3/24 Sheba PMPS 90.

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Bron and Sheba (GA)

Bron and Sheba (GA)

Member Since 2015
http://www.felinediabetes.com/FDMB/threads/3-23-sheba-amps-139-after-nadir-67-8-94.135010/

Yesterday morning Sheba had a good cycle, even reaching a green at +8.
PMPS was 196. When I tested at +3 last evening, I was a little surprised to see it was 191. No food spike or it had come and gone. As a precaution I added a small amount of MC to her second meal which she had most of between +3 and +3.5. At +3.5 I tested and she was 115 (a drop of 76 in half hour) so I gave her a teaspoon of HC. At +4 she was 76 (a drop of 115 in 1 hour). Between +4 and +5.5 I gave 1 teasp HC and drop of honey each half hour when I tested to slow the drop or stop it going down further. With all of that she stayed between 70 and 74. I did not give her any food after +5.5
I don't know if I did the right thing, but I did what I felt I had to. I was too scared to let her drop any further because she was dropping so fast and I didn't know if it would drop too low in the interim until the next test. Normally I am not worried to watch it drop if it is not dropping fast, but in this case I felt I needed to keep Sheba safe and me sane.
She has bounced this morning (no surprises there) and I have dropped her dose to 5.75 until I talk to you.
Looking at her SS it does not look remarkable and does not reflect the night.
Could she be needing less insulin?
I am exhausted from lack of sleep and woke with a very sore throat this morning. I am only getting about 3 hours sleep a night when she is dropping fast.
I don't really want to skip a dose as I don't want to loose the momentum but I can't go on like this. I would like to stay with Tight Regulation as well. Sorry to dump this on you
Please help
Thanks
 
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In order to know if she needs a dose decrease, it would help if you would let her drop below 50. As long as you're monitoring, you're going to be able to keep her safe. What you did in the 70's can be done in the 50's as well. She's not going to have a crisis just dropping below 50 - it's safe. I'm not criticizing you - the whole thing is a big learning process, just letting you know. Even though she dropped quickly in that one half hour, it doesn't mean that it would've continued at that rate, although i think for the reasons you explained, it was fine for you to intervene. You just want to have some confidence that she's going to respond just like she did at 45 instead of at 70, so that you can let her go lower.

We typically don't reduce the dose until we actually see it go below 50, but if you feel like you were really working a lot to keep her up, then she might need a dose reduction. I think since you already did reduce it to 5.75u, just stick with it and see if she "holds" the reduction. If she does, you'll continue to see green numbers when she clears this bounce.

Be watching for a failed reduction though - that means that the dose decrease was taken before she needed it. When the bounce clears, you want to see her back in green. If she resolves the bounce and it's blue or higher, I'd go right back to 6.0u with the next shot and try to regain control of her blood sugar.

Do you have a timed feeder? A timed feeder can do everything you're doing at night without you having to get up every hour or stay up. You may be doing this for a long time and you need all the tricks, bells and whistles to help you keep going and be able to get enough sleep.
 
We totally understand the stress you're under, and if you really need to sleep, you have to do what's necessary....we forget that we also need to take care of ourselves sometimes!!

That being said, the only way Sheba is going to earn her reductions is to let her drop below 50 before interceding with HC food...that's how the TR protocol works. If she's dropping too fast, I'd start with just some of her regular, low carb food to see if you can slow her down....even a little higher carb (like 9-10%) instead of a lower carb food might work if you need to use it.

She's really not "earned" the reductions you've taken so far (although I think that if you'd stuck with the 6.5, it wouldn't have been long!!!) but now that you've dropped to 5.75, let's see how she does! She may surprise us!

I don't mean to sound critical at all, especially because I know you were TRYING to enjoy your company this weekend, so that changes things. Hopefully Sheba will do well at this dose and continue to get into some of those nice, pancreas healing numbers!

Hope you feel better soon too....don't forget to force lots of fluids!
 
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Hi Bron. I just wanted to say I understand that feeling of exhaustion. I have felt that too and wondered how long I can keep going with the vigilance needed for tight regulation at times. Sending you a big hug.
 
Thank you all for replying. I do understand where you are all coming from and I feel a fraud. Maybe with a bit of sleep under my belt I will feel and be able to respond better. At the moment I just feel like howling.
Thanks
Bron
 
Hi Bron. If it helps any I have often felt similarly because I have been so exhausted and lack of sleep really affects our ability to cope. I find myself hoping for higher glucose levels so I can sleep and then I feel guilty and I also feel guilty for skipping doses or lowering doses so I can sleep or attend medical appointments as I feel I am putting our chances of remission at risk. I also feel inadequate at times seeing people confidently dosing green numbers when I feel sheer terror at times at the thought of doing so. Despite everyone here being so supportive and understanding sometimes I feel inadequate and I think lack of sleep contributes a lot to this feeling too. Though I did earn a BOS award recently I still struggle a lot with fear and at times with exhaustion too. But we need to also take care of ourselves too. Like that old saying if the plane is going down put your own oxygen mask on first and save yourself first so you are then in a position to save others. I think people like us who care so much for our furry little ones sometimes forget to look after ourselves too. We are doing our best and I send you more hugs and understanding too.
 
(((((Bron)))))

I"m not sure what you mean by "i feel a fraud" but all i can say is that this sugar dance can be so very hard in the beginning. Hang in there and it gets infinitely easier. You'll get used to all of it.

I'm sorry you're having such a rotten time of things right now. I think you're doing very well - I hope that came across in my previous post.

Big hugs, julie
 
Scroll back one month on Sheba's spreadsheet. What an amazing difference! :) You've done a fantastic job! Unfortunately, it does come at a cost to you and we totally get that. I personally have lowered Neko's dose a bit (temporarily), just so I could get some sleep. And often she's held that reduction. For a while, she was relentless at going low only at nights. One other thing to think about when you do reductions, .25U is a drop in the bucket compared to 6 units. Normally when people are increasing and 5 units or above, we suggest thinking in terms of .5U increases. At this point, I think you could also do .5U decreases when she earns a reduction, at least for a bit. Think in terms of 10% changes. And it'll give you a bit more breathing room. Something has changed in Sheba. :cool:
 
Voula said:
Hi Bron. If it helps any I have often felt similarly because I have been so exhausted and lack of sleep really affects our ability to cope. I find myself hoping for higher glucose levels so I can sleep and then I feel guilty and I also feel guilty for skipping doses or lowering doses so I can sleep or attend medical appointments as I feel I am putting our chances of remission at risk. I also feel inadequate at times seeing people confidently dosing green numbers when I feel sheer terror at times at the thought of doing so. Despite everyone here being so supportive and understanding sometimes I feel inadequate and I think lack of sleep contributes a lot to this feeling too. Though I did earn a BOS award recently I still struggle a lot with fear and at times with exhaustion too. But we need to also take care of ourselves too. Like that old saying if the plane is going down put your own oxygen mask on first and save yourself first so you are then in a position to save others. I think people like us who care so much for our furry little ones sometimes forget to look after ourselves too. We are doing our best and I send you more hugs and understanding too.
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Thanks Voula,
Appreciate your support. I am not usually such a wimp!
Sorry but must rush
Have to go to get kids from school.
Bron
 
julie & punkin (ga) said:
(((((Bron)))))

I"m not sure what you mean by "i feel a fraud" but all i can say is that this sugar dance can be so very hard in the beginning. Hang in there and it gets infinitely easier. You'll get used to all of it.

I'm sorry you're having such a rotten time of things right now. I think you're doing very well - I hope that came across in my previous post.

Big hugs, julie
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Hi Julie,

I really do understand what you are saying and why. I am just really tired at the moment.....these last few weeks have been hectic and Sheba is just the icing on the cake.
I'm sorry I have to go and collect kids from school and can't write more now
I do appreciate all the wonderful help I am getting
Bron
 
Wendy&Neko said:
Scroll back one month on Sheba's spreadsheet. What an amazing difference! :) You've done a fantastic job! Unfortunately, it does come at a cost to you and we totally get that. I personally have lowered Neko's dose a bit (temporarily), just so I could get some sleep. And often she's held that reduction. For a while, she was relentless at going low only at nights. One other thing to think about when you do reductions, .25U is a drop in the bucket compared to 6 units. Normally when people are increasing and 5 units or above, we suggest thinking in terms of .5U increases. At this point, I think you could also do .5U decreases when she earns a reduction, at least for a bit. Think in terms of 10% changes. And it'll give you a bit more breathing room. Something has changed in Sheba. :cool:
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Hi Wendy,
Sorry this has to be short. I will get back to this as soon as I can......have to get kids from school.
Really appreciate your support. You have all been wonderful and helped so much and made an incredible difference to Sheba. Sorry to rush
Bron
 
I think you'd doing great too....and so is Sheba!!

Just looking at the difference in her spreadsheet proves that something is going on and it's a positive sign!

TR is an aggressive approach already...yes, it gives our cats the best chance at remission, but boy can it be hard on us beans!!

Remember...cats have the luxury of sleeping 20 hours a day!!;)
 
Hi Julie, Wendy and Chris,

I grabbed some sleep between Sheba's PMPS and her +3 feed tonight, so feel a bit better. I shut the bedroom door so Sheba could not get in and ask for more food as it got close to the +3.
I will try and answer the above posts which I didn't have time or feel capable of doing earlier.

Firstly I want to explain about the "reductions". With going from 6.25 to 6, because I was minding 3 grandchildren for the weekend and was already tired from PJ parties, I asked Wendy if I could drop the dose just for the weekend and she gave me a couple of options of what I could do. I didn't have a chance to increase again after the weekend as Sheba was still getting green numbers and the very strong cycle last night (Monday). When I went from 6 to 5.75 I only did it until I had spoken to the forum. If you look at my first post of this thread, I said I had reduced until I spoke to you.
I completely understand one has to earn the reductions and I was not trying to get them via the back door, so to speak.
I felt bad to think you thought that, and that is why I said I felt a fraud.

Yes I have a timed feeder Julie, thank you. I use it every night. I never get up just to feed Sheba at night, only to test and to then give higher carb food if she is dropping fast. If she is dropping normally I go back to bed after the test, but if she is dropping fast I stay up until I feel she is safe.

What I was trying to do with feeding the higher carb food during the drop was to try and stop her dropping too fast. This is what I have been taught here on the forum. Feeding her low carb food, when she is dropping like that does nothing to slow the drop. The only food that will slow the drop is higher carb food, if she is having a really strong cycle. As soon as she shows signs of slowing I always stop feeding. When she is having an 'ordinary' drop I feed her nothing. I don't know if I have explained myself well or not :)
Am I doing the correct thing or should I be doing it another way?

I really do appreciate everything you guys have done for Sheba. You have made a massive difference to her numbers. Being such a party animal at night is exhausting for the bean though. And yes Chris, they can sleep for 20 hours a day! It is adding insult to injury when I find her sound asleep on my bed :cat:and I am having to be awake.

Am not sure I understood you completely about reducing 0.5 at higher numbers Wendy. I understand the method you are advocating but not what I should do at this point.....Do you want me to stay at the 5.75 and use that method when I do earn a reduction?
Alternately I will go back to 6 units if that is what you think I should do.
Thanks for being there for me and for Sheba. You do a wonderful service to the feline diabetic cause.:)
Bron
 
Bron - I meant that the next time Sheba earns a reduction, try a .5U decrease. So, stay the course, let the depot stabilize for now.
 
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