DALE 07/27 AMPS 158 +3 72 +97

[Jerica&Dale]

Hi All, have not posted in a while, been very busy summer!

I'm doing my best with Dale and I am so confused by him. He was at my friends for a month while I had family visiting, she did her best to take care of him, did not get all the readings as I wanted too, so now I've had him back for a couple of weeks and back to regular routine and testing. I bumped his insulin up to 1.75 and then a couple days later I got a 43 on a +3. Which means reduce dose ? Which I did, reduced that evening and now while his numbers are decent but not great, there doesn't seem to be much consistency with his numbers, and it seems like his nadir is +3 , +4, +5 that is not typically "normal" with lantus correct? Could he possibly be better on a different insulin ? And would med carb food from the night previous affect him still 16 hours later ? The 344 on 07/24 seems so odd, or was a bad test, and I didn't retest to confirm that either....

I am going out of town for 1 week, Dale will be going to a cat hotel for 8 sleeps. I am getting the libre monitor put on him, as the gal is more comfortable with that rather than the ear pokes ( I have 3 cats total, 2 diabetics and they're all going there for the week ) I will send my glucose monitors with her of course in case the monitors fail us, but its the best I can do to try and keep stress levels down for everyone.

I'm getting the monitor installed on him on Wednesday.

Would it be safe to keep him at the 1.5 units for the duration of his stay ? And she will of course be communicating with me daily on his numbers so we can back off dose if needed etc.

Any input is greatly appreciated. Thanks!!

 

[Bandit's Mom]

You did right to reduce from 1.75U to 1.5U after that dip to 43. For newly diagnosed cats, a dip below 50 on a human meter is a reduction.

He was doing well in May. Maybe now that he's back with you and you can feed and test regularly he may improve again?

When are you going out of town. He is seeing nadirs in the 50s on 1.5U. We usually recommend a lower "vacation" dose when the CG is traveling and the cat cannot be monitored as closely.

@tiffmaxee

 

[Jerica&Dale]

You did right to reduce from 1.75U to 1.5U after that dip to 43. For newly diagnosed cats, a dip below 50 on a human meter is a reduction.

He was doing well in May. Maybe now that he's back with you and you can feed and test regularly he may improve again?

When are you going out of town. He is seeing nadirs in the 50s on 1.5U. We usually recommend a lower "vacation" dose when the CG is traveling and the cat cannot be monitored as closely.

@tiffmaxee

Thank you for response.

Yes, I'm thinking that after I get him 100% back on track, with feeding/testing/ timing etc that we will get to a bit better of a spot, this vacation I am taking does not help, but once I get back I have nothing else planned for a while.

I'm super curious if he'd do better on a different insulin and if I should entertain that idea after I'm back.

And for reducing while on vacation, would 1 unit be too little? 1.25unit can be tricky to measure out, especially for someone newer, but I think that would probably be the safest bet for Dale.

 

[Jerica&Dale]

You did right to reduce from 1.75U to 1.5U after that dip to 43. For newly diagnosed cats, a dip below 50 on a human meter is a reduction.

He was doing well in May. Maybe now that he's back with you and you can feed and test regularly he may improve again?

When are you going out of town. He is seeing nadirs in the 50s on 1.5U. We usually recommend a lower "vacation" dose when the CG is traveling and the cat cannot be monitored as closely.

@tiffmaxee

Just reading that better, they go to cat hotel on Saturday the 31st and I will pick them up on the 8th so I got this week to get a game plan going.

 

[Bandit's Mom]

Sorry, I went to bed and just seeing this.

1U might be safer but let me tag @tiffmaxee for her advice on the vacation dose.

 

[tiffmaxee]

I’d start 1.0 Thursday and see how it goes. Will Dale be tested at all while at the hotel?

 

[Wendy&Neko]

there doesn't seem to be much consistency with his numbers, and it seems like his nadir is +3 , +4, +5 that is not typically "normal" with lantus correct? Could he possibly be better on a different insulin ?

Cats can nadir at different times, much earlier or much later than +6. And it can vary from cycle to cycle. Neko's nadir on Lantus was anywhere from +3.5 to +13, though most often +7 to +9. Where the nadirs land don't signify he needs a different insulin. If you want his numbers to be better, I'd suggest really following TR when you get back from vacation. That means not holding doses a long time.

In the mean time, enjoy the holiday. The 1.0 units will keep him safe and allow you do relax, plus be easier to measure of course.

 

[Jerica&Dale]

I’d start 1.0 Thursday and see how it goes. Will Dale be tested at all while at the hotel?

He is going to have the libre freestyle glucose monitor on him so she can check him numbers.

I'm getting the monitors put on him today so I'll have a few days to see what his numbers are like with that on.

 

[Jerica&Dale]

Cats can nadir at different times, much earlier or much later than +6. And it can vary from cycle to cycle. Neko's nadir on Lantus was anywhere from +3.5 to +13, though most often +7 to +9. Where the nadirs land don't signify he needs a different insulin. If you want his numbers to be better, I'd suggest really following TR when you get back from vacation. That means not holding doses a long time.

In the mean time, enjoy the holiday. The 1.0 units will keep him safe and allow you do relax, plus be easier to measure of course.

Thank you !
Yes, when I'm back I plan on really nailing this down. I guess I'm just so confused as it seems like I bump him up to the 1.75unit then I have to bump him back down and get a cpl good numbers then get higher days where I should then increase the dose back to 1.75 again and then it usually pushes him too low on the 2nd or 3rd day. The 1.5unit had seemed to be doing OK, he'll have a cpl higher days but then pull out some blues/greens. Is that how it can work with TR, just constantly changing the dose ? 1.5 to 1.75 and back again ?

I wonder if 1.6 units would do him OK just how on earth do you draw that? I will do more posts when I am back from my holiday to get assistance with this. Overall, he seems happy and healthy just want to get him on the perfect dose to keep him numbers steady!

 

[Wendy&Neko]

Is that how it can work with TR, just constantly changing the dose ? 1.5 to 1.75 and back again ?

It's not just TR. Fragile healing beta cells seem to heal, get tired and go on break again, no matter the dosing method. Ideally you get to a goal where he spends as much time as possible in the "healing green" to give his pancreas as much rest time as possible.

You might want to think about getting a few more +2 tests if possible. I see a number of times he's really dropped at +3. If you see him dropping a lot at +2, feed him and try to slow him down so he sees good safe green numbers, instead of diving to a reduction.