20 Dec Methos 318@amps; 325@+2; :(; 290@+5.5

SmallestSparrow

SmallestSparrow

Very Active Member
Previously: https://felinediabetes.com/FDMB/thr...9-300-pmps-318-2-283-4-5.296721/#post-3229875

I see your bet and raise
with my diamond mine
upload_2024-12-20_4-11-32.jpeg

I call with coverage of Fluffy any +2 to +10 period you choose​
Agreed.


Personally I think 8 entire hours of uninterrupted sleep is worth way more than just a diamond mine. Ymmv
 

Attachments

  • upload_2024-12-20_4-11-32.jpeg
    upload_2024-12-20_4-11-32.jpeg
    82.6 KB · Views: 90
Last edited:
Good morning Colleen, you should make a book out of it.... I hope handsome prince Methos comes down very gently for you today. And I hope you get some good news regarding his wound. I send you hugs! :bighug::bighug::bighug:
 
Heike & BInie said:
Good morning Colleen, you should make a book out of it.... I hope handsome prince Methos comes down very gently for you today. And I hope you get some good news regarding his wound. I send you hugs! :bighug::bighug::bighug:
Click to expand...
Idk maybe he needs more insulin but Idk if my vet will increase him without the specialist saying so and I’m sure they won’t talk until the new year. I’m getting desperate
So sad
 
SmallestSparrow said:
Idk maybe he needs more insulin but Idk if my vet will increase him without the specialist saying so and I’m sure they won’t talk until the new year. I’m getting desperate
So sad
Click to expand...

As far as I understood, a bounce can last for up to six cycles. He is not there yet. So maybe the question of an increase comes too early? I really hope he comes down. Looked like 3 IU was good for him. But let's ask the more experienced members or the dose whisperer. Try not to be too sad. You are doing anything you can. Maybe you can use this bouncing cycle to breathe. :bighug::kiss::bighug:
 
Heike & BInie said:
As far as I understood, a bounce can last for up to six cycles. He is not there yet. So maybe the question of an increase comes too early? I really hope he comes down. Looked like 3 IU was good for him. But let's ask the more experienced members or the dose whisperer. Try not to be too sad. You are doing anything you can. Maybe you can use this bouncing cycle to breathe. :bighug::kiss::bighug:
Click to expand...
Yeah. But 2.5 also looked really good for him. And 3.5. He’s usually been clearing in 2-3 cycles. I can’t help it. I’m so stressed there won’t be a vet. I know you have the same worry for sweet Binie
:bighug::bighug::bighug:
 
cecile & bella said:
Maybe they can advise you on the phone. Or you can try an increase with help from members here :bighug:
Click to expand...
I want him seen for his belly slash. The dosing she does by text but is reluctant to increase without seeing what the new vetoryl dose is doing. And idk if maybe he’s got an infection or just needs more insulin or a different insulin or what.

edit: his next step is either 3.25 or 3.5 (she’s not a fan of quarter units but has agreed in the past ) but she said no the last time bc we were increasing then vetoryl
 
It’s complicated bc his nadirs are high but he’s dropping below reduction point (for this forum) on a rare day. I’ve more than once been suggested to increase his dose based on SLGS and decrease it at the same dose. Which is probably why we’re stuck here for my vet. She asked the consultant for me and he said the low days meant no increase in insulin but increase his vetoryl but it’s been 5 or 6 weeks and still this weird too high but also too low place
 
Good meowning Colleen
Wishing you a nice and boring Furrrrrriday
Hopefully Methos comes down and joins his furiends in the blue and green fields.

upload_2024-12-20_11-50-8.jpeg
 

Attachments

  • upload_2024-12-20_11-50-8.jpeg
    upload_2024-12-20_11-50-8.jpeg
    44.6 KB · Views: 81
Haven’t yet heard back. I texted a photo and link to his spread sheet. I hope she can see him today or at least before Christmas next week, and maybe either treat his skin or increase his insulin. Of course everytime —-EVERY TIME—I’ve texted about can increase he dives before her reply

o_O

perhaps I need to check +8 or 9 today
 
SmallestSparrow said:
It’s complicated bc his nadirs are high but he’s dropping below reduction point (for this forum) on a rare day. I’ve more than once been suggested to increase his dose based on SLGS and decrease it at the same dose. Which is probably why we’re stuck here for my vet. She asked the consultant for me and he said the low days meant no increase in insulin but increase his vetoryl but it’s been 5 or 6 weeks and still this weird too high but also too low place
Click to expand...
Oof, all the best to you and Methos. I remember being in this spot plenty with Emmett (when he was on Prozinc). His dose would need to increase and decrease so rapidly it was hard to keep up. I hope you can figure out the right dose.

I will admit, I never really asked the vet’s advice before changing Emmett’s doses (though he was also not on any other medications that could make that more complicated). I just went by what people here suggested haha.
 
KLD said:
Oof, all the best to you and Methos. I remember being in this spot plenty with Emmett (when he was on Prozinc). His dose would need to increase and decrease so rapidly it was hard to keep up. I hope you can figure out the right dose.

I will admit, I never really asked the vet’s advice before changing Emmett’s doses (though he was also not on any other medications that could make that more complicated). I just went by what people here suggested haha.
Click to expand...
She’s gone above and beyond caring for him so I need to let her be the captain of the ship. But if someone here gave me a good explanation of what they think he needs could ask her to consider it.

edit: and as I’ve said the rules here shared with me at about the same time, same dose, were at the same time interpreted as “he needs more” and “he needs less” which is the same guessing game my vet and I’ve been playing as he’s gone up and down and up the dose list several times.
So the “nadirs too high go up 0.25” sort of cancels out “80 too low go down 0.25” so I don’t know which opinion to push with my vet. The last time I shared both and she said “he’s not going lower, obviously, and for now not going higher” maybe she will come up with something because to borrow from Semisonic he can’t stay here
 
Last edited:
  • Like
Reactions: KLD
Pending an opinion of the specialist, and some time to let his belly wound improve and more time for the vetoryl…a fat 3. so a question for the Dose Whisperer (if @Wendy&Neko comes around) or super calm Bhooma @Bandit's Mom or anyone else who’s weighed in on a dose:
How do I know if the right course is
—hold at 3 bc he’s bouncing and that’s why he’s high
—increase bc his nadir is too high 75% of the time (and either he’s just high and not bouncing or who cares if this is a bounce)
—increase bc nadir is too high 75% of the time but wait until bounce period over (6 cycles)
—decrease bc he went below 80 a few times and I didn’t take a reduction then

because I’ve sort of been told all of these and they all make sense but I can’t do all of them at once

If the Fat dose doesn’t do anything then I’ll ask her again and would like to have a sense of what I should be pushing for

trying TR was mentioned because he gets tested a lot (not my desire but it is what it is to try to keep him safe) but what is the advantage over that? I know the dose increases more quickly but I could probably sell that because it increases by less so it sort of evens out to about the same (a total of 1/2 unit may be gained in a weeks time if I understand the rules—a big if)
 
Seems like a long time for a Vetoryl increase to take effect, but that's not my wheelhouse. Just based on a few observations.

SmallestSparrow said:
—hold at 3 bc he’s bouncing and that’s why he’s high
Click to expand...
Bingo, got it in the first one. Bounces can take up to six cycles to clear. You waited five. Always try to answer the question "how low can this dose take my cat?". Ignore the bounces when making dosing decisions.
SmallestSparrow said:
trying TR was mentioned because he gets tested a lot (not my desire but it is what it is to try to keep him safe) but what is the advantage over that? I know the dose increases more quickly but I could probably sell that because it increases by less so it sort of evens out to about the same (a total of 1/2 unit may be gained in a weeks time if I understand the rules—a big if)
Click to expand...
TR and SLGS both increase by 0.25 units at a time. TR increases faster and the reduction point is lower - 68 on that AT.

Another option is to do some tweaking to SLGS, which members can do once they have a good understanding of their cat's patterns on Lantus (onset, nadir, duration) and also how he responds to food/different carbs. The most common tweak people do is to lower the reduction point a bit, provided they have the ability to monitor closely. This will allow you to hold a dose longer instead of reducing for those high greens. The downside is more risk he'll go lower and more testing required, not something I'm a strong fan of with Cushings.

His ketones have all been below 1.0 so not a concern. If they had been higher, that would be an argument for an increase.

The most important question for you is - what are your goals for Methos?
 
Wendy&Neko said:
this dose take my cat?". Ignore the bounces when making dosing decisions.
Click to expand...
But if the dose gives him a few hours of feeling good, maybe a day of decent numbers, and then five to six days of feeling bad, losing weight, and high numbers is that really a good dose? Not saying he needs more, I’m still not convinced these swings don’t mean he needs less, but where he’s at isn’t helping him. He’s been on 3 a really long time. Admittedly the vetoryl has been being altered but it’s six weeks since the 15/10 and two since 15/15 and I haven’t seen any change so I’m losing hope there
Wendy&Neko said:
The downside is more risk he'll go lower and more testing required, not something I'm a strong fan of with Cushing
Click to expand...
i haven’t been interested in TR bc he’s not a cat who should be taken routinely below 90-100. And I knew my vet wouldn’t be ecstatic about changing a dose sooner than one week. But I realized since it’s a quarter U dose, and she uses a half U increment, the results are essentially the same at the end of the week so I could reason that out—perhaps—
The ear sticks I’m not crazy over but I’m doing them anyway because the bounces send him below 100 without warning so if there’s something to gain for him —someone said I should switch to that but I don’t see that it would help decrease his dose just increase it and I still don’t know if he needs more insulin or less.

this is making me too sad. I’m not helping him anymore just torturing him and he just is so good with it all
Thanks
I think I need to go away for awhile
 
SmallestSparrow said:
But if the dose gives him a few hours of feeling good, maybe a day of decent numbers, and then five to six days of feeling bad, losing weight, and high numbers is that really a good dose? Not saying he needs more, I’m still not convinced these swings don’t mean he needs less, but where he’s at isn’t helping him. He’s been on 3 a really long time. Admittedly the vetoryl has been being altered but it’s six weeks since the 15/10 and two since 15/15 and I haven’t seen any change so I’m losing hope there

i haven’t been interested in TR bc he’s not a cat who should be taken routinely below 90-100. And I knew my vet wouldn’t be ecstatic about changing a dose sooner than one week. But I realized since it’s a quarter U dose, and she uses a half U increment, the results are essentially the same at the end of the week so I could reason that out—perhaps—
The ear sticks I’m not crazy over but I’m doing them anyway because the bounces send him below 100 without warning so if there’s something to gain for him —someone said I should switch to that but I don’t see that it would help decrease his dose just increase it and I still don’t know if he needs more insulin or less.

this is making me too sad. I’m not helping him anymore just torturing him and he just is so good with it all
Thanks
I think I need to go away for awhile
Click to expand...
Good morning, Colleen. I do hope you can get some good scientific answers. Methos is so complicated. And yet he’s so good about all of the handling. He’s such a good boy and takes it in stride.
You’re doing such a wonderful job with all of his complex conditions. I know how hard it is on you :(
Breathe and take it one day at a time. All you can do.
Ivy and I send you both a big bunch of hugs of support. Please give him kisses from us :bighug::kiss::bighug::kiss:
 
Wendy&Neko said:
Ignore the bounces when making dosing decisions.
Click to expand...
But how can I be sure it’s a bounce? If this is true then 2U was his dose. It’s confusing bc people who know all seem to tell me different things. Not criticizing (and typing blind bc of tears) but I’ve been told I’ve held him too long and that’s the prob, gone up and that’s the problems, didn’t go up and that’s the problem, and really the only common denominator is I’m the problem. And I truly want to fix it. I can go back to 3, my vet wasn’t enthusiastic about a fat 3. I just want to know what to do bc each time I change its wrong. If i don’t it’s wrong. I believe all of you but I can’t do all of the suggestions bc they contradict. I feel like he’s trapped in a bad place and I don’t know which way will help him
 
Oh Colleen I am so sorry :bighug: I know how hard it is to not know what to do. I want you to know you are an awesome mum and Methos knows you are trying to help. Because there are so many factors and because I am finding with diabetes there are other things that can play into it on any given day, as was said before it isn't always linear. Don't give up and don't be sad (I know easy for me to say)--you have so many of us who are rooting for both of you. You have done a great job up to this point and will continue to. He is very blessed to have you. Praying for wisdom <3 *hugs my friend *
 
SmallestSparrow said:
But if the dose gives him a few hours of feeling good, maybe a day of decent numbers, and then five to six days of feeling bad, losing weight, and high numbers is that really a good dose? Not saying he needs more, I’m still not convinced these swings don’t mean he needs less, but where he’s at isn’t helping him. He’s been on 3 a really long time. Admittedly the vetoryl has been being altered but it’s six weeks since the 15/10 and two since 15/15 and I haven’t seen any change so I’m losing hope there

i haven’t been interested in TR bc he’s not a cat who should be taken routinely below 90-100. And I knew my vet wouldn’t be ecstatic about changing a dose sooner than one week. But I realized since it’s a quarter U dose, and she uses a half U increment, the results are essentially the same at the end of the week so I could reason that out—perhaps—
The ear sticks I’m not crazy over but I’m doing them anyway because the bounces send him below 100 without warning so if there’s something to gain for him —someone said I should switch to that but I don’t see that it would help decrease his dose just increase it and I still don’t know if he needs more insulin or less.

this is making me too sad. I’m not helping him anymore just torturing him and he just is so good with it all
Thanks
I think I need to go away for awhile
Click to expand...

My heart goes out to you Colleen, his case is complicated and you’re doing everything you can to support him.

It’s hard to know what’s best when helping a creature who cannot speak for themselves.

You’re doing the right thing by being methodical in his treatment, you’re giving yourself and your trusted vet the best data.

Youve been doing this insulin dance since August, you two will make it through the holiday season and then hopefully your vet will be able to use your data to help you chart a more stable course forwards.

You have a great job collecting the data and so far in December none of it shows hypo numbers and the one high ketones (0.8) cleared by the next day. I would read this data as saying what you’re doing is working on a basic level, and it’s ok to give yourself some grace, and take time for yourself if it will help. Cats can feel our stress and want us to be happy.

We don’t talk about the emotional/ mental health aspect of caring for a special needs cat but it’s real. Take care of yourself, and be assured you’ve guided him to a good place and have a better handle on things than it might feel like at the moment.
 
Your post makes me sad too, Colleen! It is so hard, especially those first few months. I cried a lot too, I felt like you say, not knowing what to do and feeling like I was not helping my cat. It got better, I hope it will for you and Methos too, even though his case is so complicated. You are doing so much for him :bighug::bighug::bighug:
 
SmallestSparrow said:
But how can I be sure it’s a bounce? If this is true then 2U was his dose.
Click to expand...
You be patient and wait to see if he breaks the bounce and comes down again, like he did today. PM cycle of the 17th he saw blues, then 6 cycles of higher numbers, then he's seeing blues again. Ergo, he was bouncing.

A post you might be interested in from the Think Tank forum:
Kirsten said:
I personally have to fight overly cautious dosing much more than rebound checking, but it is also very, very tedious. In the vast majority of cats Lantus/Levemir won't allow you to achieve regulation without having daily nadirs <80 or <100. If you try to avoid nadirs <80 or <100, the cat generally ends up with long periods above the renal threshold each day. I've also come across a few people who believe that they can pick an upper and lower threshold that fit their personal comfort zone and easily maintain the BGs of their cat within that range. Aside from the fact that this is only rarely doable, in cases where it works there is still a slight level of hyperglycaemia present which IMO has a negative effect on the pancreas. You really have to work *with* these insulins and accept that euglycemia is part and parcel of how they work.
Click to expand...
The Kirsten who did the post is the one of Kirsten Roomp, the founder of the German Diabetes-Katzen forum - where Tight Regulation was started. She has a LOT of experience with feline diebetes.

The above is why I was suggesting you think about finding a dose where he can more regularly see numbers under 100, but know the risk is more poking. It will also help both of you, if you can find patterns in Methos' blood glucose data. This is not an overnight task. Every night before going to bed I spent about 10 minutes with Neko's SS, trying to see patterns in data and whether it was safe to go to bed for the night. DH called it "reading the tea leaves". I was so happy when I found a 4 cycle pattern that told me she was going low the next cycle. That was the only time she went low, but did help reduce the poking to when I needed to.

Continue with the 3F dose now that you are two doses in, let's see what it can do when the depot is established.

I know he's picky about food, but an alternate strategy is to find something a little higher in carbs than his regular food, maybe in the 5-9% range? A little higher carbs means you will be able to give that little bit higher insulin dose and keep him safe. And might help him see some better numbers and flatter cycles.
 
You must log in or register to reply here.
Back
Top