7/9 Toeby - AMPS 180, PMPS 144, +2.75 40, +3 41, + 3.3 41, +4 32, +4.5 103, +4.8 149, +5 218, +6 311

Thursday's thread: https://www.felinediabetes.com/FDMB...04-2-47-2-5-54-3-50-3-5-65-4-77-5-146.249576/

I recorded 47's two nights in a row, with a 50 in the morning between.
He had another 47 a bit over a week ago as well.
I feel he needs/has "earned" a reduction in his insulin, from 0.75 to perhaps 0.50?
I'd appreciate any input on this for when it's time to shoot in the morning.

 

Did you reduce a little last night? Spreadsheet says .60 instead of .75.

 

Yes, I reduced to the 0.6....which is what I call a "Fat 0.5"
It's not the reduction of 0.25 the TR method calls for, it just made me feel better because I felt quite sure he was going to drop based on his preshot.

 

Okay, it's morning shot time and I haven't received have firm direction from an advisor yet.
I am going to give another 0.6, knowing I can always drop down to 0.5, a full 0.25 deduction as per TR protocol, if that's advisable.
I think I would rather be at 0.5 and see how he goes, but will wait for the voices of experience...

Hellooo? LOL!!!
ETA I am just goofing around, I realize humour doesn't always translate.
I know advisors are extreeeeemely busy.

 

If you don't hear back from anybody just go with your gut. Good luck, Laura.

 

A few minutes before a full 3 hours after his PM insulin, Toeby checks out at 40
I have given him some HC gravy food
Will check again in 20 minutes.

I have not heard from any one other than the question @tiffmaxee posed last night about whether I dropped to 0.60 last night, which I responded to (I did go to 0.60 from 0.75 last night, which is not a full 0.25 drop).
I think he has to be at the most only 0.50, not 0.60, and given this reading 40 tonight, possibly 0.25 units?
I would greatly appreciate any input from advisors on this cluster of sub 50 readings as seen on my chart.
Laura - tagging
@tiffmaxee
@Wendy&Neko
@Christie & Maverick

 

Hi Laura, I'm not the most experienced at dosing, but I'd use .25 increments to decrease with Toeby given how many times he's dipped below 50 recently. A fat .5 is too much it seems, so .5 might be better or even .25 to see how he does with that and go up if you need to again. Safety first is the motto here, and it will allow you to get some rest from the testing and feeding. You can always go up by .125 (or a fat .25) as soon as you see his numbers floating higher and it's a failed reduction.

 

As a long term diabetic he didn’t earn the reduction yesterday but has tonight. Try .25.

 

You may still be seeing a little of the 0.75u depot, I might go to 0.5u myself, since numbers came up ok with a little HC before, but if you are more comfortable trying 0.25u that's ok too. Especially if he keeps lingering around here tonight even with HC.

 

Appreciate the input, Katherine and Elise!
Elise, are you thinking he should that be down 0.25 from the 0.75 he was at yesterday morning, so start tomorrow morning at 0.50?
Or 0.25 down from what he got today, the 0.60, to give him 0.35, or basically 0.25 units tomorrow morning?
I am leaning towards giving him 0.25 units and seeing where he goes from there...

He is not coming up fast, just as he did not last night....
Testing again in 20 minutes
Laura

 

Just saw your +3. Last night's cycle he floated around 50, tonight he's dabbling lower. If you are finding the numbers are hard to bring up, I'd say 0.25u tomorrow is the better option, for safety.

 

I agree, I'd go to 0.5 units too. Paw crossed he comes up for you soon.

 

Editted to add, unless he goes below 40, in which case a full 0.25 unit reduction is recommended. I guess that makes it 0.35 units?

 

20 minutes later he is still 41
Testing again in another 20 minutes.
So I think this qualifies as being hard to bring up tonight.
I gave him a few Temptations as well as several brands of food in gravy... I haven't broken out the corn syrup or anything else, just food so far.

 

20 minutes later, at what I am entering on SS as PM +4 and he is 32!!!
I gave him a big dollop of corn syrup mixed in with some FF gravy and thankfully, he ate it.
Making constant posts has distracted me, but this is kinda scary....

 

I think a reduction to .25 units is warranted at this point, Laura. Up, up, up, Toeby!

 

You're doing fine, Laura, good you gave some syrup. Post when you can, just so we know everything's going okay.

 

Yay!! +4.5 we'll call it... he is 103 - Phew!
I gave him some honey mixed into some FF, with some of his probiotics on top to be sure he was enticed to eat, as he was seeming to not be so interested in snacking.
Between the shot of corn syrup or the shot of honey, wow, that worked fast.
32 to 103 in one swoop.

 

And, will add that I am not turning in yet based on that, I will test him more to be sure he is staying up there.

 

Better at +4.5. I'd test in another 20 minutes to see the number is stable, since the syrup can wear off quickly. Best to continue with a few more tests, once they're stable above 50 you want to see 2 consecutive tests about 30-45 minutes apart, without HC or syrup intervention.

 

I'm wondering if his pancreas has been finally healing from being off the prednisolone for a while now and he might be able to kick the insulin habit soon. He's been doing really well for the past few weeks despite the budesonide EOD.

 

He is 149 twenty minutes after the 103 - I didn't give him any HC or treats this time.
Will check again shortly.

The power went off outside of town - my friend just Messaged me to see if we had power in town (post-tropical storm Elsa's winds).
I would have LOST IT if I was dealing with this with no power, fumbling with my phone to post results, so, there's a good thing!

Katherine, I too am wondering if the distance off the prednisolone, and the reduced budesonide has something to do with it.
I cannot allow myself to think he may get off the insulin tonight, but geez that would be awesome, of course, if it happened.
I have a longish story about the budesonide, but I can't get into that now... he is still on 1 mg every other day, as my SS shows.
The new vet I am working with on the budesonide saw his SS and said she thought I was running him too low, and gosh darn it if he didn't have to go hypo tonight... now she can look at the SS and say "I told you so..."
Oh well.

 

I know you were thinking of doing .5 mg budesonide every day, but he seems to be doing well BG wise, and if the budesonide is helping his IBD at bay then it's a good thing. What I've learned from Ruby being on steroids is that it can be a bit of a roll of the dice, so if you can keep him safer on less insulin, that's probably best for you and him so you wouldn't have to worry so much. Now that those pinks have basically disappeared, keeping him below 200 is a good goal.

 

+5 is 218... Oops... looks like I over-cooked it.

Oh well, I guess if being heavy handed on the syrup and honey is the worst thing that happened tonight, all is good.
He is drinking lots of water after that concoction.
I'll test him again before I turn in.

The new vet suggested I could try to give him the 0.5 budesonide capsules that I ordered daily for 2 weeks, then switch to 0.5 every other day for a couple weeks, and call before re-ordering.
However, the capsules are quite big now that I have them in hand (I picked them up last Friday, but wanted to hear from her, and didn't hear until Wednesday evening this week)
I think I'd rather just toss them and work with the 1 mg tablets and chews and maybe work on staying with the 1 mg every other day, or maybe try 1 mg every 3 days...
He takes the tiny tablets and the chews so well...
I don't want to fight with him or upset him with swallowing big capsules, or throw too much more of a variable into his total course of treatment.
And, as you point out, it doesn't currently look like the budesonide is affecting his BGs.

Before I forget to say it when I turn in, sincere thanks to everyone for their help tonight... I truly appreciate the support.
Laura

 

Better too high than too low. He will come down again. You did the right thing. Good night, Laura.

 

+6 311.... Oh my... Oh well. Good night!