Looking for advice!

Hello! I'm relatively new to these forums and I've been posting in the Relaxed group because I can only test at pre-shot times Monday-Thursday usually (I work full-time out of the house with a long commute). I also have two very young children who make things inconsistent at home, though I'm generally able to get a full curve each day I'm there since I'm getting much faster with the testing. I think the Tight Regulation Protocol is more in keeping with my personality (I'm very data-focused!), but I know I can't do it safely for her and that's obviously the real goal!

I also decided to post over here since there are so many more people and I'd like some guidance in what's happening with Mona. I switched her to a wet diet from dry W/D about two weeks ago and her numbers instantly plummeted. I had to drop her insulin really quickly to keep her from going hypo, and then I was having the problem that she wasn't low enough to shoot comfortably before I left in the mornings for work because there wouldn't be any way to test or help her up again if she went too low.

So, I stopped giving her insulin entirely 4 days ago. Since then, her number have been more stable than they were on insulin, though they still rise and come back down after each meal (food at am, +6, and pm). But, they're riding just above the normal range, so I'm wondering what I should be doing at this point. I can't do a curve again until Thursday.

Any opinions are welcome, and thank you!

I'm not a dosing expert, but Mona looks to be "in the zone" to me. Great work! I hope she keeps it up!

Welcome to Lantus Land!

Mona's numbers do look very good without insulin. Like you noted, though, they are just a little bit outside of normal range. (Recent research suggests that toward the 'closer to normal' numbers, the AlphaTrack is about 18 points higher than a human glucometer's readings.) One thought may be to re-start insulin at a very small dose -- either 0.1u or 0.25u -- and see how Mona does. Are there any PM cycles when you'd be able to get a test closer to Mona's nadir?

Testing for her PM nadir, as in testing her at 1-3am? It might be possible to do it a few times, but with the time the newborn has me up overnight already (unfortunately +4-6 isn't when HE likes to get me up!), it's probably not safe for me to do it regularly.

Oh, and that reminds me that I need to change my signature! I switched to the Arkray (Relion) BG monitor recently. It's marked as a hard break on the spreadsheet, but I didn't change my signature. So, her insulin-free numbers are all using a human monitor.

Hi Katie! welcome to you and Mona!

let me just add that you're doing plenty of testing to follow Tight Reg. Her numbers look good. When I see a ss like hers, i think remission is very possible with a little help. You do need to get at least one test in the evening cycle, but it can be at +2 before you go to bed.

when you're working, having a timed feeder is an essential tool. That's your insurance for going to work. If you have low numbers in a cat, you feed and then retest in 30 minutes - and repeat until the cat is staying up in safe numbers (over 50) without food. When I started back to work I used the timed feeder to be "me." LOL. I had the PetSafe 5 Compartment Feeder. You can have 4 compartments waiting to open. I knew Punkin always ate at +3, so I set it to open every day at +3 and put his snack in there. If his preshot number was lower, I put more food in the next 3 compartments as well. One compartment is open, so you can only fill 4 to open. Then I'd set the timer to open at 10:30 (+3.5), 11am, 11:30 and either DH or I would come home at lunch to check him and restock the feeder if necessary. We both work relatively close to home.

Of course, that didn't happen every day for us, but it was our regular go-to back-up plan. You can do the same thing at night. If you're able to get a +2, that acts as a direction pointer for how the rest of the cycle is likely to go. We can help you look at that and decide when you'd need the feeder to open or what to do about testing for the rest of the night.

I agree with Sienne about restarting the insulin. BGs in the 50-120 range are considered normal. She's got many hours every day that our outside the normal range, but not by much. I like Sienne's idea of restarting at either 0.1u or 0.25u. The very smallest dose is just a drop - you can achieve it by pushing the plunger in hard, inserting the needle into the insulin, then releasing the plunger. The vacuum you created by pushing the plunger in hard will suck in a tiny drop of insulin.

Some cats just need a little bit of support to allow their pancreas to heal. If you'll look at the New to the Group? yellow-starred sticky you can see photos of tiny doses. I think you could restart at either 0.25u or less and see how she does.

I don't want to overwhelm you so will stop there. Mona's doing great - it might very well be that a few weeks of getting her into tight regulation will be all she needs to heal and go off of insulin (OTJ). You can see we've had several cats go off recently and several more doing a 2 week no-insulin trial to see if they can hold good numbers.

Let us know how we can help you!

Looking really good so far!

I agree that it looks like Mona could use a little bit though...maybe .1 or .25 to get those numbers a little lower

If you are getting up with the baby, if you can get a test then, that'll do a lot of good towards showing us more of the picture. Trust me..you will get to the point where you can poke in your sleep! (and with a new baby, you probably are doing that more than you realize....LOL)

There are times when the only way I know I got a test was because there's a number on the meter I don't remember getting, and an entry on the spreadsheet I don't remember making :lol:

You don't necessarily have to get up an "extra" time....but getting some different times overnight will help "fill in the puzzle" so we can see the picture clearer

Thank you, everyone! I think I'll start her on just a drop of insulin and see how that goes. My syringes don't have half-unit markings (a brand new box, of course, I thought they did!), so it'll be possible for me to be more consistent with a .1/drop dose than .25, plus I'd rather see her riding a little high than low since I can't spot that most days.

I'll give her a drop tonight and get at least a +2 pm reading and then try to get one after another of the baby's feedings (they tend to be at +2, +8, and +10).

Hi Katie!

No advice from me, but I want to welcome you to LL as a fellow Californian! It looks like switching Mona to canned food made a big difference in her BGs, and it probably won't be long before she's OTJ (Off the Juice). We've had kitties here recently that went from really high doses to totally OTJ in days after eliminating dry food from their diets, so it is possible!

You will find there are some wonderful, caring, knowledgeable people here on the TRP page, and you will get lots of support, too. Good luck with getting Mona regulated and hopefully OTJ!

Isn't it amazing how just getting them off the dry food drops the BG numbers! I think the drop is a good idea, we like to support the pancreas for as long as possible to help it heal and make OTJ a real, lasting possibility.

Getting a +8 should be fine, not all cats nadir at +6 and the nadir can drift around anyway. Testing at +10 is a good idea too, it will give you a good idea of where Mona is headed for the preshot. It give you time to make plans for the upcoming cycle.

ETA: Where in Central CA? I'm on the coast in near Pismo Beach!

Hello, fellow Californians! I'm in Los Padres Forest roughly between Santa Barbara and Santa Ynez.

Sweet! Near Lake Cachuma? I often drive down to SB that way! I live in Nipomo.

Welcome Katie and Mona!

Ann, we're pretty close to each other! I live on Paradise Road off 154, past Cachuma from you.

Welcome Katie and Mona. I agree with the starting up again of insulin at 0.10 (one drop), and trying to take advantage of the test time when you're up with the baby anyhow. I'm from California too, Walnut Creek. I'm glad you're posting over here.

Wow, Katie, you have quite the household! Welcome to LantusLand! Mona sure did come down the dosing ladder when you switched the food. I'm glad you're posting here. I'm from Illinois but I've visited California. :lol:
Liz

Lookin' good here. I agree that a tiny bit of insulin is what you should do. Timed feeders are great. Just be sure to line up the 5-compartment feeder according to the instructions. Otherwise it could open between compartment dividers and Mona won't be able to get her face in to eat the food.

Ella & Rusty (from New York!)

ella's got a good point - you'll see on the reviews for that particular feeder that people complain that it doesn't rotate fully and the compartment is only half open. we discovered that only happens if you don't have the feeding tray fully seated in the base. there is a button you can press to manually forward the tray one compartment. So we always seated it completely and then rotated it one compartment to get it into the right spot. Other than that, ours worked perfectly. Some people have complained that some feeders don't have easy to set times, or preset time functions - if you're looking at different feeders, make sure you check that you have the option of setting times that you want. that's pretty important.

Nice AMPS! Are you going to stick around LL? WE like to keep tabs on each other (especially a kitteh so close to having a party!) We post a new condo every day to keep the posts from getting too long.
BTW Peyton's mom has a thread going on comparing different auto feeders.