09/24 Fistuk AMPM 65, +1 79, +2 59, +3 40... +4 59, +5 88, +9 70, +11 95

Mikanmama said:
Shelly
Well done managing the difficult and scary situation.
Hope Fistuk steadies himself soon.
Congrats on the reduction! Sending you :bighug::bighug::bighug:
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Thanks Kit. These reductions are hard earned o_O
I hope Mikan is doing well ? I haven't had a chance to catch up. sending our love :bighug:
 
@Bron and Sheba (GA) what do you say about SQ this afternoon? shall I?
And what do you think about tonight's dose?
I imagine we'll need to see what he's doing in the rest of the cycle but I'm already wondering what he will do with more than 2U if that's what he did with it this morning....
 
Hi Shelly, Sending you and Fistuk big big hugs today. You’ve had a rough ride but are handling it beautifully. Prayers for safer, smoother cycles ahead! :bighug::bighug:
 
tiffmaxee said:
Just read through this post and what happened while I was asleep. He’s making it clear he needs less insulin no question about it!
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Hi Elsie. Thanks for catching up :bighug:
Just to say that since I gave the morning's host 30 mins after the hour the +X time is 30 minutes after the hour. but I will take PMPS at the usual time because I don't want to push everything in half an hour. it'll be unsustainable for me.
I'll take a +11 at the usual time as well which means in an hour and half from now
 
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Good to see that Fistuk is heading up and eating well and that there were no ketones! Like Bron and Elise and I said before, it is pretty obvious that Fistuk has flipped a switch after breaking through glucose toxicity and is determined to go down the dosing ladder. Sometimes cats do not follow protocols on the way down and we use skips, token shots and larger reductions (even unearned ones) to take the cat to a dose it is heading towards. In such cases, our primary concern is safety - we do not want an exhausted, sleep-deprived caregiver struggling to bring the cat up from low numbers.

Fistuk has had no ketones since he was discharged from the hospital 3 weeks ago and I suggest you keep monitoring for them every day. Despite a skip, multiple token doses (even as low as 25% of his usual dose) and 0.5U reductions he hasn't bounced over 200 from limes (even the 30s!). He is in greens and limes within 2-3 cycles after a skip/token dose. We want to find a dose that you can shoot safely and consistently without needing a token dose every 2-3 cycles. I was thinking that you could stay with 2U for now and see how he does on it. I won't be surprised if he needs even less but we have no idea where he is going to stop. If we find that it is too low a dose, we could go back up quickly.

How does that sound to you?

@tiffmaxee what do you think?

(Note to lurkers: this advice is specific to Fistuk's current situation. Please do not copy dosing.)
 
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I agree with Bhooma. If things change and he shows us he needs more or less insulin you test enough we can adjust immediately. I’m also concerned about his tummy being upset and the need for so much hc and or honey. At some point he might not have that appetite if it continues. Once in awhile tummy upset is not so bad but every day is another matter. I
As mentioned continue to test for ketones.
ANY LURKERS D NOT FOLLOW THIS ADVICE. Every cat is different and this advice is for Fistuk only.
 
Bandit's Mom said:
Good to see that Fistuk is heading up and eating well and that there were no ketones! Like Bron and Elise and I said before, it is pretty obvious that Fistuk has flipped a switch after breaking through glucose toxicity and is determined to go down the dosing ladder. Sometimes cats do not follow protocols on the way down and we use skips, token shots and larger reductions (even unearned ones) to take the cat to a dose it is heading towards. In such cases, our primary concern is safety - we do not want an exhausted, sleep-deprived caregiver struggling to bring the cat up from low numbers.

Fistuk has had no ketones since he was discharged from the hospital 3 weeks ago and I suggest you keep monitoring for them every day. Despite a skip, multiple token doses (even as low as 25% of his usual dose) and 0.5U reductions he hasn't bounced over 200 from limes (even the 30s!). He is in greens and limes within 2-3 cycles after a skip/token dose. We want to find a dose that you can shoot safely and consistently without needing a token dose every 2-3 cycles. I was thinking that you could stay with 2U for now and see how he does on it. I won't be surprised if he needs even less but we have no idea where he is going to stop. If we find that it is too low a dose, we could go back up quickly.

How does that sound to you?

@tiffmaxee what do you think?

(Note to lurkers: this advice is specific to Fistuk's current situation. Please do not copy dosing.)
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Thank you for the full explanation, Bhooma.

What I see is that Fistuk had had 3 cycles of 4.5 and then run into HG.It was quite difficult o bring him up from that.
Then he had a token dose and 2 cycles of 4 unite, reduction of 0.5 even though protocol would have said 0.25 reduction and he run into HG again.

I don't have much experience with insulin so it's hard for me to feel confident about making a decision. What I had in mind is either following a reduction protocol from this point which means giving 1.75 or giving another token dose of 1unit.

I can give 2u. But I just wonder if it's for the sake of following protocol or because it's the right thing for Fistuk. The protocol supposed to serve him and not the other way around.

I'm feeling quite uncertain at the moment.
 
tiffmaxee said:
I’m also concerned about his tummy being upset and the need for so much hc and or honey.
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it is indeed another concern for me. Honey is no food for cats and he's had quite a lot of it. HC doesn't seem to pull him up and I don't have a chice about giving honey.

He hasn't yet been to the toilet since last night so I'm wondering if the psyllium husk begins to work.

Well. I don't know. as I wrote earlier I feel quite unsettled.
 
If you choose to follow TR as written you would reduce to 3.75. You can try that if it makes you feel more comfortable. The depot from 4 is influencing his bg but in between his been given 2.0 so that should have helped . I’m amazed he hasn’t jumped up with the lows and all the hc/honey.
 
Shelley a question.

You mention HG events...
Other than low BG any symptoms?

Looks like he nadired very late again. At amps,

Along with a late nadir, looks like you are getting a longer duration than we expect with lantus, and some significant overlap (his next dose is onseting, before the previous dose has fizzled out. This is probably contributing to the lows you are facing at the start of the cycle.

Hope you have a decent cycle tonight.

On the plus side all that green is lovely and healing.

:bighug:
 
Gill & George said:
Shelley a question.

You mention HG events...
Other than low BG any symptoms?

Looks like he nadired very late again. At amps,

Along with a late nadir, looks like you are getting a longer duration than we expect with lantus, and some significant overlap (his next dose is onseting, before the previous dose has fizzled out. This is probably contributing to the lows you are facing at the start of the cycle.

Hope you have a decent cycle tonight.

On the plus side all that green is lovely and healing.

:bighug:
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Hi Gill

He's rather asymptomatic. I can see he's going towards the low by the way he eats and there's a sound that he makes that's like he's being under water. But he's not shacking or lethargic or other symptoms I read in the list.

yes it does look he nadirs late at pm cycles. I took +1 bc I was concerned he'll go down quite soon after the morning's performance.

It certainly looks like his body is doing something unusual with the insulin. But I'm too happy to see that his body is responding well to the healing process. I feel that now the we've lowered the dose we might begin to see more stability.

Have a good night and than k you for all your support :bighug:
 
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