126 at +12. Please advise.

Status
Not open for further replies.
Angel's mommie

Angel's mommie

Member Since 2017
In case anyone gets the chance, please, could you look at Angel's SS and advise on how much I should shoot this morning. I would like to try TR, but am not sure I am ready yet. Thoughts? Thank you.

He is 126 at +12 this morning. For now, my plan is to test again in 30 mins and probably continue the <1 unit of lantus (I've been using 1 and <1 units for a long time now) if his numbers are above 150. Basically <1 = 1 including the air bubble.
 
Last edited:
I am sorry no one got to you in a timely manner this morning. It can help get eyes on your post if you select the "?" prefix on the subject title.

Are you still using the Alphatrak meter? If so, that 66 last night meant that he earned a .25 unit dose reduction down to 0.75 units, which you can shoot tonight.

Have you decided yet whether you want to follow the Tight Regulation (TR) or Start Low Go Slow (SLGS) for dosing? If so, could you put either TR or SLGS in your signature. That'll help us help you with dosing decisions. And as a side note, the SLGS reduction point is 90, for TR a reduction is earned if you go below 68 on that AT. That's one of the differences between the two methods. You do mostly test enough for TR, but I would suggest adding at least a +2 or before bed test at the night time. As you saw last night, kitties, often go lower at night.

Here is your last post here: http://www.felinediabetes.com/FDMB/...n-from-138-to-174-in-2-give-25-lantus.174751/ For continuity, we include those links so we can easily see what happened before.
 
Hi Shefali, I see that you did shoot the 1 unit and as Wendy says, Angel earned a reduction from last night's drop to 66. Since his +2 is the same as the preshot number (PS) it could indicate an active cycle. Pease get some more test on him through this cycle as he could drop lower again and you will want to catch that and steer with higher carb food if necessary.

ETA So the reduction he earned would be .25 so the new dose woud be .75 unit Here is what it looks like on a syringe.
 
upload_2017-3-14_18-43-50.png
 
Wendy&Neko said:
I am sorry no one got to you in a timely manner this morning. It can help get eyes on your post if you select the "?" prefix on the subject title.

Are you still using the Alphatrak meter? If so, that 66 last night meant that he earned a .25 unit dose reduction down to 0.75 units, which you can shoot tonight.

Have you decided yet whether you want to follow the Tight Regulation (TR) or Start Low Go Slow (SLGS) for dosing? If so, could you put either TR or SLGS in your signature. That'll help us help you with dosing decisions. And as a side note, the SLGS reduction point is 90, for TR a reduction is earned if you go below 68 on that AT. That's one of the differences between the two methods. You do mostly test enough for TR, but I would suggest adding at least a +2 or before bed test at the night time. As you saw last night, kitties, often go lower at night.

Here is your last post here: http://www.felinediabetes.com/FDMB/...n-from-138-to-174-in-2-give-25-lantus.174751/ For continuity, we include those links so we can easily see what happened before.
Click to expand...

No worries, Wendy and Neko -- that was such a hurried post :). And thank you so very much for your very useful response and tips. I want to do TR, and will add that to my signature. However, for the next few days I think I'll focus on collecting data, maybe test 6-8 times a day but AFTER stopping the free feeding -- I just read that that is not a good idea, so now am working on what a good feeding schedule will be. Also I need to adjust Angel's cycle to 9 AM/PM. So for the next three days there'll be changes, but then hopefully I can go to full TR mode in a week or two.

I will certainly include previous links from next time -- great idea.

OMG, they certainly do go lower at night, huh! I woke up to test him last night, lol, as I was so worried he might have a hypo that I couldn't sleep properly :).

Thank you so so so much!
 
Bobbie And Bubba said:
Hi Shefali, I see that you did shoot the 1 unit and as Wendy says, Angel earned a reduction from last night's drop to 66. Since his +2 is the same as the preshot number (PS) it could indicate an active cycle. Pease get some more test on him through this cycle as he could drop lower again and you will want to catch that and steer with higher carb food if necessary.

ETA So the reduction he earned would be .25 so the new dose woud be .75 unit Here is what it looks like on a syringe.
Click to expand...

Gosh, thanks for all that great info, including the photo! Until now I've been free feeding, but now I'm going to be more controlled with the food so the numbers are clearer. Trying to work out what the best feeding schedule would be. Any suggestions?
 
HC foods -- anything with gravy, yes? He adores some of the FF gravy foods. Are there suggestions about whether chicken is better than beef etc?
 
Bobbie And Bubba said:
Save the HC food if Angel starts to go below 68 that will come in handy for steering when he is dropping Have you seen this list for carb count in wet food ?

http://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174185/

This will be your best friend . The carb count is the third from the left I think that beef is higher than chicken .
Click to expand...

Thank you. Yes, I've seen this fabulous list -- it was what led to my food choices for Angel. Much appreciated, Bobbie and Bubba!
 
Angel's mommie said:
maybe test 6-8 times a day but AFTER stopping the free feeding -- I just read that that is not a good idea
Click to expand...
Not true, some kitties are grazers. In that case, you can leave food out and just lift it for the last two hours before shot time. In the beginning, you don't want to have a preshot number that is influenced by eating carbs within the last couple of hours. You would ideally prefer to have kitty eat most of his food in the first half of the cycle before nadir, but not all kitties cooperate with this idea. :cat: Very low carbs is better in the back half of the cycle, as the insulin is waning then and too much carbs will put the brakes on the insulin action.

On the list, anything 15% and above is considered high carb or HC. There are some HC options that do not include gravy. Medium carb or MC, is 10-14%. Below 10% is LC or low carb which should be his regular food.

Some cats are more carb sensitive than others. My girl only needed an HC of about 16-17% to bring her up. Some people have cats that need over 20% carbs to bring them up. Take good notes as you use the different types of foods and you'll learn what works for Angel.
 
Ah, good to know that, Wendy and Neko. I might need to do a combo -- on days I'm home I can feed manually, and can free-feed on days I'm gone and at night. Very useful info: thank you. So I'm thinking on the days I need to go in to work maybe I'll remove the food as soon as I wake up, and then test/shoot after 2 hours just before I leave. It's a bit tricky knowing how much to leave out at night, but I'll do my best (we have 3 cats, so one never knows who's eating how much -- often one will binge or just not eat all night).
I will keep good notes. Thanks again.
 
Max had chronic pancreatitis and was fed several small meals up to +5-7 daily and at night as well. I tended to feed mostly lc/mc and fed based upon test results through the cycle.
 
tiffmaxee said:
Max had chronic pancreatitis and was fed several small meals up to +5-7 daily and at night as well. I tended to feed mostly lc/mc and fed based upon test results through the cycle.
Click to expand...
Useful to know. I'm just trying to absorb all your info and feedback right now. Head spinning, so much to learn. Thank you, tiffmaxie!
 
Shefali

Angel is looking quite good!! A couple things might help him.

--dosing consistency: to the extent that you can, shoot the same dose unless he earns a reduction or clearly needs an increase. You've shot a 123 before so shooting a 126 should have been a piece of cake as long as you were there to monitor
--if you stall, you should shoot the full current dose; stalling and then shooting a reduced dose is almost like a double whammy
--you are easily testing enough right now for TR and, if you want to do TR, I don't see any reason to wait
--as I posted on Chase's condo and Wendy stated, if you are going to feed after nadir, I'd go with a small, LC snack but I'd try to get the majority of calories in him prior to nadir, if possible; if it's not, it's ok but just be sure you aren't feeding him more than LC or a big helping; even if you feed LC, if you give a large serving, it can potentially nip his duration
--if you can put remarks on his SS as to when and what kind of food you feed, it helps us determine if switching up the feed times or amounts might help. You can look at Chase's SS to see how Sandi does it which has been very helpful

Let's see how he does with the reduction. Good luck with it and pls let us know how we can help.
 
Gosh, Marje, I am so very grateful to you for taking the time. I cannot believe what angels you (all) are. Thank you. Your response made me very happy, and I will try to follow all your advice. Wow. I absolutely want to begin Angel on TR if you think it is okay (and of course I will not hold you responsible if there's a mishap :); I fully understand this is my choice). I just let him eat a bunch :( as I hadn't yet seen your message, but now will be careful of the post-nadir feeding thing. I did see Sandi's SS (saved it!), and will follow the food-notations.

I'm thinking of the following plan: I'll monitor him closely and get data as best as I can (I have to go out at some points) for the next two days with the correct feeding schedule, while also trying to move his cycle closer to 9 or 10 AM/PM, which are easier to manage, and really carefully studying the protocol and peoples posts/SS charts. And, if all looks well, will begin TR the day after that, on Friday. I'll post Thursday night, in case you or anyone else get a chance to look.
Again, thank you so so so much. I'm so very grateful (and I know Angel, my mom, and my husband are too :)!). In my case it isn't just that I absolutely adore Angel (and I do; he is my darling baby whom I rescued as a wee thing eating out of a dumpster), but also I desperately need to be with my 83 year old mom who has all sorts of health issues in India during summer -- so I really, really want to see if I get him into remission again, if at all it is possible. I am going to devote myself to this for the next few months.
 
A question: is it better for one to stick with the same thread (is that a 'condo'?) and keep changing the title, or to start a new one? Or does it depend on context, as in start a new thread only if it is a totally different question?
 
Start a new thread (condo - the place where our cat's live :)) once a day. If you have any questions, include them on the thread title. Once the question is answered, take down the "?" prefix to let us know it's answered. If you have a new question part way through day, just edit the title and put the new question up there with the "?" prefix. Several of us will scan the board for "?" so it helps to alert us that you need some help. It helps us to keep all the content for the day in one place.

Here's post Tricia wrote to help new members.
 
Angel's mommie said:
Gosh, Marje, I am so very grateful to you for taking the time. I cannot believe what angels you (all) are. Thank you. Your response made me very happy, and I will try to follow all your advice. Wow. I absolutely want to begin Angel on TR if you think it is okay (and of course I will not hold you responsible if there's a mishap :); I fully understand this is my choice). I just let him eat a bunch :( as I hadn't yet seen your message, but now will be careful of the post-nadir feeding thing. I did see Sandi's SS (saved it!), and will follow the food-notations.

I'm thinking of the following plan: I'll monitor him closely and get data as best as I can (I have to go out at some points) for the next two days with the correct feeding schedule, while also trying to move his cycle closer to 9 or 10 AM/PM, which are easier to manage, and really carefully studying the protocol and peoples posts/SS charts. And, if all looks well, will begin TR the day after that, on Friday. I'll post Thursday night, in case you or anyone else get a chance to look.
Again, thank you so so so much. I'm so very grateful (and I know Angel, my mom, and my husband are too :)!). In my case it isn't just that I absolutely adore Angel (and I do; he is my darling baby whom I rescued as a wee thing eating out of a dumpster), but also I desperately need to be with my 83 year old mom who has all sorts of health issues in India during summer -- so I really, really want to see if I get him into remission again, if at all it is possible. I am going to devote myself to this for the next few months.
Click to expand...
As long as he's not eating any dry food and you are monitoring him at PS and a couple other times each cycle, I don't see any reason why you can't do TR.

Thank you for being willing to add his food to his SS. It will help you and us. And as a note, feeding is not a "one size fits all" concept. It takes some experimentation, sometimes, to figure out the best feeding strategy to fit his curve, his hunger, and your schedule as well as the other cats.

There are some cats, like Chase, who definitely benefit from food management of their curve but others who really don't need it quite so much and Angel might be one. We will have to see. But it might just be that you can free feed him when he's hungry before nadir and then find a way to be sure he doesn't get too hungry towards the end of the cycle and provide something small and LC doesn't impact his duration.

It's very important to remember that Angel is a long-term diabetic because it's been more than a year since he was diagnosed even though he went into remission. Once a diabetic, always a diabetic but those in remission are insulin independent and controlled by LC diet.

It's also important to note that when a cat comes out of remission, we need to be a little more aggressive in getting them back into remission. That's where shooting any number above 68 on your AT provided you have supplies and are available and able to test becomes important. Once a member has some data and experience, stalling, shooting reduced doses, and skipping are more for the member than the cat;). And that's ok......if we are sick or have other important obligations, sometimes it is necessary to stall, skip, or shoot a reduced dose.

However, by and large, the more you are able to shoot a consistent dose about every 12 hours, the better for Angel. Again...keeping in mind the safety factors of only shooting above 68 (AT) and being sure you are available and able to monitor if you shoot green numbers. As you can see with Chase yesterday, sometimes the BG really flattens out and less testing is needed.
 
Wendy&Neko said:
Start a new thread (condo - the place where our cat's live :)) once a day. If you have any questions, include them on the thread title. Once the question is answered, take down the "?" prefix to let us know it's answered. If you have a new question part way through day, just edit the title and put the new question up there with the "?" prefix. Several of us will scan the board for "?" so it helps to alert us that you need some help. It helps us to keep all the content for the day in one place.

Here's post Tricia wrote to help new members.
Click to expand...
Thank you so very much, Wendy&Neko. Will follow this. And Tricia's post is so very useful! Thanks!
 
Marje and Gracie said:
As long as he's not eating any dry food and you are monitoring him at PS and a couple other times each cycle, I don't see any reason why you can't do TR.

Thank you for being willing to add his food to his SS. It will help you and us. And as a note, feeding is not a "one size fits all" concept. It takes some experimentation, sometimes, to figure out the best feeding strategy to fit his curve, his hunger, and your schedule as well as the other cats.

There are some cats, like Chase, who definitely benefit from food management of their curve but others who really don't need it quite so much and Angel might be one. We will have to see. But it might just be that you can free feed him when he's hungry before nadir and then find a way to be sure he doesn't get too hungry towards the end of the cycle and provide something small and LC doesn't impact his duration.

It's very important to remember that Angel is a long-term diabetic because it's been more than a year since he was diagnosed even though he went into remission. Once a diabetic, always a diabetic but those in remission are insulin independent and controlled by LC diet.

It's also important to note that when a cat comes out of remission, we need to be a little more aggressive in getting them back into remission. That's where shooting any number above 68 on your AT provided you have supplies and are available and able to test becomes important. Once a member has some data and experience, stalling, shooting reduced doses, and skipping are more for the member than the cat;). And that's ok......if we are sick or have other important obligations, sometimes it is necessary to stall, skip, or shoot a reduced dose.

However, by and large, the more you are able to shoot a consistent dose about every 12 hours, the better for Angel. Again...keeping in mind the safety factors of only shooting above 68 (AT) and being sure you are available and able to monitor if you shoot green numbers. As you can see with Chase yesterday, sometimes the BG really flattens out and less testing is needed.
Click to expand...

This all sounds great, Marje. I'm going to be mildly inconsistent for a few days as I move Angel to a 10AM/PM cycle, but will try and be as consistent as possible after that. Today, sadly, I have to do the opposite of your advice: I'm monitoring his food pre-nadir, but will need to leave out a little post-nadir as I'm gone for 5 hrs. He throws up foam if he has an empty stomach, so I'll just leave a bit and hope he gets some. Tomorrow too will be interesting as our cleaning lady will be here 9-2, which means he hides for 5 hrs flat, but I'll try and feed the best I can. Luckily she only comes once in 4 weeks!

I do have a question: THIS time 'round, Angel was diagnosed less than a year ago (post-steroids) on July 22, 2o16. Doesn't that make him a new diabetic? His previous diabetes was in 2014, and he'd gone into remission within 3 months (by end 2014). Maybe I should change my signature to make all this more clear :).

I've stockpiled 400 test strips ;) . Will move to a human meter after using those, though. Can't afford to keep continuing with Alphatrak :(.

Thank you a million!!!
 
Last edited:
Angel's mommie said:
This all sounds great, Marje. I'm going to be mildly inconsistent for a few days as I move Angel to a 10AM/PM cycle, but will try and be as consistent as possible after that. Today, sadly, I have to do the opposite of your advice: I'm monitoring his food pre-nadir, but will need to leave out a little post-nadir as I'm gone for 5 hrs. He throws up foam if he has an empty stomach, so I'll just leave a bit and hope he gets some. Tomorrow too will be interesting as our cleaning lady will be here 9-2, which means he hides for 5 hrs flat, but I'll try and feed the best I can. Luckily she only comes once in 4 weeks!

I do have a question: THIS time 'round, Angel was diagnosed less than a year ago (post-steroids) on July 22, 2-16. Doesn't that make him a new diabetic? His previous diabetes was in 2014, and he'd gone into remission within 3 months (by end 2014). Maybe I should change my signature to make all this more clear :).

I've stockpiled 400 test strips ;) . Will move to a human meter after using those, though. Can't afford to keep continuing with Alphatrak :(.

Thank you a million!!!
Click to expand...
How long they've been diabetic is based upon first diagnosis even if they went into remission within a week. So he has been diabetic since 2014.

It's no issue for us if you use an AT. :)
 
Marje and Gracie said:
How long they've been diabetic is based upon first diagnosis even if they went into remission within a week. So he has been diabetic since 2014.

It's no issue for us if you use an AT. :)
Click to expand...

Ah! Thank you for clarifying. I was very optimistically thinking he's a "new diabetic." Have also noted your point about a cat who's come out of remission but gone back needing extra aggressive measures.

I'm going to need to stop using the AT 'cos of the expense, lol. Those 450 test strips cost almost $500, whew!!! Teachers salaries aren't high enough to afford AT with multiple testing, lol ;).
 
Marje and Gracie said:
As long as he's not eating any dry food and you are monitoring him at PS and a couple other times each cycle, I don't see any reason why you can't do TR.

Thank you for being willing to add his food to his SS. It will help you and us. And as a note, feeding is not a "one size fits all" concept. It takes some experimentation, sometimes, to figure out the best feeding strategy to fit his curve, his hunger, and your schedule as well as the other cats.

There are some cats, like Chase, who definitely benefit from food management of their curve but others who really don't need it quite so much and Angel might be one. We will have to see. But it might just be that you can free feed him when he's hungry before nadir and then find a way to be sure he doesn't get too hungry towards the end of the cycle and provide something small and LC doesn't impact his duration.

It's very important to remember that Angel is a long-term diabetic because it's been more than a year since he was diagnosed even though he went into remission. Once a diabetic, always a diabetic but those in remission are insulin independent and controlled by LC diet.

It's also important to note that when a cat comes out of remission, we need to be a little more aggressive in getting them back into remission. That's where shooting any number above 68 on your AT provided you have supplies and are available and able to test becomes important. Once a member has some data and experience, stalling, shooting reduced doses, and skipping are more for the member than the cat;). And that's ok......if we are sick or have other important obligations, sometimes it is necessary to stall, skip, or shoot a reduced dose.

However, by and large, the more you are able to shoot a consistent dose about every 12 hours, the better for Angel. Again...keeping in mind the safety factors of only shooting above 68 (AT) and being sure you are available and able to monitor if you shoot green numbers. As you can see with Chase yesterday, sometimes the BG really flattens out and less testing is needed.
Click to expand...

Wow. At this point I cannot even BEGIN to imagine shooting green numbers. So much to learn! I may need a lot of handholding there :(....sorry!
 
Bobbie And Bubba said:
That is exactly how I felt when I received so much help here . We just pay it forward .
Click to expand...
Best philosophy EVER. I hope to do the same someday, if I ever get to be as knowledgeable as you/so many of you. It is a joy to be in a place with so many caring, wonderful people who adore and want to do their very best for the little creatures who make their lives magical. This site feels like the distilled essence of the best of humanity, and the very best of what the internet can be. I was actually thinking I might write about it some day.
 
Angel's mommie said:
Best philosophy EVER. I hope to do the same someday, if I ever get to be as knowledgeable as you/so many of you. It is a joy to be in a place with so many caring, wonderful people who adore and want to do their very best for the little creatures who make their lives magical. This site feels like the distilled essence of the best of humanity, and the very best of what the internet can be. I was actually thinking I might write about it some day.
Click to expand...
So sweet, so well said. Are you a writer , Shefahaali?
 
Bobbie And Bubba said:
So sweet, so well said. Are you a writer , Shefahaali?
Click to expand...
I used to write more; haven't done it for ages -- it's difficult, and not something I particularly enjoy doing, but every now and then I think...oh my gosh, it would be cool to write on this amazing phenomenon/idea :)! Might just end up being a long FB post tho, who knows :p. I do think, though, that this group really is a phenomenon -- and phenomenal -- although will admit I have very little experience of internet groups.
 
I find it's easier to get rid of air bubbles if the syringe is pointing up. First draw the plunger back down so there is air in the top of the syringe. Then do the flicking. Air bubbles seem to gravitate to other air bubbles. Then slowly push or twist the plunger to remove the bubble.
 
Wendy&Neko said:
I find it's easier to get rid of air bubbles if the syringe is pointing up. First draw the plunger back down so there is air in the top of the syringe. Then do the flicking. Air bubbles seem to gravitate to other air bubbles. Then slowly push or twist the plunger to remove the bubble.
Click to expand...
Will try that next time. Thank you. Those air bubbles are frustrating -- I usually end up factoring them in, as they're basically wasted space.
 
Wendy&Neko said:
I find it's easier to get rid of air bubbles if the syringe is pointing up. First draw the plunger back down so there is air in the top of the syringe. Then do the flicking. Air bubbles seem to gravitate to other air bubbles. Then slowly push or twist the plunger to remove the bubble.
Click to expand...
I also never thought of twisting the plunger. Hmmm. Good idea. That might help dislocate them -- they're usually so pernicious and rude and refuse to move!
 
Angel's mommie said:
I also never thought of twisting the plunger. Hmmm. Good idea. That might help dislocate them -- they're usually so pernicious and rude and refuse to move!
Click to expand...
Just wanted to you to know: OMG your advice re bubbles has made the WORLD of a difference -- cannot thank you enough, Wendy&Neko! I'm dealing with those infuriating bubbles like a pro now! What a difference a pro tip can make :bookworm::D
 
Status
Not open for further replies.
Back
Top