? 8/9/2019 Lilly AMPS = 356, +4.5 = 349, +9.5 = 319; PMPS = 328;feeling so discouraged :(

Kelsey & Lilly

Kelsey & Lilly

Member Since 2019
I'm continuing to feel just so so discouraged by Lilly's numbers. I don't know what I'm doing wrong or what more I can possibly do. I saw BLUE for the first time in over a month -- but I guess it was a fluke because she's come right back up and stayed there. I was hoping it was a bounce and she'd go back down but it doesn't look like she's going that way. Time to increase the dose again? Or do I need to do a full curve this weekend?
*I will add she has conjunctivitis, currently. Getting eye cream. Vet didn't think it should spike her BG though, and her numbers have remained just as pink as before.*
 
You may want to switch to a human meter - at least the numbers look lower on human meters. I can understand your feelings though - it's a long, long way to the finish line - think of yourself in the longest marathon you can imagine - and that'll help you pace yourself and your emotions. They need whatever amount of insulin they need - patience is the #1 requirement with this disease. Which protocol are you following? TR or SGLS? Please keep an eye on the number of cycles at the same dose (based on the protocol you're following) and increase as recommended until you see better numbers.

We're actually climbing the dosing ladder ourselves...every now and then Luci hits the green lagoon...but quickly retreats to those higher numbers. You don't want to wait too long for those dose changes and don't let the bouncing drive you crazy...it happens...

Take it one day at a time :)
 
I just want to add that people who use an AlphaTrak are going to see higher numbers, because human meters run low. My numbers might look like yours if I used an AlphaTrak. It’s worth noting that the protocols were written to use with human meters too. In other words, maybe your numbers aren’t so awful. You saw a nice streak of blue just a little while ago. It would probably look dark green with a human meter.
 
Well, switching to a human meter would only serve to make me feel better, not necessarily bring her BG down, haha. I'm using an AT because I felt more comfortable with the accuracy/consistency over the human meter i tried at first and because it was my compromise with my vet to be able to do curves at home. I'm just so frustrated because the specialist I saw in June to switch her to Lantus told me she looked like she was trying to go into remission. And if anything she's doing worse on Lantus than she was on Prozinc. :(

I'm not sure what you mean by "keep an eye on the number of cycles at the same dose (based on the protocol you're following) and increase as recommended until you see better numbers." ??

I am unable to get daily midcycle tests with my work schedule (my fiance has been doing it recently, but that's not a long-term thing), so I'm unable to comfortably do TR, so I guess I'm following SLGS. I got some advice to hold her dose for a bit longer since I recently took her out of town and the stress doesn't help BG, and before that I was told not to increase until I was able to get some mid-cycle tests (which can't be done until the weekend, usually).
 
The SLGS dosing method is in the stickies and worth reading and reviewing a few times. I consult the stickies regularly..... because I need to. :bookworm::rolleyes:
If you need to change your shot schedule somebody should be able to help you with that. I haven't dealt with it yet so have zero advice.

1 cycle = 12 hours
2 cycles = 1 day
6 cycles = 3 days

And to repeat what was stated above, the protocols were written to use with human meters. :)
 
Here's my thought...

When you decided to switch to Lantus, Lily was at 2.0u of ProZinc. That's where your Lantus dose should have been. You could have started a little lower but it looks like you took Lily's dose all the way down to 0.5u. Essentially, you started over with regard to the amount you were dosing and you're not back to the 2.0u dose yet.

Typically, when switching from an insulin like Prozinc, you can make a unit-to-unit switch to Lantus. If you feel like you can handle doing TR, it's more aggressive than SLGS (which I'm assuming is the dosing method you're using). Regardless of whether you stick with SLGS, keep in mind that by having started over, you've lost time but you are being systematic with what you've been doing. This takes patience!

 
Okay, now I'm feeling more confused. . .
I appreciate the patience and the help with this.

Is that to say that I CAN'T do either protocol just because I'm using a pet meter? I'm not sure how that makes sense? And, how would switching to a human meter actually help me?

Thanks for the thread on TR with a full time job. I admire those that are able to do it. I just cannot feasibly do it, and my schedule is about to get even tighter (i.e., working 10 hour shifts with an hour commute each way), and I work in a prison so it's literally dangerous for me to go to work with only a few hours of sleep having to stay up and test her when she drops in the greens. Working in a prison also means I'm essential staff -- I CANT be late to work if I have to delay AM shots. Again, I admire those who can do it. It just doesn't work for me.

Regarding the switch to Lantus -- from 6/30 - 7/3, i had to skip two shots (again, that whole have to get to work thing, and not having any data on where lantus was going to take her), so the vet told me to reduce the dose each time, because I needed to get a consistent shot (part of the problem on Prozinc was her bouncing around due to me having to skip shots).

ETA: I also can't do TR because I just haven't gotten the data yet -- I couldn't tell you when her true nadir is, or when the insulin begins to go into effect, since she's only been on Lantus a little over a month now.
 
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Sorry you feel that way Kelsey, it is indeed very frustrating to keep seeing pinks and reds (let alone blacks) all the time, and seeing our kitties being knocked out by the sugar. I empathize. It looks like Lilly needs a higher dose, so you'll have to increase it at some point. Working far and having a diabetic cat at home is not simple, and I can't imagine how stressed you must be. I'm stressed and I'm at home! I wish you luck and all the best. It will get better with time, that's what I like to think.
 
Thank you so incredibly much for the validation and support. I was hesitant to increase after that wonky dip 2 nights ago, but I think the balance of the data days it's time for another increase. I just wanted a second set of eyes to confirm. And to vent It's honestly hard to be on this forum every day and see other cats doing so well and see how much data other cat parents can get. it makes me feel guilty.
 
Kelsey & Lilly said:
I work in a prison so it's literally dangerous for me to go to work with only a few hours of sleep having to stay up and test her when she drops in the greens.
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Just want to say - you're doing the best you can for your kitty. The important things are making sure you're able to do your job safely, then if Lily gets into a position where you're concerned about shooting and leaving, make the safest decision that you can; many people either reduce the dose at those situations that make you uncomfortable and/or leave down a healthy portion of medium carb food. You want to make sure Lily is safe at work too - her job all day is to work that insulin as best she can and if possible get an automatic feeder so she has access to food when you think her numbers might be going lower. You'll figure that out over time...it hasn't been very long. Hopefully you can get more tests on the weekends...and in some cases you'll just have to let what insulin you can safely give her do it's best - the last thing you need is to come home from a long day at work to find a hypo cat that needs to go to the ER - expensive and then you're really up half the night - not a pretty picture at all.

So read some of the other condos where people work all day and how they handle it; @carfurby, @Bellasmom come to mind - perhaps others can think of some more who work full time out of the home - and how they're handling getting those numbers down safely.
 
Kelsey & Lilly said:
Okay, now I'm feeling more confused. . .
I appreciate the patience and the help with this.

Is that to say that I CAN'T do either protocol just because I'm using a pet meter? I'm not sure how that makes sense? And, how would switching to a human meter actually help me?

.
Click to expand...

It does make sense.

From the sticky:


THE USE OF PET-SPECIFIC METERS IS DISCOURAGED BECAUSE THE DOSING METHODS USED ON THE FDMB WERE CREATED WITH METERS CALIBRATED FOR HUMANS. ALL REFERENCED NUMBERS CORRESPOND WITH METERS FOR HUMANS, NOT PET METERS.

The numbers guiding the dosing protocols do not match the numbers produced by pet meters. 100 on a human meter does not equal 100 on a pet meter. There is no formula to convert them either.

Example: A kitty will hit the reduction number quicker with a human meter - because human meters generally read lower than pet meters - and you will take action sooner than with a pet meter = safety for your cat, avoidance of severe lows, proper dosing based on the cat, best use of expensive insulin and diabetic supplies, etc.

Switching to a human meter would help you because it would allow you to utilize the protocol of your choice and with more safety and potentially better results. The numbers you populate the spreadsheet with will make sense in light of the protocols. It would allow you better accuracy, better results, more safety for the cat, sanity, and maybe allow a protocol to safely regulate your cat even with your work schedule!

The pet meters speak a different language than the protocols and it cannot be translated.

This is how I understand what's written in the sticky about this issue.

ETA: I've continued to mull this over for the past hours, unfortunately, and I can see how the AT2 meter would work with the protocols and where the differences would occur vs using a human meter. Maybe I'm still wrong. Unless I missed it, maybe the pros and cons of using either meter should be listed and how the results of the protocols would differ with each.
The recommendation is to use a human meter and even though I own an AT2 I don't use it. As far as my situation at this time---- to remove as much confusion as possible, to inject as much safety as possible for my cat and to adhere to K.I.S.S. = human meter.
Overall what gets highlighted for me is confusion about these issues.
Sorry for rambling. I'm sleep deprived.
 
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Hello. I've not visited you before. I want to make a couple of comments. First, you can use a pet meter and follow either protocol. You just need to keep in mind the take action number is 68. If you are following SLGS you still reduce if the number goes under 90 with either a pet meter or a human meter. For TR the reduction number is 68 and not 50.

I follow SLGS because I work full time and have no one to help me. I am able to get up early enough to get a +10 test during the PM cycle so I know if Furball is going up or down at AMPS. I also always get a before I go to sleep test to give me an idea of if I need to leave extra food out for her during the night. All you can do is find what works for your schedule in getting tests done and don't worry about what other people do. You're doing your best or Lilly and that is more than a lot of people will do.

If you are following SLGS, you do a curve once a week and make decisions on dosing based on the nadir of the curve and any low numbers you managed to catch during the week. I don't know if you have to work on weekends, but that's when I do Furball's curve.

It looks to me like Lilly is still bouncing from the blues on the night of 8/7. Sometimes it can take a couple of days to clear a bounce.

Hang in there, you're doing a great job with Lilly.
 
Carla's point about the meters is correct. You can use a pet or human meter -- it doesn't matter as long as you know where the dose reduction point is. Many vets encourage the use of a pet meter because it's what they use and the calibration of a pet meter is closer to a serum chemistry analyzer which is what's used when they send out for blood work. One is not more accurate than another -- they are just calibrated differently. Many people here will switch from a pet meter to a human meter due to cost. The cost for strips for a human meter is a fraction of the cost for a pet specific meter. It's entirely your call.
 
Kelsey & Lilly said:
Okay, now I'm feeling more confused. . .
I appreciate the patience and the help with this.

Is that to say that I CAN'T do either protocol just because I'm using a pet meter? I'm not sure how that makes sense? And, how would switching to a human meter actually help me?

Thanks for the thread on TR with a full time job. I admire those that are able to do it. I just cannot feasibly do it, and my schedule is about to get even tighter (i.e., working 10 hour shifts with an hour commute each way), and I work in a prison so it's literally dangerous for me to go to work with only a few hours of sleep having to stay up and test her when she drops in the greens. Working in a prison also means I'm essential staff -- I CANT be late to work if I have to delay AM shots. Again, I admire those who can do it. It just doesn't work for me.

Regarding the switch to Lantus -- from 6/30 - 7/3, i had to skip two shots (again, that whole have to get to work thing, and not having any data on where lantus was going to take her), so the vet told me to reduce the dose each time, because I needed to get a consistent shot (part of the problem on Prozinc was her bouncing around due to me having to skip shots).

ETA: I also can't do TR because I just haven't gotten the data yet -- I couldn't tell you when her true nadir is, or when the insulin begins to go into effect, since she's only been on Lantus a little over a month now.
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Just to follow up, I only wanted to share the info because it helped me to decide when I was weighing my options with Figaro. No judgment at all if you aren't confident about TR, and no need to explain (although that makes a lot of sense! Wow!). Only you can know what is best for her and what works for you is an important part of that equation... because she needs you! :)
 
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Kelsey & Lilly said:
Okay, now I'm feeling more confused. . .
I appreciate the patience and the help with this.

Is that to say that I CAN'T do either protocol just because I'm using a pet meter? I'm not sure how that makes sense? And, how would switching to a human meter actually help me?

Thanks for the thread on TR with a full time job. I admire those that are able to do it. I just cannot feasibly do it, and my schedule is about to get even tighter (i.e., working 10 hour shifts with an hour commute each way), and I work in a prison so it's literally dangerous for me to go to work with only a few hours of sleep having to stay up and test her when she drops in the greens. Working in a prison also means I'm essential staff -- I CANT be late to work if I have to delay AM shots. Again, I admire those who can do it. It just doesn't work for me.

Regarding the switch to Lantus -- from 6/30 - 7/3, i had to skip two shots (again, that whole have to get to work thing, and not having any data on where lantus was going to take her), so the vet told me to reduce the dose each time, because I needed to get a consistent shot (part of the problem on Prozinc was her bouncing around due to me having to skip shots).

ETA: I also can't do TR because I just haven't gotten the data yet -- I couldn't tell you when her true nadir is, or when the insulin begins to go into effect, since she's only been on Lantus a little over a month now.
Click to expand...

Do not feel guilty. You are doing your best and you have to live your life. I work really long hours too so I feel your pain. The people who test frequently are most likely retired, work at home etc. Regarding skipping shots, one thing I have been doing lately if I have to skip a shot in the evening, is I do an 18 hour cycle - so if I had to skip the evening shot, I wake up at midnight test and shoot if her numbers warrant it. This has 2 advantages: 1- she doesn’t go a full 24 hours without insulin and 2 - I don’t have to give a shot in the morning when I am running around getting ready for work. I then get back on track that evening. I wouldn’t recommend doing this all the time but it works for me for those times when I either can’t be home for the evening shot or kitty is too low for me to comfortably shoot at PMPS.
 
Kelsey & Lilly said:
*I will add she has conjunctivitis, currently. Getting eye cream. Vet didn't think it should spike her BG though, and her numbers have remained just as pink as before.*
Click to expand...
When conjunctivitis is cleared the BG numbers may go lower naturally BC any kind of infection or inflammation which conjunctivitis is do raise the BG.
 
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