? 3/20, Susie, 270 AMPS, 230 @+3

https://felinediabetes.com/FDMB/threads/3-19-susie-disparity-in-the-pmps-numbers.244936/

Hoping to see a blue or two today. Wishing all kitties safe numbers today. If nadir's don't go lower I will look at increasing the insulin to 1.75 on Tuesday. Have a question. Regarding the comment "When reductions fail". What does that mean? You make a reduction but it doesn't result in an increase in BG? I noticed that with SLGS if a reduction fails you still have to hold the dose for a week but what if the numbers aren't safe? I would not wait a week if a reduction fails and my kitty's numbers are too low.

 

Failed reductions are for TR. If kitty earns a reduction but then you notice numbers bobbling up on the new dose, you don't have to wait for the required 6-10 cycles (for nadirs <200) to take kitty back up to a good dose.
Butters had a failed reduction, imo, at .5u. Look at her spreadsheet around 03/13ish. She had earned a reduction from .75u to .5u by staying overall <100 for seven days. But her numbers started climbing on the .5u, so I brought her back up to .75u rather quickly, because the reduction had failed.

If, however, Butters had earned the reduction to .5u by dropping too low, like <50, then I probably wouldn't have gone back to .75u. In that case, I would've taken her dose to .625u.

I hope you see some blue today

 

I see what you are talking about. So reductions that result in unwanted increases can be addressed pretty quickly with TR but one would have to wait a week for an increase if they are using the SLGS method. What about a failed increase? If blood glucose goes too low (at least for comfort) then would a bean have to wait an entire week to raise the dose on SLGS? How in the world do you measure .625 units?

 

There isn't a failed increase.

If a reduction is earned anytime under SLGS (a drop <90), which you are following, then regardless of what the dose is, you would take the dose down by .25u immediately.

I use calipers for dosing so I can basically measure any size dose. I love the accuracy of measuring my doses rather than going by the lines. I don't know if I could eyeball a dose like .625u, but you could think of it like a "fat" .5u, I suppose. Plunger would be slightly below the .5u line.

 

Lyla, and a few others use digital calipers to measure insulin. The calipers allow beans to fine tune a dose in that way.

It’s better to think of the 2 methods separately. Failed reductions happen with TR only.

On SLGS, we hold the dose for 7 days, unless BG goes below 90, in which case an automatic reduction of 0.25 units is taken at the next available shot.
Let’s assume that BG does not go below 90 during that 7 day time period...in this case, a curve is performed (testing BG every 2 hrs for 12 hrs, or every 3 hrs for 18 hrs) and it is assessed to determine if the current dose should be held, reduced, or increased.

Here is a link to the dosing methods. If you scroll down to SLGS, it will give you the parameters and instructions

https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/

 

I use calipers for dosing so I can basically measure any size dose. I love the accuracy of measuring my doses rather than going by the lines. I don't know if I could eyeball a dose like .625u, but you could think of it like a "fat" .5u, I suppose. Plunger would be slightly below the .5u line.

Lyla, and a few others use digital calipers to measure insulin. The calipers allow beans to fine tune a dose in that way.

I have the calipers too but no mm measurememt for .625. I guess I would look at it like Lyla said. A "fat" .5 units. Thanks for the link, Tanya. I have seen it and actually printed it and put it in a notebook. I guess I should just stop worrying about any low numbers above 90 except at shot time. I have a long way to go anyway.

 

Summer, you can measure any dose using calipers, even .625. For example, I use BD syringes, and 1 unit measures 1.62 mm. To get .625 units, I multiply 1.62 by .625 and that gives me 1.0125 mm, which I would round to 1 mm on the calipers. Make sense?

 

You don't have to worry about a failed reduction on SLGS. You look at the dose every 7 days unless a reduction is earned. You take reductions immediately.

 

Okay, so I am using the UltiCare Vet RX syringes. 1 unit is 1.25 mm on my caliper. 1.25 X .625 = .78 mm. How would I round that out? I have always been horrible in math.

 

You wouldn't. Your digital calipers should be able to give you up to one-tenth of a mm. I only rounded up to 1 mm in my example because there were four decimal places.

 

Don’t worry about how to measure those in between doses with SLGS, they aren’t relevant. Changes are by 0.25 units at a a time.

 

Understood.

 

Good to know. Something less to worry about. Am I the only one that you know of that is using the SLGS dosing protocol on Lantus? I'd like to follow someone else that is using it that might have similar results on their spreadsheet.

 

No, there are other members using SLGS. Look at other people’s posts, their signature should say what dosing method they are using. Reading other posts, especially of new people, is a good way to learn. Often there are similar questions.

Two experienced SLGS people posted here, Carla and Tanya (thebigfuzz).

 

From everything i observed on the forum i noticed that using the calipers is very useful specially with very low doses when approaching last few reductions, when you don’t want to decrease by 0.25 in order not to “rush” the kittie into no insulin

 

Yes, I wonder how people can get "one drop"? Is that measured on the caliper? I don't know how.

 

I was wondering abt the same thing ))

 

You get one drop by pushing on the plunger when you insert the needle into the vial or pen and the plunger bounces back a little when you release your finger. That pulls one drop into the needle.

 

Fascinating. Thank you for the explanation, Katherine.

 

thank you, i should save this link for future use

 

I printed it, Marina. I don't want to forget this info either.

 

It has become apparent to me that I was getting better numbers with the Vetsulin. Yes, the numbers were up and down but I am seeing fewer blues on Lantus. I'll have to weigh whether I stay with the Lantus.

 

In my opinion your biggest problem is that you follow SLGS and it takes you too long for you to get to a good dose and in meanwhile you lose motivation.
I understand that a hypo is very scary for you (just like for all of us) but it is a higher chance Susie would get to a hypo situation with vetsulin than with lantus. Vetsulin is so agresive and unpredictable that any cycle might mean a huge drop.
In the end it is your decision to make but maybe it is worth trying to switch to TR which will allow you to increase quicker before you go back to Vetsulin. You can switch back to SLGS once you reach a better dose.

 

Marina, I am not a "night tester". I do not like to get up several times during the night to test. I am not a "gambler". I don't want to take chances with Susie and this is what will be required of me if I switch to TR. Numerous night time test. I am good with the daytime test but "honest to God" I need my sleep at night. I will not go back to Vetsulin. I will stay on the Lantus on SLGS and I will hang in there until we get the dose correct. As I have always said, I am not looking for remission. I am looking for numbers between 90 and 120 and I will be happy with those for the rest of her life.

 

I am happy this is your decision, i honestly believe it is the best for you both and i honestly believe you are close to the dose that will give you that. We root for you two

 

It just takes time to find a good dose. We say it's a marathon, not a sprint. Hang in there.

 

The problem is that you haven't reached a good dose with Lantus yet. Plus you restarted at 1 unit so Susie spend some time in higher numbers, allowing her body to get used to it and some glucose toxicity to set in. A couple more days and you can increase again via SLGS.

You don't have to be to follow TR. We've had people who for various medical reasons have had to go to sleep at +2 or +3. What they do is the same as people who go to work during the day. Get the before bed test, then load the autofeeder with whatever appropriate carbs are needed to keep kitty safe. I also was not a fan of night testing, but I learned enough of Neko's patterns to know the times I did have to get up after my before bed test, and when I didn't.

 

Thank you for your support, Marina and Chico!