11/21 Mary Grace AMPS 327 + 2 312

Hello LL!!

Yesterday: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=108488

Mary looks like she is feeling better, still testing negative for ketones. Her peeing is still very heavy, but she is not drinking as much water has she was.

I am really at a loss for what to do to try and get her to surf at lower numbers. I have read and read other's condos and questions. I regret starting her on Lantus so high (2.5 units) and the vet wanted me to do 3 units. I had several members here tell me I should start over and just do 1 unit but I was leery of that because of her high numbers. I have said this before but feel like I need to stress how my own type 1 diabetes knowledge has really blocked my brain from accepting anything else (We humans don't bounce--only when we over compensate for a low--which is very typical) So I kept wanting to increase, even when people here are explaining and explaining so patiently about the bounces. Type 1's when figuring out their rates per hour will always increase when the numbers are high. But her numbers seem the same before and after each increase I have made. So I concede, I am not the all knowing just because me and Mary Grace share the same disease. It is the same but also different in treatment. Please forgive me for what may has seemed to be stubbornness, I truly am putting Mary Grace before myself in regards to financially getting everything she needs and I am checking her bs before I even look to see where I am!
I am trying to be patient and just go with this dance, but wonder what I should do differently (if anything).
Thanks to those that have stuck with me and for all the others that gave me such warm welcomes.
Hope everyone has a good day.

Ugh! I can tell you're frustrated. :YMHUG: It is sooo hard to be patient with this whole thing! You have been on 2.5 for a long time, but it's hard to know just how low she is going during the day. Seems to me protocol would dictate a .25u increase, but I'm no brainiac when it comes to dose changes. Please get a second opinion on that! Perhaps some more mid-cycle testing this weekend will paint a better picture? If you would like more expert eyes, add dose?? to your main header and we can see what others think.

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

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Hang in there, Elizabeth! You ARE helping Mary and you're on the right track!

Remember Elizabeth...our kitties are leading this dance...all any of us can do is follow...and yes, it's horribly frustrating!!

I know you have some problems getting mid-cycle tests due to work, but I think it would be safe to go ahead and increase her to 2.75 and test as often as you can...and then let's see where she's at over the weekend when you can get more testing in.

We can always fall back and punt and start over at 1 unit, but since we're here now, I think we should just forge ahead a little more and see what her numbers tell us.

One thing I have noticed on cats that get higher doses...at some point, they seem to hit that "perfect" dose and then start working their way down the dose ladder...fast!! I guess you'd call it a "breakthrough" dose..it's like their pancreas all the sudden says "Oh yeah..I get it now...you want my blood glucose to go DOWN!!" :lol:

hi elizabeth!

don't feel like you need to apologize - really. we try to give information out so people can make decisions, but you are the person standing there, watching her and you want to be able to trust your gut. i know i'm not offended if you don't take my advice and i sincerely doubt anyone else is either. you're the person in charge, our goal is just to try to teach you what we know so you can make those decisions.

this isn't a quick fix for hardly anyone. that's why we say "it's a marathon, not a sprint" here on LL. occasionally we get a cat here that is here and gone in a couple of weeks. the cat just needed a little bit of support and then their pancreas kicked back into gear. more common is that it takes months. we just can't control it all.

i am unsure about increasing the dose. as i've said, i'm not certain she's not overdose. the key bit of info in dosing with Lantus is to be able to answer the question about how low the current dose is taking the cat. she looks bouncy - which isn't uncommon.

but i am particularly aware of her drops from the preshot highs to +1 and +2's in the tests you have gotten. the typical curve would have us seeing an increase in numbers at +1 from the carbs in the food, then back to about the same number as the preshot at +2. we're not seeing a food spike and her +2's are often quite a bit lower than the preshot. with cats, too much insulin can look a lot like not enough insulin, so it's just kinda tricky.

so i think it's possible we're having some zig-zag looking cycles in there with high highs and lowish lows. can we hold off a dose change til this weekend, which is almost here, and could you get tests every 2-3 hrs over the weekend so we have a little more info to look at?

if she'd started with a weight-based dose it would've been 1.6u - if i'm remembering correctly you said she's about 9.5lbs, right? so starting at 2u isn't that far off. if she had started at 1.5u, then we could have more confidence that she's not overdose, but in that absence, we can still move on, i just think we need more data. another option would be to drop her dose to 1u and hold it for a few days to see what that does. but i'd be reluctant to recommend an increase at this point.

that said, while her numbers show a lot of highs, cats seem to be able to tolerate this pretty well. some go for months, literally, in high numbers before we hit the right dose with them to bring them out of the clouds. so don't over-worry about it. if you look at some of the other cat's ss, you'll see plenty of high numbers in many of them. i know it's hard not to worry, especially since you know what it feels like to have blood sugar fluctuations more than the rest of us do. i imagine it doesn't feel great.

how does that sound to you?

:YMHUG: Elizabeth I am feeling your pain and frustration I am the kind of person who wants things to be good, not soon, but YESTERDAY :lol: And lord help me when it comes to my babies! But everyone is right and I know that now. It is a marathon. A few lucky people get to sprint through, but the rest of us become a family and hang around cheering each other on. You really are doing an amazing job and you obviously love Mary Grace so much, but try to remember that the number one goal to all of this is making her 'feel' good. I still struggle to remember that, but it is so true. The kitty is more than the numbers and yes we want those under control, but we want her to feel good everyday. You will continue to see improvements, watch for that as much as you do the numbers on your meter. Love her with all your heart every day, be open minded to different approaches, research and most importantly go with your gut every day. Continue to ask questions, any and all questions. And let her lead this dance and she will help teach YOU the moves We are gonna get thru this my friend, together ;-)
Scritches to Mary Grace and hugs to you!

Tara, Julie, Chris and Tara THANKS for the words of encouragement and advice.

Tara: Yes, I am frustrated but without FDMB I would have gone nuts! I am not really getting any support from family or friends, just one of my neighbors. Its amazing how many people think its cruel to test her sugar! And I was looking at her labs from her initial diagnosis and it stated "no home monitoring". Thanks for the hug!

Chris- I hope your mom is doing better! I have had you both in my thoughts. I wish I would have started the 1 unit but I thought the more insulin you take, the harder it is for your pancreas not to need it (thats why type 2 diabetics should never go on insulin--they can do it w/o) But great to know that maybe after hitting that magic number she might require less. I am going to hold off on the increase for at least a few days, I will be able to get some good amount of numbers like I did last Saturday. Probably not every hour but at least every 2 hours.

Julie- I tend to think it is the bounce to. On 11/17 at +10 AMPS she was 286 then a very high rise at her PMPS 457. She is consistently lower after her shots at +1 and +2. I am going to try and relax and let her lead this dance. Thats how I got successful at testing because I finally relaxed (thanks Chris for all the tips)

Kim- Yes, I am the same way, now! now! now! She is my baby and i want her OK. She and her civvies are the absolute world to me. And when I see a 411 like I did tonight at PMPS, I cringe because I know what 411 feels like to me... So I am striving to seperate those feelings and she the whole picture..like her coat seems shiny again, shes playing, shes purring (even when I am testing sometime---NEVER would have thought that!)

Everyones support here at FDMB is unbelievable, what a wonderful community of sugar cat lovers!

Oh and some might remember me talking about my continuous glucose monitor, well I have found where some vet hospitals use them. They are not recommended for home use because the cat would have to stay within 20 feet of the transmittor and the expense (cash price is about 950 for a three months supply)

Sending warm hugs to all!