Sybil thread - when is a reduction warranted?

Sybil’s mom

Sybil’s mom

Member
Hello again. I feel like we have made great strides in just over a month with Sybil (thanks to the expertise and advice here). She went green last night and this morning.

The last thread was getting long so I started a new one. When/how do I know to reduce her insulin and how much? Tomorrow I won’t be able to monitor during the day.

Thank you so much!

https://www.felinediabetes.com/FDMB/threads/sybils-first-blue-pmps.294376/
 
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Hi Ami, I'm at work at the moment, but thought I'd pop in quick, I know you shoot a little earlier..

Following SLGS - Sybil earned a reduction with that 72 today, so new dose 1.75 units. HOWEVER, I'm a little concerned about you stopping the HC dry RX food because Sybil has seemed to respond really well. When exactly did you stop mixing it in? I can't stay around right now, so, without being able to discuss further at the moment and figue out the timeline, I might err on the side of caution if you can't monitor and drop down to 1.5 units to be safe.
 
Shelley & Jess said:
Hi Ami, I'm at work at the moment, but thought I'd pop in quick, I know you shoot a little earlier..

Following SLGS - Sybil earned a reduction with that 72 today, so new dose 1.75 units. HOWEVER, I'm a little concerned about you stopping the HC dry RX food because Sybil has seemed to respond really well. When exactly did you stop mixing it in? I can't stay around right now, so, without being able to discuss further at the moment and figue out the timeline, I might err on the side of caution if you can't monitor and drop down to 1.5 units to be safe.
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Shelley & Jess said:
Hi Ami, I'm at work at the moment, but thought I'd pop in quick, I know you shoot a little earlier..

Following SLGS - Sybil earned a reduction with that 72 today, so new dose 1.75 units. HOWEVER, I'm a little concerned about you stopping the HC dry RX food because Sybil has seemed to respond really well. When exactly did you stop mixing it in? I can't stay around right now, so, without being able to discuss further at the moment and figue out the timeline, I might err on the side of caution if you can't monitor and drop down to 1.5 units to be safe.
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Hi. I have been slowing the mix from the first day on this board when I was told it was no good. Every day I did slowly less and less until finally it was all Dr. Elsy’s. It wasn’t all at once. It was actually very little mix. The excess I ended up donating to a rescue along with a full bag. For the last several days there has been no mix at all.

Thank you for popping in. I appreciate the feedback.

Sybil thanks you too :)
 
Hi Ami. I'm really excited to see all that GREEN!!! Hooray. I would just reduce her dose down to 1.75. Your switch to all Dr. Elsey's kibble has been very gradual and it is not a new thing at all (as you said).
 
She was not in any danger at all today and has had a fantastic curve so far. Absolutely no danger even with the Alpha Trak meter. So, she did earn a .25 unit reduction by dropping below 90 (per the SLGS protocol). Congratulations! That is really wonderful! Having said all this, depending upon her PMPS number, we may want to do a small temporary reduction just for tonight and see how it goes. I would say if it's a number that we have no data to support yet, then we may do shoot a lower dose. Also, a lot depends upon you and how you are feeling/doing, etc. and what's going on with you. But I am really excited that she's getting in to such great numbers for more of the time.
 
Suzanne & Darcy said:
She was not in any danger at all today and has had a fantastic curve so far. Absolutely no danger even with the Alpha Trak meter. So, she did earn a .25 unit reduction by dropping below 90 (per the SLGS protocol). Congratulations! That is really wonderful! Having said all this, depending upon her PMPS number, we may want to do a small temporary reduction just for tonight and see how it goes. I would say if it's a number that we have no data to support yet, then we may do shoot a lower dose. Also, a lot depends upon you and how you are feeling/doing, etc. and what's going on with you. But I am really excited that she's getting in to such great numbers for more of the time.
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Ok I think that’s what I needed to hear that she wasn’t in any danger with these numbers. It’s very scary for me. I’m ok today. I still have some DM rx cans. I had taken the DM Rx dry out of the signature earlier.

Tonight I will likely only be able to test post pm shot +2 as I hardly slept last night and tomorrow is a very long day without monitoring.

You’re the expert. If 1.75 unit is safe tonight I am ok with that. I’m very excited to finally have some positivity and hope in all of this. Sybil understood the assignment.
 
So there are a lot of factors at play here such as her PMPS, which I do have a feeling is going to be lower than we are accustomed to seeing unless she really pops up due to the greens. And if you can monitor at all like you did last night. And then tomorrow? If you are working all day then we may just want to do a 1.5 units. You can always go back up in dose if it's not working for Sybil. She is doing great and you are doing great! If you're feeling really nervous, we will also take that into consideration because I want you to take care of yourself, too! I don't know how you do it all, Ami. You're amazing!
 
What time is her shot? You are in FL and I am in GA, so maybe I can pop by around shot time. She may make it easy on you because of being in a higher yellow or a pink. If she does not, just reduce to 1.5 (or less - as a one-time reduction) and get some rest! No she wasn't in danger today, but I remember how scary it was too see greens at first. Then maybe, just to keep your stress low and since she's so new to seeing the greens go ahead and do the 1.5 units and we should soon know if that is too little insulin for her. Who knows, maybe she will surprise us! :-)
 
Understood about the DM wet... I'm pretty sure it's much lower in carbs than the dry, but I don't recall off the top of my head what the carb percentage is.
 
I had looked up the DM wet and it was low so I kept it in the cupboard, but I am not making any other food changes now. They always ate FF Naturals and it was like a treat which is how I entice the shot time and it’s working. I won’t change too many things at once.

I can do +2 tonight after pm shot but no monitoring tomorrow.

So what I’m understanding what you said is aim for 1.5 units tonight unless if her PMPS is higher yellow or above do 1.75 units. I feel ok with that.

Shot time is 5:00. It’s 5:00 somewhere (haha here).

Thank you for helping me to give my baby the best life I can while she is here.
 
Sybil’s mom said:
It’s 5:00 somewhere (haha here)
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;)
Sybil’s mom said:
So what I’m understanding what you said is aim for 1.5 units tonight unless if her PMPS is higher yellow or above do 1.75 units
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Well, I am also saying that if her PMPS is really a lot lower than what we are used to seeing then we may need to do a half dose or even less ... something like that. Also, you told me that you didn't get much sleep last night and need rest, so we may just go ahead with the 1.5 as the new dose going forward (because we can always go back up if it's not working.) This will keep your stress level lower as well for now as you gradually gain more confidence and also as we see what Sybil is up to right now. I will definitely check in with you at about 4:45 or so and then whenever you get the PMPS you can let me know what it is and we can confirm everything. Okay?
 
I don't know if you can, but if you can get a test in 8 minutes at 3 o'clock we may have a better idea of what her PMPS will be. If she's still eating, she better stop now since the food is supposed to be taken away two hours prior to her shot so we can trust that number is not inflated by food.
 
Suzanne & Darcy said:
;)
Well, I am also saying that if her PMPS is really a lot lower than what we are used to seeing then we may need to do a half dose or even less ... something like that. Also, you told me that you didn't get much sleep last night and need rest, so we may just go ahead with the 1.5 as the new dose going forward (because we can always go back up if it's not working.) This will keep your stress level lower as well for now as you gradually gain more confidence and also as we see what Sybil is up to right now. I will definitely check in with you at about 4:45 or so and then whenever you get the PMPS you can let me know what it is and we can confirm everything. Okay?
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Sounds like a good plan. Thanks for all of your efforts.
 
Suzanne & Darcy said:
I don't know if you can, but if you can get a test in 8 minutes at 3 o'clock we may have a better idea of what her PMPS will be. If she's still eating, she better stop now since the food is supposed to be taken away two hours prior to her shot so we can trust that number is not inflated by food.
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201
 
Yep, she's on her way up. So her PMPS shouldn't be too low. I like not having surprises. If you want to try the 1.5 we can just go with that for now (at least tonight and tomorrow.) She's doing much better and you can always increase if it's clear that it's not enough insulin. What do you think?

I feel like it was really perfect timing that you were home today to get these tests. Don't be afraid of greens though. 50-120 are normal BG numbers for a healthy cat (human meter). With your schedule, we are aiming for more like 90-150 tops. It takes time. Seeing this happening with her today is making me feel really happy.
 
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Thank you! It’s 213 but we have a bad storm loud cracking lightning right outside the window and thunder. She was scared but I brushed her and tried to calm her down. I feel good with either lowered dose.
 
Keep in mind that take action doesn’t always mean the same thing. It can mean feed a little of the regular LC and test in 15 minutes to make sure numbers are stable or rising. It can mean to give a very small amount of MC food and test in 15-20 minutes. If numbers aren’t stable or rising then move to HC food (wet food is best) a small amount- and test again in 15-20 minutes. Factors to consider in deciding how to handle low numbers are things like: is it early in the cycle? How far from nadir am I? If it’s two hours before nadir you can decide to be a little more aggressive with the carbs. It’s helpful if you can get someone experienced in handling low numbers to assist you in these situations so a good idea to post for help here and possibly also on the health forum (you can always PM me too to let me know you need help.)

A 68 on your AT meter doesn’t mean it’s time to panic and that number doesn’t mean your cat has hypoed. It does mean to take some steps to make sure kitty doesn’t drop below 68 and if so to bring the numbers up with food/karo syrup, as needed and in small amounts of a teaspoon of food at a time and a drop or two of karo. Have you read through and printed out the how to handle hypo instructions?
 
Suzanne & Darcy said:
Keep in mind that take action doesn’t always mean the same thing. It can mean feed a little of the regular LC and test in 15 minutes to make sure numbers are stable or rising. It can mean to give a very small amount of MC food and test in 15-20 minutes. If numbers aren’t stable or rising then move to HC food (wet food is best) a small amount- and test again in 15-20 minutes. Factors to consider in deciding how to handle low numbers are things like: is it early in the cycle? How far from nadir am I? If it’s two hours before nadir you can decide to be a little more aggressive with the carbs. It’s helpful if you can get someone experienced in handling low numbers to assist you in these situations so a good idea to post for help here and possibly also on the health forum (you can always PM me too to let me know you need help.)

A 68 on your AT meter doesn’t mean it’s time to panic and that number doesn’t mean your cat has hypoed. It does mean to take some steps to make sure kitty doesn’t drop below 68 and if so to bring the numbers up with food/karo syrup, as needed and in small amounts of a teaspoon of food at a time and a drop or two of karo. Have you read through and printed out the how to handle hypo instructions?
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Thank you and yes I have read all of that and printed a bunch of reference pages. You’re amazing. I will always reach out for help when I have questions and you are always there for me which I greatly appreciate. I’ve learned so much already and I’m only about a month into this journey. I appreciate you all so much.
 
A great start to the day and I like the numbers you recorded last night. It looks like yesterday’s a.m. cycle was good as well (just based on her PMPS). I look forward to seeing how she does today.
 
Suzanne & Darcy said:
145. Snack time for Sybil
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I don’t know what that means and just saw this but thanks for checking in.

We had another green this morning and she was playing so much last night and went down and back up a flight of stairs!!! She’s definitely feeling better.

I have to get back to work but thank you!!
 
It was just a reminder that +2 (145) would be a very good time to give Sybil a little LC food (well +2 is a good time every single day to give her a snack actually).
 
Suzanne & Darcy said:
It was just a reminder that +2 (145) would be a very good time to give Sybil a little LC food (well +2 is a good time every single day to give her a snack actually).
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I see, thanks for the explanation . My schedule isn’t so open but I feel like everything is going great the way we have it right now and with both furbabies happy. Sybil is so much happier and energetic too and it’s great to see greens that don’t scare me :)

I appreciate the feedback and definitely the dosing advice.

I hope you’re having a wonderful day and I hope the members you were trying to reach after the hurricane are ok. I’ve been keeping everyone in my thoughts.
 
Technically, you have earned another reduction with that 88 today, which you can take if you want to. It’s very borderline, and she did just get a double reduction. However, there’s your schedule. Sybil is doing really well and I think we are seeing the benefits of ditching the high carb kibble. I love hearing about how great she feels :)
 
Suzanne & Darcy said:
Technically, you have earned another reduction with that 88 today, which you can take if you want to. It’s very borderline, and she did just get a double reduction. However, there’s your schedule. Sybil is doing really well and I think we are seeing the benefits of ditching the high carb kibble. I love hearing about how great she feels :)
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Thank you! I think I will hold it for a couple of days and I’ll be back asking for your amazing advice! Please be sure to take some credit for Sybil’s improvement. She said thanks.
 
Suzanne & Darcy said:
That’s what we are here for!
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Ok maybe I should reduce tomorrow. She just tested 78 (at the +2) and I’ll check again at the +3 tonight and see if it goes up a little it if it goes down. But I may feel better now reducing her dose. Would it be to 1 unit? What are you thinking? Does this change your opinion at all? (I told you I’d bug you again - I just didn’t think it would be so soon). Thank you! O don’t know how you keep up with everyone. You’re amazing.
 
Yes. I would go ahead and reduce by .25 tomorrow morning based on that 78 and you are working tomorrow. Congratulations! Sybil is working hard to get those reductions!
 
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