? Do I lower her dose for PM?

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Emily Alsip

Emily Alsip

Member Since 2022
Hello!

Holland has been on Lantus insulin since 6/24/22. Her dose for the past 8 days has been 0.25U AM/PM.

I did an 18-hour curve on Thursday, 7/14 (day 6 at the 0.25U dose) and her numbers were amazing!!! Nadir was 121 at +9. I felt very confident continuing at the 0.25U dose.

Yesterday started great but then got a 367 +3 PM reading (she had HALF of a temptations treat an hour before this reading!)

AMPS today was 226, and now +4 is 79. Ugh. Does this mean she goes to a token dose twice daily for a week and then reevaluate with another curve? She's acting totally normal and eating well. I'm just learning, but I'm so tempted to test carefully today and continue cautiously at 0.25 because I believe it was the half treat that messed things up.

Advice please?

Thank you! I'll link spreadsheet in a sec.
 
Emily Alsip said:
Hello!

Holland has been on Lantus insulin since 6/24/22. Her dose for the past 8 days has been 0.25U AM/PM.

I did an 18-hour curve on Thursday, 7/14 (day 6 at the 0.25U dose) and her numbers were amazing!!! Nadir was 121 at +9. I felt very confident continuing at the 0.25U dose.

Yesterday started great but then got a 367 +3 PM reading (she had HALF of a temptations treat an hour before this reading!)

AMPS today was 226, and now +4 is 79. Ugh. Does this mean she goes to a token dose twice daily for a week and then reevaluate with another curve? She's acting totally normal and eating well. I'm just learning, but I'm so tempted to test carefully today and continue cautiously at 0.25 because I believe it was the half treat that messed things up.

Advice please?

Thank you! I'll link spreadsheet in a sec.
Click to expand...


https://docs.google.com/spreadsheets/d/1pdMJMsWTZowPJrqMV972hxPUzu4A_lO19hQOhvRKy-w/edit
 
Previous post
https://felinediabetes.com/FDMB/threads/stalling-and-next-days-timing.265832/#post-2976186

Hi Emily

If you can set up what we call your signature that would be great

To set up your signature which you will see is at the end of everyone's post in gray, click on your name up top and then tap on the word signature and add this information
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
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Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information. Then link your SS to your signature

Have you read the dosing methods for lantus and pick one to follow? They will tell you when you have to decrease or increase is needed. When you decide can you add that to your signature when you set it up and also to your SS

https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
 
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I don’t know here, I think she needs more than 0.10u still. I guess I’d also wait to see what the rest of this cycle shows us.

If you were following SLGS, a reduction was earned but I’m not sure it should be taken, too many blues and that one 367 makes me think you should hold this dose for a bit longer - I don’t think half a temptation treat would spike that high but ECID.

I think following TR at this point would be a good idea (reductions under 50). Would probably give a stronger remission if you held off for more healing greens.

Looking forward to seeing what our experts say.

ETA: on the flip side, you can always go back up to 0.25u in a few days if 0.10u doesn’t work well
 
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Emily Alsip said:
Thank you. I will do the signature now.
Click to expand...
Thanks Kim. I thought with the chronic pancreatitis and steroid use, she would be unlikely to achieve remission. Is that inaccurate?

She's up to 111 (+7) now with no interventions, so I'm less worried and thinking I should do 0.25U tonight as long as she goes up more between now and then.
 
I’m really not the one to ask about pancreatitis as I’m not familiar with it or the combo or the fact that’s she’s still on steroids. It might be tougher to achieve but not sure it’s unheard of.. It would mean you have to keep a closer eye on her BGs more often. I know flairs up generally increase BGs from the pain. Remember though, getting your kitty well regulated is our ultimate goal and I think you can achieve that. You two are doing really well :bighug:

The fact that you’re seeing these numbers now, kinda looks like she’s tryna prove us wrong ;) I sure hope so!
 
Emily Alsip said:
Hello!

Holland has been on Lantus insulin since 6/24/22. Her dose for the past 8 days has been 0.25U AM/PM.

I did an 18-hour curve on Thursday, 7/14 (day 6 at the 0.25U dose) and her numbers were amazing!!! Nadir was 121 at +9. I felt very confident continuing at the 0.25U dose.

Yesterday started great but then got a 367 +3 PM reading (she had HALF of a temptations treat an hour before this reading!)

AMPS today was 226, and now +4 is 79. Ugh. Does this mean she goes to a token dose twice daily for a week and then reevaluate with another curve? She's acting totally normal and eating well. I'm just learning, but I'm so tempted to test carefully today and continue cautiously at 0.25 because I believe it was the half treat that messed things up.

Advice please?

Thank you! I'll link spreadsheet in a sec.
Click to expand...
I can tag a few members to take a look at your SS. Thanks for doing your signature and adding Holland's health issues

I can tag a few members for you to look at your SS SS is in her post #2
@Chris & China (GA)

@tiffmaxee

@Wendy&Neko

@Bron and Sheba (GA)

@Bandit's Mom
 
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If your kitty dropped under 90 on SLGS you reduce the dose. So the new dose is 0.1 units
upload_2022-7-17_9-26-25.jpeg
 

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I totally hear you. That's what I've been taught. And you'd then stay at the 0.1U for a week.

But her spreadsheet looks sooo good otherwise at this 0.25 dose? Did you take a peek? It was one little blip. I hate to go backwards.
 
Yes I looked at your SS I would not give dosing advice without looking first at the SS:)
The higher numbers are most likely bouncing which is very common in newly diagnosed diabetic cats. She is still very early in this FD journey and is doing very well.
See how she goes on the 0.1 for a week.
Are you giving snacks during all the cycles? keep posting and asking questions.
 
Bron and Sheba (GA) said:
Yes I looked at your SS I would not give dosing advice without looking first at the SS:)
The higher numbers are most likely bouncing which is very common in newly diagnosed diabetic cats. She is still very early in this FD journey and is doing very well.
See how she goes on the 0.1 for a week.
Are you giving snacks during all the cycles? keep posting and asking questions.
Click to expand...

She eats a larger amount at shot times and I also leave out the same food during the day with an ice pack under it. When I'm home, I notice she tends to go for a few licks every hour or so? She's a good eater though still quite thin at the moment.
 
Emily Alsip said:
Hi! I only feed a few kibbles as a treat after tests so it would be easy to do something else. But I thought the cleanprotein was ok? Nope?
Click to expand...

If you ever wanted to follow the TR Dosing Method you can give
Freeze dried treats
https://www.chewy.com/halo-liv-littles-grain-free-100/dp/29214

You can give her any freeze dried treats for a snack
most members give freeze dried treats , they are low carb, you can probably find them in some local pet stores also
I did a search for you on here and copied what some members said they use,

When testing you can give them a treat so they will associate after testing they will get a reward, any freeze dried treats are ok such as
PureBites Freeze-Dried Cat Treats with Chicken Breast 2.3 oz ()https://www.amazon.com/dp/B071P

Also chewys has freeze dried treats also


The freeze dried treats you can get at petsmart, petco and order from chewy. Purebites is popular (cheaper if you buy the dog food ones). My crew like vital essentials it's dehydrated freeze dried raw comes in flavors

freeze dried minnows, made by Vital Essentials. I also buy the ones made for dogs. They're the same as the freeze dried minnows for cats. just cheaper. They also carry other freeze dried treats. I ordered mine through Amazon.

I think the vital essentials are more of a crunchy texture than the purebites

If you cat likes any of these you can buy the bigger bags for dogs they are the same ,you will get more for your money just break then up into smaller pieces
.

You can Google freeze dried treats and see what other ones there are and different flavors
Just make sure that is the only ingredient in them meaning turkey, chicken, minnows etc

Here is another one , I see you can get these in different flavors also just look
You may have to break any freeze dried treats in half if they are too big
https://www.amazon.com/Vital-Essent...ocphy=9003521&hvtargid=pla-630511512365&psc=1

@Emily Alsip
 
You test enough to do TR and it looks like you aren’t feeding dry food. We have had cats here with pancreatitis and ibd that go into remission.
 
Hi Elise and Diane! Thank you thank you collecting info for us on safer treat options! She's liked freeze dried Stella & Chewy's chicken before. Maybe I'll see if that's ok too.

Do you see cats who stay on pred go into remission?

I can test pretty often right now. But in three weeks I'll be down to 4ish times a day (amps, +1/+2, pmps, +3/+4?) I need to read up more but I don't think that's adequate for TR.
 
I would see how she does following SLGS and continue testing while you can. With that data you can decide if you want to try TR. If you can get her off dry great. If not it’s decided for you. People do TR with full time jobs. I personally would not attempt that without a cat that uses an auto feeder.
 
tiffmaxee said:
I would see how she does following SLGS and continue testing while you can. With that data you can decide if you want to try TR. If you can get her off dry great. If not it’s decided for you. People do TR with full time jobs. I personally would not attempt that without a cat that uses an auto feeder.
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Hi Elise,

She never eats dry as a meal. It was just a few pieces of kibble as a treat after testing. So that's super easily fixed with all the other safer treat recommendations.

Can you please explain how a feeder is super important for TR? I have other cats too. I give her canned food in the morning and she usually eats all of that by lunch. Then grazes every hour or so on a new can. I put an ice pack under the plates if im not home to feed smaller amounts often. The other guys all eat the same food as her. Then new food again in the PM. Sometimes the plates end up empty a few hours after I go to bed and someone will alert me to that problem I get up and feed them again. There's always food available.
 
If you test at +2 which is typically onset and she’s low you would want her possibly to eat a little higher carbs so she doesn’t get too low while you are gone. As long as she has food out all day you wouldn’t need an auto feeder though.

With multiple cats how do you know who is eating? I only have two and both eat fast. They on are raw food. They consume all I put out in about a minute or two and one eats even faster than the other. I actually fed them in separate rooms because one has food allergies.
 
Emily Alsip said:
Hi Elise and Diane! Thank you thank you collecting info for us on safer treat options! She's liked freeze dried Stella & Chewy's chicken before. Maybe I'll see if that's ok too.
Click to expand...
I have never fed freeze dried treats but I did a search on our site and copied what other members said about Stella and Chewy

Here it is
What have you tried for treats? Oliver loved Bonito flakes; Niko likes freeze dried chicken (PureBites). Other s like Stella and Chewy's treats. All are a little crumbly/crunchy.


Primal and Stella & Chewy are all low carb because they are freeze-dried raw foods.
I give both of my cats, even the diabetic one,

Are you talking about these



So I assume they are ok.
 
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tiffmaxee said:
If you test at +2 which is typically onset and she’s low you would want her possibly to eat a little higher carbs so she doesn’t get too low while you are gone. As long as she has food out all day you wouldn’t need an auto feeder though.

With multiple cats how do you know who is eating? I only have two and both eat fast. They on are raw food. They consume all I put out in about a minute or two and one eats even faster than the other. I actually fed them in separate rooms because one has food allergies.
Click to expand...

Prior to diabetes diagnosis, Holland was one of two who ate almost exclusively wet food. And she's super into food so I always saw her eat plenty. The other wet food eater kinda hangs out in a different area, so it was easy for me to tell with her too. The others were dry food lovers! I guess I didn't know exactly how much each ate, but as long as I could watch everyone eat a few times a day and knew they had an appetite, I felt ok.

Now everyone eats LC wet food! I give everyone a plate and make sure they're interested. If I'm worried about anyone I'll separate them for the day to be sure they're eating.
 
It's not letting me attach a file. But I found an email from the company when I was looking at phosphorus for a CKD kitty.

The Stella & Chewy chicken is a little high... 10.10 carbs (per 1000 kcal) but the duck is much lower at 3.3.
 
Emily Alsip said:
It's not letting me attach a file. But I found an email from the company when I was looking at phosphorus for a CKD kitty.

The Stella & Chewy chicken is a little high... 10.10 carbs (per 1000 kcal) but the duck is much lower at 3.3.
Click to expand...
Just pick a different one :p I'm glad Tyler never wanted treats :p
He's been in remission since 1-24-21
It took me 2 years and 4 months to get him in to remission knock on wood
 
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