2/13 Disco AMPS 236,+11.25 115,+11.5 93,+12 73,+12.25 60,+12.5 50,+13 45,+13.5 75,+14 93, +15 94

Bandit's Mom said:
I think I was wrong (yet again) about the "+11.50 hours from today's PMPS". Maybe post a question tomorrow AM (on a new condo) asking about shot time? I think it should be fine to shoot Disco at 8am. But I would like a confirmation from an experienced member.
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Wendy&Neko said:
You can shoot any time you want tomorrow morning, because you skipped. You just need to be at least 12 hours after your previous shot which was this morning.

It’s unfortunate you didn’t feed him earlier to prevent the reduction. Like you said, next time get that +9.5 or +10 and feed if dropping. He is barely spending any time in healing green numbers. The goal is to spend as much time in the 50-120 range, if remission is your ultimate goal. Regulation is a prerequisite to remission.

The +1 cell on the spreadsheet for tonight needs a different colour, it’s too close to blue. After years of looking at spreadsheets, our brain gets wired to look for colour patterns.
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Oh! Thank You! Your input is so precise and to remember.

When I feed him at the +9.5 or +10, it's LC (his usual raw diet) and is it just a snack, like 2 teaspoons, not his full meal? And do you think that the late times I was feeding him as his shot times were late, has any impact on these crashes? I need to be more consistent with his snacks and not let a cycle go by with only one snack maybe?

And I'll fix the SS color, thanks for catching that-I am going back and forth from my laptop and phone and they look different as to my color options. Since the numbers in +1 cell go from 45 to 60, is green ok?
 
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Congrats on the dose reduction.

I want to make a couple of observations. The 2.75u dose was held for too long (1/24 to 2/6). With TR, the dose is evaluated no longer than 5 days (when nadirs are mostly in the <200 range; after 3 days in the > than 200 range).

I'd encourage you to give some serious thought to how low you're willing to shoot. It will help if you can start shooting lower than blue numbers. Ultimately, with TR, you want to be able to shoot any number above 50. I'm not suggesting you do that immediately but you want to work your way down to shooting low numbers. Right now, you get a low pre-shot number, skip, and you end up with the double whammy of a bounce plus skipped shot and it takes at least 6 cycles for the bounce to clear.
 
Sienne and Gabby (GA) said:
Congrats on the dose reduction.

I want to make a couple of observations. The 2.75u dose was held for too long (1/24 to 2/6). With TR, the dose is evaluated no longer than 5 days (when nadirs are mostly in the <200 range; after 3 days in the > than 200 range).

I'd encourage you to give some serious thought to how low you're willing to shoot. It will help if you can start shooting lower than blue numbers. Ultimately, with TR, you want to be able to shoot any number above 50. I'm not suggesting you do that immediately but you want to work your way down to shooting low numbers. Right now, you get a low pre-shot number, skip, and you end up with the double whammy of a bounce plus skipped shot and it takes at least 6 cycles for the bounce to clear.
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In a case like Disco's where he was falling rapidly (and probably below 50), one would feed MC and shoot? Even though he was 77 at PS, it was obvious he was headed downward at some speed. That was the concern.
 
@Bandit's Mom - That could be dangerous. You need to wait and see which way numbers are going. You also do not feed to raise numbers and then shoot. As soon as the carbs wear off, numbers can plummet. If you shoot a dropping number, use MC/HC to artificially raise numbers, and then the carbs wear off, you could potentially spend several hours trying to get numbers into a safe range. I understand the concern with Disco's numbers last night.

It is possible to shoot a dropping number but I would not recommend it to anyone who is still new at managing their cat's FD and especially not to anyone who has very limited experience with steering their cat's numbers with food. It takes considerable knowledge about how sensitive your cat is to carbs, how the kitty responds to both insulin and carbs, and how confident you are with your ability to manage the situation.
 
Sienne and Gabby (GA) said:
@Bandit's Mom - That could be dangerous. You need to wait and see which way numbers are going. You also do not feed to raise numbers and then shoot. As soon as the carbs wear off, numbers can plummet. If you shoot a dropping number, use MC/HC to artificially raise numbers, and then the carbs wear off, you could potentially spend several hours trying to get numbers into a safe range. I understand the concern with Disco's numbers last night.

It is possible to shoot a dropping number but I would not recommend it to anyone who is still new at managing their cat's FD and especially not to anyone who has very limited experience with steering their cat's numbers with food. It takes considerable knowledge about how sensitive your cat is to carbs, how the kitty responds to both insulin and carbs, and how confident you are with your ability to manage the situation.
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Thanks. That's what we thought. That we didn't have the experience or the courage to shoot a rapidly falling number. This has happened with Disco on Feb 8th to. He went all the way to 39!
 
Sienne and Gabby (GA) said:
Congrats on the dose reduction.

I want to make a couple of observations. The 2.75u dose was held for too long (1/24 to 2/6). With TR, the dose is evaluated no longer than 5 days (when nadirs are mostly in the <200 range; after 3 days in the > than 200 range).

I'd encourage you to give some serious thought to how low you're willing to shoot. It will help if you can start shooting lower than blue numbers. Ultimately, with TR, you want to be able to shoot any number above 50. I'm not suggesting you do that immediately but you want to work your way down to shooting low numbers. Right now, you get a low pre-shot number, skip, and you end up with the double whammy of a bounce plus skipped shot and it takes at least 6 cycles for the bounce to clear.
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Thank you for your expertise and input! Yes, too long on the 2.75. Not sure now why I did that, maybe fear of being new to TR or not getting asking or seeing any input on time to change in my threads. Yes, it is my responsibility to read the stickies and documents and I don't even say I'm an experienced vet healthcare professional now because I feel so dense and dumb about FD. Again, I would be totally lost without this groups experienced members!!

I, too, feel both regret and fear that I didn't shoot at 73, but how fast he dropped on 2/8 scares me. I feel like I don't have any 'rhythm' with what he is doing. So much different than the first couple of months while on Vetsulin (in spite of these scares, glad to be off that) and the first month on Lantus on SLGS.

And you are right, I have to be diligent on learning how to steer him with food, it seems that much of his issue is due to his food needs? As to the couple of congrats on the dose reduction, @Wendy&Neko said 'Unfortunately' and I wonder why (I'm sure she will explain that) and want to not wait to increase to 2.75 again, if he is having ok numbers, do I do that after 6 cycles per TR even though he had problems last night, but be vigilant about doing a +9.75 or +10 and steer with food. Also, as I am having trouble even figuring out what his nadir is, how do I know how not to feed after his nadir? Do I need to test hourly while I'm awake, I know now that getting +1 and+2 is important for him while I am trying to learn what his nadirs are?
 
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If it's any consolation, I'm having a hard time sorting out when Disco's nadir is. Some of the difficulty is due to the bouncing and as soon as he clears a bounce, he drops into low numbers. I would have likely stalled last night and done the same as you did. It's also the trade off with stalling. If you had shot and then fed, there's no way to know if the numbers would have come up over that 2 hour (maybe) period before onset due to Disco having eaten dinner. Sometimes, you make your best guess which is why it's important to get comfortable with steering the cycle with food.
 
Sienne and Gabby (GA) said:
If it's any consolation, I'm having a hard time sorting out when Disco's nadir is. Some of the difficulty is due to the bouncing and as soon as he clears a bounce, he drops into low numbers. I would have likely stalled last night and done the same as you did. It's also the trade off with stalling. If you had shot and then fed, there's no way to know if the numbers would have come up over that 2 hour (maybe) period before onset due to Disco having eaten dinner. Sometimes, you make your best guess which is why it's important to get comfortable with steering the cycle with food.
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Of course, I didn't think of the fact that I could feed him to steer him and then just test 2 hrs later, for example last night when I tested him at 10.75 and he had dropped from 258 at +6 to 148 at 10.75, if I had fed him to steer him, it possibly would have brought his number up and I could have shot him at 12.75 and not skipped, right? Also, when feeding to steer, it's LC right? and is it just a couple of teaspoons?
 
I didn't mean you would feed him at +10.75.

If you hadn't stalled, you would have tested at PMPS, gotten the 73 and shot. At that point (PMPS), you would have fed Disco dinner. In a perfect world, his numbers would rise until onset (although you would be urged to get a +1 and +2 just in case...) and then hopefully surf in green numbers.

I wouldn't have suggested that you feed within 2 hours of shot time. If you did what you suggested above, you would have potentially inflated the PMPS. The risk is a false sense of confidence and if you shot and didn't test until +2, there could be a good chance you see low numbers (and then panic!!). The only time I've fed or recommend that someone feed their cat after +10 is if the numbers are below 50 (on TR or below 90 with SLGS). It's the same if you're seeing dose reduction-worthy numbers at any other point in the cycle -- you use food to raise the numbers.

When I refer to steering the cycle, it's not necessarily a matter of LC. The choice of what % carb food you use depends on the circumstances -- how low the numbers are, how fast the numbers are dropping, where in the cycle the drop is occurring, etc.
 
Sienne and Gabby (GA) said:
I didn't mean you would feed him at +10.75.

If you hadn't stalled, you would have tested at PMPS, gotten the 73 and shot. At that point (PMPS), you would have fed Disco dinner. In a perfect world, his numbers would rise until onset (although you would be urged to get a +1 and +2 just in case...) and then hopefully surf in green numbers.

I wouldn't have suggested that you feed within 2 hours of shot time. If you did what you suggested above, you would have potentially inflated the PMPS. The risk is a false sense of confidence and if you shot and didn't test until +2, there could be a good chance you see low numbers (and then panic!!). The only time I've fed or recommend that someone feed their cat after +10 is if the numbers are below 50 (on TR or below 90 with SLGS). It's the same if you're seeing dose reduction-worthy numbers at any other point in the cycle -- you use food to raise the numbers.

When I refer to steering the cycle, it's not necessarily a matter of LC. The choice of what % carb food you use depends on the circumstances -- how low the numbers are, how fast the numbers are dropping, where in the cycle the drop is occurring, etc.
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Thank you for clarifying your suggestions for me, I think sometimes I condense my thoughts and leave out something important when getting direction. When one is steering with food, is there a rule on how much each portion to feed? Seems like it's 1-2 teaspoons but want to clarify that.
 
Hi Sienne--

Just to avoid confusion, I think feeding at +10.75 was an unorthodox suggestion I made in Teri's thread this morning. I know it's not the way we normally do things, I was just trying to think of other possible ways to try to head off situations like last night's. The idea was that you'd still be keeping a 2hr food-free window (thus, shooting late), but maybe would have been able to head off the deepest part of the dive and hopefully not shooting quite as late as you would going through the usual stalling process.

Just an idea, though-- again, I know it's not the normal procedure!
 
How much to feed can again be situation dependent -- mostly depending on how low the numbers are. If you test and get numbers in the 30s, I'd give a fair amount of HC. (I used either Karo or honey since Gabby was gluten intolerant. Gravy based food had gluten. So I'd be using maybe 3 drops of syrup, maybe 4.) If it's +3 and numbers are in the 60s, I'd probably give a teaspoon or so of LC to keep numbers from dropping.
 
Sienne and Gabby (GA) said:
How much to feed can again be situation dependent -- mostly depending on how low the numbers are. If you test and get numbers in the 30s, I'd give a fair amount of HC. (I used either Karo or honey since Gabby was gluten intolerant. Gravy based food had gluten. So I'd be using maybe 3 drops of syrup, maybe 4.) If it's +3 and numbers are in the 60s, I'd probably give a teaspoon or so of LC to keep numbers from dropping.
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Thx! I will keep those notes handy!
 
Nan & Amber (GA) said:
Hi Sienne--

Just to avoid confusion, I think feeding at +10.75 was an unorthodox suggestion I made in Teri's thread this morning. I know it's not the way we normally do things, I was just trying to think of other possible ways to try to head off situations like last night's. The idea was that you'd still be keeping a 2hr food-free window (thus, shooting late), but maybe would have been able to head off the deepest part of the dive and hopefully not shooting quite as late as you would going through the usual stalling process.

Just an idea, though-- again, I know it's not the normal procedure!
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Yes, that is how I understood your suggestion, shooting a little late to still keep the 2 hr food-free. I couldn't find the suggestion as I was looking on yesterday...
 
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