can eat up to +8 without going too high.
I think getting some tests later in the cycle and over nights might help see how he's doing especially on the 5th or 6th cycle after blues or better numbers.
The blues that were only once cycle apart makes it look like he might be able to clear bounces a bit quicker too.
 
Here is a link to your last condo. http://www.felinediabetes.com/FDMB/...145-7-214-pmps-506-2-483.183543/#post-2036805 We like to include that so people can go back and see what has already been discussed.

Steph is right, if you are still feeding dry, then you shouldn't try TR. But SLGS is very flexible, so you can test as much as you want. I see you've started getting some nighttime tests in, which is awesome. Many cats go lower at night. If you are trying to get Felix weaned off dry food, check out Catinfo.org for great info on feline nutrition and tips for transitioning from dry to wet food.

Susan&Felix said:
Do I understand right that the SLGS protocol would be to hold at 6.25 units a couple more days and then do an every-two-hours curve? Would I then just go off that curve to decide the dose, or do those bounces get factored in?
Click to expand...
Yes, according to SLGS, you hold a dose seven days then do a 12 hour curve to see how he's doing. Then:
  • 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
Click to expand...

Tomorrow will be the 7th day on 6.25. Are you able to do a curve on Monday? One thing to take into account is if you see some lower numbers between now and then, Felix might be bouncing on curve day, which isn't helpful. However, you are getting some random tests in, which is wonderful, so you should still have a pretty good idea if this dose is right or not. I'm not a fan of the way you got to this dose, but that's water under the bridge, so what we now need to figure out is whether or not Felix really needs this much insulin. I'm sure you're read here somewhere, or been told, that too much insulin can also look like too little.

For now, keep doing what you're doing. If you can get a few tests in later in the cycle, that would be good. Just look at the SS and anywhere you see a lot of white, try to get a test in that range next time. Think of it as a jigsaw puzzle - the more pieces you fill in, the clearer the picture becomes.

In case you haven't seen it, here is a link to a post we put together to help new members get comfortable using the Board. Please ask lots of questions. We love to help!
 
Chuck's spreadsheet sure is colorful! And inspiring! I know that impatience vs. foot-dragging thing very well.

I have tended to free feed. I've been trying to get more aware of meal-sized portions for everyone so it's less likely that there's much left to scavenge. Now that the other cats are getting more canned food, I don't feel as compelled to always have dry available for grazing. I do leave a little food out at night, but it's during the day that Felix tends to do his eating-as-a-hobby.

Thanks for the testing advice, too. I'm eager to get useful data.
 
Thank you, Tricia! Lots of helpful stuff there. I'll try a curve on Monday.

By the way, Felix seems done with his alone time and has come out to snuggle. He appurrciates all you guys do to try to help him and other kitties feel better.
 
I like the way you have been testing lately. I think you would have seen him dive low by now if the dose was too high.

For curves, you can optionally test every 3 hours for 18 hours, so that would get some detail on a second cycle. If he is clearly bouncing on the day you decide to curve, I would reschedule it. The point of a curve is to get some detail on how low he's going.

For larger dose cats above 5 units, we usually move to 0.5 unit changes. If you think about it, 0.25 is a pretty small percent chance of his current dose. If his nadirs are almost where you want them to be and you are tweaking, then a 0.25u change can work.
 
This is new--lowest numbers late in the cycle.

I had planned to test around +9 just because I don't have much data from that slot. He was so hungry from restricted grazing today that I let him have some food at about +8 and then thought: oops!, that's going to affect that +9, so I'll hurry and test at +8 before the food takes effect. 108?!

I thought maybe there was something wrong with the strip, plus I figured the food would bring the bg back up. But the retest at +9 is 89.
 
I know greens aren't bad, but they kind of freak me out: I wish he'd let me get a little more used to seeing blues first.
 
Wendy&Neko said:
According to SLGS, that 89 earns a reduction! Seems to always happen, you talk about an increase then they throw you a lower number. :p Down to 6.0 units you go.
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[Reminding myself there are no stupid questions except the ones you don't ask]: Does that mean tomorrow night (after the full 7 days/14 cycles) or with his next shot (less than an hour from now)?
ETA: Just found the answer to my question in the SLGS sticky:
"Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately."
 
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Sorry I had to abandon you tonight, but I asked Wendy to check on you, just in case. Turns out you did just fine!

Looks like a bouncing we will go! :rolleyes:

Congrats on the reducie.
 
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