Introduction, Bounce? Dosing query.

Status
Not open for further replies.
Deb and Sylvester

Deb and Sylvester

Member Since 2023
Hi All!

This is officially my first post here, even though I was a 4 year lurker when I had another sugar baby ( passed in August 2022 from unrelated/non diabetes circumstance).

In early January, my Sylvester was was diagnosed, he is 10, a dry food cat ( I am trying everything to convert him and his roommates, believe me I KNOW the importance of a low carb wet diet).
Sly will eat only about 1/3 of a can of wet twice daily and a fish broth twice daily. He is pretty good about drinking water after a nibble at the food bowl, and after snacks.
He hasn't had any dry snacks since DX, no known DKA or ketones (which is another struggle, because he won't let me near the litter box when he's in there, and my Vet is hesitant to do a cyto for a sample because he's a BIG boy). We are on generic Lantus (Winthrop glargine).

I finally got him onto a combo of Young Again Mature, and Purina DM (dry) He gets 3/8 YA and 1/8 of the DM. Fancy Feast pate, 1/3 can BID, fish or chicken broth 1/8 cup BID and freeze dried snacks only in between, 2 or 3x a day.

DX came when I brought him in for constipation and a diminished appetite.

Sly lived outside up until this past September. I have had him since he was a wee kitten. When my last sugar baby passed, we decided instead of adopting another cat for my resident gal, we would bring him and his half brother indoors. I have 3 indoor cats, and I also have 5 rescues that live in a shelter we built in my yard (they have a large catio, and indoor heated 7x7 house).

My Vet thinks it's possible the move indoors could have pushed Sly into overeating, and that just alone could have exacerbated a pre-diabetic condition. So she is hopeful that we may be able to get to remission.

Our Vet is awesome, knows I have the experience because my other cat was very well regulated on TR (despite 2 comorbidities), and lets me run the gamut and make ultimate decisions with all my cats.

I added that info, so I can explain why our SS says SLGS/ custom dosing to breakthrough dose.

Sly is an 18 lb cat, so both my Vet and I knew that his starting dose should have been in the 3 unit range, but ECID, and wanted to make sure we were being safe. Started with 1 and increased pretty rapidly every 3 days based on nadir.

As presumed, at 4 units, we started getting results. Also to add, I switched to the Relion meter exclusively a few weeks ago, due to cost, and just ensuring that I am getting a more accurate curve/ cycle reading instead of guessing conversions. He has become very good at allowing me to test, and injection time is a breeze. (Thank goodness!)

So now here is where I am banging my head, because "bouncing" is absolutely driving me nuts, and I am trying to find the pattern.

If you take a peek at his SS, you can see that his current dose of 5 units has succeeded in getting him down to nice numbers over the last week, and I am just trying to determine if I should continue to hold this dose, because he may just be taking his time clearing those blues from a few days ago. We have been at 5 units for about a week, and have hit that 100 mark, so I don't want to go up and risk passing this dose as the "magic" number.

I know he is newly diagnosed, and overall, I am happy with where we are in the game, but I just wanted some outside input. My Vet kind of leaves it up to me, but she also thinks it's ok to wait another day or 2, as he may just be clearing those lower numbers.

Thank you in advance, and thanks especially for such a wonderful site, it has been a bright light in some dark days,

Regards,
Deb
 
How much should Sly weight?
Is he losing weight?I have had two cats get DX'd when they were obese. One, Nala was 18 lbs via vet records and was untreated when I adopted her but only weighed 14 lbs. She went i to remission after treatment with Lantus for about 5 months now she weighs about 9 ½ lbs. The other, DeeDee weight 17 lbs when I adopted her and was on I think 3 units of Vetsulin. She went into remission after about 6 months on SemGlee glargine insulin and when her weight went down to about 9 ½ lbs.

Will Sly eat only low-carb canned the FF you are only feeding a little of? If not can you drop the dry DM? That would be better.

When you dropped the dry Purina One and substituted the dry D that was good and should have resulted in decreased BG/decreased insulin needs. It may be that 5 units is too much. with a depot insulin like Lantus I think one dose should be held at least 5 days before increasing, not the 3 days you used. Not holding long enough and changing from Purina One could have resulted in missing the best dose. On 2/3 and 2/10 you got good BG drops, really too good based on the hight PS when using Lantus. Typically with Lantud you can get a shallow cureve with lowest iabout 100 or even lower with a PS of below 200. I muyself would drop the dose but that is me.
 
Deb and Sylvester said:
Hi All!

This is officially my first post here, even though I was a 4 year lurker when I had another sugar baby ( passed in August 2022 from unrelated/non diabetes circumstance).

In early January, my Sylvester was was diagnosed, he is 10, a dry food cat ( I am trying everything to convert him and his roommates, believe me I KNOW the importance of a low carb wet diet).
Sly will eat only about 1/3 of a can of wet twice daily and a fish broth twice daily. He is pretty good about drinking water after a nibble at the food bowl, and after snacks.
He hasn't had any dry snacks since DX, no known DKA or ketones (which is another struggle, because he won't let me near the litter box when he's in there, and my Vet is hesitant to do a cyto for a sample because he's a BIG boy). We are on generic Lantus (Winthrop glargine).

I finally got him onto a combo of Young Again Mature, and Purina DM (dry) He gets 3/8 YA and 1/8 of the DM. Fancy Feast pate, 1/3 can BID, fish or chicken broth 1/8 cup BID and freeze dried snacks only in between, 2 or 3x a day.

DX came when I brought him in for constipation and a diminished appetite.

Sly lived outside up until this past September. I have had him since he was a wee kitten. When my last sugar baby passed, we decided instead of adopting another cat for my resident gal, we would bring him and his half brother indoors. I have 3 indoor cats, and I also have 5 rescues that live in a shelter we built in my yard (they have a large catio, and indoor heated 7x7 house).

My Vet thinks it's possible the move indoors could have pushed Sly into overeating, and that just alone could have exacerbated a pre-diabetic condition. So she is hopeful that we may be able to get to remission.

Our Vet is awesome, knows I have the experience because my other cat was very well regulated on TR (despite 2 comorbidities), and lets me run the gamut and make ultimate decisions with all my cats.

I added that info, so I can explain why our SS says SLGS/ custom dosing to breakthrough dose.

Sly is an 18 lb cat, so both my Vet and I knew that his starting dose should have been in the 3 unit range, but ECID, and wanted to make sure we were being safe. Started with 1 and increased pretty rapidly every 3 days based on nadir.

As presumed, at 4 units, we started getting results. Also to add, I switched to the Relion meter exclusively a few weeks ago, due to cost, and just ensuring that I am getting a more accurate curve/ cycle reading instead of guessing conversions. He has become very good at allowing me to test, and injection time is a breeze. (Thank goodness!)

So now here is where I am banging my head, because "bouncing" is absolutely driving me nuts, and I am trying to find the pattern.

If you take a peek at his SS, you can see that his current dose of 5 units has succeeded in getting him down to nice numbers over the last week, and I am just trying to determine if I should continue to hold this dose, because he may just be taking his time clearing those blues from a few days ago. We have been at 5 units for about a week, and have hit that 100 mark, so I don't want to go up and risk passing this dose as the "magic" number.

I know he is newly diagnosed, and overall, I am happy with where we are in the game, but I just wanted some outside input. My Vet kind of leaves it up to me, but she also thinks it's ok to wait another day or 2, as he may just be clearing those lower numbers.

Thank you in advance, and thanks especially for such a wonderful site, it has been a bright light in some dark days,

Regards,
Deb
Click to expand...
I can tag a few members for you, can you please add the meter you are using to your signature also

@tiffmaxee

@Suzanne & Darcy

@Bron and Sheba (GA)

@Sienne and Gabby (GA)

@Wendy&Neko
 
Larry and Kitties said:
How much should Sly weight?
Is he losing weight?I have had two cats get DX'd when they were obese. One, Nala was 18 lbs via vet records and was untreated when I adopted her but only weighed 14 lbs. She went i to remission after treatment with Lantus for about 5 months now she weighs about 9 ½ lbs. The other, DeeDee weight 17 lbs when I adopted her and was on I think 3 units of Vetsulin. She went into remission after about 6 months on SemGlee glargine insulin and when her weight went down to about 9 ½ lbs.

Will Sly eat only low-carb canned the FF you are only feeding a little of? If not can you drop the dry DM? That would be better.

When you dropped the dry Purina One and substituted the dry D that was good and should have resulted in decreased BG/decreased insulin needs. It may be that 5 units is too much. with a depot insulin like Lantus I think one dose should be held at least 5 days before increasing, not the 3 days you used. Not holding long enough and changing from Purina One could have resulted in missing the best dose. On 2/3 and 2/10 you got good BG drops, really too good based on the hight PS when using Lantus. Typically with Lantud you can get a shallow cureve with lowest iabout 100 or even lower with a PS of below 200. I muyself would drop the dose but that is me.
Click to expand...

Hi Larry,

I was actually wondering the same thing. The increase to 5 and the change from the Purina One to the DM coincided with each other. That's when I saw the 100 and the 120 consecutively.

To answer your question regarding weight, he was about 20 lbs, and went down to 18 at DX. He has not lost any additional weight, and may have gained some back (waiting for scale to arrive) he has a good appetite, but not ravenous like he was at DX.

I really try with the FF, I have even tried in between regular feedings, just to see if there is interest. ( my last sugar boy was so good at only wanting to eat wet, but I'm not letting Sly's choice discourage me).

Do you think it would set us back to drop back to 4.75?

Thank you for the response,
Deb
 
Larry and Kitties said:
How much should Sly weight?
Is he losing weight?I have had two cats get DX'd when they were obese. One, Nala was 18 lbs via vet records and was untreated when I adopted her but only weighed 14 lbs. She went i to remission after treatment with Lantus for about 5 months now she weighs about 9 ½ lbs. The other, DeeDee weight 17 lbs when I adopted her and was on I think 3 units of Vetsulin. She went into remission after about 6 months on SemGlee glargine insulin and when her weight went down to about 9 ½ lbs.

Will Sly eat only low-carb canned the FF you are only feeding a little of? If not can you drop the dry DM? That would be better.

When you dropped the dry Purina One and substituted the dry D that was good and should have resulted in decreased BG/decreased insulin needs. It may be that 5 units is too much. with a depot insulin like Lantus I think one dose should be held at least 5 days before increasing, not the 3 days you used. Not holding long enough and changing from Purina One could have resulted in missing the best dose. On 2/3 and 2/10 you got good BG drops, really too good based on the hight PS when using Lantus. Typically with Lantud you can get a shallow cureve with lowest iabout 100 or even lower with a PS of below 200. I muyself would drop the dose but that is me.
Click to expand...

Larry, I think you're onto something.

Just checked my notes from the a.m. that he had the 278 AMPS, and went to 100. On that day, I decreased the DM and replaced it with YA.

I do now think he needs a lower dose.
I am thinking I will go back to 4.5 units tonight and start from there, because with the carb reduction, I don't want to miss a potential good does between the 4.5 and 4.75U.

Does that sound feasible ?

Thank you again,
Deb
 
@Diane Tyler's Mom

So you think anyone else will chime in? I hate to be a pest, but I'm going to scale back to 4.5U pm shot, unless someone thinks I should go further, to 4 or 4.25U.

I am thinking back to something I read a few years about chronic rebound and the dose being too high. At that time my sugar cat was also seeing an Endocrinologist who thought that was the case with him, and it was.

Thank you for your help.

Deb
 
Awww! Thank you so much, he's an absolute sweetheart. Getting ready to shoot soon, going with a skinny 4, and we'll see where he goes. He's been flat for too many cycles after those blues.

Thank you again, I'll check in shortly!

Deb
 
So we were 377 PMPS and I checked at +1.5 and we have a 337. I'll check him again at +4 (It's time for night time check on my rescue gang! )

My hope is going down to 4U is far enough.
In hindsight, I didn't account for the food change on the 7th, I cut the DM in half.

Thanks again all, have a good night !
I'm so glad that I came in here and asked, I was feeling frustrated!

Deb
 
Hi Deb, Looking at the SS I would encourage you to get more tests in during the PM cycle as that will give you a lot more information.
And when you get a drop at +2 when you do test, I would test again as that cycle is most likely to be an active cycle.

I can't see the reasoning in reducing the dose. A reduction has not been earned.
If it is to stop the bouncing, reducing the dose will only prolong bouncing in the long run.
A cat needs to be exposed to the lower numbers so they can get used to them again.
Even with the food change, the 5 units is OK
The 5 units is finally giving you some better numbers and reducing the dose will only encourage glucose toxicity, in my opinion.
I am going to tag @Wendy&Neko for her input.
 
Bron and Sheba (GA) said:
Hi Deb, Looking at the SS I would encourage you to get more tests in during the PM cycle as that will give you a lot more information.
And when you get a drop at +2 when you do test, I would test again as that cycle is most likely to be an active cycle.

I can't see the reasoning in reducing the dose. A reduction has not been earned.
If it is to stop the bouncing, reducing the dose will only prolong bouncing in the long run.
A cat needs to be exposed to the lower numbers so they can get used to them again.
Even with the food change, the 5 units is OK
The 5 units is finally giving you some better numbers and reducing the dose will only encourage glucose toxicity, in my opinion.
I am going to tag @Wendy&Neko for her input.
Click to expand...

Hi, thank you for your reply!

I had a feeling he was bouncing, because I thought I saw a bit of a pattern, but then I started thinking about the food changeover, and the reduced carb count, so I opted to only shoot 4 tonight.

I just tested him at +4 and he was 267. I'm kicking myself RN, but I know I can do this.

Sly is much more challenging than my last sugar boy, so I keep reminding myself ECID.

Would it be acceptable to go back to the 5 for AM shot?

Thank you so much for your time,
Deb
 
Deb and Sylvester said:
Hi, thank you for your reply!

I had a feeling he was bouncing, because I thought I saw a bit of a pattern, but then I started thinking about the food changeover, and the reduced carb count, so I opted to only shoot 4 tonight.

I just tested him at +4 and he was 267. I'm kicking myself RN, but I know I can do this.

Sly is much more challenging than my last sugar boy, so I keep reminding myself ECID.

Would it be acceptable to go back to the 5 for AM shot?

Thank you so much for your time,
Deb
Click to expand...
Hi Deb
Lantus dosing is based on the nadir not the preshot, so unless he drops under 90, I would go back to 5U.
It's better not to do 2 things at once, so I would not increase the dose while you are doing a swap over to a low carb diet.
And let the BG numbers tell you if you need to reduce the dose instead of guessing.
Bron
 
Hi Bron,
Thank you, I shot 5 this morning, AMPS was 373.

I imagine then, the flat rebound only applies to cats that are well regulated. When my last diabetic cat experienced these flats, his dose was too high, that's why Larry's advice made me think a possible reduction may be required.

Looking back in my files last night though, it was over a year into treatment that my last cat required reduction.

Thanks again, I will try to get more tests in the PM cycles, he seems to hit nadir pretty early.

Take care,
Deb
 
@Bron and Sheba (GA) @tiffmaxee

I have one final question.

Considering I lowered the dose by 1 unit last night, and resumed the 5U this morning, do I treat this as the start of a new dose hold? Meaning should I hold the 5U for another complete 14 cycles before going up on the dose?

Thank you,
Deb
 
Deb and Sylvester said:
@Bron and Sheba (GA) @tiffmaxee

I have one final question.

Considering I lowered the dose by 1 unit last night, and resumed the 5U this morning, do I treat this as the start of a new dose hold? Meaning should I hold the 5U for another complete 14 cycles before going up on the dose?

Thank you,
Deb
Click to expand...
Yes. The count starts over and ask as many questions as you have. Someone will almost always answer.
 
tiffmaxee said:
Yes. The count starts over and ask as many questions as you have. Someone will almost always answer.
Click to expand...

Thank you @tiffmaxee

I wish I hadn't jumped the gun, he may have broke the bounce today. I'm trying to be patient for my boy, he's being so good for me, and I'm just still sort of in shock about the DX, because I never thought I'd have 2 diabetic cats in my lifetime.

That being said, I suppose the universe has it's plan, right?

Thanks again,
Deb
 
Ale & Minnie (GA) said:
Just wanted to add that we adjust the dose here by .25 units so if he does earn a reduction, the dose would go down to 4.75. Do you have 1/2 unit marked sirynges?
Click to expand...

Hi there!

Yes, I use the 1/2 U syringes.

I'm going to wait out the week at 5U, so I just hope he breaks this bounce a bit and shows me some yellows again. I made a mistake dropping down to 4 last night, because I think that's probably too low a dose, even with the change in dry food, it wasn't super drastic. I went into hyper protection mode yesterday.

Today's a new day, and we are making some progress since DX, so I'm feeling more confident, especially since posting here yesterday.

Thank you so much,
Deb
 
@tiffmaxee

If I hold the 5U for the suggested 7 days, but see no improvement during that time, are we running the risk of glucose toxicity?

I'm new to SLGS, my last sugar baby was regulated on TR, so this a learning curve after 4 years of "something else" embedded in my brain! :confused:

Deb
 
Deb and Sylvester said:
@tiffmaxee

If I hold the 5U for the suggested 7 days, but see no improvement during that time, are we running the risk of glucose toxicity?

I'm new to SLGS, my last sugar baby was regulated on TR, so this a learning curve after 4 years of "something else" embedded in my brain! :confused:

Deb
Click to expand...
While you are feeding dry food you can’t do TR which is definitely better at getting a cat regulated. But if you need to be using dry for whatever reason, SLGS is the next best thing.
As long as you follow the SLGS method and increase when the BGs tell you to, you shouldn’t have glucose toxicity.
 
Last edited:
https://felinediabetes.com/FDMB/threads/02-16-sly-amps-401-2-287-3-264.274254/

I actually did this morning, and then his numbers moved down, so I removed verbiage from the header. I thought you both gave me wise advice. There's the link above. I'll definitely use the board for advice.

Seeing his number move down made me realize that I should trust the process, and follow his patterns instead of it just being all numbers.
:)

Deb
 
Status
Not open for further replies.
Back
Top