4/6 Mouzer: PMPS 108/+2 120/+3 103/+4 98/+5 85/+6 77/+80

Cherryl & Mouzer

Cherryl & Mouzer

Very Active Member
Good Morning :)
Mouzer is surfing safely hahaha

I laughed as I thought of Mouzer's dives on a higher dose, from the safe green to the unsafe hypo green, and how I stayed up having to test every 60, 30 and eventually 15 minutes, and stay on top of that with hc, mc, honey/syrup, and have my nerves crashed and Mouzer in misery and my husband all mad because I am asking him for directions to the emergency vet, which is not affordable...

And now, with the lower dose, Mouzer's going from safe green to safe blue, and my testing hourly for some hours because I wanted to know when would he go from the safe green to the safe blue, but not testing because I had to test and not having to worry over unsafe hypo greens and not having to go for the hypo kit and not having to speak of an unaffordable emergency vet.

And Mouzer did start to get a little upset with me upon the last three test but this testing was not a matter of life and death and I promised I wont do it the next day, I will give him a break.

My laughter is in how either way I stayed awake for the tests.
My comfort is in that with the safe greens and safe blues, I am not having to stay up due to a life or death situation and possible unaffordable emergency vet visit, and if I have to leave him for a time, I can leave, whereas with the safe greens dropping to unsafe hypo green, I could not leave at all.

So, even if it turns out we need to take Mouzer up to .75, I like this route better than the unsafe route. As long as Mouzer is not shooting sky high in his numbers, this is a good route for him, at this time. I know those blues are dreadful to be seen by the forum, but I am years accustomed to seeing Mouzer have such blues as this, along with his greens, so for now, I am ok with it. As long as the blues do not take over as the majority numbers, and as long as the blues do not go above 165, and that 165 not to be a regular event.

Mouzer will be under observation to see if the dose needs an increase or decrease.
Time will tell, same as for all those playing the hypo green game :)

4/6 Mouzer: AMPS 93/+3 122/+5 104/+6 75/+9 113/PMPS 108/+2 120/+3 103/+4 98/+5 85/+6 77/+80

4/5 Mouzer: AMPS 99/+2 117/+4 81/+6 86/+9 106/PMPS 121/+3 62/+4 72/+5 77/+6 86/+7 63/+8 102/+9 133
 
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Bellasmom said:
Looking good!
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I like it so far, but still watching the blue to make sure it does not take over.
I am waiting out the full 6 cycles in order to make a decision as to whether or not to increase dose or take current dose a little longer.
Going this way is giving me time to learn, rather than my mind being frozen in time with constant worry and the freak out mode ahahahaahaa
 
I hope you and Mouzer have a great (safe) day. When was Mouzer first diagnosed, Cherryl? Was he diabetic prior to the February 2021 date on your spreadsheet? Then went into remission? Then relapsed?

I hope you will not have to test Mouzer too much today... is it going to be the break from testing that you promised him? :-)
 
Mouzer is having an overall great for nadirs.
I dont want his bg any lower than 72 and Mouzer has taken drops from a 72 to uncomfy numbers for me.
I think less blues would make me feel better.
I offer food to Mouzer always, and Mouzer either eats or runs from it. I cannot make him eat.
I am going to work on this, to see about getting him to eat and flatten out the curve.
I just dont know if he will eat at the time it is that I need him to eat. He is a cat :cat:
 
Suzanne & Darcy said:
I hope you and Mouzer have a great (safe) day. When was Mouzer first diagnosed, Cherryl? Was he diabetic prior to the February 2021 date on your spreadsheet? Then went into remission? Then relapsed?

I hope you will not have to test Mouzer too much today... is it going to be the break from testing that you promised him? :)
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Mouzer is considered a long term diabetic, dx 2017 and in remission in one month and two or three days after dx. He has been in remission until, from the time I caught it, I cannot say exactly when, February 2021. Mouzer reacts a bit weird in all of this, so he does have to be treated a little differently and observed more often because he is so unpredictable - ECID :)
There is a 2017 tab at the bottom of Mouzer's SS, if you would like to see it. It is all I have to go by, except testing I did throughout, without recording it on the SS. Now, I wish I kept that up.
I always hope everyone has a great day, especially the ever so many who are working so hard for their diabetic kitties.
In all that I have gone through, just in my short times here, and watched all of you go through, I have a huge heart for every parent of and the diabetic kitty ❤️
 
I am going to give Mouzer a break now, until amps +9.
I just wanted to hang out and catch his nadir, of which I am pleased but still unsure of the blues, and how to fix that without raising the dose to lower the nadir. And food is what I am looking at :)
Actually, I should get a +7 because Mouzer does have a +7 nadir hahaha or a nadir whenever he feels like it :joyful:
But I will leave him alone, as I promised him last night :)
 
I am going to try food control lolol on a cat ahahahaa to try manipulating the curve and control some of the blues.
And I laugh about this control, not that I do not control Mouzer's food, but that Mouzer controls the 'when' he will eat it hahaha

I am not so sure this can work for Mouzer to eat at PS, +1,+2,+3.
That is 3:30am, 4:30am, 5:30am, 6:30am for am times, and I have struggled getting Mouzer to eat when I want him to since we went to these early morning hours. And being as the last meal would be at 6:30am, I know he is going to want more to eat, somewhere between 6:30am and 1:30pm
and then no food from 1:30pm til PM Shot at 3:30pm.
Feeding at these pm hours might be possible and surely more possible than feeding these hours in the am time.

As long as Mouzer does not do anything wonky, I will be getting to bed after pmps +6. I stayed up last night because I needed to see when the green went to blue, but then I missed when did the blue go back to green, being as we woke with amps in green.
I wish I could do this 24 hours a day for three days in a row :D
 
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Cherryl & Mouzer said:
I am going to try food control to try manipulating the curve and control some of the blues.
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Perhaps if you don't mind, Cherryl, I'd like to offer some additional clarification, to help you and others who may be interested in what you are referring to by "using food to manipulating the curve".

In most cases when caregivers are looking to try and manipulate the curve by using food, it would be in order to prevent a kitty from dropping too fast and too low. When you are trying to slow down the drop, it can help to feed more of the food earlier in the cycle (starting point is +1, +2, +3), then adjust as needed based on how your cat responds to the food. Kitties who are bouncers can benefit from this, since bounces happen from either going too low, or from having steep drops. I think most would agree, Mouzer is not a bouncer :rolleyes:

Also, this technique can help where a kitty is perhaps carb sensitive, and they experience large food bumps, with only LC food. In theses cases, strategically placing out meal times helps flatten the curve.

In general, by flattening the curve, you are able to hold onto a dose longer, and get as much insulin in kitty as is safe to do so. The technique also enables some caregivers to give higher doses of insulin than they would be able to do otherwise.

Here is the full info post for others who may be interested in learning about using food to manipulate the curve

That said, I think it does help to experiment with feeding times, in order to help the kitty get the best possible combined effects between the insulin and the food. As always, ECID, each caregiver needs to understand how their cat responds to insulin and carbs, and adjust feeding schedule based on what you see working or not working after 3-4 days. You want to give the experiment some time to see if it works before adjusting, if necessary.

Mouzer's cycles lately are looking not too shabby :)
 
Christie & Maverick said:
Perhaps if you don't mind, Cherryl, I'd like to offer some additional clarification, to help you and others who may be interested in what you are referring to by "using food to manipulating the curve".

In most cases when caregivers are looking to try and manipulate the curve by using food, it would be in order to prevent a kitty from dropping too fast and too low. When you are trying to slow down the drop, it can help to feed more of the food earlier in the cycle (starting point is +1, +2, +3), then adjust as needed based on how your cat responds to the food. Kitties who are bouncers can benefit from this, since bounces happen from either going too low, or from having steep drops. I think most would agree, Mouzer is not a bouncer :rolleyes:

Also, this technique can help where a kitty is perhaps carb sensitive, and they experience large food bumps, with only LC food. In theses cases, strategically placing out meal times helps flatten the curve.

In general, by flattening the curve, you are able to hold onto a dose longer, and get as much insulin in kitty as is safe to do so. The technique also enables some caregivers to give higher doses of insulin than they would be able to do otherwise.

Here is the full info post for others who may be interested in learning about using food to manipulate the curve

That said, I think it does help to experiment with feeding times, in order to help the kitty get the best possible combined effects between the insulin and the food. As always, ECID, each caregiver needs to understand how their cat responds to insulin and carbs, and adjust feeding schedule based on what you see working or not working after 3-4 days. You want to give the experiment some time to see if it works before adjusting, if necessary.

Mouzer's cycles lately are looking not too shabby :)
Click to expand...

Thank You :)
That sticky is what I have been reading and going back to. I know of this curve from past, but Mouzer, as a norm, has always preferred to eat PS,+2,+4,+6 and sometimes at +9, but we are now doing everything five and a half hours earlier than Mouzer's norm, what he is accustomed to for times. I have been struggling with his eating schedule since the new times.

I thought maybe to try the PS,+1,+2,+3 but this might be much harder than even trying to get him in timing with our new time for his normal patterns of eating.

It was mentioned to try 'this manipulation of the curve' for trying to control the blues that Mouzer is having off-nadir times.
Although, I do admit, from below, what I paste, I found myself confused at reading ... it's a method of feeding used to prevent kitty from dropping too fast and/or too low.
Being as the method was suggested, I wondered if by doing this, would it even him out, somehow. So, this is why I spoke of trying it.
Below is what I speak of from the sticky...

what is meant by using food to manipulate the curve?
simply put, it's a method of feeding used to prevent kitty from dropping too fast and/or too low.
the amount of food usually fed to the cat is broken down into several mini-meals fed throughout the course of the day with the intention of flattening out the curve.
-----
I am watching. I do not know how long it takes the depot to rebuild from Mouzer's token and two skipped shots, so I am waiting a bit to see if that is why for the blues, if insulin is going to depot before going to Mouzer for what is needed now.

It may very well turn out he needs .75 but I admit, I am even scared to do that much because of his drop to the 30's. I will do it, reluctantly, and hope if I have to do this, we have no such drops. I cannot go through what those drops to me, my husband lol and Mouzer ...

I do not like going into the 'hypo green' numbers at all. I dont want to. I do not know exactly what is happening to Mouzer and that it may not show right away, same goes with wanting to keep him in the safe range, not going to high and having the damage done from that.

Also, my husband is far less willing to go further in debt over emergency, than I am, and he is the money maker here. He also is far less willing to give up his life for a cat, than I am. I have given up my entire life for animals, all the way around lolol

As for Mouzer's cycles of late, I like the nadirs, for the most, however I do not like the 'so much' blue I see, otherwise.
I am hoping it is due to depot needing to rebuild.
 
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Because Mouzer does have +7 nadirs, I think I will stay awake one more hour and see if he goes lower this cycle.
I wish I could figure how to get Mouzer's am cycle to be more like the pm cycle.
 
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I was seeking to find what is an 0.5 fat - dose.
I found an example and took a screenshot but this thing to upload a file says I do not have permission, go figure lol
I just want to know if I am understanding correctly that an 0.5 fat is an 0.75 skinny and that I would draw up to just under the 0.75 mark, with the plunger being just under 0.75.
This is a link where I am seeing this, but I want to confirm this before I decide to try this.
https://diabeticcatcare.com/DCCCOK/FatsandSkinnies.htm
 
Skinnying and fattening doses are difficult to do without callipers. Although people have been dosing before half unit syringes and callipers by counting drops.

I have found that my dosing has become more accurate with callipers. Another thing that has helped was using my smartphone camera as a magnifier rather than a magnifying glass. (Thanks to @Hercule's mum for that suggestion!). The resolution is much better with it.

I don't know if you've noticed that a lot of syringes have "zero error". The zero mark does not align with the plunger position when it is fully pressed. There can be as much as 0.5U above the zero mark.

Take a look at this pic with two syringes and where the zero mark is. The plunger is fully pressed.


upload_2021-4-7_10-58-32.png
 

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Bandit's Mom said:
Skinnying and fattening doses are difficult to do without callipers. Although people have been dosing before half unit syringes and callipers by counting drops.

I have found that my dosing has become more accurate with callipers. Another thing that has helped was using my smartphone camera as a magnifier rather than a magnifying glass. (Thanks to @Hercule's mum for that suggestion!). The resolution is much better with it.

I don't know if you've noticed that a lot of syringes have "zero error". The zero mark does not align with the plunger position when it is fully pressed. There can be as much as 0.5U above the zero mark.

Take a look at this pic with two syringes and where the zero mark is. The plunger is fully pressed.


View attachment 60521
Click to expand...

So far, the syringes I have used go either even with the zero mark or below it and I have wondered if Mouzer gets more insulin on those that go a little below the mark. I have pulled back to get even with the mark and then draw from the pen, but I cannot say I have always caught this. I havent had one that stopped short above the zero mark yet, but that can happen one day, too.

I recall fat and skinny doses being spoken of in past but I just could not remember for sure where on the syringe to pull up the dose.
Because Mouzer is having nadirs that I dont want him to go below, I am thinking, before I try a full 0.75 dose, I will try a fat 0.50 dose.
I do not want his nadirs lower, darn it lolol To lower his nadir, is to stay up all night or stay home all day and all of life stops and all work gets behind. I am trying prevent this from happening, along with that I dont want Mouzer going into the hypo green area.

Me and cell phones dont click. I would not know how to use anything on mine except the alarm, of which I just learned of late :D
I would use my magnifying glass but I cannot hold it and also hold the syringe and do what is done to pull the juice from the pen.
 
This post is just for my saving the thread hahaha

https://www.felinediabetes.com/FDMB/threads/how-low-is-too-low.142105/
Libby and Lucy said:
Recently I’ve seen some statements about low numbers in the Lantus/Levemir group that I believe merit further discussion.

“We intervene at 50 (some even say 40)”

If only it was that simple! The saying “every cat is different?” Very true. Also “every cycle is different.” What is the normal range for your cat? What is his onset/nadir? Is he currently surfing or dropping? Is that normal for him? What has he eaten today and when? Is that normal for him? How much food does it take to make him surf? How long does it take for that food to kick in? What if it doesn’t? If you cannot answer all of these questions, then you should think hard about whether it makes sense to wait until the cat is already very low to intervene with food.

For two of my three diabetic cats, that advice could have been very dangerous and possibly fatal. For example, if I saw Jazzy dropping fast, I knew it took a long time and a LOT of food to get her leveled out. If I waited until 50 to give a teaspoon or two of high carb, I don't think I would have been able to turn her around in time (and Jazzy was a GREAT eater, no worries about whether the food would go in). Putting on the brakes for her required a whole can of food (a 5.5 ounce can). She wasn't interested in being finessed! I thought it was because she was on a higher dose, and maybe it was, but then I saw the same thing with Kris, who was only 7 pounds and on a much lower dose. In both cases, if they were dropping and hit 100 I would start feeding high carb – not to try to prevent a reduction, but to TRY to get ahead of them so they wouldn’t crash. Kris had a pretty good bounce mechanism (not as good as Lucy's) so chances are he would have been ok, but I didn't trust Jazzy to bounce.

“Symptomatic hypos are rare (or don’t occur) above 30”

This statement needs to be thrown out with the bath water. First, I’ve seen cats that displayed hypo symptoms in the 60s. It’s not the norm, but it does happen. 40s and 50s too. Know thy cat. Second, who cares? Just because a hypo doesn’t show symptoms does not mean it’s safe. Do you really want to flirt with hypo? There was a great link on the old board (now lost) that explained the brain damage that can occur even before symptoms appear. DO NOT become complacent about low numbers, and do not let anyone tell you to be casual about them.

“So What SHOULD I do?”

Feeding the Curve seems to be a lost art. For Lucy, who responded a little more typically, finesse was more possible. We used to say “teach them how to surf.” If your cat is dropping into green and that’s new for him, or if he typically bounces to the moon as soon as he sees green, try feeding him a little food to see if you can get him to stop dropping and start surfing. For example, maybe your cat is dropping, and you get an 80 at +4 and you like that number. Wouldn’t it be great if he can stay there instead of either plunging or bouncing? Maybe he can. Give him a couple of teaspoons of low carb and retest in 30 minutes to see if maybe that got him to stay in the 80 range. If he’s still dropping, maybe try a little higher carb to see if that works. You want to “bump him onto the surfboard” and see if you can get him to stay in a nice range. Most of the time this will not work in the beginning, but keep at it. One day you will notice that your cat DOES surf. He might surf for just an hour before bouncing, but that’s progress! Next time maybe it will be 2 hours, or 4, then one day maybe he’ll just stay on that surfboard forever. Lucy did.

“What About Feeding to Prevent a Reduction?”

This is not what I’m talking about here! Instead, you are feeding proactively to try to get him to surf in nice numbers. There’s a big difference. There are people who do feed to prevent reductions, and there are reasons for it, but that is an advanced technique that is not necessary for very many cats.


Now you are saying “obviously she is too much of a scaredy cat to do Tight Regulation, we NEED low numbers.” No, we don’t. We need the cat to be in the pancreas healing range. 60-90 is a good target for most cats. The guidelines about dose reductions? It is not our GOAL to get below 50 or 40. That is a safety measure – we want to prevent that range, so if the cat hits that range we need to get them out of it and reduce the dose so they don’t do it again. And if they DO do it again, we need to get them out of it and reduce the dose so they don’t do it again. And so on.


More food for thought – “hypo unawareness”

This recent study discusses, among other things, something that we have observed here for years: “… episodes of moderate hypoglycemia are not without clinical consequences. Recurrent episodes of moderate hypoglycemia can lead to decreased sympathoadrenal responses and decreased awareness of hypoglycemia, collectively termed hypoglycemia associated autonomic failure (HAAF)7, which leads to an increased risk of more frequent and more severe episodes of hypoglycemia.”

We "teach" our cats not to bounce from low numbers by repeatedly exposing them to normal/lowish numbers. It's part of tight regulation, but it does carry a lot of responsibility.

How many times have people here commented that their cat was in the 20s or 30s and didn’t look for food? Lucy did that. Is that ok? Obviously Lucy survived the 30s, and most cats do. But would she have been just as unaware in the 20s? Or teens? What if she went low at night and didn’t wake up? I don’t know. Personally I feel that it if I push her into tightly regulated numbers that could result in hypo, it is my responsibility to be sure she stays safe. If she isn’t noticing her low numbers, then I have to notice them for her. If I cannot test 24/7 (and I don’t know about you, but I can’t stay awake 24/7 forever), then I need to prevent hypos rather than reacting to them.

Bottom line: “How Low is Too Low” is very situational and there is no single answer. All that data you have been gathering – use it! Know your cat, then do what is right for him or her. There are others here who can give advice based on their own experience or their observations, but YOU know your cat better than anyone else. Trust yourself, trust your data, and don’t become complacent.
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Tuxedo Mom said:
Thank you so much for this post. I have been doing reading recently on hypos and your posting reinforces the fact that a cat can be experiencing hypo effects without showing outward signs. The body can be "responding" to a perceived hypo even though the numbers do not justify a hypo alert. Another good article:

http://clinical.diabetesjournals.org/content/24/3/115.full

I personally am more concerned about continuous "hypoish" numbers than about periods of higher numbers. Hypos can kill quickly...high numbers slowly effect the body and organs over time. Regular testing and patience are the best approach IMHO

Another good article although this one relates more to type 1 diabetes:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279554/
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