3/1 Jasmine. PMPS 364 • +2~293 • +4~185 • +6~173 • +11~131

previous day

I txt my vet this morning and we decided to reduce her dose to 0.5iu for now. I feel better about reducing it and hopefully able to do more consistent dosing to get her on an even keel first. If I stayed with 0.75 today I was worried she would build on her lows overnight and just end up even lower or cause her PMPS to be too low to shoot without needing intensive monitoring overnight again.

So I have given 0.5iu this morning with my vets blessings too and we will see how she goes.

 

Thanks Bobbie, that makes a bit more sense.
I feel like maybe a wee bit of somewhere in the middle is where is ideal for me? Or do I really have to choose one or the other? I’ve reduced her dose anyway, though she didn’t quite get to that point if on TR, she did get close. I can monitor her closely during the days 5 days a week as I only work 1-2 days. I don’t love monitoring all night long as it affects our life a lot when sleep is reduced, but I can if I have to. Last night proved that! Haha. But hypos do worry me, and having to monitor HEAPS around them. But I guess that’s just what happens if it happens.

 

So the tins I have apparently vary from 633-1027 per can?? That seems like a lot. If I do that required calories per day on even an exaggerated 10lb, is still only 206. And she eats more than one can a day at the moment. Not sure exactly how much more as I haven’t been measuring and just give her more whenever she asks for it.

And no she doesn’t seem to ask for more at any particular time or BGL. She pretty much eats every 2 hours. I give her a good big teaspoon full, add a little water and she will eat most of it and leave a little behind. She very rarely will clean her bowl out totally except when I’m forcing her to wait until her shot time and then she will scavenge out the tiny bits that might be around her bowl.

She also never ever has acted super thirsty or super hungry like is classic for diabetic cats. She got lethargic and sick and dehydrated when she was heading in to DKA, but never sat at the water bowl or anything. She is more apt to loose her appetite than be ravenous so I’ve made sure she pretty much always has food!

 

I think that would be per kg.

 

following on from @Bobbie And Bubba another difference with TR is if there is a failed reduction, ie you see numbers remain high or trending up, you can call a failed reduction and raise the dose.
Let's see how she does on the 0.5u, it would be good if we can get to a dose that you can shoot consistently and work up from there.

 

That would make sense! Haha. Duh. It was a long night. Lol.

So that makes it 117-190 calories per can, roughly. She is probably ideally needing 179 calories a day if she were 8lb which sits well with more than a can of the lower caloric cans and would be fine with a whole can of the higher caloric ones. So I haven’t really paid much attention to the calories on the cans before and now I know that I will aim for the higher calorie flavours for her to try and increase her weight again.

 

It was, you're doing great holding it together.


Sounds like she's been a healthy kitty till the FD, lets hope that once you get her settled in to Lantus you can find a dose that keeps her in good numbers and the bouncing eases up. If you look at Georges ss, you can see that if you can get her regulated, it is possible to keep her BG's within quite a narrow margin.

 

Yeah I’ve seen other kitties manage to keep within quite tight levels so I hope once we can settle down her bouncing, we can work her down.

Her +2 was more like 2h 15m later, because kids. But it’s a jump higher than her AMPS, so that indicates a bounce doesn’t it? So what do I expect then? And I just need to stay steady and ride it out more than anything don’t I?

 

Good job everyone for last night...thanks Gill and Bobbie for taking over.
Jazz is certainly responding to the Lantus well.
I think a reduction to 0.5 unit is a good idea and hopefully you will be able to not have to skip. As Gill said you can always go back up if you have a failed reduction.
My only concern with TR for you is it is a more aggressive approach and it would be hard for you with the three little kids/baby and lack of sleep which does happen as you saw last night, and your ability to test often when Jazz drops low. At the moment Jazz is running the show!
Try and get some more frequent ketone tests in if you can.
It will be interesting to see how she goes on the 0.5 unit.
I’m sure your vet is learning a lot with all this going on! I hope she’s more receptive to swapping cats over to Lantus after this.

 

Yes that’s probably a bounce after the greens last night. I’d get a +6 just to be sure. Yes you just ride it out. Nothing you can do about bounces. Jazz doesn’t seem to bounce for long though.

 

Yeah the testing all night long will be hard to do frequently! But if we have to, we have to. I’m not sure that I’m really following any set protocol right now and just following Jazz! Hopefully once she settles in we can follow something more specific.

I will try to get more ketone tests too. Aim for daily, more would be bonus but less may happen too.

Ok, will get a +6 but otherwise ride it out. Hopefully tonight will be a nice steady night and we can see some settling down tomorrow! Haha.

 

Hi Bron,
glad you're about, it's getting close to bedtime here.
Jazz does indeed look like she is bouncing so hopefully you'll all have a quite day.

I'll check back in the morning. I'm hoping we'll see a return to some nicer numbers, but with a little less drama.
She is spending longer in those lower ranges than she was on Caninsulin, hopefully that will give her time to get used to them and reduce the bouncing.

 

yep ride out the bounce.
They can take upto six cycles to clear, but they can clear sooner. It wouldn't surprise me if she clears them sooner.
You'll know if she is starting to clear a bounce when you spot a sharp drop.
While she's bouncing it's time for you both to catch a break.

Just keep an eye on her appetite, behaviour, ketones, let us know if you feel something is up/

 

Thank you for your support all night Gil!

 

Nite nite you're welcome.

 

I think testing for ketones once a day is enough unless she shows signs of ketones or seems sick and lethargic.
With regards to the food, she has been in very high numbers for most of the time she was on caninsulin and most likely for a while before diagnosis and she would not have been able to utilise all the nutrients in the food she was eating. Now that she is getting more time in normal numbers she will be able to use all those nutrients and hopefully put on the weight she lost. And her appetite is improving all the time isn’t it, with the odd day where she doesn’t eat as much?
I remember Sheba was very thin at her first diagnosis but she eventually put on all her muscle again but it took time.
Would Jazz eat a cooked scrambled egg (no salt added)? That is full of protein and wonderful nutrients. I feed my cats an egg every week.

 

Yes, another good reason for TR protocol.

ETA: And thanks for adding that @Gill & George.

 

@Bobbie And Bubba @Gill & George
Was just looking for info on failed reductions as I thought it applied to both TR and SLGS and found this thread where @Jill & Alex (GA) answered someone who was following SLGS and said if the dose fails to go up in dose.......i think I’m reading it right. Scroll down part way and read on. It's a really good thread.
http://www.felinediabetes.com/FDMB/threads/new-dose-wonkiness-ndw-and-failed-reductions.46012/

 

Yeah her numbers have been consistently high, and her appetite has been fairly minimal. But yes her appetite is improving in general, as originally she wasn’t even eating a whole (156g) friskies can. Now she is eating more than one 185g can. So hopefully we can get her stable at lower levels and help her utilise her food better again.

And yes she might eat an egg. When she wasn’t eating a week or so ago we tried it and she wasn’t overly keen but she wasn’t eating much of anything then! We have our own hens so might as well give her an egg too. Haha.

 

Anyway, her +6 shows her surfing along in pink still. Much as she did yesterday really.

 

The guidelines for the SLGS are to be followed as written for newbies. But, when peeps have a handle on their kitties' onset, nadir , duration, how long it usually takes kitty to clear a bounce and such, those guidelines can be relaxed to the caregivers ability.

 

I give Bubba eggs every three days. Today was his egg day. He didn't like them scrabbled so if Jasmine won't eat it that way, try hard boiled. Then I slice and dice it up and add water to it to make it like deviled eggs. He eats it that way.

 

I actually feed my current cats raw egg yokes each week. They can’t have raw egg white because it inhibits absorption of some vitamin B.
When I’m cooking eggs Harry is always right beside me asking for some. I think they are a great food.
I used to hard boil Sheba’s eggs too.
Bubbas eggs sound very gourmet! Lucky boy.

 

Hey up.
I haven't been about much of late. It's been a bit scorchy hereabouts.

Yay. You got her on the lanctus. Way to go.

I gave Ty chopped hard boiled egg which he would eat mixed with other food.

 

It has been hot hu! And yes, so happy to finally get her switched over.

I will try her with egg soon!

 

PMPS is very level with everything else all day which is similar to yesterday, so not sure WHAT she will do tonight. It’s the lower dose though so hopefully it’ll just be gentle on her. I do like that it’s so much consistent pink and not reds and blacks though. I know pink isn’t good, but it’s better than red and black I had gotten used to seeing a lot!!

 

Yup, Bush fires here. Rather too close.
Husband out with civil defence to help.

Yup. Egg is helpful if Jasmine will take it

 

Pink is fine..........................for now.

 

Pink is a good step! It is but a step for now, but a good one. I’d rather she dropped in nice steps than big leaps. Haha

 

Looks like she’s still bouncing. See what her +2 is.
Sorry you are getting the heat. We have it much cooler than it was but still warm. Adelaide has the heat too so I suppose we will get it next. Sorry about the bush fires. They are so destructive..... and so much loss of wildlife.

 

Morning

We have hens too, when they're in full production we have a surplus, so our dogs (Jazz and Rosco) and civies (iris, fred, felix) get eggs, Iris in particular loves eggs, she's always trying to steal my scrambled egg or spinach omelette

As Bron has said, she looks like she's bouncing, might last 6 cycles, might last less, we don't know how long it will take her to clear a bounce less, it wouldn't surprise me if she clears them sooner rather than later. A sharp drop would indicate that she's clearing, as Bron recommended a +2. Would that be your normal bedtime? If you go to bed a bit later if she's still high at +2 I'd get a just before bed just to make sure that she's staying put, best to be a little cautious until you can figure out her patterns on Lantus.

 

I’m staying up for a +2 which is due very soon. Then yeah I am off to bed. But I can get up if needed later too. Will see what her +2 shows soon.

 

If she's still in the pink then you're probably safe to head off to bed.

I think you said you usually get up early before her shot is due, I'd grab a test first thing, just in case she is lower than you expect at amps, it can be helpful to know if she is just starting to drop, if she's flattish, or heading back up.

I hop you can get some sleep tonight.

 

A drop. Dammit. It’s gonna be another long night isn’t it? Sigh.

 

Yep. Looks like another few tests at least! But hey! Jazz is doing so well!!

 

Haha, yeah it’s all progress, right?

And I realise I’m looking at the colours, but in reality the drop tonight, is HALF the drop it was last night. She dropped 140 last night from her PMPS to her +2, whereas tonight she’s only dropped 71. I’m hoping that means a less harsh drop? I found out last night I can test her in bed (she sleeps with us) without even having to get up or disturb the household too much! But of course last night I still had to get up to feed her to try slow the drop.

 

Anyway, my alarm is set for midnight (+4) and 2am, and I guess we will see how things go from there?

 

You are a good mama bean!

 

She may just stay flat and yellow tonight. But she seems to like her PJ parties.

First time on Lantus, I did the same, I also would take his cat food up to the bedroom, so I could give him a snack without having to go downstairs, I found that if I didn't go back downstairs, I could get to sleep that much quicker.

 

Blue now. Still higher than last nights +4 blue though. She got herself up to eat so I just got up to follow her.

Can I try for two hours? Or do I need to go down to hourly again like this time last night?

 

I think you could leave it for two hours.

 

Boards ben down, but I saw she's still blue at +6 and flat. I should think you can call it a night.

 

Yeah the board was down when I came to check in with her +6. I checked in at +8 here and saw the comment so didn’t bother testing and we all went back to sleep.

Now it’s +11 and she’s loudly demanding food but of course she can’t have any, especially cos she’s now at 131!? Sigh.

 

I was feeling so hopeful in the night, of her curve being shallower than it had been, but her lower level now makes me wonder what happened after then; did she go lower and is now rising? Or did she surf along and has dropped? And now what? If it’s rising, do I still shoot because it’ll continue to rise after the shot? What if it’s still low? Sigh.

 

She certainly is.