Needing advice, feeling discouraged

[Sarah and Blaze]

Well I’m feeling a little discouraged with Blaze’s current numbers. Ever since we reduced to 0.75U (because we are on SLGS and he went below 90 on 10/3, earned a reduction), he has been consistently high in the pinks and reds. I know because I’m doing SLGS, we have 3 and a half more days before we can increase his dose but looking at his spreadsheet, it doesn’t look that great over the past two months, with mostly yellows, pinks and reds. I’m feeling really frustrated and discouraged. I’m interested in trying TR but am nervous to try it due to work. I feel like I should give it a try, I can get a +1 test every morning before I leave for work except for Thursdays because it’s my early day, but I would be able to go home at lunch on Thursdays for. +5.5-6.5 test. I have an auto feeder. I feel like I should be able to make it work, but I’m nervous.

Does anyone have any advice, help, encouragement? Anything?! Just not sure what to do

 

[Beth 73]

All I can offer is hugs , Sarah, but I know experienced folks are around and will help shortly Maybe add ? Icon to thread to attract attention

 

[Sarah and Blaze]

All I can offer is hugs , Sarah, but I know experienced folks are around and will help shortly Maybe add ? Icon to thread to attract attention

Thank you Beth, you’re so sweet! I just added the ? icon, thank you

 

[Figaro's Liz]

A few thoughts... are you able to get any tests in towards the end of the AM cycle, ~+10? Those can be helpful too. You can kind of squeeze tests in on the early or late end of the cycle to get some idea of what is happening. I personally don't find +1s very useful with Figaro unless I am shooting a green PS.

Could you move up your shot time by one hour so you could squeeze in a +2? I get up at 6:18am every morning (and I am NOT a morning person ), shoot and feed, and often sleep for another hour or so. Then I do my own routine, and get a +2 or +3 and put out food as I am heading out the door. Sometimes I run home during lunch but with a +2-3 I don't really need to usually (though I like to see him during the day ). Then of course, more tests on the weekends and at night to help you fill in the blanks.

On SLGS you can lower your reduction threshold once you have a decent amount of data. More experienced members may be able to weigh in about that... I believe @carfurby does SLGS taking reductions at 60 instead of 90.

Lastly... I will just say, only you can ultimately decide if TR can work for you. You can always try it and if it is too much, go back to SLGS. I didn't see any progress with Figaro on SLGS, got frustrated and switched to TR and like it better. I work full time but have the luxury of a somewhat flexible schedule and an understanding boss.

 

[Figaro's Liz]

Oh and I am sure someone will link this thread:
http://www.felinediabetes.com/FDMB/...ion-possible-with-a-full-time-job-yes.129378/

I have read it probably 100 times! It is doable

 

[Briere Fur Mom]

All I can say is I feel your pain! We're in the same boat together. My 2 sugar babies are playing the same game as your extra sweet baby. I'm "waiting it out" and trying to stay patient. My boys made the switch to Lantus about 2 weeks ago. I hope that Blaze starts working the juice for ya! Good luck

 

[Penelope and Mačka]

Hi Sarah, please don't get discouraged, Blaze is still early in the diabetes adventure, it will get better!!
Look at Macka's SS. It took us 4 months to see green! When I look at Blaze's SS it seems to me that he likes to bounce from lower numbers. You can only be patient. With 1 unit, he went into the greens last week, so you can't really give a higher dose than that, I would think? He might go lower than what you see at night too.

Regarding TR, many people here work and follow this protocol. I did it for a while (and wasn't working), but found it a little too stressful. However, it helped us reach a better dose faster. Now we're back on SLGS because I work again, and seeing good results anyway. You could give TR a try, you don't have to be married to it!

 

[Sarah and Blaze]

A few thoughts... are you able to get any tests in towards the end of the AM cycle, ~+10? Those can be helpful too. You can kind of squeeze tests in on the early or late end of the cycle to get some idea of what is happening. I personally don't find +1s very useful with Figaro.

Could you move up your shot time by one hour so you could squeeze in a +2? I get up at 6:18am every morning (and I am NOT a morning person ), shoot and feed, and often sleep for another hour or so. Then I do my own routine, and get a +2 or +3 and put out food as I am heading out the door. Sometimes I run home during lunch but with a +2-3 I don't really need to usually (though I like to see him during the day ). Then of course, more tests on the weekends and at night to help you fill in the blanks.

On SLGS you can lower your reduction threshold once you have a decent amount of data. More experienced members may be able to weigh in about that... I believe @carfurby does SLGS taking reductions at 60 instead of 90.

Lastly... I will just

I get off work at 5pm Monday through Thursday so DH could probably get a +10/+11 test for me since he gets home from work before me. I doubt the +1 would be very helpful either, I can usually get home on my lunch for a +6 test but that’s not always the case. I’m a dental hygienist so if a patient is late or I run late, I’m not able to make it home at lunch.

Right now we are on at 6:30am/pm schedule and that seems to work best for me so I can go to the gym after work and still make it home by 6:30pm. I have no problem getting up earlier to test earlier but the 5:30pm test time wouldn’t work because that would mean DH would have to do PM test/feed/shot every Monday through Thursday and I don’t think he would be willing to do that

Maybe I should tried a modified SLGS like you said, before I jump into TR. Blaze earned a reduction a few days ago but so far, the reduction isn’t sticking so I think it would be better to lower the reduction number like you said. I am very interested in trying TR and I know I could do it, it would require more help from DH, but I think the best thing for us right now would be to try a modified SLGS and see how that goes first. I have two weeks off in December, maybe I can plan on a TR trial for December when I can be home more.

I appreciate all your input and advice, it makes me realize that I can handle TR, in the near future

 

[Sarah and Blaze]

All I can say is I feel your pain! We're in the same boat together. My 2 sugar babies are playing the same game as your extra sweet baby. I'm "waiting it out" and trying to stay patient. My boys made the switch to Lantus about 2 weeks ago. I hope that Blaze starts working the juice for ya! Good luck

Thank you! It’s just so frustrating for him earn a reduction and then stay in these high numbers!! But you’re right, I need to be patients and wait this out. I think I will try for a modified SLGS with regards for reductions, since this reduction isn’t sticking. I’m interested in TR, but am thinking I should wait a bit longer before I go there. I hope your babies start working that juice too! Thank you for the encouraging words !

 

[Sarah and Blaze]

Oh and I am sure someone will link this thread:
http://www.felinediabetes.com/FDMB/...ion-possible-with-a-full-time-job-yes.129378/

I have read it probably 100 times! It is doable

Also, Figaro is so handsome!! Reminds me of my civvie, Mitzy!

 

[Sarah and Blaze]

Hi Sarah, please don't get discouraged, Blaze is still early in the diabetes adventure, it will get better!!
Look at Macka's SS. It took us 4 months to see green! When I look at Blaze's SS it seems to me that he likes to bounce from lower numbers. You can only be patient. With 1 unit, he went into the greens last week, so you can't really give a higher dose than that, I would think? He might go lower than what you see at night too.

Regarding TR, many people here work and follow this protocol. I did it for a while (and wasn't working), but found it a little too stressful. However, it helped us reach a better dose faster. Now we're back on SLGS because I work again, and seeing good results anyway. You could give TR a try, you don't have to be married to it!

You’re right! I’m being too hard on myself. He does bounce after low numbers, I just thought he would clear the bounce by now, but it may be that he just needs to be back on 1U and stay there a little longer. I like the idea of a modified SLGS with taking reductions at 70 instead of 90. That might help the reduction stick better. I will try to get some more tests later in the evening to see where the 0.75U is taking him, I just usually get a +2 and if it’s high, I head to bed. But I should see how low he is getting during the night cycle.

I think I will stick it out with SLGS, I think it works best for my schedule and doesn’t require TOO MUCH help from DH, although he is helpful when needed I may try TR in December when I’m off work for two weeks, but for now, am going to be patient thank you Penelope!

 

[Sarah and Blaze]

@carfurby

Do you have any advice on a modified SLGS? Blaze earned a reduction after going below 90 on 10/3, so we decreased from 1U to 0.75U, but I’m wondering if this dose is not sticking. Maybe I should lower the reduction number to 70?

Any advice is greatly appreciated!!

 

[Bron and Sheba (GA)]

If you have a failed reduction you don’t have to wait 7 days to increase again. Once you see a failed reduction you are best going back to the last dose that was working for your kitty. In this case 1 unit.

 

[Sue and Luci]

I may try TR in December when I’m off work for two weeks,

I've read thru the comments above...and I believe that the best person to make the ultimate decision is of course YOU. Only you know how much you can manipulate your schedule to get more tests. I started out on SLGS because I was afraid I wouldn't be able to get as many tests and I though being conservative would be the way to go...but as time passed and with a bit of encouragement I changed to TR...and I really love the fact that you can increase the dose sooner than on SLGS, and you don't have to decrease should you see that glorious 90 or just below - in my opinion that window of 90-100 is so darn small...it's a much smaller 'target' if you will; than 50-100...so just keep that in mind...

It is entirely up to you and your schedule and no one here knows your schedule better than you. I admire you for thinking about TR - and even giving it a temporary try - like if you happen to get a three day weekend - Thanksgiving is coming...so that's a thought...and of course Christmas/New Year's...I know it's hard for you beans that work outside of the house..but if DH could chip in a time or three, that really helps too.

We're here to support you...whatever your decision!

 

[Sarah and Blaze]

If you have a failed reduction you don’t have to wait 7 days to increase again. Once you see a failed reduction you are best going back to the last dose that was working for your kitty. In this case 1 unit.

Oh really?! I thought I had to hold the dose for 7 days on SLGS. I would much rather go back to 1U instead of waiting three more days to go back up.

 

[Bron and Sheba (GA)]

Oh really?! I thought I had to hold the dose for 7 days on SLGS. I would much rather go back to 1U instead of waiting three more days to go back up.

You hold the dose for 7 days when you increase the dose to see if it is working, but if you do a reduction and it is obviously not holding, then you increase back to the dose that was working before the decrease.....
It's been 7 cycles since the lower numbers so I don't think it is bouncing at this stage.

 

[Sarah and Blaze]

You hold the dose for 7 days when you increase the dose to see if it is working, but if you do a reduction and it is obviously not holding, then you increase back to the dose that was working before the decrease.....
It's been 7 cycles since the lower numbers so I don't think it is bouncing at this stage.

Thank you Bron!! I didn’t think it was a bounce anymore either but this whole time I was thinking I had to wait 7 days to increase. Dang it! I will be giving 1U tonight then, he was having better numbers there and the 0.75U is definitely not working right now. I am going to lower the reduction number to 70, since 90 isn’t working either and give that a try.

I am planning on trying TR at some point, just not yet. I appreciate everyone’s options and advice! Makes me realize I can do it!!

 

[Idjit's mom]

Sarah, there has never been any doubt that you could do it. You are an intelligent, very competent person. Learning the intricate steps to the "sugar dance" can be a challenge, and every cat has his/her own way of dancing. Plus, just when you think you have learned the steps, they can decide to change the rhythm, method or whatevers. LOL That's just dealing with a cat!

 

[JoyBee&Ravan]

The experienced people here CAN & Will help you to help Blaze. Take a few deep breaths & try to be calm . Out Kitties feel our stress.
I wish you the best of luck! Everyone here wants to help.We were all new ,just like you!

 

[AmandaE]

Thank you Bron!! I didn’t think it was a bounce anymore either but this whole time I was thinking I had to wait 7 days to increase. Dang it! I will be giving 1U tonight then, he was having better numbers there and the 0.75U is definitely not working right now. I am going to lower the reduction number to 70, since 90 isn’t working either and give that a try.

I am planning on trying TR at some point, just not yet. I appreciate everyone’s options and advice! Makes me realize I can do it!!

That is the path I took at first too Sarah, I am personally really glad I took my time getting to know Mowgli's patterns before I started a TR trial, I think I would be really soiling myself if I was in the same situation as this weekend (BG 25 ) and didn't have a better base knowledge of Mowgli's typical reactions. One thing: if you are changing your reduction point please make sure to add it to your signature. Something like 'Modified SLGS - DO NOT COPY DOSING' also add a line to your spreadsheet showing where you started the modification.

In case you're curious I have a post where I asked the same information about a modified SLGS HERE. There is particularly specific and helpful advice from Jill (May she rest in peace) on post #12. On things to consider if you want to start modifying SLGS

Hope you find that helpful

ETA: Mitzy is SOOOO CUUUUTE love her face!!!!

 

[Bron and Sheba (GA)]

Thank you Bron!! I didn’t think it was a bounce anymore either but this whole time I was thinking I had to wait 7 days to increase. Dang it! I will be giving 1U tonight then, he was having better numbers there and the 0.75U is definitely not working right now. I am going to lower the reduction number to 70, since 90 isn’t working either and give that a try.

I am planning on trying TR at some point, just not yet. I appreciate everyone’s options and advice! Makes me realize I can do it!!

I think you are doing really well.
Make sure you test mid cycle tonight with the increase. But the depot has been drained so it might take a day or two to show results. Who knows. ECID and they like to keep us guessing

 

[carfurby (GA)]

SLGS can be frustrating because you reduce when you see a number 90 and then the reduction doesn't hold. That's why I modified the reduction number for Furball. You do have to be careful about bouncing though when you can't get any mid cycle tests in. There have been days where if I had only seen Furball's AMPS and PMPS I would have thought she stayed high all day but she got into lower numbers.

 

[Wendy&Neko]

The concept of failed reduction is only for TR, not for those following SLGS. The dose holding times are there for safety because there may not be as much testing.

 

[Figaro's Liz]

Also, Figaro is so handsome!! Reminds me of my civvie, Mitzy!View attachment 48306

What a doll

 

[Sarah and Blaze]

Sarah, there has never been any doubt that you could do it. You are an intelligent, very competent person. Learning the intricate steps to the "sugar dance" can be a challenge, and every cat has his/her own way of dancing. Plus, just when you think you have learned the steps, they can decide to change the rhythm, method or whatevers. LOL That's just dealing with a cat!

Thank you Lou! I appreciate your kind and encouraging words! I do think I could handle TR and want to give it a try, when I'm ready but I don't think I'm ready just yet. I would need to talk to DH to let him know he will have to get some testing in for me before I get home from work, since he gets home before me, but I think I'm going to wait until maybe Thanksgiving. I'm going to give modified SLGS a try first, get Blaze back up to 1U tonight and not do reductions until he gets below 70 and see how that goes. I know I have so much help and support here and am so grateful for everyone here!

 

[Sarah and Blaze]

The experienced people here CAN & Will help you to help Blaze. Take a few deep breaths & try to be calm . Out Kitties feel our stress.
I wish you the best of luck! Everyone here wants to help.We were all new ,just like you!

View attachment 48307

Thank you!!

 

[carfurby (GA)]

Don't forget to modify your signature line with your modified SLGS. See how I did it for Furball below.

 

[Sarah and Blaze]

That is the path I took at first too Sarah, I am personally really glad I took my time getting to know Mowgli's patterns before I started a TR trial, I think I would be really soiling myself if I was in the same situation as this weekend (BG 25 ) and didn't have a better base knowledge of Mowgli's typical reactions. One thing: if you are changing your reduction point please make sure to add it to your signature. Something like 'Modified SLGS - DO NOT COPY DOSING' also add a line to your spreadsheet showing where you started the modification.

In case you're curious I have a post where I asked the same information about a modified SLGS HERE. There is particularly specific and helpful advice from Jill (May she rest in peace) on post #12. On things to consider if you want to start modifying SLGS

Hope you find that helpful

ETA: Mitzy is SOOOO CUUUUTE love her face!!!!

Thank you so much for all your advice and input Amanda, I appreciate it so much and you've helped me see that I CAN follow TR while working and I want to, but I'm going to start a modified SLGS to gather more info about Blaze's patterns and just gain more experience so I feel more prepared for when I do decide to switch to TR at some point. I've only been on this diabetic kitty journey for two months even though it feels like years, I would rather take my time and learn more about Blaze and how he reacts to the insulin.

I will add those things to my SS and I'm going to read your condo about modified SLGS too. Thank you so much girl!

 

[AmandaE]

Thank you so much for all your advice and input Amanda, I appreciate it so much and you've helped me see that I CAN follow TR while working and I want to, but I'm going to start a modified SLGS to gather more info about Blaze's patterns and just gain more experience so I feel more prepared for when I do decide to switch to TR at some point. I've only been on this diabetic kitty journey for two months even though it feels like years, I would rather take my time and learn more about Blaze and how he reacts to the insulin.

I will add those things to my SS and I'm going to read your condo about modified SLGS too. Thank you so much girl!

My pleasure! We definitely have a similar thought process on feline diabetes so it only makes sense for me to share the condos where I had already asked the same questions

Notice the theme where it is so important to know onset, nadir and duration

 

[Sarah and Blaze]

I think you are doing really well.
Make sure you test mid cycle tonight with the increase. But the depot has been drained so it might take a day or two to show results. Who knows. ECID and they like to keep us guessing

Thank you Bron, I'm really trying to de my best for Blaze, but I honestly couldn't do it without all of you so thank you guys for all your help and advice!

I will get some mid cycle tests in tonight for sure since we're going back to 1U but I wouldn't be surprised if tonight was slow and then next night or two become more active, but we will see! Blaze likes to keep me on my toes!

 

[Sarah and Blaze]

SLGS can be frustrating because you reduce when you see a number 90 and then the reduction doesn't hold. That's why I modified the reduction number for Furball. You do have to be careful about bouncing though when you can't get any mid cycle tests in. There have been days where if I had only seen Furball's AMPS and PMPS I would have thought she stayed high all day but she got into lower numbers.

Yes, I try my best to make it home on lunch to get mid cycle tests during my work week, but from what I have gathered, Blaze likes to get low in the evenings so I always get testing in the evening and of course on weekends when I'm home.

Do you think a good reduction number is 60 when doing a modified SLGS? Or should I try 70 first?

 

[Sarah and Blaze]

The concept of failed reduction is only for TR, not for those following SLGS. The dose holding times are there for safety because there may not be as much testing.

That makes sense, thank you! I wish I would have known that, I wouldn't have held this 0.75U dose this long LOL oh well, you live and you learn!

 

[Sarah and Blaze]

My pleasure! We definitely have a similar thought process on feline diabetes so it only makes sense for me to share the condos where I had already asked the same questions

Notice the theme where it is so important to know onset, nadir and duration

I'm actually a little confused with figuring out Blaze's onset, nadir and duration. Do you think I need more testing or can you tell by looking at his SS?

 

[Sarah and Blaze]

Don't forget to modify your signature line with your modified SLGS. See how I did it for Furball below.

@carfurby
@AmandaE

Just modified my signature line. Does this look okay to try out?

• Take reductions at 70
• Increase the dose nadirs are more than 130
• Hold the dose if nadirs are between 71-129
• Skip or give a reduced dose if 120 or under? Will give reduced dose if I'm home to monitor, skip the shot if I can't be home

Or should I increase the numbers when starting this modified method?

 

[carfurby (GA)]

I think taking reductions at 70 is a good start. I'm not sure about the rest. I'm really tired right now and can't process it.

 

[Sarah and Blaze]

I think taking reductions at 70 is a good start. I'm not sure about the rest. I'm really tired right now and can't process it.

I hear ya Carla! Well thank you for responding to all my questions and all the advice you have given me. I’m going to start with taking reductions at 70 and go from there

 

[Wendy&Neko]

I wish I would have known that, I wouldn't have held this 0.75U dose this long LOL oh well, you live and you learn!

Actually, I was suggesting the opposite, hold the dose longer. Has anyone told you about the +2 test as an indicator of how the cycle might play out? If the +2 is lower than the preshot, then you will have an active cycle coming up, that may need more monitoring. I look at the PM cycles of the 3rd and 4th. The 3rd had about a 100 point drop and lots of action after, and the 4th had a 50 point drop, showing some action, and a yellow AMPS after that. Did he drop the night of the 4th? Or just slide down all night? Given that he jumped to red after that, indicates to me a bounce, likely from going lower, we just don’t know how much.

That bounce started six cycles ago tonight. Bounces can take six cycles to break, which would put any bounce breaking to tonight. Increasing the cycle that a bounce breaks can make an overly active cycle. Hence the suggestion to wait before increasing. That plus SLGS does not have the concept of going back up sooner than seven days because of a failed reduction.bthat is a TR concept.

I'm actually a little confused with figuring out Blaze's onset, nadir and duration. Do you think I need more testing or can you tell by looking at his SS?

There are many examples in Blaze’s spreadsheet that show he has dropped a lot by +2. You would profit by getting some +1 and +1.5 data at times, to see if you can figure out his onset. He seems to onset early. You might also want to give him a second meal a bit before onset, to slow the speed of that drop. Fast drops also can cause bounces.

Nadirs can and do move a bit, but it looks like possibly around +4. But it’s hard to tell because every time he has gone lower then, he has gotten MC or HC which interrupts the cycle. Gathering more data with only LC on board will give you better data. Though it looks like the darn cat really likes going lower at night.

Modifying the SLGS guidelines should only be done when you have the data to know thy cat. Know the onset, nadir, duration, and his response to carbs. I would say you aren’t quite there yet, it is still early days in Blaze’s journey. One example where a reduction at 90 might not have worked does not make a trend.

Above all, this is a marathon, not a sprint.

 

[Sarah and Blaze]

Actually, I was suggesting the opposite, hold the dose longer. Has anyone told you about the +2 test as an indicator of how the cycle might play out? If the +2 is lower than the preshot, then you will have an active cycle coming up, that may need more monitoring. I look at the PM cycles of the 3rd and 4th. The 3rd had about a 100 point drop and lots of action after, and the 4th had a 50 point drop, showing some action, and a yellow AMPS after that. Did he drop the night of the 4th? Or just slide down all night? Given that he jumped to red after that, indicates to me a bounce, likely from going lower, we just don’t know how much.

That bounce started six cycles ago tonight. Bounces can take six cycles to break, which would put any bounce breaking to tonight. Increasing the cycle that a bounce breaks can make an overly active cycle. Hence the suggestion to wait before increasing. That plus SLGS does not have the concept of going back up sooner than seven days because of a failed reduction.bthat is a TR concept.

There are many examples in Blaze’s spreadsheet that show he has dropped a lot by +2. You would profit by getting some +1 and +1.5 data at times, to see if you can figure out his onset. He seems to onset early. You might also want to give him a second meal a bit before onset, to slow the speed of that drop. Fast drops also can cause bounces.

Nadirs can and do move a bit, but it looks like possibly around +4. But it’s hard to tell because every time he has gone lower then, he has gotten MC or HC which interrupts the cycle. Gathering more data with only LC on board will give you better data. Though it looks like the darn cat really likes going lower at night.

Modifying the SLGS guidelines should only be done when you have the data to know thy cat. Know the onset, nadir, duration, and his response to carbs. I would say you aren’t quite there yet, it is still early days in Blaze’s journey. One example where a reduction at 90 might not have worked does not make a trend.

Above all, this is a marathon, not a sprint.

Oh no, I completely misunderstood you I gave Blaze 1U tonight, others were saying he could go back to 1U because it didn’t seem like a bounce at this point. I’m getting conflicting information. I just want to do what’s best for Blaze. And yes. I always get a +2 test in the evening (I’m not home for a +2 in the morning during the work week), and if the +2 is lower than the pre shot, I typically test more until I feel that Blaze is safe.

I was told that if the reduction doesn’t seem to be working, I could go back up to the dose that was working well before 7 days, which was the 1U, so that’s why I did that tonight.

I will start getting some evening +1-+1.5 to figure out onset. He gets an after dinner snack at +3 but I can adjust that to be closer to onset to slow the drop.

I was thinking his nadirs look to be between +3 and +5. So next time he’s dropping quickly, you suggest only feeding him LC snacks? Typically from what I have seen, LC doesn’t do anything to slow him down when he’s dropping quickly, he’s usually lower at the next test if I give him a LC snack. Is that what I want to happen?

So you suggest I continue with SLGS and no modification yet? At least until I better understand his onset, Nadirs and duration? As for how he responds to carbs, it seems to me like LC doesn’t do very much when he’s dropping fast, and even MC sometimes doesn’t help much either.

Going to get his +2 test now. Thank you for all this advice and info, I look forward to hearing back from you!

 

[AmandaE]

I tend to agree with Wendy on this one, I think before you alter methodologies it is really important to be able to answer those questions: when does Blaze have onset? when does he nadir? how long does insulin last in his system? You really need to understand these concepts and be able to choose them from your own data in case Blazes patterns shift and it becomes dangerous to use 70 as a reduction point.

It is totally up to you what you want to do though. If you want to modify SLGS now, I would recommend really taking a look at the data you have, and kind of like a worksheet decide for each day individually where you think onset and nadir are as well as when it seems the dose pooped out. After spending some time with that data and gaining confidence on how to identify these characteristics you will be in a better place for a modification.

Typically from what I have seen, LC doesn’t do anything to slow him down when he’s dropping quickly, he’s usually lower at the next test if I give him a LC snack. Is that what I want to happen?

Basically from guiding with LC you are seeing what Blazes body will naturally do on his own without the intervention of carbs, that will allow you to see what low numbers Blaze gets into on his own while in the safety of your care. Next time you notice him getting into the lagoon maybe post a question that you would like to put off intervening with carbs as long as it is safe to do so, that will hopefully get some members attention to guide you in your endeavour to gather this data. If you are nervous when Blaze gets into the 90s it will be really tough to use a 70 reduction point. But if you can gather more information on how low Blaze goes on his own without intervention with carbs you will better understand what is safe when you switch to a 70 reduction point.... that was wordy.... make sense?

 

[Chris & China (GA)]

I was told that if the reduction doesn’t seem to be working, I could go back up to the dose that was working well before 7 days, which was the 1U, so that’s why I did that tonight.

That's just for Tight Regulation....On SLGS, you hold the dose for 7 days no matter what. (unless he drops below 90 and earns a reduction) Don't worry...sometimes people get mixed up.

So next time he’s dropping quickly, you suggest only feeding him LC snacks?

Yes...by going straight to the MC or HC, we can't know if he might actually earn a reduction by dropping below 90 since you intervene before he has a chance to.

So you suggest I continue with SLGS and no modification yet? At least until I better understand his onset, Nadirs and duration?

I would....at least until you understand him a little better as well as understanding how the insulin works. It was a good 5-6 months before I felt like I truly understood how Lantus worked in China and started trying to make my own dosing decisions (which I still ran by the people who had helped me learn for awhile!)

 

[Wendy&Neko]

I was told that if the reduction doesn’t seem to be working, I could go back up to the dose that was working well before 7 days, which was the 1U, so that’s why I did that tonight.

No worries. This is a peer reviewed board. You won’t always get consensus in suggestions. It’s up to you to sort through what you see, who you see it from, and make your own decisions. No offence take either way. Sometimes I will comment on something, even after another action is done, because there can be other people reading posts and I want to clarify something. In your case, I think you had enough data to go up safely, and that would have been my suggestion if you were following TR. not all people following SLGS test as you do, and for them, increasing might not have been safe.

I was thinking his nadirs look to be between +3 and +5. So next time he’s dropping quickly, you suggest only feeding him LC snacks? Typically from what I have seen, LC doesn’t do anything to slow him down when he’s dropping quickly, he’s usually lower at the next test if I give him a LC snack. Is that what I want to happen?

When they first hit green, it can help get them surfing if you feed a couple tsp of LC. Obviously this is a balancing act, and if he is dropping too fast, you need to keep him safe. Try the LC experiment when you think it safe to do so.

So you suggest I continue with SLGS and no modification yet? At least until I better understand his onset, Nadirs and duration? As for how he responds to carbs, it seems to me like LC doesn’t do very much when he’s dropping fast, and even MC sometimes doesn’t help much either.

I don’t think it will take you long to gather data on his onset and nadirs. And as Amanda suggests, getting an idea of his normal can tell you whether he drops fast then levels out on his own, or keeps dropping. Food experiments also take some repeating to make sure you have the amounts and carbs right. You also might want to think about gradually lowering the reduction number, from 90 to 80 first, when you get to that point.

You and Blaze have only been at this a month and a half. It can take a cat’s body up to three months to really learn how to work the hormone (insulin), and then we have to learn by observing them. Having said all this, I was guilty of being very impatient when I started. It was really hard for me to learn to slow down.

 

[Sarah and Blaze]

I tend to agree with Wendy on this one, I think before you alter methodologies it is really important to be able to answer those questions: when does Blaze have onset? when does he nadir? how long does insulin last in his system? You really need to understand these concepts and be able to choose them from your own data in case Blazes patterns shift and it becomes dangerous to use 70 as a reduction point.

It is totally up to you what you want to do though. If you want to modify SLGS now, I would recommend really taking a look at the data you have, and kind of like a worksheet decide for each day individually where you think onset and nadir are as well as when it seems the dose pooped out. After spending some time with that data and gaining confidence on how to identify these characteristics you will be in a better place for a modification.



Basically from guiding with LC you are seeing what Blazes body will naturally do on his own without the intervention of carbs, that will allow you to see what low numbers Blaze gets into on his own while in the safety of your care. Next time you notice him getting into the lagoon maybe post a question that you would like to put off intervening with carbs as long as it is safe to do so, that will hopefully get some members attention to guide you in your endeavour to gather this data. If you are nervous when Blaze gets into the 90s it will be really tough to use a 70 reduction point. But if you can gather more information on how low Blaze goes on his own without intervention with carbs you will better understand what is safe when you switch to a 70 reduction point.... that was wordy.... make sense?

Yes, I agree that I should hold off any changing of methods until I have a better understanding of Blaze’s onset, nadir and duration and have more experience in all this. When Blaze dropped below 90, I wasn’t nervous but I might be if he dropped to 70 so I agree that I just need some more time with SLGS. And with seeing how he does without the intervention of carbs as well, like you said.

So for an example, the night of 10/3 when he dropped below 90, you suggest (with the help of others on the board) to not feed him any MC or HC food and see how he does, correct? Do I give any LC snacks then? And just continue to test every 30 minutes and see how low he goes, where he nadirs and where he starts to surf without MC or HC? Sorry for so many questions, I just want to make sure I understand so I know what to do the next time he’s low.

 

[AmandaE]

So for an example, the night of 10/3 when he dropped below 90, you suggest (with the help of others on the board) to not feed him any MC or HC food and see how he does, correct? Do I give any LC snacks then? And just continue to test every 30 minutes and see how low he goes, where he nadirs and where he starts to surf without MC or HC? Sorry for so many questions, I just want to make sure I understand so I know what to do the next time he’s low.

Yes! that is what I would suggest, take good notes on what you feed and dont feed too much at a time in case you do need to intervene. If you look at my spreadsheet in July you can see where I am trying to figure those lower numbers out for myself, and steering with LC as often as I can. And when you're ready to see what you can do with LC definitely post for help and someone will provide some ideas and guidance

ETA: I asked for help during those times in July too

 

[Bron and Sheba (GA)]

I stand corrected on the reduction fail and going back to best dose thanks @Wendy&Neko
Sorry Sarah for giving you the wrong info.

 

[Sarah and Blaze]

I stand corrected on the reduction fail and going back to best dose thanks @Wendy&Neko
Sorry Sarah for giving you the wrong info.

It’s okay! I appreciate your help so much!

 

[Sarah and Blaze]

That's just for Tight Regulation....On SLGS, you hold the dose for 7 days no matter what. (unless he drops below 90 and earns a reduction) Don't worry...sometimes people get mixed up.



Yes...by going straight to the MC or HC, we can't know if he might actually earn a reduction by dropping below 90 since you intervene before he has a chance to.



I would....at least until you understand him a little better as well as understanding how the insulin works. It was a good 5-6 months before I felt like I truly understood how Lantus worked in China and started trying to make my own dosing decisions (which I still ran by the people who had helped me learn for awhile!)

Okay now I know to hold the dose for 7 days. He was a day and a half early on this increase, I hope he’s okay. He’s definitely dropping quickly tonight though but he’s still in safe numbers. I’m only feeding him LC snacks right now too, even though he’s not super low.

And sounds good, I will hold off on changing any methods or modifying anything. I will just keep doing what I’m doing. Thank you for all your help and guidance, I really needed it.

 

[Sarah and Blaze]

Yes! that is what I would suggest, take good notes on what you feed and dont feed too much at a time in case you do need to intervene. If you look at my spreadsheet in July you can see where I am trying to figure those lower numbers out for myself, and steering with LC as often as I can. And when you're ready to see what you can do with LC definitely post for help and someone will provide some ideas and guidance

ETA: I asked for help during those times in July too

Okay thank you so much! I will start doing that with small LC snacks when he’s in those lower numbers. And I will definitely ask for help, I ask for help ALL THE TIME

 

[Chris & China (GA)]

So for an example, the night of 10/3 when he dropped below 90, you suggest (with the help of others on the board) to not feed him any MC or HC food and see how he does, correct?

Just so you understand....they earn a reduction when they drop below 90 on SLGS, but you don't necessarily have to intervene with HC unless he drops below 50. The point where we intervene is below 50 because that's getting too low. On TR, they don't earn a reduction until they drop below 50 once....but on SLGS, since there's usually less testing going on, we raise the reduction point to 90 for safety's sake.

Now if he drops fast, you'll have to experiment to see what works best for him (what carb % and when the best time to feed is) but that takes time.

 

[Sarah and Blaze]

Just so you understand....they earn a reduction when they drop below 90 on SLGS, but you don't necessarily have to intervene with HC unless he drops below 50. The point where we intervene is below 50 because that's getting too low. On TR, they don't earn a reduction until they drop below 50 once....but on SLGS, since there's usually less testing going on, we raise the reduction point to 90 for safety's sake.

Now if he drops fast, you'll have to experiment to see what works best for him (what carb % and when the best time to feed is) but that takes time.

Okay got it. So if he’s in those lower numbers (90 or lower) I don’t have to intervene with any food but should still test every 30 minutes until he’s going back up? And only need to intervene with food if he’s getting to 50 or lower OR if I can’t stay up to feed and test really late, correct?

And if he is dropping, like tonight, would I want to feed him snacks to slow him down?

 

[Chris & China (GA)]

So if he’s in those lower numbers (90 or lower) I don’t have to intervene with any food but should still test every 30 minutes until he’s going back up?

You can give LC food, but the HC is for when he drops too low (under 50)…..Sometimes you'll want to feed something MC to slow down how quickly he's dropping, but first, try LC....if it's not enough, then try MC. Try to save the truly HC for under 50.

You might not need to test every 30 minutes either.....just kind of depends on how he responds to the food, but generally, you do want to keep testing until you're sure he's coming up and holding his own without having to feed him anything other then LC food

And if he is dropping, like tonight, would I want to feed him snacks to slow him down

TRY LC first and test again in 30 minutes....see if the drop is slowing down...if it is (like dropping 20 points instead of 80 points in 30 minutes for example) you'd test again in another 30 to see how it's going. There's really no wrong thing to do as long as you document it in your "remarks" so you learn for "next time" (and there's always a "next time" so you're going to be able to get plenty of practice!)