1/14 MISSY AMPS 176, +1 212, 194 +2, 126 +3.5 - ADVICE PLS

Hi there
Missy has been back on the dosage she started on 1 unit/12 hours.
I think she is responding well. I am not used to seeing her in low numbers. I know this is exactly what we want to see but I also can't help but worry she will drop too low.

She tends to drop and raise quickly which is why I test her often. She is a VERY cooperative kitty and sleeps while I test. Today was her lowest AMPS @ 176. I know she could drop below 100 today.

What I do not know is what do I do? What would be the best way to handle how today has gone. At +3.5 she was 126. I feed her small meals throughout the day and gave her 1/4 can of Fancy Feast Pate when she was at 126 at +3.5. I retested in +4.25 and her BG went down a little bit to 124.

At what point do I intervene? Or do I just leave her to be a lower number and not worry about her. I know her body needs to get used to lower numbers. I have experienced one situation with her where she dropped from I think 220 to 84 in not even 2 hours.

I am considering TR protocol.

Her spreadsheet is up to date. I have also attached the link to my conversations with Bandits Mom.

Thank you for your help!


https://www.felinediabetes.com/FDMB...7-7-203-9-194-10-264-pmps-316-1-385-2.241308/

 

When you shoot lower numbers with Lantus, you tend to get flatter cycles, as you are seeing today. 126 and 124 are basically the same number, within meter variance so not really dropping. And she's still in quite safe numbers and doing what we call surfing, or hanging out around a certain blood sugar numbers. Feeding small meals throughout the day, as you've done so far today, is a good idea.

We don't want kitties below 50, so below that is definitely high carb food time. If you have a kitty that drops fast, you can give a little bit of food around onset (typically when the insulin take hold and some cats drop fast then). That means enough testing to know when onset is for Missy, and maybe feeding a bit of fresh food 1/2 hour before then.

Slowing down fast drops has two purposes. One - fast drops can cause bounces so you want to stop those. Second - you can get her to spend more time in nice normal numbers, without earning a reduction for just a very quick trip down. The more time she spends in normal numbers, the less she'll bounce. Less bouncing general will eventually flatten out her cycles.

 

Thank you!! That makes a lot of sense. I find every new situation with Missy I am in learning mode. So much to learn still and different situations to experience. I think you are right. She is surfing today. I just tested her again and its been the same number now 108 for the last 2 hours. I have tested every 30 min. I just fed her a little Fancy Feast Pate 1/4 can so we'll see how she is. I am trying to coast her nicely through this as she almost at +6.

Right now I am so undecided with what protocol to use. I will be honest I am nervous to do Tight Regulation. I've spoken to Bandits Mom quite a bit about this and she is really encouraging me to try it. She knows I test a lot so that seems to be a factor when people are choosing a protocol. I was a little nervous to shoot 1 unit at 176 at AMPS. This is Missy's lowest AMPS since starting on insulin. I've read the dosage on TR is upped quite a lot (even every 3 days) and that is worrisome for me especially when I am starting to see some lower numbers. I just looked at Butter & Lyla spreadsheet and wow she shoots 2.75 units when Butters is at 58. I don't understand why she would shoot so much with such a low number. Maybe there is a different circumstance than Missy but the thought of that kinda freaks me out.

I also will tell you I do not have a lot of support at home, actually none. What I mean by that is I am Missy's primary caregiver. No one else wakes up to check on her and test her in the night or even throughout the day so it has limited the things I have been doing. My husband and boys are nervous to test her and have needle phobias I also get tired but remind myself that I need to do this for her sake and hopefully one day she will go into remission. I know TR may be the best protocol for her but seeing peoples spreadsheets and how much dosages increase with even low numbers I don't know if I can do it, at least not yet. What I don't want is my my fears getting in the way of her having the best shot at remission. Bandits Mom is concerned about Missy jumping from 1 unit to .75 and basically making no progress. Maybe once she spends more time in lower numbers I will be a little more calm about it. Plus this is all new to me so I am learning lots about this disease, how to treat it and how to look after Missy. This is day 16 on insulin for Missy so we are very new to all of this and I find it overwhelming at times.

Thanks for listening.

 

The thing with TR, you slow down the increases as the nadirs get lower. With blues, you hold the doses 6-10 cycles. With those nice low blues you are seeing today, I'd hold this dose for 10 cycles. With green nadirs, you hold for 10 cycles.

Regarding shooting low, it's something you work your way towards. It takes time and data before you become comfortable doing it. As I said above the cycles really become flatter as you shoot lower. For Neko, I love shooting the 80's cause it meant she'd move no more than 10 points the entire cycle. The first few times do take a leap of faith, and hopefully someone around here to help you. And the size of dose really doesn't matter. Your cat needs however much insulin they need. Neko had a couple secondary conditions that meant she needed a slightly larger dose. A quick scan to remind me shows I shot green preshots at 7 units, shot 51 (2.8) at 6.0 units. I've seen much higher dose cats do the same. Again, not something we did when new and when you do, hopefully with someone "holding your hand".

I hear you on the support. It took months before I could get hubby to test, and he never did the night shift the entire 5 years, except maybe twice. For some reason he was fine with shooting from the start. I have a blood phobia, so it took some work on my part to get over that with testing. I also spent a lot of time trying to figure out Neko's blood sugar patterns, so I could test strategically, and test less times than some people here do. However, the work was rewarded. My vet wouldn't have figured out the secondary conditions - people here helped me with that. And she did get regulated and pretty good quality of life for her almost 5 years on insulin.

 

I think a lot of us can relate to your situation and emotions. I know @Butters & Lyla manages Butters on her own and @LindyNova is does with Nova (there are countless others but those came to mind). My hubby will test but hasn't learned to shoot yet. And your family may come around but even if they don't you have the support of the board

Ah, those early days are so overwhelming. Actually they still can be. It's okay and every day you'll pick up something new. Missy is so lucky to have you in her corner

Keep asking questions and keep learning

 

Hi Tammy, I was an emotional wreck when my Ruby was diagnosed. Thankfully I stumbled upon this board, but even after spending nearly every day looking at stickies, reading posts, following other cat's spreadsheets, I thought I would never get it. It takes time. I started on SLGS because I was afraid of offending my vet, had not gotten the hang of testing yet, and was just plain scared of those low numbers. Eventually I decided to forget about my vet's feelings, finessed testing, took on TR and was awarded "balls of steel" by mods here for shooting below 100. Half of what goes on here is psychological training, reinforcing you for the eventual possibility of giving insulin at a low number. There are so many wonderful people here to help you so when it does happen, chances are you will not be alone and you will have someone here to hold your hand. I haven't shot as low as Lyla has with Butters, but if presented with the opportunity I would have no problem with it at all anymore as I know what Lantus does now and I have all of the supplies I need to feed Ruby and keep her out of danger.

Patience pants, Tammy. Patience pants!

 

Hi,

We all stood where you are standing right now. There is so much to learn and there is the routine change for starters. I constantly felt like I was drinking from a fire hose. You will get support on the board if you want it, and that feeling of being overwhelmed: it will subside. You will learn. And then before you know it, you will be helping others, giving support and encouragement too. You will continue to encounter new situations (I still do), but they will become fewer and farther between, and you will have enough of a knowledge base to handle them and/or ask questions.

The people on this board will support you, whatever you decide. Ask as many questions as you need.

I personally think it would be great if you decided to try TR with Missy and see if we can get her regulated quickly. As others have mentioned, you certainly test enough. People here will support you and coach you when you get those lower numbers. Safety is always taken into consideration first and foremost. You can always switch back to SLGS if you decide TR isn't for you. Ultimately, it is your decision and you will be supported here either way.

Yes, it can get exhausting. I personally think it is worth it. Butters is living her best life. I have shot as low as 50 (we don't shoot lower than that) and I don't even give it a second thought anymore. The dose is irrelevant. A cat needs as much insulin as it needs.

Go easy on yourself and take your time to think things over. You are doing an amazing job with Missy!

 

Hi Tammy, Welcome to Lantus/Levemir land. You are doing a fantastic job with testing and handling this on your own. Yep, I do not have any support, even after a year. I work full time as well. I didn't start TR until I was forced to work from home near the beginning of last year. Even tho at times I am exhausted, the reward of getting our sweet kitties regulated, or even into lower #s, and seeing them thrive is the reward. Remission is always the ultimate goal, but not all of us will get there quickly if at all. With your example of testing & shooting, and explanations/demonstrations....your family may come around in time.

I think you should move to TR when you are ready to. Take your time to get to know how Missy reacts to food and what her pattern might show you about when the insulin takes hold, how low she goes and when she starts to come back up. Those blues can be pret-ty scary for someone only 6 weeks in. I know I had some major anxiety when I first started, especially when those #s popped up while following slgs at the beginning. I wouldn't shoot if below 150. Now...heck, I'll shoot a 50, because I know that Nova is particularly sensitive to carbs and will raise with a bit of normal food. I don't intervene with medium to high carb food unless she goes below 50, or I want to sleep at night...past her usual test/food at midnight. As the saying goes...shoot low to stay low.

Keep reading, and then read some more. Give yourself and Missy a break on the testing when she is in the "pinks". Get to know what a bounce is and how long it takes her to get back to whatever her normal #s are at that time.

@Bandit's Mom gives very good advice, and the folks on this board are very helpful and will always answer your questions, and guide you along your journey. Good luck to you & Missy. Hang in there & breathe. Missy is in charge now......follow her lead and your gut. You and Missy may be one of the lucky ones who get to remission sooner rather than later.

 

Wow you've been doing this along time. Good for you on getting over you blood phobia. I hope one day soon my gang here will face their fears and learn to do some testing. It sure would make my life easier. Thanks for all the great info. I am going to print this thread out and add it to my binder. I really, really appreciate all the help and support I am getting from everyone.

 

Tammy, you can call it a night and test at AMPS tomorrow. She is bouncing from the AM lows.

 

You all are so amazing on this group. I honestly mean this... but I could not have done this without all the support and information I have been given. My vet led me in the completely wrong direction. He didn't say to home test, didn't tell me to change her diet, so many things went wrong. Now I have hope... I know we're on the right track. And I agree with you I am exhausted too most days now but it is so worth it to get her regulated and into remission. I need to read the info in these threads because I think I am starting to understand TR a little better. Missy had a good day today. She was nicely surfing around 176 at AMPS to 190 at +9. She is up a little bit tonight but it may mean I can get a little more sleep and I don't have to worry about her being in low numbers. Thanks again for all your support.

 

Thank you for sharing... I was looking at Butters spreadsheet. I can see its been a lot of work. Your spreadsheet is so detailed. That must take up so much of your time. My family sees Missy's spreadsheet and I get the google eyes like I am absolutely crazy. It does look confusing and overwhelming at first glance but one you understand what you're looking at its a piece of cake. It is the best way to chart and share progress. Thank you for sharing and for your words of hope and inspiration. I really appreciate it a lot.

 

Thank you so much! I appreciate your vote of confidence in me. I want to do all I can to get Missy into remission. I am very lucky to have found this group and have people like you I can gain knowledge and support from.