4/3 Dimi PMPS 58 (Libre)

Bobbi Kraham

Bobbi Kraham

Member Since 2022
Hi, We're 3 months in and still unregulated. Numbers were looking great on Friday for the first time (yay), and then I gave him a small amount of Dr. Elsey's Chicken kibble and numbers shot way up. This could be a coincidence but the timing would suggest it was the kibble, though I understand it is very low carb. For the rest of Friday and Saturday his numbers stayed high, so this morning I increased his dose to 1.75. He's been reading low on the Libre all day, and his PMPS is 58. I'm assuming this means no shot, but then I know overnight and tomorrow he will go way high again. I feel like this is a constant rollercoaster, can't seem to get him steady. I'd appreciate any insight or guidance

@tiffmaxee
@Wendy&Neko

Previous Post: https://felinediabetes.com/FDMB/thr...2-5-40-3-107-4-54-4-5-41.260574/#post-2924708
 
He also got Lo on 1.5 units, so 1.75 units is way too much insulin. Please lower his dose to 1.25 units. You might even consider skipping or giving a token dose like 0.5 units tonight, to help drain the depot.
 
Now that I've said that, a couple observations. First, it will really help us to help you if you decide on which dosing method you'd like to follow. Then put either TR or SLGS in your signature.

Are you still giving the Dr. Elsey's dry on a regular basis? Your signature says just the pate's. If you are feeding dry at all, you have to use the SLGS dosing method. If the dry is just for low numbers, you might want to consider getting some high carb wet food. Which doesn't last as long in the system as the dry food does.

You need to hold doses longer than you have been doing. Even with TR you don't increase until after at least 6 cycles, and hold for 10 cycles if you see greens. With SLGS you hold doses for 7 days before evaluating it. With both dosing methods, you reduce immediately if you see a number below what we call the reduction point, which 50 for TR and 90 for SLGS.

The low numbers followed by high numbers is just his body's reaction to those low numbers, we call it bouncing. It's a perfectly normal reaction, especially in recently diagnosed cats. The high numbers can last up to six cycles after the lower numbers. Try to ignore the high numbers. We determine dose based primarily on how low the dose takes the cat.
 
Thanks for your feedback @Wendy&Neko. I haven't chosen a dosing strategy. Tight regulation is appealing, but I'm terrified of a hypo situation. Dimi seems to jump from really high to really low. With the exception of last Friday, 4/1, he's never coasted for any significant period in the target range. I'm able to watch him during the day b/c I'm still working from home, but I'm so afraid of an overnight hypo. Especially because he doesn't seem to have a clearly defined nadir.

Re. kibble: I took away all kibble on March 9, but on Friday afternoon, 4/1, I gave him a small amount of a sample pack I had received of Dr. Elseys. I thought that kind of kibble was ok for sugar cats, but he did jump way up afterwards, unless that was a coincidence.

Against my vet's direction, I held his dose at 1.5 units for 7 days (3/27 - 4/2). She wants me to increase his dose, because on 1.5 units, his numbers have stayed consistently in the upper 200s and 300s (with the exception of 4/1) and on 1 unit, they stayed in the upper 300s - 400s. My spreadsheet is all over the place and I can't tell if we're making any progress.
 
He’s on too much insulin so he drops too low and then his body panics and he bounces. You will have a symptomatic hypo if you continue on 2.0 I fear. If you get a lo with the Libre I would check again with an ear prick. Some have found issues with the Libre when it reads lo. It might be right but best to double check if possible.
 
tiffmaxee said:
He’s on too much insulin so he drops too low and then his body panics and he bounces. You will have a symptomatic hypo if you continue on 2.5 I fear. If you get a lo with the Libre I would check again with an ear prick. Some have found issues with the Libre when it reads lo. It might be right but best to double check if possible.
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He was receiving 1.5 units for a week and I increased to 1.75 this am, not 2.5. Re. the libre: At +5 today when the Libre read low, I checked on the Relion and got a reading of 88 and then at +6 got a reading of 98 when the Libre still said low
 
So you are seeing a lower reading with the Libre. It’s still a reduction since under 90. I got confused with the dosing. . What dose did your vet want you to give?
 
With the lo readings 2.0 is definitely too high. I suggest you lower to 1.25 as Wendy suggested. Surely with those lo readings I can not imagine your vet would say to go up to 2.0. You dint want a symptomatic hypo and needing to go to the ER for a glucose drip.
 
tiffmaxee said:
With the lo readings 2.0 is definitely too high. I suggest you lower to 1.25 as Wendy suggested. Surely with those lo readings I can not imagine your vet would say to go up to 2.0. You dint want a symptomatic hypo and needing to go to the ER for a glucose drip.[/QUOTEI
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I increased today to 1.75. Should I go back to 1.5? won't 1.25 be too low?
 
No, 1.25 units will not be too low. Both 1.75 and 1.5 units were too high. He will be high in the morning due to the skip, and possibly for a few days after that. Try to be patient, the depot will have to rebuild so you will see higher numbers at first, but they will come down over a few days.
 
Wendy&Neko said:
No, 1.25 units will not be too low. Both 1.75 and 1.5 units were too high. He will be high in the morning due to the skip, and possibly for a few days after that. Try to be patient, the depot will have to rebuild so you will see higher numbers at first, but they will come down over a few days.
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Thank you so much to you and @tiffmaxee ! Really appreciate your feedback.
 
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