11/29 Chester Clarification Please!

Home alone all week, so maybe the kibble will be better monitored. Of course, my track record isn't the greatest either. I'm going to wait about 15 minutes before shooting this a.m. He ate a lot and pretty fast. I have a funny feeling that might find it's way to my floor. :?

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Re: 11/29 Chester's +11=377, amps 363

Good morning guys! I hope that chester is able to keep his fuds in his tummy and not on your floor ... have a great day guys!

Re: 11/29 Chester's +11=377, amps 363

NO PUKUS NO YACKIN NO HURLIN NO SINGIN' RALF NO!!!

Re: 11/29 Chester's +11=377, amps 363

Hope Chester settles. Perhaps if you hold the dose (your choice of dose) for 5 days he will attain some consistency in his numbers. I realize you are afraid of low numbers but maybe you can find his good dose for blue numbers. I have attached the guidelines for reductions. Good luck with no forbidden foods. Normal feline BG is 60-120 or 70-120.

Reducing the dose...
If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
If an attempted reduction fails, go right back up to the last good dose.
Try to go from 0.25u to 0.1u before stopping insulin completely.

Random Notes...
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.
A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.
Sometimes a dose will need to be "fine tuned" by adding some "fat" or "skinny-ing up" the dose.


There are circumstances such as ketones present, an unusually low preshot number, a caregiver leaving the cat with a sitter, relatively high flat curves, loss of appetite, infection, a schedule change, ability to monitor, etc. which may call for adjustments to these guidelines.


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These are "general" guidelines which have worked for many cats.
Every Cat Is Different. Learn how YOUR cat responds to insulin.
We are laypersons - not veterinarians. Please discuss dosing, methods, and care for your cat with your veterinarian.
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Re: 11/29 Chester's +11=377, amps 363

Let me preface by saying I've read the stickies...and reread the stickies...

Reducing the dose...
If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit.

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However, I've also been told several times that if I'm using an AlphaTrak meter my cutoff is 80. The AlphaTrak consistently measure quite a bit (30-40 often) over the Relion (I bought one to compare) that I think this makes lots of sense. If Chester was 40 or 50 on an AlphaTrak he would most likely be comatose.

If an attempted reduction fails, go right back up to the last good dose.

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Which is what I did when he got below 80 twice in one day. I guess my frustration comes from being told not to jump around so much when what I'm doing is correcting what was a failed dose. I had him on .33 for six cycles before switching back to the .5 (which I thought was along the lines of what the stickies recommended). It was the .5 that was apparently too high for him, which I corrected by going back to his "last good dose."

Sometimes a dose will need to be "fine tuned" by adding some "fat" or "skinny-ing up" the dose.

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This is frustrating me as well. I've been told to just "skinny" up the dose, but I'm only reducing or increasing (as the case may be) by one drop. I don't know how you can physically shave a dose in less than one drop increments. I have to do something that my husband will be able to duplicate when I'm away. He won't be able to reproduce what I see as a large drop or a small drop, so going in increments of less than a drop won't cut it in this case.

There are circumstances such as ketones present, an unusually low preshot number, a caregiver leaving the cat with a sitter...which may call for adjustments to these guidelines.

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Which is kind of the boat I'm going to be in when I leave him with my DH...just trying to get prepared for that.

I'm sorry to sound so whiny and frustrated...but sometimes I feel that my head is being turned every which way...that I'm trying to follow the stickies only to be told that I'm not by some and that I am by others. I'll admit...sometimes I'm hesitant to post what I'm doing with Chester because I feel I'm somehow always going to get it wrong (except when he gets into the kibble...I KNOW that's wrong!)

It looks as if he is bouncing to me....I hope that when this bounce is over, he will get some nicer numbers again.....
that .50u looks like it drives him right down, eh?
Not sure if anyone has talked about feeding mini meals to you in the past...but Jaye...you are usually gone all day so that would not have worked in the past with you. If one feeds mini meals at +1 and +2, it slows the steep drops. So, the numbers do not get quite as low as what you saw in the 2 cycles two days ago.
I would hold this dose for a couple more cycles to see if he brings the range down.
Once can control the numbers a little with food. So, the mini meals work for a time, but if they really want a dose reduction, the still do go low no matter what you try to do. He went low twice in one day on that .50u.....
It is good that you will be the dry food monitor this week! ;-)

Yup, I agree that he's bouncing. Just wish I knew from what. No one witnessed the alleged brown sugar ham swipe or even a kibble raid, but the numbers are so suspicious. Usually I'm painfully aware that he's gotten into the carbs.

Unless I gave a fur shot, but I'm being so VERY careful that I honestly don't think I've given one of those in a long, long time.

Pat+Raja+Shadow said:

Not sure if anyone has talked about feeding mini meals to you in the past...but Jaye...you are usually gone all day so that would not have worked in the past with you. If one feeds mini meals at +1 and +2, it slows the steep drops. So, the numbers do not get quite as low as what you saw in the 2 cycles two days ago.

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I just got the new Petsafe5 feeder, so I'm able to schedule some meals. I've been giving one at 8:30 (which is his +3) but maybe with what you're saying that's too late and the drop has already begun. I have it opening onto a totally empty slow at 11:00 (+5.5) but maybe that's too late in the day. The trouble is, of course, getting him to eat when it feeds him. He's not alone during the day...I leave him with one or two brothers. He's such a social guy that confining him (or them) away from each other would be very detrimental to his happiness.

Today all the food was gone...at least I know it was all eaten before 11:00 a.m.

Do you think those two low greens two days ago might have gotten his Liver in a twist? Some kitties bounce for 72 hours...so it's hard to say definitely when they will stop. I don't know. but now you will be home to watch that dry stuff. I hope he comes down for you.
He seemed to drop at +3 when you increased the dose. So, I am just saying...maybe if you had fed a little before that...like at, +1 and +2 you could soften the drop. I have that with shadow when I increase...he drops very early in the cycle and sometimes food at the right times before the expected drop allows me to give the added insulin.
Is your "33" like a skinny 5.0u do you think? If so, that wasn't all that much of an increase. But it really lowered him a lot.
2nd cycle on it and he was in the greens. If you increase it to that again, I would front load his food so as to soften the drop.

I agree with Pat. I think you've got a bounce happening.

First, Chester isn't "bouncing" from food. The kibble just causes a HC spike that takes a while to resolve. It's why we don't use kibble to raise BG level -- it takes too long to clear out of the system.

Bounces aren't just caused by a low number. A fast drop in numbers can also produce a bounce. So on Saturday, you had a bounce from the low numbers in the AM cycle that began to clear except the drop during the PM cycle was from 323 to 79 with a straight shot back up.

It may be that you will want to hold the dose until Chester drops below 80 on the AT three times. This is an alternative that is described in the revised version of the Tilly Protocol. I think whatever we can do to help Chester flatten out the cycles will help.

Pat+Raja+Shadow said:

Is your "33" like a skinny 5.0u do you think? If so, that wasn't all that much of an increase. But it really lowered him a lot.
2nd cycle on it and he was in the greens. If you increase it to that again, I would front load his food so as to soften the drop.

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Yes, I'd call it a skinny .5 It's basically 0.5 minus a decent size drop.

First, Chester isn't "bouncing" from food. The kibble just causes a HC spike that takes a while to resolve.

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Yup, I keep using bounce and spike for the same thing and I need to remember that they're not the same...maybe I have both going on at the same time?

It may be that you will want to hold the dose until Chester drops below 80 on the AT three times.

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That scares me! ;-) (Of course, a lot of dealing with diabetes scares me).