? 21/03 Maggie AMPS 384/+3 200/+5.10 105/+6.30 72 /+7 68 , DOSE ADVISE

hellen_maggie

Member Since 2025
20/03 Maggie AMPS 380 / +3 257 / 5,30 229 , PMPS 279 / +2 184 / +3 177 /+5 228

Hi everyone,
I’m really unsure what to do with Maggie’s dose and I would truly appreciate your advice. The 0.50f dose we used over the past few days turned out to be too low, as she stayed in high numbers the whole time. Since yesterday morning, when we increased the dose to 0.75U, her numbers have been much better overall. However, today she dropped very fast, from a preshot of 384 down to 68 at +7! I understand that according to SLGS I should reduce the dose back to 0.50U. But I also know that 0.50f was clearly not enough for her and kept her in high ranges. Her diet is still about 80% high carbs 20% low carbs, as I’m still in the process of transitioning her to low carb food, so I’m not able to follow TR at the moment. I feel really stuck and honestly quite desperate at this point.

I would really appreciate your guidance 🙏 🙏 🙏
 
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I understand how you feel, and I would not want to take that reduction either. I don't know whether or not I would in your shoes; this is definitely an area where I would put weight on more experienced advisors. I wish I could be of more help with that.

I do think it's worth trying to catch your breath and remember that while Maggie is having some pretty high numbers at AMPS and PMPS, she's spending most of her cycles in much more moderate BG values. She's mostly in the range recommended by the veterinary establishment, even though at FDMB we push for lower. This is a frustrating situation, but it's not dangerous. While I relate to the feeling of desperation, I don't think it's serving her or you, and I hope you can take some comfort in how hard you're working for her. ❤️ She's lucky to have such a dedicated caretaker.

Setting numbers aside, how is she feeling lately overall, do you think?

Big hugs, and I hope someone with more expertise will have more solid advice to offer.
 
I understand how you feel, and I would not want to take that reduction either. I don't know whether or not I would in your shoes; this is definitely an area where I would put weight on more experienced advisors. I wish I could be of more help with that.

I do think it's worth trying to catch your breath and remember that while Maggie is having some pretty high numbers at AMPS and PMPS, she's spending most of her cycles in much more moderate BG values. She's mostly in the range recommended by the veterinary establishment, even though at FDMB we push for lower. This is a frustrating situation, but it's not dangerous. While I relate to the feeling of desperation, I don't think it's serving her or you, and I hope you can take some comfort in how hard you're working for her. ❤️ She's lucky to have such a dedicated caretaker.

Setting numbers aside, how is she feeling lately overall, do you think?

Big hugs, and I hope someone with more expertise will have more solid advice to offer.
Thank you so much, Gen, for your support.
Maggie, especially today, is like a completely different cat. I can’t get enough of watching her play as if she were 13 months old instead of 13 years! Her appetite is great and her litter box habits are also good. Overall, she seems to be doing really well.
The big dilemma is coming in about 2 hours from now… 😟

P.S. I feel very lucky to have her, you can’t imagine how much this little soul has given me over the 13 years we’ve been together. It’s the least I can do for her… I just feel like I’m not doing the best I possibly can.
 
You're doing quite a lot, and more than many people are able to! But ultimately we can't have complete control over their little bodies and biological processes; we're human caretakers, not gods. We can just do the best we can with the tools we have, and try and learn what works better or worse as we go. Honestly, after reviewing some of the scientific literature, I think it's amazing how far we've come and how much better you and really all of us here are doing than is the norm ... nevermind the norm 5, 10 or 15 years ago.

But it's hard on us! I'm glad to hear that Maggie is feeling so good, and I hope you can take comfort and joy from that. ❤️ One thing I've tried to learn is not to look at an individual shot as so portentous. If you hold the dose in 2 hours, you can always consider changing it after another 12. The difference for her won't be so big. It's all incremental.

Big hugs. I hope you can give yourself some credit, though I know that's hard in and of itself, especially when things aren't where we wish they were. (Boy do I ever. I'm having a much harder time practicing what I'm preaching right now, and I am not going to pretend otherwise. Sympathy and solidarity are yours, as much as you want. :bighug:)
 
Hello, although I am new at this, I have found that it is ok to skip a shot and keep with the same numbers until they settle in, then decide. It's so easy to chase numbers and try to do things too fast. Remember it's safer to be high once in a while than to dip too low. *HUGS*
 
You're doing quite a lot, and more than many people are able to! But ultimately we can't have complete control over their little bodies and biological processes; we're human caretakers, not gods. We can just do the best we can with the tools we have, and try and learn what works better or worse as we go. Honestly, after reviewing some of the scientific literature, I think it's amazing how far we've come and how much better you and really all of us here are doing than is the norm ... nevermind the norm 5, 10 or 15 years ago.

But it's hard on us! I'm glad to hear that Maggie is feeling so good, and I hope you can take comfort and joy from that. ❤️ One thing I've tried to learn is not to look at an individual shot as so portentous. If you hold the dose in 2 hours, you can always consider changing it after another 12. The difference for her won't be so big. It's all incremental.

Big hugs. I hope you can give yourself some credit, though I know that's hard in and of itself, especially when things aren't where we wish they were. (Boy do I ever. I'm having a much harder time practicing what I'm preaching right now, and I am not going to pretend otherwise. Sympathy and solidarity are yours, as much as you want. :bighug:)
Thank you so much for this… it truly means a lot to me. ❤️
You have no idea how much I needed to hear these words right now.
I know deep down that we can’t control everything, but sometimes it just feels like such a huge responsibility and I’m so afraid of not doing the absolute best for her. I’m trying to remind myself that this is a journey and that every step ,even the difficult ones, is part of it.
Seeing Maggie like she is today really gives me hope. She’s playing, she’s eating, she feels like herself again… and I’m trying to hold on to that feeling.
I really liked what you said about not putting so much weight on a single shot. I think I needed that perspective. You’re right, it’s all incremental.
And please… don’t be so hard on yourself either. You’re doing an amazing job with Gen, even if it doesn’t always feel that way. I think we’re all just trying our best for these little souls we love so much.
Big hugs back to you and thank you again for your kindness and support. It truly makes me feel better❤️
 
Hello, although I am new at this, I have found that it is ok to skip a shot and keep with the same numbers until they settle in, then decide. It's so easy to chase numbers and try to do things too fast. Remember it's safer to be high once in a while than to dip too low. *HUGS*
Thank you for taking the time to share your experience, I really appreciate it. ❤️
I understand what you’re saying, and I agree that safety comes first and that it’s better to be a bit higher than risk going too low.
I should mention though that the one time we skipped a shot, her numbers didn’t go well afterwards and her cycle was quite off, so I think that experience is making me a bit more cautious about skipping again.
I’m still trying to find the right balance and not rush things… it’s definitely a learning process.
Thank you again for your support.
 
Is the food transition going slow because she won't eat the LC?

Bandit was also a kibble addict and after a couple of years of suffering low carb kibble, she absolutely refused to eat it and was eating only HC dry. With dry food and especially HC dry food, numbers can be hard to regulate. What you could try is to feed the HC food in the first part of the cycle and see if you can feed only LC after the nadir. Also see if you can "prevent a reduction" by using food that is, feed the curve and keep her over 90.
 
20/03 Maggie AMPS 380 / +3 257 / 5,30 229 , PMPS 279 / +2 184 / +3 177 /+5 228

Hi everyone,
I’m really unsure what to do with Maggie’s dose and I would truly appreciate your advice. The 0.50f dose we used over the past few days turned out to be too low, as she stayed in high numbers the whole time. Since yesterday morning, when we increased the dose to 0.75U, her numbers have been much better overall. However, today she dropped very fast, from a preshot of 384 down to 68 at +7! I understand that according to SLGS I should reduce the dose back to 0.50U. But I also know that 0.50f was clearly not enough for her and kept her in high ranges. Her diet is still about 80% high carbs 20% low carbs, as I’m still in the process of transitioning her to low carb food, so I’m not able to follow TR at the moment. I feel really stuck and honestly quite desperate at this point.

I would really appreciate your guidance 🙏 🙏 🙏
Hi Hellen, This is the quandary many people find themselves in with SLGS (including Jude and I): as soon as you get into some good numbers, you drop into a range that, according to SLGS, you're required to take a dose reduction rather than holding the dose to see how the cat does on it, which you could do on TR. I know that you're a bit stuck in SLGS because of the dry food, but just know that once you get over that issue, Maggie might be easier to regulate when you switch to TR (if you chose to do that).
 
Hi Hellen, This is the quandary many people find themselves in with SLGS (including Jude and I): as soon as you get into some good numbers, you drop into a range that, according to SLGS, you're required to take a dose reduction rather than holding the dose to see how the cat does on it, which you could do on TR. I know that you're a bit stuck in SLGS because of the dry food, but just know that once you get over that issue, Maggie might be easier to regulate when you switch to TR (if you chose to do that).
Hi Mary,
This phase is really difficult for me… it feels like I’m stuck between a rock and a hard place, and honestly I don’t know how to handle it.
We’ve restarted the food transition again today (we had to pause for a few days because of some soft stools), but to be honest I’m not feeling very optimistic about it. I feel quite exhausted with everything at the moment.
And now I feel like I have to “play with fire” for a whole week, since I’m pretty sure her numbers will stay high, like today, where she’s been consistently over 240…
I’m really trying to do the right thing, but it’s just hard for me right now.
 
Is the food transition going slow because she won't eat the LC?

Bandit was also a kibble addict and after a couple of years of suffering low carb kibble, she absolutely refused to eat it and was eating only HC dry. With dry food and especially HC dry food, numbers can be hard to regulate. What you could try is to feed the HC food in the first part of the cycle and see if you can feed only LC after the nadir. Also see if you can "prevent a reduction" by using food that is, feed the curve and keep her over 90.
Hi Bhooma,
thank you so much for your thoughts!
Unfortunately, I’m having a really hard time completing the food transition because Maggie has a very sensitive stomach. Every time I try to increase the amount of low-carb air-dried food, her stools become very soft. This has happened with every new food I’ve tried to introduce so far.
We’ve also had three episodes of intense vomiting and diarrhea, which I suspect were triggered by the food changes. Because of all this, I’m starting to suspect she might have IBD.
Right now, I’m trying once again to continue the transition, but extremely slowly, and I’ll see how it goes.
I have tried feeding the curve multiple times, sometimes it worked, sometimes it didn’t. However, after yesterday’s dose reduction, her numbers are not looking good again.
Do you think there’s any alternative approach, other than waiting the full 7 days?
 
Hi Bhooma,
thank you so much for your thoughts!
Unfortunately, I’m having a really hard time completing the food transition because Maggie has a very sensitive stomach. Every time I try to increase the amount of low-carb air-dried food, her stools become very soft. This has happened with every new food I’ve tried to introduce so far.
We’ve also had three episodes of intense vomiting and diarrhea, which I suspect were triggered by the food changes. Because of all this, I’m starting to suspect she might have IBD.
Right now, I’m trying once again to continue the transition, but extremely slowly, and I’ll see how it goes.
I have tried feeding the curve multiple times, sometimes it worked, sometimes it didn’t. However, after yesterday’s dose reduction, her numbers are not looking good again.
Do you think there’s any alternative approach, other than waiting the full 7 days?
Sorry to hear that you're dealing with so much on the food front. I tried very hard to get Bandit to eat wet food and gave up. I can imagine what you're going through!

Have you been able to figure out if Maggie is allergic/reacting to a particular protein? Sorry if you've answered this before. Does she get any probiotic? I think that's a big help for IBD. I don't have any experience with IBD, but I'll tag @tiffmaxee who has experience with both IBD and food allergies.

On the dosing front, since you are testing so much and are following SLGS only because of the food (and not inability to test/lack of data), you could look at a lower reduction point like 80 or 70, so you can hold a dose where she sees safe, high greens.

WRT feeding the curve, what did you feed yesterday when she dropped to 105 and then 72?
 
Sorry to hear that you're dealing with so much on the food front. I tried very hard to get Bandit to eat wet food and gave up. I can imagine what you're going through!

Have you been able to figure out if Maggie is allergic/reacting to a particular protein? Sorry if you've answered this before. Does she get any probiotic? I think that's a big help for IBD. I don't have any experience with IBD, but I'll tag @tiffmaxee who has experience with both IBD and food allergies.

On the dosing front, since you are testing so much and are following SLGS only because of the food (and not inability to test/lack of data), you could look at a lower reduction point like 80 or 70, so you can hold a dose where she sees safe, high greens.

WRT feeding the curve, what did you feed yesterday when she dropped to 105 and then 72?
I’m not 100% sure that Maggie has IBD, but I do suspect it because of the frequent vomiting, the occasional soft stools, and the difficulty we’re having with the food transition. She also develops skin allergies from time to time (on her ears, across her face and chin, and between the eyes and ears where the fur is thinner).
All the dry food she used to eat in the past were chicken-based. The food I’m trying to introduce now is a novel protein (venison) with very limited ingredients, so I’m hoping this will help me determine whether her allergies and other symptoms are food-related.
We’re also starting probiotics this morning (Purina Pro Plan FortiFlora) to support her through the transition.
Regarding the dose, she usually drops into greens with the dose of 0.75. I reduced to 0.60, but it doesn’t seem to be holding her. Do you think it would be reasonable to try 0.65 or 0.70?
There’s also something I’m not sure I fully understand: why is TR not recommended when the diet includes dry food? Sorry but I’m not sure I’ve completely grasped the reasoning behind that...
As for feeding the curve, whenever I see Maggie drop below 100, I give small amounts of Royal Canin kibble every 30 minutes, since it’s the only high-carb option I can use to bring her numbers up. I know dry food doesn’t act quickly, but unfortunately I don’t have another alternative right now.
Thank you again, your support is truly invaluable to me 🌹 ❤️
 
I hate allergies! My Mocha gets both dermatitis and EGC. I have found that 1/2 a regular strength Zyrtec pill every 24 hours has gotten rid of the dermatitis. It sometimes has the unexpected side effect in cats of increasing the appetite that just might help get her to eat foods you want her to eat. For EGC Mocha develops it after a year or two eating a protein and I have to switch. Some use hydrolyzed protein for IBD but for a cat that is picky I doubt she would like it but worth a try.I don’t know if low carb though. It is hard when dealing with so many things at once and I empathize. As for bringing up the bg will she eat the dry if you dribble a little honey on it to get it to work faster?
 
I hate allergies! My Mocha gets both dermatitis and EGC. I have found that 1/2 a regular strength Zyrtec pill every 24 hours has gotten rid of the dermatitis. It sometimes has the unexpected side effect in cats of increasing the appetite that just might help get her to eat foods you want her to eat. For EGC Mocha develops it after a year or two eating a protein and I have to switch. Some use hydrolyzed protein for IBD but for a cat that is picky I doubt she would like it but worth a try.I don’t know if low carb though. It is hard when dealing with so many things at once and I empathize. As for bringing up the bg will she eat the dry if you dribble a little honey on it to get it to work faster?
I hadn’t really thought of honey as an option, I always assumed it was only for very low numbers (like under 60). But I’ll try adding a tiny amount on a kibble the next time she drops below 100. I just hope she’ll eat it…
Do you think the FortiFlora we’re starting tomorrow might help her? It wasn’t recommended by my vet, I came across it through my own research online and here on the forum.
The tip about Zyrtec is really helpful, we might consider trying it in the future if her allergies flare up again.
I’ve looked into hydrolyzed protein diets, but unfortunately most of them are quite high in carbs. Also, here in Greece the options are very limited. Even getting Ziwi was very difficult, a colleague has to buy it from Germany and send it to me by courier, there was no other way for me to get it.
I would really appreciate it if you could also share your opinion about her dose at this stage, it would help me a lot.
Thank you so much for your help ❤️
 
Honey works fast so might slow her down. Just try a couple drops and see if it works or causes too big a jump. It wares off quickly too unfortunately. It will be trial and error. FortiFlora is not the greatest probiotic. One used here is Visbiome. Both of mine get 1/4 a capsule daily. It is a human probiotic also manufactured as a veterinary supplement. You could look at the ingredients and see if you can find one very similar. Look at human probiotics. I know it was not available in Australia but Bron found something very similar in Australia.

As for dosing I think she might be very sensitive to changes like Max was. So I increased and decreased in very small amounts and used digital calipers as I found the marks on the syringes could be off by a lot. See what happens with your current dose.

Info - Dosing with calipers updated w/videos
 
Hi Mary,
This phase is really difficult for me… it feels like I’m stuck between a rock and a hard place, and honestly I don’t know how to handle it.
We’ve restarted the food transition again today (we had to pause for a few days because of some soft stools), but to be honest I’m not feeling very optimistic about it. I feel quite exhausted with everything at the moment.
And now I feel like I have to “play with fire” for a whole week, since I’m pretty sure her numbers will stay high, like today, where she’s been consistently over 240…
I’m really trying to do the right thing, but it’s just hard for me right now.
Hi Hellen, I understand how difficult and frustrating this is for you. Most all of us do. Feline diabetes, alone, is challenging, but when it's combined with other complicated health issues such as a sensitive tummy, especially when food plays such an important role in how they process insulin, it can be utterly overwhelming. Jude has urinary tract issues which not only brought him out of remission, but which also cause ongoing issues with fluctuating blood glucose. One thing many of us have noticed is that for some reason, those bg numbers we see each day can have a profound effect on our emotions, especially when they are higher than we'd like--we're doing our best for our little furbabies, and we want them to get better, and it's frustrating when all of our efforts fall short. But you're doing everything you can to help Maggie right now, and you're absolutely correct that she is more than just those daily numbers--focusing on the fact that she is feeling better and seeming more like herself is very important for you. I'm glad you're getting some guidance and advice about the food here from people who have struggled with that additional issue. I hope that this issue will get resolved.

As an aside, you mentioned using FortiFlora as a probiotic. What I've been told here on the forum is this: while FortiFlora is really tasty to kitties and is a good food topper (Jude loves it as a topper), it's not the most effective probiotic. I've had problems finding one for Jude--I ended up trying one that I discovered had some sweetener in it, and it boosted his bg. Just yesterday, I finally ordered Visbiome, which I've heard is quite good but is also quite pricey.

You're doing a great job with Maggie. She's very lucky to have you caring for her. I hope she starts to see some better numbers soon.
 
Honey works fast so might slow her down. Just try a couple drops and see if it works or causes too big a jump. It wares off quickly too unfortunately. It will be trial and error. FortiFlora is not the greatest probiotic. One used here is Visbiome. Both of mine get 1/4 a capsule daily. It is a human probiotic also manufactured as a veterinary supplement. You could look at the ingredients and see if you can find one very similar. Look at human probiotics. I know it was not available in Australia but Bron found something very similar in Australia.

As for dosing I think she might be very sensitive to changes like Max was. So I increased and decreased in very small amounts and used digital calipers as I found the marks on the syringes could be off by a lot. See what happens with your current dose.

Info - Dosing with calipers updated w/videos
Thank you so much,I truly appreciate it. All the information you shared has been really helpful to me!
 
Hi Hellen, I understand how difficult and frustrating this is for you. Most all of us do. Feline diabetes, alone, is challenging, but when it's combined with other complicated health issues such as a sensitive tummy, especially when food plays such an important role in how they process insulin, it can be utterly overwhelming. Jude has urinary tract issues which not only brought him out of remission, but which also cause ongoing issues with fluctuating blood glucose. One thing many of us have noticed is that for some reason, those bg numbers we see each day can have a profound effect on our emotions, especially when they are higher than we'd like--we're doing our best for our little furbabies, and we want them to get better, and it's frustrating when all of our efforts fall short. But you're doing everything you can to help Maggie right now, and you're absolutely correct that she is more than just those daily numbers--focusing on the fact that she is feeling better and seeming more like herself is very important for you. I'm glad you're getting some guidance and advice about the food here from people who have struggled with that additional issue. I hope that this issue will get resolved.

As an aside, you mentioned using FortiFlora as a probiotic. What I've been told here on the forum is this: while FortiFlora is really tasty to kitties and is a good food topper (Jude loves it as a topper), it's not the most effective probiotic. I've had problems finding one for Jude--I ended up trying one that I discovered had some sweetener in it, and it boosted his bg. Just yesterday, I finally ordered Visbiome, which I've heard is quite good but is also quite pricey.

You're doing a great job with Maggie. She's very lucky to have you caring for her. I hope she starts to see some better numbers soon.
You guys are all so helpful I can’t thank you enough for your guidance and for caring about Maggie’s health. Since my vet has no experience with Lantus, I honestly wouldn’t have been able to manage this without you.

Αbout proviotic: I will look into whether Visbiome is available here in Greece.

By the way, today we made a huge step forward, we increased her low-carb food by 5 grams, and the plan is to increase it by 5 grams every 3 days (which is a huge achievement for us!). If this goes well, we’ll have completed the transition in about a month.
Wish us luck!!!
 
Hi Hellen, I understand how difficult and frustrating this is for you. Most all of us do. Feline diabetes, alone, is challenging, but when it's combined with other complicated health issues such as a sensitive tummy, especially when food plays such an important role in how they process insulin, it can be utterly overwhelming. Jude has urinary tract issues which not only brought him out of remission, but which also cause ongoing issues with fluctuating blood glucose. One thing many of us have noticed is that for some reason, those bg numbers we see each day can have a profound effect on our emotions, especially when they are higher than we'd like--we're doing our best for our little furbabies, and we want them to get better, and it's frustrating when all of our efforts fall short. But you're doing everything you can to help Maggie right now, and you're absolutely correct that she is more than just those daily numbers--focusing on the fact that she is feeling better and seeming more like herself is very important for you. I'm glad you're getting some guidance and advice about the food here from people who have struggled with that additional issue. I hope that this issue will get resolved.

As an aside, you mentioned using FortiFlora as a probiotic. What I've been told here on the forum is this: while FortiFlora is really tasty to kitties and is a good food topper (Jude loves it as a topper), it's not the most effective probiotic. I've had problems finding one for Jude--I ended up trying one that I discovered had some sweetener in it, and it boosted his bg. Just yesterday, I finally ordered Visbiome, which I've heard is quite good but is also quite pricey.

You're doing a great job with Maggie. She's very lucky to have you caring for her. I hope she starts to see some better numbers soon.
Mary, if you have pet insurance Visbiome might be covered if ordered directly from them. I hope you ordered from them anyhow as they ship for free. While the bottle says one capsule a day I was told to give 1/4 or 1/3 daily. So it lasts a lot longer.
 
Mary, if you have pet insurance Visbiome might be covered if ordered directly from them. I hope you ordered from them anyhow as they ship for free. While the bottle says one capsule a day I was told to give 1/4 or 1/3 daily. So it lasts a lot longer.
Thanks, Elise! We don't have pet insurance, but I did order directly from the mfg. and it was free shipping, so a little savings there. Good to know about the dose. If I just had one cat, the price would not be so high, but with five, I simply can't give them all the Visbiome. Jude is the one I'm most worried about right now, and I think his diarrhea might be a result of receiving so many antibiotics, so he'll get the pricey stuff.
 
I hate allergies! My Mocha gets both dermatitis and EGC. I have found that 1/2 a regular strength Zyrtec pill every 24 hours has gotten rid of the dermatitis. It sometimes has the unexpected side effect in cats of increasing the appetite that just might help get her to eat foods you want her to eat. For EGC Mocha develops it after a year or two eating a protein and I have to switch. Some use hydrolyzed protein for IBD but for a cat that is picky I doubt she would like it but worth a try.I don’t know if low carb though. It is hard when dealing with so many things at once and I empathize. As for bringing up the bg will she eat the dry if you dribble a little honey on it to get it to work faster?
Hellen, maybe you can check also xozal, a great alternative to zyrtec. I find that it's side effects (lethargy, drowsiness ) are not as pronounced as in zyrtec. Plus, it come not only as pill but as syrup for kid's as well and its more easy to adminstrate.
By the way, today we made a huge step forward, we increased her low-carb food by 5 grams, and the plan is to increase it by 5 grams every 3 days (which is a huge achievement for us!). If this goes well, we’ll have completed the transition in about a month.
Wish us luck!!!

This is great news!!! You will see Maggie will come around in no time! 🥰 :bighug:🥰
 
Hellen, maybe you can check also xozal, a great alternative to zyrtec. I find that it's side effects (lethargy, drowsiness ) are not as pronounced as in zyrtec. Plus, it come not only as pill but as syrup for kid's as well and its more easy to adminstrate.


This is great news!!! You will see Maggie will come around in no time! 🥰 :bighug:🥰
Just a reminder to be careful with those kid's syrups as they can contain a sugar-based flavoring, which can boost blood glucose. I've made several mistakes with Jude by giving him medicines that contained some form of sugar. This even happened with two versions of liquid medicines that were compounded for him--they slipped a sugar-based flavoring into them. Now I ask every time I get a refill: is there any sugar in this?
 
Just a reminder to be careful with those kid's syrups as they can contain a sugar-based flavoring, which can boost blood glucose. I've made several mistakes with Jude by giving him medicines that contained some form of sugar. This even happened with two versions of liquid medicines that were compounded for him--they slipped a sugar-based flavoring into them. Now I ask every time I get a refill: is there any sugar in this?
You are absolutely right Mary!
 
It is interesting what Mary said about Zyrtec. The only side effect my cats had was increased appetite. I gave given it to three cats so far.
 
It is interesting what Mary said about Zyrtec. The only side effect my cats had was increased appetite. I gave given it to three cats so far.
Did you give the syrup? I only mentioned this because sometimes the syrups can contain sugar. And I'm not saying Zyrtec does, but just mentioning it because I've had issues with meds that seemingly sneak a little sugar into them. I've given Jude the Zyrtec pill, and he did have a bit of an increased appetite.
 
No syrup. I give the pills. I give 1/2 a 10 mg pill. It is tiny and I hide it in a little ground sardine. She thinks it is a treat. I also give pills in empty gel capsules.
 
Regarding the dose, she usually drops into greens with the dose of 0.75. I reduced to 0.60, but it doesn’t seem to be holding her. Do you think it would be reasonable to try 0.65 or 0.70?
I don't think micro-dosing will make that much of a difference. How do you even measure a difference of 0.05U or 0.10U? In any case, I don't think it is the dose. It's probably a combination of HC dry as well as her pancreas deciding to contribute a little more insulin sometimes that you get erratic cycles. It can happen even to cats on low carb wet food. You will suddenly see green in a cycle and then nothing for a few cycles/days. It can be very frustrating. Check out Bandit's SS in 2019-2020. It was pretty much like Maggie's.

There’s also something I’m not sure I fully understand: why is TR not recommended when the diet includes dry food? Sorry but I’m not sure I’ve completely grasped the reasoning behind that...
A lot of people (including me when Bandit was first diagnosed) have wondered this. TR was developed when there was no low carb dry and the cats were on a low carb canned diet. It's an aggressive protocol (as compared to SLGS) and it was tested with low carb canned food. One doesn't know how it will work if a key parameter like food is changed.

As for feeding the curve, whenever I see Maggie drop below 100, I give small amounts of Royal Canin kibble every 30 minutes, since it’s the only high-carb option I can use to bring her numbers up. I know dry food doesn’t act quickly, but unfortunately I don’t have another alternative right now.
Do you feed it in the first part of the cycle? Say at +2 or even when she dropped to 200 at +3? The idea is to feed food early to prevent that dive later in the cycle. Feeding carbs later can reduce duration and cause numbers to go up faster at the end of the cycle. What if you tried feeding some of the PS meal at +1 and +2? Feed the RC dry in the first 3 if not 4 hours of the cycle and keep the low carb for later.
 
I don't think micro-dosing will make that much of a difference. How do you even measure a difference of 0.05U or 0.10U? In any case, I don't think it is the dose. It's probably a combination of HC dry as well as her pancreas deciding to contribute a little more insulin sometimes that you get erratic cycles. It can happen even to cats on low carb wet food. You will suddenly see green in a cycle and then nothing for a few cycles/days. It can be very frustrating. Check out Bandit's SS in 2019-2020. It was pretty much like Maggie's.


A lot of people (including me when Bandit was first diagnosed) have wondered this. TR was developed when there was no low carb dry and the cats were on a low carb canned diet. It's an aggressive protocol (as compared to SLGS) and it was tested with low carb canned food. One doesn't know how it will work if a key parameter like food is changed.


Do you feed it in the first part of the cycle? Say at +2 or even when she dropped to 200 at +3? The idea is to feed food early to prevent that dive later in the cycle. Feeding carbs later can reduce duration and cause numbers to go up faster at the end of the cycle. What if you tried feeding some of the PS meal at +1 and +2? Feed the RC dry in the first 3 if not 4 hours of the cycle and keep the low carb for later.
Actually, this is the tool I use to measure her doses.

Her feeding schedule is: a big meal before AMPS/PMPS, followed by snacks at +0.5, +1, +2, +3, and +4.5. So she doesn’t eat anything after nadir or during the second half of the cycle. Do you think there’s anything I could improve?

Another question I have is why it’s considered too risky to follow TR when the diet is above 10% carbs. At the moment we’re around 18%, but I’m hoping to reduce that further soon.

Thanks for your support Bhooma 🙏 🙏 🙏
 

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Mary, if you have pet insurance Visbiome might be covered if ordered directly from them. I hope you ordered from them anyhow as they ship for free. While the bottle says one capsule a day I was told to give 1/4 or 1/3 daily. So it lasts a lot longer.
Hi Elise.
I finally managed to find Vivomixx:
"Vivomixx and Visbiome are essentially the same high-potency probiotic, both containing the original 8-strain "De Simone Formulation" (450 billion CFU) intended to manage conditions like IBS and ulcerative colitis. They are identical in formulation but sold under different brands due to regional licensing: Vivomixx is sold in Europe/UK, while Visbiome is the branded equivalent in the US."
You mentioned to Mary yesterday that the dosage is 1/4 or 1/3 of the capsule daily. What would you recommend as a starting dose?
 
Her feeding schedule is: a big meal before AMPS/PMPS, followed by snacks at +0.5, +1, +2, +3, and +4.5.
Which food does she get at these meals? A mix of the RC and the Ziwi Peak?


Another question I have is why it’s considered too risky to follow TR when the diet is above 10% carbs. At the moment we’re around 18%, but I’m hoping to reduce that further soon.
The reason is the same. TR was developed for cats eating low carb canned food and they want that it be followed only for cats eating low carb canned food.
 
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