? Should I increase again? Anyone help?

Hi, I’m hating Silver’s numbers. Should I increase again or wait until after this weekend’s curve? Concerned he’s going to be high all week. I’m going to get a test in before bed but even if it’s yellow it’s still been too high the past five days now. So upset I can’t get him in good numbers. I get a blue day or a green then high again for several days. :-(

 

Bump. Anyone?

 

Are you following SLGS or TR? The answer differs based on dosing method. Earlier it sounded like you were following SLGS. http://www.felinediabetes.com/FDMB/threads/slgl-question.187197/

It"ll help us help you if you put TR or SLGS in your signature.

 

SLGS and I know that that protocol says to wait until 7 days but are these protocol P.D. set in stone if you know he is too high? Seven days seems to long to be riding this high. He’s not gone down at all from his dose increase on Saturday and now on day 5 of highs. I’m worried.

 

I can't give you dosing advise, but to say, this requires the patience pants. It's a marathon not a sprint. And our kitties run at their own pace. Big hugs, someone with more experience should be coming on soon. It will get better, you will find his dose. Phoebe has proven that to me after quit a few months.

 

I can work on having patience but not at watching my cat waste away before my eyes as I can’t get these numbers to come down. I’m so upset.

 

SLGS is not a protocol, but a dosing method based on experiences here. What is the reason you are following SLGS? If it's because you cannot monitor during the day, then the reason for holding the dose is safety first. I wouldn't increase if you can't monitor.

 

Ok.

I’m following SLGS as I’m gone 12 hours a day.

Is he not in dange being so high so long?

 

Rather too high for a few days than too low when you cannot monitor.

 

You actually can do TR with 3 tests per day.....the 2 Pre-shots and at least 1 other test somewhere in between but it can be hard on a worrying caretaker and may require losing some sleep to get some later tests on the PM cycle

The high numbers are a problem, but they do take time to do damage. Are you checking for ketones? They're more likely at high numbers than low ones.

From the "Can you do TR with a full time job" thread (highlights are mine)

The hard part of managing tight regulation while working is the point at which the cat starts RUNNING down the dosing scale. This is not an easy time for anyone – be conservative if you need to. I was very lucky that Lucy made her big run during the holidays, when I could take extra time off work. If you are not able to do that, be prepared to skip shots or take reductions when you may not want to. It’s ok, if your cat is intent on getting those dose reductions he or she will do so anyway! The payoff during this time can be huge, so some short-term sacrifice can be worthwhile. Post on the board for suggestions.


Tips for working within a tight schedule:

• No dose increases without enough data to know where this dose is taking your cat. If I was able to get the right tests during the week, I could often increase the dose after 3-4 days. If I wasn’t confident, I would wait until after curve day. It is VERY important that you are able to trust your dose if you will be gone every day. Fortunately that is not hard to do if you manage your dose changes methodically.
• Know your cat – plan your dose increases around your cat’s typical response. For example, if your cat usually responds on cycle 3 of a dose increase, plan so cycle 3 will be a cycle when you’re home. I often did increases on Thursday nights – that would leave me home and able to monitor on cycles 3-7. Depending on the results of those cycles, I could do another increase if needed on Sunday night.
• To avoid getting into situations with too much overlap and having to leave for work, especially because Lucy was prone to dramatic responses, I tried to avoid shooting any earlier than +11 during the week. If there was a day I arrived home after 7:30 pm, I would either skip that evening’s shot or skip the next morning’s. Use your head about which one to skip – if at 7:30 she was high, I would go ahead and shoot and skip the AM. If the evening number wasn’t too bad, I might skip the evening shot and plan to shoot in the morning (which would be +24). This might cause higher numbers for a few days, but is sometimes necessary.
• High carb food can be your friend. Of course you don’t want your cat to be over dose, but if you do run into a low number at a time when you have to leave, carb her up! We call that aborting the cycle. High carb gravy, syrup, whatever works for your cat. If you have been following the Tight Regulation protocol and being careful with your dose increases, your cat should not ever be so far over dose that you can’t fix it with food. Safety first.

This all sounds great, but is it safe?

Diabetes is never 100% predictable, but by getting a few spot checks every evening, you will have a good idea of how low each dose is taking your cat and whether an increase or decrease is appropriate. By contrast, basing your dosing on the results of a single curve can leave you guessing – kitty was high all day on the curve, but is he really high all the time, or did you just happen to choose a day when he was bouncing to do your curve? To me, getting some midcycle tests in 8 or 9 cycles out of every 14 seems safer than relying on curves in only 1 or 2 cycles.

Just some things to consider.....I'm not pushing anything on you. You have to do what makes you comfortable. It doesn't do any good to be more aggressive with the cat's treatment and kill off the caretaker with worry

 

I can’t do this. I don’t keep good health and cannot lose sleep. I can only get one test in during the evening. If I cannot ever know what his nadir is until the weekends how can I possibly do TR when it says to base dosing on nadir.

I do not have the time or energy for TR and am doing the best I can. I’m finding I cope less and less well with stress than I used to. My mom is also in hospital having just had a stroke - she’s the other side of the world from me and it’s more than I can handle.

 

I gave it a lot of thought and I’m gonna increase to 1u tonight. He’s been high the past six days and I can’t bear to wait until the weekend with him so high. I’ll get some more evening tests in to make sure he is ok.

 

Glad to see you made it here.

 

Thanks