05/13 Teja +400 AMPS

[Malia]

Hello everyone, so glad to be here. I've been reading the basics and wow! I've learned so much that I didn't know.

My Teja is newish diagnosed. We are still working out many things. She is on prednisolone, which we are in the process of weaning her off of in the next two weeks. The steroid made her crazy high and crazy low when it wore off. It looks like she has been "bouncing" from this and just trying to get her regulated. It doesn't help that I am terrified of low numbers. When I see her numbers trend downward, I have been trying to manage that with food, so she can learn to surf. I believe she has gotten used to being in the 300s and 200s, so when she gets to the 100s and lower, she bounces.

We are doing the low and slow way. Teja's internal medicine vet has been helping and guiding with dosing suggestions. But with all of Teja's circumstances (CKD, food allergies, suspected IBD) there are so many unknowns she can only know so much. Because of her food allergies, it's hard for me to find the hc, mid carb diets. We toggle between wet food Hill's d/d and RC PR. We do have a homemade recipe waiting to be used until after the steroid taper.

I just don't know enough. I've read through the basics and thank you for that info. My tired brain will have to reread it many times. With the tapering of the steroid (started on 05/10) we've seen her glucose number do some odd things. Hopefully this will help us in the long run.

I'm scared guys. I just want to do the best.for my Teja and I feel like I'm failing her. It's just myself and her here (with other kitties in the house). I'm a cat lady and live alone. I work from home so I can obsess on numbers all day, which isn't healthy. And I just don't know what to do. I have a better understanding now thanks to the basics and understanding bouncing. But I just need some guidance as to how to best help my baby. I don't know what I'm doing. Please help me.

 

[Bandit's Mom]

Hi @Malia, welcome to the LBL forum. I'm going to link your previous post in the Main/Health forum for continuity:
https://www.felinediabetes.com/FDMB...7y-female-newly-diagnosed-as-of-today.289153/

Yes, I only did 2 units last night because I was terrified of giving her too much with 3 units. I will work to update her spreadsheet for last night's numbers.

If you are following the SLGS dosing method, you want to hold a dose for a week unless she drops below 90 and earns a reduction. Lantus dosing is based on nadirs and not preshots. It's a depot insulin that works well with consistency. By dropping below 90 yesterday, she earned a reduction to 2.75U and that's what you want to give. If she drops below 90 again, you would go down to 2.5U and so on.

So please go back up to 2.75U tonight.

Like the bouncing effect. I think this is what my Teja has been going through with her ups and downs. Because it always seems that when she comes rocketing down, that she goes right back up for a day. I had no idea.

Yes, the higher numbers you saw last night and this morning are her bouncing from the lower numbers you saw yesterday morning. Bouncing reduces as cats get used to lower numbers. We do not give a higher dose based on bounce highs. Just stay with a dose and let her earn a reduction.

We are here to help so don't be scared. You are dealing with a lot of conditions and you are a great mom for taking such good care of her. But you need to take care of yourself to be able to take care of her. Like we keep saying here, FD is a marathon and not a sprint, so you need to pace yourself.

 

[Malia]

Hi @Malia, welcome to the LBL forum. I'm going to link your previous post in the Main/Health forum for continuity:
https://www.felinediabetes.com/FDMB...7y-female-newly-diagnosed-as-of-today.289153/


If you are following the SLGS dosing method, you want to hold a dose for a week unless she drops below 90 and earns a reduction. Lantus dosing is based on nadirs and not preshots. It's a depot insulin that works well with consistency. By dropping below 90 yesterday, she earned a reduction to 2.75U and that's what you want to give. If she drops below 90 again, you would go down to 2.5U and so on.

So please go back up to 2.75U tonight.


Yes, the higher numbers you saw last night and this morning are her bouncing from the lower numbers you saw yesterday morning. Bouncing reduces as cats get used to lower numbers. We do not give a higher dose based on bounce highs. Just stay with a dose and let her earn a reduction.

We are here to help so don't be scared. You are dealing with a lot of conditions and you are a great mom for taking such good care of her. But you need to take care of yourself to be able to take care of her. Like we keep saying here, FD is a marathon and not a sprint, so you need to pace yourself.

Oh Boomha, thank you! Thank you! Thank you! You made made me cry and made me feel better. My friend across the street who is a retired nurse said the same thing to me about taking care of myself.

There was so much information to read on this forum and I am so grateful. I had no idea about "bouncing" and I thought I was failing her. I spent today reading through stickies (when I should have been working lol).

So my big question is, do you let the bounces happen?

Or can you manipulate the drop in the bounce with food? I did read where that was a suggestion. Maybe trying to lessen the drop with some meals so you ease into the lower BC.

Has everyone dealt with bounces?

And if there is a drop in a bounce that got low, and it's getting time for the next shot of insulin, would you just give the same amount of insulin at the usual time? Or would you wait to give the next dose? I imagine that would be the time to come here and ask for help.

I have so many questions. Thank you for reaching out. I don't know anyone else who has gone through this. I've never done anything with this complexity and severity before. I'm not about to give up. I just don't know what I'm doing.

Thank you so much!

 

[Bandit's Mom]

So my big question is, do you let the bounces happen?

Or can you manipulate the drop in the bounce with food? I did read where that was a suggestion. Maybe trying to lessen the drop with some meals so you ease into the lower BC.

Yes, you can reduce bounces (to an extent) by "feeding the curve". Bouncing is caused by lower numbers that a cat is not used to as well as by sharp drops in the BG. You can prevent/reduce the latter by feeding snacks in the part of the cycle where she drops hard. In active cycles, like the one you saw yesterday morning, we suggest feeding a small snack (even a tsp of food is enough) every hour - in the first part of the cycle - or as long as she is dropping. Once numbers start heading up, you don't want to/need to feed. In fact, feeding after the nadir can reduce the duration of insulin and cause numbers to go up sooner. Some cats are okay without food after +4 or +5 (which is where Lantus typically nadirs), but others need another small snack later in the cycle (otherwise they get acidity or just plain cranky). In such cases, we recommend feeding the lowest carb snack possible after the nadir.

Has everyone dealt with bounces?

Yes. Bouncing is very normal in newly-diagnosed, unregulated cats. As their bodies get used to lower numbers the bouncing reduces and even stops.

And if there is a drop in a bounce that got low, and it's getting time for the next shot of insulin, would you just give the same amount of insulin at the usual time? Or would you wait to give the next dose? I imagine that would be the time to come here and ask for help.

I'm not sure I understood your question. With SLGS you can shoot any number over 90 - especially if you can monitor. Lantus is very good at giving flat cycles when you shoot low and with newly DX cats, you can always count on a bounce coming sooner or later. And yes, you would give the same dose (unless a reduction is earned). Shooting lower numbers is scary at first - and we have all been there - but with time and experience, you will see that you get lovely cycles when you shoot consistently.

In cycles where the bounce clears, there is extra downward momentum and you can see later nadirs. Numbers might keep dropping till the end of the cycle - like you saw on 4/30. Some cats nadir at the end of the cycle when clearing bounces. Such caregivers get used to shooting low because they know that numbers are more likely to head up from that end-of-cycle nadir.

Whenever you encounter a lower preshot that you aren't comfortable shooting, just post here for help. Use the "?" prefix in your thread title and say something like "NEED HELP WITH LOW PRESHOT" so that you get the attention of people scanning the Board.

 

[Malia]

Yes, you can reduce bounces (to an extent) by "feeding the curve". Bouncing is caused by lower numbers that a cat is not used to as well as by sharp drops in the BG. You can prevent/reduce the latter by feeding snacks in the part of the cycle where she drops hard. In active cycles, like the one you saw yesterday morning, we suggest feeding a small snack (even a tsp of food is enough) every hour - in the first part of the cycle - or as long as she is dropping. Once numbers start heading up, you don't want to/need to feed. In fact, feeding after the nadir can reduce the duration of insulin and cause numbers to go up sooner. Some cats are okay without food after +4 or +5 (which is where Lantus typically nadirs), but others need another small snack later in the cycle (otherwise they get acidity or just plain cranky). In such cases, we recommend feeding the lowest carb snack possible after the nadir.



Yes. Bouncing is very normal in newly-diagnosed, unregulated cats. As their bodies get used to lower numbers the bouncing reduces and even stops.


I'm not sure I understood your question. With SLGS you can shoot any number over 90 - especially if you can monitor. Lantus is very good at giving flat cycles when you shoot low and with newly DX cats, you can always count on a bounce coming sooner or later. And yes, you would give the same dose (unless a reduction is earned). Shooting lower numbers is scary at first - and we have all been there - but with time and experience, you will see that you get lovely cycles when you shoot consistently.

In cycles where the bounce clears, there is extra downward momentum and you can see later nadirs. Numbers might keep dropping till the end of the cycle - like you saw on 4/30. Some cats nadir at the end of the cycle when clearing bounces. Such caregivers get used to shooting low because they know that numbers are more likely to head up from that end-of-cycle nadir.

Whenever you encounter a lower preshot that you aren't comfortable shooting, just post here for help. Use the "?" prefix in your thread title and say something like "NEED HELP WITH LOW PRESHOT" so that you get the attention of people scanning the Board.

There is so much to learn. Thank you for clarifying for me. And thank you for answering my post. I really appreciate your help with getting me this far, especially with the spreadsheet.

This is so scary. Teja and I have tackled so much together. She is my little partner in this journey of life. Okay, a marathon. I will do it.

Thank you Bhooma

 

[Bandit's Mom]

This is so scary. Teja and I have tackled so much together. She is my little partner in this journey of life. Okay, a marathon. I will do it.

It is indeed overwhelming and a steep learning curve. You can do it. We are here to help and provide support!

 

[Diane Tyler's Mom GA]

We are doing the low and slow way.

Welcome Malia and Teja, you couldn't have found a better group to join.
It would be helpful if you can add SLGS (method) to your signature and at the top of your spreadsheet so members know and won't have to ask you what dosing method you are following
@Malia

 

[tiffmaxee]

Welcome to LLB. I was a basket case when I first joined as well. The stickies can be overwhelming for sure so read a little at a time as things come up and as fd starts to make more sense. Keep asking questions, over and over again if you need help understanding. I think FD makes CKD. look easy at first but soon you get into a routine and then it’s quite the opposite. What are the suspected IBD symptoms? Are you giving a good probiotic such as Visbiome? It’s helped with at with suspected IBD.