? 2/12 - Xander | PMPS (2/11) 261, +3 236, +5.75 54, +8 58, +10 324

[Brianna & Xander]

Yesterday's post

Hi everyone. Sorry, gonna be a long one. It's been... a bad night.

The day before yesterday, I thought maybe we'd finally found a good dose for Xander at 1 unit. Nadir was 97. Yesterday we spent all day in the yellows again (not sure why, doesn't seem like he went low enough to bounce). Then last night he had one of his random, seemingly unpredictable dives.

From 12:30 AM - 1:00 AM, he had dropped by 72 in about 30 minutes, then another 76 by 2:00 AM. I didn't see that until later, but I was woken up by the Libre's low glucose alarm at 2:40 AM, he was at 54. I thought this might have been a compression low because he was sleeping on the bed with us, because when he got up the number went up a little, but then it just dropped again.

At 3:08 I gave him 0.4 oz FF Grilled in Gravy (~14%), about 2 tsp. It seemed like he had a tiny bump and then dove again. At 4:17 I gave him 1 oz of the same food. Again a small bump, then a dive. At 4:45 I just gave him the other half of the can (another 1.4 oz) to try to get a bigger bump and stop the diving. Naturally right after that it kicked in and the cycle seemed to wear off and he skyrocketed.

For anyone who's been following me, you know that getting manual blood checks is basically impossible with Xander. If he's <50 on the Libre I attempt it (and usually fail), but fortunately most of the time it's not needed. The one time we were able to directly compare, the Libre seemed to be about 10 points lower when in the 50-80 range.

Anyway. Guess this still isn't the right dose. I don't understand the dives. It's not even just that he goes <90 so often, it's that there are these big drops and it seems like he just doesn't stop going down. I was so hopeful because of that cycle the other day. It's dropping just as low at 1 unit as it was at 1.75 units. It doesn't help that this batch of needles has been a pain because the stopper doesn't line up to the 0, and I have to adjust to accommodate it. I'm trying my best, but maybe last night he actually got 1.125 or 1.25 unit instead of 1 and that's why this happened. I'm starting to just grab a different needle every time I see that because they're impossible to be super specific with.

I understand that with SLGS he's earned another decrease, but given the situation with the needles I just mentioned, is it worth sticking with the 1 unit a little longer to see if he drops that low again, or should I just immediately decrease again?

Any idea what's up with these uncontrollable dives? It seems like he doesn't respond all that much to food until it feels like it.

I had been considering switching to TR but I feel like I just need more info and understanding about my specific cat, which I never get because he just seems so random. No consistency. Nothing solid to base anything on.

I'm so tired. I've mentioned before that this is literally my entire life now, no time or energy for absolutely anything else. I'm also chronically ill and generally it's hard enough to take care of just me. One major thing is I have narcolepsy, which means these 2 months of being even more chronically sleep deprived than usual is making me physically ill and emotionally always falling apart. (For reference, studies showed that a "normal" person would have to go over 3 days without sleep and try to function like they normally would to feel the same degree of fatigue a person with narcolepsy has on a typical day. Last night I got a whopping hour and a half. A normal person would be miserable but I don't know how to express to you what that's like with narcolepsy.) Thanks for reading.

 

[Brianna & Xander]

His favorite place, on my desk (and likely in the way lol)

 

[tiffmaxee]

How about switching to TR?

 

[Brianna & Xander]

How about switching to TR?

I'm open to trying it. I just feel like I'd be more comfortable if I understood him more, but I feel like I'm blindfolded. He's always so inconsistent that I can't gain any insight.

I also worry that because it's basically impossible to manually test him, it might be really hard when it comes to him going below 50 on the Libre, which seems like it'll happen a lot more often. Is it still going to be safe to do TR if I have to rely entirely on the Libre?

 

[tiffmaxee]

The Libre actually reads lower than a hand held in low numbers. So if there’s a drop under 50 you would take it since ear pricks aren’t possible and he will be safe. If you don’t want to take the reduction he earned now would be a good time to give it a try. You can switch back to SLGS if you don’t like it. Most people who have the choice are afraid to not take a reduction if in the 50’s but you are wanting to not take one so what have you got to lose by trying TR?

 

[Brianna & Xander]

The Libre actually reads lower than a hand held in low numbers. So if there’s a drop under 50 you would take it since ear pricks aren’t possible and he will be safe. If you don’t want to take the reduction he earned now would be a good time to give it a try. You can switch back to SLGS if you don’t like it. Most people who have the choice are afraid to not take a reduction if in the 50’s but you are wanting to not take one so what have you got to lose by trying TR?

Yeah, it just seems like he goes to that same low regardless of how high the dose is so far, so like at some point I'll be giving him 0.25 units and still hitting the 50s and going back up to the 300s.

The highest carb food I have around right now is 15%. I do have honey if it's needed. Is that enough to try, or should I wait until I find some foods that are higher carb?

I was supposed to give him his dose 10 minutes ago but I've been waiting because I wasn't sure if I was doing 1 or 0.75.

 

[tiffmaxee]

You can add honey to the 15% to make it hc. We have no idea yet how carb sensitive he is. You might not need more than that. As 15% is the high end of mc. If you want to wait until you get hc then take the reduction. It’s up to you.

 

[Brianna & Xander]

You can add honey to the 15% to make it hc. We have no idea yet how carb sensitive he is. You might not need more than that. As 15% is the high end of mc. If you want to wait until you get hc then take the reduction. It’s up to you.

I ended up shooting 1, so I guess we're taking a swing at TR for now. I might also try to incorporate some version of manipulating the curve (as outlined here) to see if maybe that helps with the diving.

I had just gotten some higher LC food (~6% rather than 0-3% he usually gets) for the exact purpose of seeing how sensitive he is, just unfortunately hadn't had the chance to try it yet. Didn't seem worthwhile while he was mid-bounce and his numbers were crazy, but maybe I should just do it any any time and watch for the difference.

 

[tiffmaxee]

I did a lot if manipulation of the curve. I’d test and decide what snack to give as Max got mini meals in the first half of the cycle. It looks like Zander onsets at +1 so you might want to save some of his preshot meal and give him that at +1. Max didn’t onset until +2-3 unless he started low so he got a snack then.

 

[Brianna & Xander]

I did a lot if manipulation of the curve. I’d test and decide what snack to give as Max got mini meals in the first half of the cycle. It looks like Zander onsets at +1 so you might want to save some of his preshot meal and give him that at +1. Max didn’t onset until +2-3 unless he started low so he got a snack then.

From what I've seen when there's any cycle with lower movement it seems like he really starts to decrease somewhere between 4-6 and it tends to continue downward for the rest of the cycle (sometimes bleeding into the next). So it wouldn't be the first half of the cycle for him, not sure sure what difference that would make. But I was planning to at least start out trying the quarter meal at preshot, +1, +2... Maybe +3, but at night that would get pretty late. We'll see I guess.

 

[Tim & Pookey]

I’m sorry Brianna that this has become your life. I can definitely relate to that and I think a lot of us can. The one thing I’ll say about dives and bounces is that things can change, so hang in there. I’m sure you’ve seen it too, some cats here have ups and downs, then one day it’s like they found the right dose and things settle in. TR might help you get to that.

 

[Brianna & Xander]

I’m sorry Brianna that this has become your life. I can definitely relate to that and I think a lot of us can

Thanks, Tim. I don't say this to sound dramatic, it's just true: on the hard days I feel like my soul is just shriveling up and dying. Wish I could turn the power off until I have to feed or dose and just not have to be conscious for the rest. Anyway. That's depressing. Sorry!

The one thing I’ll say about dives and bounces is that things can change, so hang in there. I’m sure you’ve seen it too, some cats here have ups and downs, then one day it’s like they found the right dose and things settle in. TR might help you get to that.

That's what I'm hoping for! That maybe if I just push a little instead of taking the reduction maybe one of these doses will settle in and work.

 

[Briana + Binx]

I wish I had some advice for you, but as I'm new to this whole process, just sending a message to show support and sympathy It's a difficult thing you've signed up to do but you're giving it 150% - I'm sure Xander is incredibly grateful to have such a dedicated cat parent!! Binx was having a similar pattern of a full drop/no curve through cycles and numbers all over the place. Some days his AMPS would be in the pinks and his PMPS would be green - how can you plan for this or understand what's happening with no consistency! It's incredibly frustrating to deal with.

I have seen in some threads that others are using calipers to get more accurate dosing. I'm not familiar nor have used them myself, but here's one of the threads. Maybe this would help?
https://felinediabetes.com/FDMB/threads/dosing-with-calipers-updated-w-videos.79851/

Good luck with the start of TR! Hoping for the best for you and Xander!

 

[Brianna & Xander]

I wish I had some advice for you, but as I'm new to this whole process, just sending a message to show support and sympathy It's a difficult thing you've signed up to do but you're giving it 150% - I'm sure Xander is incredibly grateful to have such a dedicated cat parent!!

Thank you so much! I really appreciate the support. I really am trying so hard. It's heartbreaking when it seems like it's not enough.

Binx was having a similar pattern of a full drop/no curve through cycles and numbers all over the place. Some days his AMPS would be in the pinks and his PMPS would be green - how can you plan for this or understand what's happening with no consistency! It's incredibly frustrating to deal with.

Exactly this! How can you plan for it/understand it if there's not consistency?! I'm so glad you know what I mean. It's like white water rafting while blindfolded.

Do you feel like switching to TR is what made things a little less crazy for Binx?

I have seen in some threads that others are using calipers to get more accurate dosing. I'm not familiar nor have used them myself, but here's one of the threads. Maybe this would help?
https://felinediabetes.com/FDMB/threads/dosing-with-calipers-updated-w-videos.79851/

I've been keeping this in mind! Thank you!

 

[Briana + Binx]

Do you feel like switching to TR is what made things a little less crazy for Binx?

We're still not perfect yet, but I feel like he has been a bit more consistent - this may also be from the fact that I've started feeding him smaller meals throughout the first half of his cycle. Among the many things we're learning, one of the biggest with TR has been the comfort to shoot low and that seems to have helped quiet a bit. Binx would go through big swings because I would skip a shot at pretty much any number less than 100-150 (vet's direction) and then it would take some time to get back to a place were the dose was holding better. Even early in TR, I would reduce the dose if he was low and still see those big swings. However, I see you're already pretty good with shooting some low numbers and poor Xander, when he goes low he is only having small food spikes and you have to continue feeding. It's the classic - every cat is different - which is also so frustrating when you're trying to find answers.

I think trying TR could help and I'll be watching to see how you do!

 

[Brianna & Xander]

We're still not perfect yet, but I feel like he has been a bit more consistent - this may also be from the fact that I've started feeding him smaller meals throughout the first half of his cycle. Among the many things we're learning, one of the biggest with TR has been the comfort to shoot low and that seems to have helped quiet a bit. Binx would go through big swings because I would skip a shot at pretty much any number less than 100-150 (vet's direction) and then it would take some time to get back to a place were the dose was holding better. Even early in TR, I would reduce the dose if he was low and still see those big swings. However, I see you're already pretty good with shooting some low numbers and poor Xander, when he goes low he is only having small food spikes and you have to continue feeding. It's the classic - every cat is different - which is also so frustrating when you're trying to find answers.

I think trying TR could help and I'll be watching to see how you do!

I'm planning to try manipulating the curve too, but I think I'm gonna wait until I'm a little more settled in TR (just change one variable at a time).

It is so frustrating and I'm glad you understand what I mean. I feel a little like I must be the crazy one sometimes because I'm supposed to be seeing these patterns but it's impossible with the constant big swings and bounces!

Thank you so much again! I'm gonna follow you too and see how you and Binx are doing.

 

[Briana + Binx]

Thank you so much again! I'm gonna follow you too and see how you and Binx are doing.

 

[bluesunshine]

So sorry you are struggling. Having to deal with your own health with taking care of Xander sounds really tough. I also struggle just with managing sleep and making sure Bell is safe. The ever present pressure to be on top of your cat's well-being is a really fatiguing thing. I'm still working to find a healthy balance in all of this. But this has brought me closer to Bell than I ever would have been without it. Rooting for you!

 

[Brianna & Xander]

So sorry you are struggling. Having to deal with your own health with taking care of Xander sounds really tough. I also struggle just with managing sleep and making sure Bell is safe. The ever present pressure to be on top of your cat's well-being is a really fatiguing thing. I'm still working to find a healthy balance in all of this. But this has brought me closer to Bell than I ever would have been without it. Rooting for you!

Thank you so much for the kind words, Seth! I'm sorry that you can relate too. It really is exhausting to try to give 150% to our babies that depend on us while still managing to keep ourselves alive and healthy lol

But you're right, and Xander and I have gained and even closer bond through all of this too. He was already my best buddy but through all this I've seen that he really is my "soul kitty."

Thank you so much again, I truly appreciate your kindness.