11/2 Ming PMPS = 490, +2 = 454

Crista & Ming said:
I’m starting to think 5 units is too much again. Should I stick with 5 units one more day?
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I would stick with the 5U or even I would talk to Wendy or Sandy about about increasing a little soon.

You are 6 full cycles on the dose but 2 of them were possibly a partial FS, it affects the dose. Plus timing was off and there were 2 abortions.
It makes the 5U dose evaluation very difficult.

Another thought is the food.

Check out 5%-10% carbs as daily reg feed stick with one particular carbs level for 3 or 4cycles, keep recording BG and foods and than have a look at it. It is really a matter of sticking with one level of carbs for a while and to assess where does it bring Ming.

If the BG spikes up by a lot on 7% food - switch to 5% and repeat the testing/ recording regimen for another 3-4 cycles. Then a have a look at and compair with results whilst on 7%.

Reserve HC (165 and up) and MC food (11-15%) for nearing 50 early in the cycle or going below.

You got recommendation to use MC gravy to boost the raw food when it was not clear what kind of foods were available.
I ,for example, thought that you only had Raw (no carbs), 3.5% carbs FF and FF Beef 20%... If I knew you had 7% LC on hand I'd recommend using it instead of adding gravy to raw or 3.5% food.

The point is to find carbs level that will let you keep the dose that gives Ming good nadirs and to minimize big or fast drops.
It can also flatten cycles.

I hope others will provide their opinion but I'd keep the dose. And test for ketones.
 
I’m on mobile so it’s wonky trying to quote posts. But @Tanya and Ducia, is there a range of how many points is too many for a spike? As well as a drop?

I’ll stick with the 7% carb food for now. Although I have this suspicion that food either doesn’t have a huge affect on Ming or its effects take longer than 1-2 hours to show.

I totally understand why we’re loading Ming up with carbs/trying out different carb levels in food, but is this more of a temporary thing or a long term plan? I would love to have Ming only on raw one day again.
 
Crista & Ming said:
I totally understand why we’re loading Ming up with carbs/trying out different carb levels in food, but is this more of a temporary thing or a long term plan? I would love to have Ming only on raw one day again.
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My thinking is that you should keep Ming on foods that allow you to keep him on a dose that produces good nadirs regularly, does not require you to steer up a lot with HC/MC foods, no Hypos and he is ketone free.

I love raw diet! But some kitties require a bit higher carbs food daily, still in LC range thou, to process their insulin doses the most efficiently.
I cannot explain why it works (see Sandy's previous post on the subject)
- giving carbs to a diabetic is odd to say the least but the trick allowed many to achieve flatter cycles.
It is all very ECID.
Is it definitely a thing for Ming? - IDK.
You need more data to compare the results.

Your focus, me think, should be on securing that DKA won't repeat itself, ketones are negative or never above Trace level at all times and that he is not in danger of Hypo.

Crista & Ming said:
is there a range of how many points is too many for a spike? As well as a drop?
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...well 100 points either way - up or down- in one hour for example is too much, right?;):)

hard to set a "range" for something that is not static.
A lot depends on what time of the cycle spike or drop occur.
With Ducia I seek 20-30 spike after 10 mg LC food.
If she drops 50+ points by +1 it is my warning sign.
It is very ECID.
 
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Lol seems like Ming likes to break all the “rules”.

Thanks for the explanation and reigning in my focus, @Tanya and Ducia :) When I’m alone with my thoughts, I get carried away. Doesn’t help that I just worked 11 hours and the only beings I spoke to was a sugar cat and a dog that literally ate tons of sugar and chocolate. :banghead:

@Sandy and Black Kitty hope your appointment is going well!
 
Hi there :cool:

The time has come for you to read about, and decide, which path towards achieving regulation, or if its in the cards remission, you want to follow.
One path is SLGS and the other is TR. All things considered, if he were my cat I would go with TR.

Crista & Ming said:
Well..even though Ming had a carb fest last night, he’s still at 212 at +11. Let’s see if he’s up at AMPS.

And if pattern goes to show, he’s gonna bounce.
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Looks like you were correct.
Crista & Ming said:
I’m starting to think 5 units is too much again. Should I stick with 5 units one more day?
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It may be too much but we don't want to guess - we need to see how low 5u is taking him. The info on both SLGS and TR contain guidelines around evaluating dose and counting the number of cycles on a given dose is key. Its important to know that if you have a furshot, the count starts over. Same for skipping or shooting a BCS dose.
So, this mornings dose is cycle 2 at 5u.
Crista & Ming said:
I’ll stick with the 7% carb food for now. Although I have this suspicion that food either doesn’t have a huge affect on Ming or its effects take longer than 1-2 hours to show.

I totally understand why we’re loading Ming up with carbs/trying out different carb levels in food, but is this more of a temporary thing or a long term plan? I would love to have Ming only on raw one day again.
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It's temporary.

Before I continue, what is your work schedule for the next few days? We need a strategy that will help you find out how low this dose is taking him.

Also, what is the ketone situation this morning?
ETA-on my way to the gym...BBL
 
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Sandy and Black Kitty said:
One path is SLGS and the other is TR. All things considered, if he were my cat I would go with TR.
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Yes, I do think I need to do more reading/read again on those methods. I read them last weekend and found SLGS most attractive in terms of my work schedule BUT also NOT good for Ming. That was my dilemma. I'm trying to think around my work schedule and of those around me to see if doing TR is sustainable. I'm in a lucky place right now since I'm working the night shift but once my day time shifts start.. It's going to take a bit to figure things out. But that's in another week.

Sandy and Black Kitty said:
what is your work schedule for the next few days?
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I'm here all weekend again. Not working until Tuesday night. But I hope I can go out with friends on Saturday night but will stay home if Ming is being weird.

Sandy and Black Kitty said:
Also, what is the ketone situation this morning?
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I'm waiting for him to go pee :rolleyes: He's sleeping right now and I'm trying to fight sleep myself until +2
 
Crista & Ming said:
He's bouncing a lot. Is it because his body is not used to being so low? Could this dramatic bouncing have been avoided if we started from low? And then a small voice inside of me wonders if this dose is too much? I know xxxxxxx mentioned that too high of a dose can look like not enough. What a headache!!
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One of my pet peeves is when the old chestnut "too high of a dose can look like not enough" is trotted out, without completing the sentence. The second part of that sentence is "when the caregiver is not testing very much and primarily getting just preshot tests". If you are testing enough, kitty will tell you the dose is too much by going under 50. We aren't seening that. You and your family are getting lots of mid cycle tests in. It's also not a good idea to unnecessarily lower kitty's dose with DKA in the recent past.

Bounces can happen for two primary reasons. First, going lower than their body is used to. Ming isn't used to greens yet, much less low blues. Second reason is fast drops. Some cats like to drop fast at onset. It's ECID but for some cats, a drop of more than 50 points an hour sets off the counter regulatory hormone alarm which dumps blood sugar causing a bounce. A third type of bounce, a bit related to the first is a long stretch in numbers they aren't used to. Chances are Ming spent quite a bit of time in the blues again last night. The shot after a fur shot can sometimes be a little more active if there was a fur shot yesterday morning.

Paws crossed that with some time off you can get 6 cycles in a row, on time and full dose, so you can properly evaluate this dose. Also keep in mind that Ming is still learning how to work Lantus. It's a hormone, changes don't happen overnight.
 
Negative ketones just before +6. He’s at 599 at +6.

I’m still half asleep but I’ve read the replies and will read them again once I’m fully awake :cat: THANK YOU for the explanations though!!
 
+8.5 = 565. Fed him 1 oz FD raw pork with lots of water lol

He looks good :) all Ps in place. He did go to the washroom again but I missed it.

@Sandy and Black Kitty I was wondering if he would be so bouncy if we started “clean” after his hospitalization. But then again, he was pretty bouncy on PZI as well. But you’re right, we’ll never know now lol

Edit: he’s been himself since ... a few days ago??? No longer sleeping the whole day. He’s actually following me around and playing with his toys and rummaging through clothes and bags that are left out (his fave thing to do it seems).
 
Crista & Ming said:
I was wondering if he would be so bouncy if we started “clean” after his hospitalization.
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Do you mean started at a low dose of Lantus? With ketones in the recent history, that wouldn't have been a good thing to do. It's getting to a dose where they start to see long stretches of green that will help them get used to lower but safe numbers, and hence reduce the bouncing.

Good to hear Ming is feeling playful again. :)
 
Wendy&Neko said:
Do you mean started at a low dose of Lantus? With ketones in the recent history, that wouldn't have been a good thing to do. It's getting to a dose where they start to see long stretches of green that will help them get used to lower but safe numbers, and hence reduce the bouncing.

Good to hear Ming is feeling playful again. :)
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Not necessarily a low dose but just not whatever happened in the hospital where he would get 10 units in the morning and 7 at night.

Okay, I must drill PATIENCE into my head ahhah! It's a marathon, not a race. Thanks Wendy for the reminder and explanations. I really appreciate it :) Helps calm my nerves and reminds me of what we're trying to achieve.
 
514 @ +10.5. He’s going down as usual.

I would like to shoot him 15 mins earlier. So instead of 9, it’d be 8:45.
 
Crista & Ming said:
He looks good :) all Ps in place.
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Great!
Crista & Ming said:
Edit: he’s been himself since ... a few days ago??? No longer sleeping the whole day. He’s actually following me around and playing with his toys and rummaging through clothes and bags that are left out (his fave thing to do it seems).
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Wonderful!
Crista & Ming said:
I'm trying to think around my work schedule and of those around me to see if doing TR is sustainable. I'm in a lucky place right now since I'm working the night shift but once my day time shifts start.. It's going to take a bit to figure things out. But that's in another week.
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When you have a chance, you will find some really good tips about following TR with a full time job here
(I know...more reading...)
Crista & Ming said:
514 @ +10.5. He’s going down as usual.

I would like to shoot him 15 mins earlier. So instead of 9, it’d be 8:45.
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Go for it.
 
Some thoughts on feeding...

Feeding is most definitely an ECID thing; Ill share with you how we worked it with BK.

First of all, the 5 compartment digital timed feeder was a lifesaver.
BK lived in a cottage that is behind our main house, which came to be known as 'BK Central'. I was a full-time corporate drone back then but had the good fortune of working from home and my office was in the cottage. So BK was my shop cat. Also, my SO, a night owl, was on board and very involved in caring for BK. He became known around Lantus Land as "the nightwatchman"

After BKs 2nd hospitalization with DKA, along with Lantus and R at PS times, I started shooting R at +6, both AM and PM. So I was sleeping on a small futon in my office. After about 6 weeks I was burnt out. I can't remember exactly when I got the feeder however it allowed me to sleep in the house in my own bed again knowing that the feeder would present food to BK at whatever times I programmed. BK was good about eating too. His IAA (which was not diagnosed until we were about 9 months in) was so extreme it was an entire year (and a whole lotta insulin) before he had his first taste of HC o_O

Eventually I settled on a full meal (1/2 can FF) with each Lantus shot and a mini meal of 1/4 can at +4 and again at +8, both AM and PM. So I could be sure he wasn't eating his +8 meal until +11, I set the feeder to advance at +10. To not to be cruel (he came running when he heard the feeder advance) the +10 slot always presented a treat of a chunk of freeze dried chicken breast.

So when insulin sensitivity returned, I made decisions on using food to guide with consideration to the regular meal schedule.
Had he just eaten a meal? Was a meal coming up in 30 minutes? ...these were questions whose answers helped me decide how much guiding was needed and when.

It worked out pretty well :cool:
 
A little late to post. Got caught up talking to my mom.

PMPS = 490. He peed and there were negative ketones!

Sandy and Black Kitty said:
he 5 compartment digital timed feeder was a lifesaver.
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Oh yes, that's a great idea and an idea I forgot existed. Time to do some shopping :)

Sandy and Black Kitty said:
Also, my SO, a night owl, was on board and very involved in caring for BK. He became known around Lantus Land as "the nightwatchman"
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I love that! :joyful:

Thank you for the insight, Sandy. :)
 
Sandy and Black Kitty said:
When you have a chance, you will find some really good tips about following TR with a full time job
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Yes I've read it but haven't wrapped my head around it. I work 10 hour shifts (11 hours lunch included) that vary in start and end times and commute sometimes takes 30ish mins. So I'm almost gone an entire cycle some days.

But! I have family at home. Which is another resource I can work with somehow and whom will HAVE to learn how to deal with Ming because I'll be gone for a month in December... another thing in the horizon that makes me knees shake haha!

For now, I'm going to focus on tonight and get some answers as to where Ming takes us during his nights.
 
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Also this came in the mail today :)
 
Aaaand I just noticed him sitting in front of the water bowl and drinking water which sometimes means he feels bad. So I gave him cerenia. I stopped and forgot to give it to him every day since Tuesday.
 
It could also be his higher numbers today causing him to be thirsty. How has his appetite been in general?
 
Wendy&Neko said:
It could also be his higher numbers today causing him to be thirsty. How has his appetite been in general?
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His appetite has been good. He ate "all" his PM meal. All in quotations because the sides of the bowl still have some food.

Maybe I'll give subq fluids just in case? Or should I wait a little more to give time between insulin doses?
 
Does he seem dehydrated if you do the scruff test or check his gums? I used to like to give fluids when I knew Neko's numbers were on the way up. Just to prevent numbers from coming down from fluids.
 
Yeah he doesn't seem dehydrated. Scruff went down right away and gums went right back to pink within a second and felt moist.

Okay, I'll hold on the fluids for now. :) Thanks Wendy
 
+4 = 454

No change.

Maybe I’m overthinking this but... his blood does seem pinker which was an issue twice already with high lipase. Sigh... I hope he’s not about to have another episode. Or maybe the HC food is taking a toll on him.
 
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