? SLGL Question

[Juliet]

Hi

Someone pointed out this sticky to me which is really helpful:

Hold the dose for at least a week:

• Unless your cat won’t eat or you suspect hypoglycemia
• Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unitimmediately.

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours:
Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit

• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose

• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

I have a question on it - when I am doing the curve after holding the dose for 7 days - what if he is bouncing on curve day? Do I still increase dose as above? How do I know its a bounce and not too little insulin? This is the bit I find hardest to understand and it doesn't help that I am limited in how much I can test.

 

[Juliet]

Bump....does anyone have any input?

 

[Gill & George]

It is difficult, if test day is a bounce cycle the info you get is not very helpful.

By getting the just before bed check an spot checks where you can it can make the decision easier.

 

[Tricia Cinco(GA) & Harvey]

I have a question on it - when I am doing the curve after holding the dose for 7 days - what if he is bouncing on curve day? Do I still increase dose as above? How do I know its a bounce and not too little insulin?

You have asked the million dollar question, and one of the biggest frustrations of doing SLGS. Sorry, there is no good answer. You can only look for trends in the numbers that you do have to try to see if it might be a bounce. I see you try to grab random tests when you are able. That is great. Also, look at how Silver is doing: is he peeing a lot, drinking a lot? Does he seem to have energy and feels well? Eating well?

Since you had to reduce the dose for a while, you're basically starting over on the .5, so let's see where he's at when you do your next curve. I suspect he need to go up to .75, but he hasn't been on .5 long enough this time to be sure yet.

Sorry, wish I had a better answer for you.

 

[Juliet]

Ok, I am planning on trying to get some more evening tests in where I can. Just before bed is usually just a +3 tho and I think he only starts to come down at that point.

 

[Juliet]

He is eating, peeing and drinking normally - but he is constantly hungry.

I ran out of syringes with the half unit markings so I actually think he may be getting 0.66u - I did 1u and squeezed out a fat drop, leaving two fat drops left in syringe. I have ordered more of the half unit marking syringes which arrive tomorrow but think I should continue doing the same with the other syringes for this week so its consistent. Right?

 

[Tricia Cinco(GA) & Harvey]

He is eating, peeing and drinking normally - but he is constantly hungry.

I ran out of syringes with the half unit markings so I actually think he may be getting 0.66u - I did 1u and squeezed out a fat drop, leaving two fat drops left in syringe. I have ordered more of the half unit marking syringes which arrive tomorrow but think I should continue doing the same with the other syringes for this week so its consistent. Right?

Yes, consistency is always more important than perfect accuracy. That's wonderful if you can get those extra tests in. There is no such thing as too much data!

 

[Gill & George]

Ok, I am planning on trying to get some more evening tests in where I can. Just before bed is usually just a +3 tho and I think he only starts to come down at that point.

But even if they don't tell you how low he's going they will give you an indication that he is having an active cycle and is not just staying high and flat, that can be helpful.

 

[Juliet]

As you can see from his pic he still likes to get up to mischief. Caught in the act with his sister joining in!

 

[Really Riley (GA)]

You have asked the million dollar question, and one of the biggest frustrations of doing SLGS. Sorry, there is no good answer. You can only look for trends in the numbers that you do have to try to see if it might be a bounce. I see you try to grab random tests when you are able. That is great. Also, look at how Silver is doing: is he peeing a lot, drinking a lot? Does he seem to have energy and feels well? Eating well?

Since you had to reduce the dose for a while, you're basically starting over on the .5, so let's see where he's at when you do your next curve. I suspect he need to go up to .75, but he hasn't been on .5 long enough this time to be sure yet.

Sorry, wish I had a better answer for you.

This answers my question also. In Riley's case the last increase in insulin resulted in what looked like bouncing and a 24-hour test confirmed. His curve looks identical to Somogyi curves I've seen published online. I reduced his dose from 3 units to 2 because I wanted to give his body a break. (He previously showed a drop to 110 while he was at 2 units in September.) Now I have to decide how to proceed.

 

[Tricia Cinco(GA) & Harvey]

I reduced his dose from 3 units to 2 because I wanted to give his body a break.

Reducing the dose isn't going to give his body a break. Rather, it could create insulin resistance, which will make it even harder to bring the numbers down and require more insulin. Bouncing isn't hard on the body - continued high numbers are. If you haven't already done so, please post a condo of your own and ask for input. We'd be happy to help you figure this out.

His curve looks identical to Somogyi curves I've seen published online.

There is no proof that Somogyi happens in cats - in fact, it's in doubt if it actually happens in humans. Here is a link to a paper done by Roomp & Rand (the authors of the TR protocol paper) on the subject: http://www.felinediabetes.com/FDMB/...urgery-2015-roomp-1098612x15588967-pdf.16129/

 

[Gill & George]

lease post a condo of your own and ask for input.

Here is Rileys condo
http://www.felinediabetes.com/FDMB/...ws-314-in-2-hrs-now-what.187203/#post-2078016

 

[Tricia Cinco(GA) & Harvey]

Thanks, Gill. I hadn't had time to look for it yet.

 

[Gill & George]

Thanks, Gill. I hadn't had time to look for it yet.

No worries, just wanted to be helpful.

 

[Really Riley (GA)]

Reducing the dose isn't going to give his body a break. Rather, it could create insulin resistance, which will make it even harder to bring the numbers down and require more insulin. Bouncing isn't hard on the body - continued high numbers are. If you haven't already done so, please post a condo of your own and ask for input. We'd be happy to help you figure this out.



There is no proof that Somogyi happens in cats - in fact, it's in doubt if it actually happens in humans. Here is a link to a paper done by Roomp & Rand (the authors of the TR protocol paper) on the subject: http://www.felinediabetes.com/FDMB/attachments/journal-of-feline-medicine-and-surgery-2015-roomp-1098612x15588967-pdf.16129/[/QUOTE]

This is a good study. Thank you very much for providing this info. It really helps to find this!

 

[Really Riley (GA)]

Reducing the dose isn't going to give his body a break. Rather, it could create insulin resistance, which will make it even harder to bring the numbers down and require more insulin. Bouncing isn't hard on the body - continued high numbers are. If you haven't already done so, please post a condo of your own and ask for input. We'd be happy to help you figure this out.



There is no proof that Somogyi happens in cats - in fact, it's in doubt if it actually happens in humans. Here is a link to a paper done by Roomp & Rand (the authors of the TR protocol paper) on the subject: http://www.felinediabetes.com/FDMB/attachments/journal-of-feline-medicine-and-surgery-2015-roomp-1098612x15588967-pdf.16129/[/QUOTE]

One more question - can I download this file without an Adobe purchase? It would even be great if I could download a usable link. Forgive me if I'm missing the obvious.

 

[Squeaky and KT (GA)]

I wanted to give his body a break.

Tricia spoke to the effects of reducing the dose but I'd like to add one thing. Insulin is a hormone required to turn food into energy. It's not a chemical medicine forcing his body to do something. His pancreas should be secreting it naturally but it's not so you must supplement. Backing off a dose is actually making his body work harder rather than giving him a break.

HUGS and headbutts too!

 

[Bobbie And Bubba]

Tricia spoke to the effects of reducing the dose but I'd like to add one thing. Insulin is a hormone required to turn food into energy. It's not a chemical medicine forcing his body to do something. His pancreas should be secreting it naturally but it's not so you must supplement. Backing off a dose is actually making his body work harder rather than giving him a break.

HUGS and headbutts too!

Hi Lyresa!! Sorry for the highjack!

 

[Juliet]

Hi Lyresa!! Sorry for the highjack!

Who is Lyresa? This was my post originally but I’ll forgive the hikack

 

[Bobbie And Bubba]

Who is Lyresa? This was my post originally but I’ll forgive the hikack

@Squeaky and KT (GA) is Lyresa. Sorry for the high jack.

 

[Squeaky and KT (GA)]

Yep that be me Juliet. My name is Lyresa but my nickname/User ID has been 'Squeaky' since dirt...as in the original 'AOL' even. Yep I iz old... KT was my first diabetic, Dakota is my current little old man extra sweet kitty.

@Bobbie And Bubba - BIG HUG!!!!!