7/10 Boris AMPS 136, +6 81

[learjetta]

Yesterday's post here. Still not sure what I'll be doing if/when Boris earns another reduction before I leave for my work trip, and about what appears to be an impending OTJ trial.

George, one of our other non-diabetic kitties, woke me at 4:15AM to inform me the automatic feeders hadn't opened yet and he must eat RIGHT AWAY. Sigh. But since I was up I took the opportunity to test Boris's BG by myself, and it was 106. I have to admit, I was hoping for green so I was a little disappointed, which is silly because it's still a great number!

Did I mention I tested Boris's BG while I was half asleep, in the middle of the night, by myself? That's a win!

Happy hump day all!

 

[AmandaE]

Nice one Melanie!! the half asleep night test! another notch in the feline diabetes belt

Don't be discouraged about the 106, like you said Boris is still doing so great!

Hope you get some good advice on what to dose while you're away and that you have an awesome day

 

[carfurby (GA)]

It's great to see Boris doing so well. You may need to do the drop dose for your vacation. That's where you hold the plunger of the syringe in while you insert it and then let go of the plunger. It sucks a drop into the sryinge.

 

[Marje and Gracie]

Last condo here. I haven't done much posting (other than my reduction question) since Boris has been doing so well.

Since we removed dry food Boris has been on a rapid reduction trend. Given his nadirs since his last reduction (and provided we have a good nadir today) we will be reducing from 0.5u to 0.25u tonight.

If this trend continues, he'll be down to a nothing dose in no time at all, which is very exciting! To that end, I'm looking for some advice on how to proceed. Boris's last BG curve was on 6/27, and that's mostly because he's steadily been getting reductions since.

Should I do a BG curve today? He's on his 6th cycle since his last reduction, so this SHOULD be indicative of how this new dose is treating him. Or do I wait until after this new reduction takes hold, and do a BG curve on Thursday or Friday?

Should I consider lowering the threshold for insulin reductions as we near a nothing dose? I'd really like to see him have a chance at a strong remission, so I don't want to be too hasty. His AMPS numbers have in the mid-blues pretty consistently, and I feel like we might want to see more low blues to high greens there before considering an OTJ trial.

I will be traveling for work next week, and my husband will be handling everything alone. Boris waits patiently for his shot after eating, but he's not easy to test alone. My parents are available as needed to at least get AMPS, + 6, and PMPS while I am gone, but overnight testing is out of the question unless he is feeling cooperative. Given that, I'm considering a vacation dose, especially given his current downward trend. However, given that he will be on 0.25u, there's almost nowhere to go at this point.

My husband also doesn't want to bother my parents too much (they're in their 80's), so I think we will start this afternoon with letting him test Boris on his own to see if it is doable with a little practice. If so, maybe we won't need a vacation dose after all.

Any advice is welcome! Thanks!

@carfurby tagged me yesterday but it was my birthday so sorry I didn’t respond.... and we’ve been busy today.

Under SLGS, you would do the curves a week apart but there’s certainly no reason you couldn’t grab more data whenever you have the chance. More data = more helpful in making decisions. It’s likely the 0.5u is still affecting his BG and could be for up to six subsequent cycles but if I see a really low number after four cycles after the reduction, I advise to reduce again. Certainly, for SLGS, if he dropped below 90 after four cycles, I’d reduce.

When using SLGS, once you are experienced and really know your cat, your data should be your guide. But you are still pretty early in this and so, for safety reasons, I won’t advise you to lower your reduction threshold. He’s not failed any reductions so I can’t see the need to be more aggressive than the method calls for in such a newly diagnosed cat. IMHO.

If he gets down to a drop of insulin bid and is still seeing a lot of blue and doesn’t look ready for a trial, we have other techniques to help get him to the finish line.

For a “vacation dose”, it’s fine to take him back to a drop if your husband can’t test him. If he can and will be able to do it as you have been, I’d leave the dose at 0.25u until he earns the next reduction with a drop below 90.

I hope all that helps.

 

[learjetta]

Under SLGS, you would do the curves a week apart but there’s certainly no reason you couldn’t grab more data whenever you have the chance. More data = more helpful in making decisions. It’s likely the 0.5u is still affecting his BG and could be for up to six subsequent cycles but if I see a really low number after four cycles after the reduction, I advise to reduce again. Certainly, for SLGS, if he dropped below 90 after four cycles, I’d reduce.

I guess part of the issue is, I don't want to put Boris through a curve unless I know his depot is operating from his new, reduced dose, but by the time we get there, it's time for another reduction. So that's why I haven't done a curve in a few weeks... we've been on a pretty steady routine of reduce, wait a few cycles, and reduce again. I just don't know how valuable the curve is when the depot hasn't reduced to match the dose yet.

Thanks for your response, and happy belated birthday!

 

[Marje and Gracie]

I guess part of the issue is, I don't want to put Boris through a curve unless I know his depot is operating from his new, reduced dose, but by the time we get there, it's time for another reduction. So that's why I haven't done a curve in a few weeks... we've been on a pretty steady routine of reduce, wait a few cycles, and reduce again. I just don't know how valuable the curve is when the depot hasn't reduced to match the dose yet.

Thanks for your response, and happy belated birthday!

It seems it’s not clear to you why you do a curve. The curve is done to see how low he’s going so you can determine if he needs more or less insulin. If he’s earning reductions before you can do curves, then you already know how low he’s going. So a curve isn’t really necessary in that instance. But if he’s not earning reductions and you don’t know whether to go up or down, the curve is what gives you info to help make a decision.

I misunderstood and was just responding to your question of whether you should do a curve thinking you wanted to do one before a week was out; thus my response.

 

[learjetta]

Thanks!