Not urgent. 04/14 Mowgli PMPS 155; Am I too shy with dosing?

[AmandaE]

Hi Everyone,

I have a couple questions about the SLGS method and one of them is around when I should determine if Mowgli’s BG is too low to shoot his typical dose

Today for the second time in about a week Mowgli’s BG numbers were lower at the end of the cycle than at the beginning. Today he was at 155 at his PMPS so I delayed 40 mins and his numbers hadn’t really changed.

I was nervous to give him the full 1.5u dose so I just gave him 1u and fed him. This is also what I did on 04/08. I’m unsure if this is the proper way to handle this situation. Am I being too “gun shy” on my 1.5u dose? Should I have given mowgli his full dose this evening?

I’m kind of thinking if I back off of his dose every time I get a blue Pre shot reading that he will never transition from yellow days to blue days and finally dark green days.

I’ll continue with this method for now but for the long game I’m afraid my nervousness in administering a full dose might get in the way of Mowgli making it to remission.

Any clarification of SLGS method is welcome... I was backing off the dose from my interpretation of the sticky document on dosing types.

Thanks!

 

[Sienne and Gabby (GA)]

I'm seeing your point about the difference in AMPS vs PMPS numbers. However, what you don't know is where Mowgli's numbers were at mid-cycle. He may have been lower and the PMPS was a number that was rising from nadir. What complicates things further is that I wouldn't necessarily assume that Mowgli's nadir is mid-cycle. Some cats have late (or early) nadirs.

What I generally tell people, regardless of which approach to dosing they're following, is that you need to work your way down to shooting progressively lower numbers. With TR, for example, most of us would shoot anything above 50 but only after being data ready. You also need to be available to monitor if you plan on shooting those lower numbers. There's no one "right" way to get comfortable with shooting lower other than to pick a place where you feel comfortable and when you see that PS number, shoot! Just make sure you're available to monitor and have supplies (extra strips and HC food) should numbers drop.

If you avoid shooting lower by skipping or reducing the dose, you kitty is likely to have higher numbers during those cycles and your dose count for the purpose of a dose increase starts over again. As a result, your cat may be spending more time than necessary in higher numbers. At the moment, Mowgli hasn't seen much green. I'd encourage you to aim to see him spending more time in blue and green numbers.

 

[AmandaE]

If you avoid shooting lower by skipping or reducing the dose, you kitty is likely to have higher numbers during those cycles and your dose count for the purpose of a dose increase starts over again. As a result, your cat may be spending more time than necessary in higher numbers. At the moment, Mowgli hasn't seen much green. I'd encourage you to aim to see him spending more time in blue and green numbers.

I also want to see the same. Would you say then, that I am being a little shy and that the next time I’m seeing this pattern, as long as he is above 100 that I give him the full 1.5u?

I will say though when I see those blues at the pre shot it just makes me nervous because I can’t be home to monitor on week days. I guess I’m not comfortable with greens yet. Hopefully I’ll get there soon

 

[AmandaE]

Also! I wish he would get one of those blue PMPS on a Saturday night so I could have confidence and time to stay up if needed

I guess Mowgli’s diabetes has its own schedule and it doesn’t consider my work days

 

[Sienne and Gabby (GA)]

These kitties just never want to cooperate with our schedules! You can't imagine how many "migraines" I had some mornings when Gabby's numbers were running low or I would shoot and come home at lunch time since my office wasn't that far away. Once I had a handle on Gabby's patterns, I knew what was feasible (e.g., giving her a bunch of HC food since she had an early nadir).

I wouldn't necessarily tell you to shoot at 100 -- especially if you're not going to be home. You can always work toward shooting the full dose if Mowgli in in the mid-to-upper blues vs. reducing the dose. Take it at a pace that's comfortable for you.

 

[AmandaE]

Thanks @Sienne and Gabby (GA). As I spend some more time, and you get more familiar with me around here you will see that patience is a virtue that I have to constantly work on!

I think that I am going to have to take a risk for the next lower PMPS (even on a work night) and shoot him when he is in the mid to high blues, so that I can get the data that I need to feel more comfortable with his dosage. now that he's more used to lantus I do feel like his curves are typically relatively flat. I wish I worked close enough to home to be able to check in on him but unfortunately it isn't an option for me, due to my work I also have to be careful about late nights and not getting enough sleep (safety sensitive position). I do think a couple of late nights will be worth it though if it gets Mowgli in a better place.

Thanks again for your advice

 

[Wendy&Neko]

What will help you in future is getting an idea how carb sensitive Mowgli is. You are doing a good job on keeping track of his food intake on the spreadsheet. The first times you have to feed higher carbs, you will get an idea what you need to feed, and when, to help keep Mowgli safe. I notice that you are only feeding one meal per cycle. Is he a grazer or will he eat it all at once? I used at automatic feeder to help spread out the meals, and to provide some food when Neko tended to nadir, epseicially if I would be away then. She wasn’t consistent on her nadir times, but she also nadired late.

 

[AmandaE]

What will help you in future is getting an idea how carb sensitive Mowgli is. You are doing a good job on keeping track of his food intake on the spreadsheet. The first times you have to feed higher carbs, you will get an idea what you need to feed, and when, to help keep Mowgli safe. I notice that you are only feeding one meal per cycle. Is he a grazer or will he eat it all at once? I used at automatic feeder to help spread out the meals, and to provide some food when Neko tended to nadir, epseicially if I would be away then. She wasn’t consistent on her nadir times, but she also nadired late.

So. Interestingly enough. I started feeding Mowgli with half cans of Friskies and then leaving a third of a can out frozen for him to eat later around mid cycle. That led to him psychotically licking a frozen solid brick of food until it was gone. I interpreted that as a message to me that he’s still starving from his diabetes so I started leaving out a full can at a time.

I kind of expected him to just hammer the full can at once but when I set the full can out he’s more prone to grazing through the day. I think the half can wasn’t enough to fill him Which threw him into a food panic causing him to eat all his frozen food.

Now he eats about 1/3 to 1/2 a can and saves the rest for another point in the day. I will eventually get a timed feeder but the up front costs of adding a new cat to my house that is also diabetic has led me to trying other timed food techniques first. Additionally we have been trialling giving Mowgli full access to the rest of our house and our other cat Nyx over the past week, so I think he has been being more of an adventurer giving him another activity to keep him busy outside of eating.

I think we’re on the same train of thought that Mowgli is having lower PM readings because he is running out of food later in the day. So again I see a timed feeder in our future.

I’m pretty nervous of a hypo event so I’m just naively hoping that mowgli will transition flawlessly to lower numbers without any traumatic events

 

[Marc & Jen]

I think we’re on the same train of thought that Mowgli is having lower PM readings because he is running out of food later in the day. So again I see a timed feeder in our future.

We just began testing out the Petsafe 5 today thanks to @Wendy&Neko 's suggestion. I set it up this morning but had to head out of town for work and my husband found it half way across the room from where I left it today when he got home but it was all still perfectly in tact I think it's going to work out well and we will probably get a second one for our other cat. FA gets very hangry and starts breaking things if he doesn't have food always available to him. We are planning to fully transition to wet food on Wednesday of this week and this automatic feeder will be key since we both work full time.

https://www.amazon.com/PetSafe-5-Me...gital/dp/B000GEWHNS?tag=felinediabetesfdmb-20

Also hello, from a former resident of AB! Isn't flying with cats fun

 

[AmandaE]

@Marc & Jen helloooo from your former province! I have My eyes on the PetSafe5 as well, it has definitely gained a good reputation around this forum for sure. I plan to get one when Mowglis appetite dies down a bit.

I was relatively lucky with Mowgli and wet food, he went right for it and his stomach handled it really well. I want to try and switch my other cat Nyx over but she really isn’t interested at all and she has no current health issues so I’m waiting until we have mowgli regulated first.

I actually didn’t fly with my cat. I paid for my sister to fly him to me it was horrible for her and due to all the checking of pets and his insulin etc... she ended up missing her flight and I had to pay for another one Apparently Mowgli was super popular along the way, 3 people asked to take his picture! Such a handsome man!