12/27/20 Chicamonkey AMPS 534/+6 380/PMPS 368/+4 268

Good morning!

Yesterday
https://felinediabetes.com/FDMB/thr...326-8-275-pmps-303-4-276.240536/#post-2706241

 

Gosh that looks like a bounce...but maybe she's just high and needs more juice. Only one more cycle to go and you can increase again unless she hits some much better numbers later today.

Have a pleasant day Suzi!

 

Thank you.
I don’t think she’s bouncing but I’m so new I don’t know....
her 4 hour was 270-ish last night , I find it hard to believe she dipped low and bounced but I could be wrong.
Is it too late to start low and go slow? meaning can I stay at 2.25-2.5 for a while. I spoke with her vet Thursday and he’s not keen on her getting more than 2.5 units for fear of hypo events ????

 

You can switch to Start Low, Go Slow anytime. It requires you to hold a dose for seven days and do a curve (test every 2 hours for 12 hours or every 3 hours for 18 hours) on day seven, then determine if an increase is needed based on that. The threshold for reductions and shooting with SLGS is 90 (vs 50 with TR).

Have you shown your vet your spreadsheet? I email mine to my vet for his review. It may make your vet feel more comfortable with you following TR.

 

She could be bouncing from the lows of the AM cycle of 12/25. Bounces can take up to 6 cycles to clear and numbers can be pretty wonky till they do. Some cats go high before they clear a bounce. Bounces begin to clear faster when cats get used to better numbers. The right dose also helps.

The normal BG range for cats on a human meter is 50-100, but for some reason all vets want diabetic cats to run higher! Every vet I have met has advised me not let Bandit fall below 200. I have stopped asking for advice on managing her diabetes. I say yes yes and continue to do what I think is right. I am confident I will keep my baby safe. At least I like to think so. I am not at all suggesting that your vet does not know what he's talking about or that you should totally disregard his advice. Just sharing my experience.

Sorry, If I am repeating what I've said before, but it is not a great idea to let cats remain at higher BGs. That leads to issues like glucose toxicity, hind leg neuropathy and of course, it is hard on the kidneys. Bringing Bandit to lower numbers has helped her clinical signs - the weight loss, excessive thirst, excessive urination have all resolved. Thank God!

If you decide SLGS is what you want to do, we are here to help you with that.

 

I just want what is best for monkey ....
It concerns me that my vet wanted to start her on 2 ( which I thought was a high initial dose) and now keep her there.
I emailed him her spreadsheet and told him what I’m doing and that I’m deferring to his expertise for interpretation.....
Ialso let him know I check her urine for ketones weekly and it’s negative thus far.
I figure , if he has a problem with how I chose to test her, which I feel was conservative, he may not be the best vet for us, .....
Her +6 today was 380

 

Everything you’re saying makes perfect sense to me...
I’m getting nervous with bumping her up to 2.5
While I’m at work....

 

Could she have got into contraband?
Could she have eaten just prior to amps this morning? are you managing to pick up food 2hours before amps/pmps?

It doesn't look like she was likely to have done anything crazy last night, she was basically flat from about +4 in the am cycle.
However, I do think she is bouncing, it may be off the blues, but she also dropped from 200 pts to her nadir yesterday, it looks like she dropped sharply at onset yesterday morning from 496 to low 300s that could be what set her up for that black amps.
Bounces are not only caused by a drop into low numbers (hypo territory) but also by sharp drops, drops into lower than usual numbers or spending longer than usual in a range that she is not used to.
If she is yellow this evening at pmps you might want to watch for an active pm cycle, get a test in at +2 and before bed.

with respect that comment from your vet doesn't make sense. She needs what she needs, we have had cats whose dose was more than 60u of lantus, just a quick look through peoples ss, will show you how different dosing can be for each cat. As we like to say ECID (every cat is different) Chica needs what she needs, it doesn't help to get fixated on a dose.

What's your work schedule like?
Can you take her up in dose perhaps just before a day off? Is it possible to work around your time off?
She's not all that 'used' to seeing blues, with TR when a kitty is new to blues you would hold for at least 8 cycles, so I probably would hold this dose tonight and for a couple of cycles more, give her time to clear the bounce and see if she makes it back to blue or even green when she does.

From the guidelines for TR.
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.
• Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
• Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.

 

There is no possibility of her getting into contraband....
I’m going to hold her at 2.25 for at least 10 cycles. That will get me close to NYE. I’ll have off work for 3-4 days and will be able to better evaluate her numbers this week. See if she really is bouncing from those blues.... and then bump her up .
Thank you