? 04/02 Blanche, 122@AMPS L, 63@+2.30 L, 47@+2.50GM, 99@PMPS GM, 52@+3.30GM, 59@+7GM Any way to cut a drop in half?

[Blanche]

Hello dears!

It was five difficult days from my previous visit, and since work couldn't be ignored any more, I'm five days with almost no sleep at all, and currently 42 ½ hours straight on my feet. Plus today when I saw a 63@AMPS+2.30 on Libre I left the court calling an emergency, I grab a taxi and came back at home to a very lime 47@+2.50 on GM.
I have to admit that I'm not the same person I was 15 days ago, and I didn't panic, I fed her, I physically carried her to the food, and once she ate and her BG start to rise, I left to go back, repeating to my self that she will be all right, she will be all right. (Ok, the lost sign for two hours didn't help but I manage not to came back a second time. )
Tonight we had the second deep green PMPS and since she is on the green side, but with a considerable drop after +2.
I'm wondering what to do with the lime 47@AMPS+2.50 since she is clearly not ready for a OTJ trial but I cannot take an other reduction. I cant really cut a drop in half.
Otherwise, Blanche is doing fine as you can see
We change our shirt with a white one, a hand out from my baby niece , with a green ribbon to secure it and to match her eyes.
And she was so proud of her 99@PMPS, all she wanted was just one more head rub
She says she missed all her fellow sugar kitties and I remind her that if she could let me sleep a few hours I'll be able to visit their posts and check if they behaved in her absence

 

[Mary & Jude]

Oh, my--her little face is so precious! Kiss her for me!

@Bandit's Mom hopefully will have some guidance for you.

 

[Blanche]

Oh, my--her little face is so precious! Kiss her for me!

@Bandit's Mom hopefully will have some guidance for you.

Thank you Mary!
I'll happily do it!
Give a special belly rub to Jude for me

 

[Staci & Ivy]

Sending more kisses to sweet Blanche! Love this sweet photo

She seems to need less and less insulin! Yay

 

[Bandit's Mom]

Did she drop to 47 @+2.5 even after getting food between AMPS and +2.5?

 

[Blanche]

Did she drop to 47 @+2.5 even after getting food between AMPS and +2.5?

Hi Bhooma, yes she ate between AMPS and + 2.50, @+0.30 but not as much as usual.
Maybe because it was earlier than her usual +2? Maybe she suddenly stopped to like the food? She ate only about 30g.
I note everything about her eating habits in comments in order to gather as much as possible data for her insulin response.
Now she had an 87@AMPS and I decide to stall for a moment. Yesterday with an 99@PMPS we passed almost all the cycle struggling to keep her head above 60...

 

[tiffmaxee]

She’s looking so good.

 

[Mary & Jude]

I'm glad you decided on the NS. Even though she wasn't getting a lot of insulin, the depot can still influence the numbers for the next day or two. It will be interesting what you'll see in the next few cycles!

 

[Allie & Gen]

Oh, hello, sweet face! I want to boop her nose so badly.

She seems to be in a bit of a hurry to ditch the insulin! You're doing an exceptional job managing it all - very impressed at how quickly you got up to speed with managing her, if I haven't said so before. I have no special advice to give at this point, but wishing you both the best always!

 

[Blanche]

I'm glad you decided on the NS. Even though she wasn't getting a lot of insulin, the depot can still influence the numbers for the next day or two. It will be interesting what you'll see in the next few cycles!

Hi Mary,
When I saw the 87@AMPS, the NS was a no-brainer, especially after the yesterday's night cycle - a nightmare. I couldn't give her insulin and then pass all day try to feed the beast. Today, at 04.50am, she had a 66@PMPS +8 and I let her lick two fat drops of honey from my finger, I was desperate to catch even three hours of sleep. Half an hour later I test a 91@GM, and yet she dropped again 67@PMPS+9. Today she dropped again at 70@PMPS+4.20!
So, I will let the beast rest and wait. The one thing I don't know, am I on OTJ Trial? Or not yet?

 

[Blanche]

Oh, hello, sweet face! I want to boop her nose so badly.

I can relate!

She seems to be in a bit of a hurry to ditch the insulin! You're doing an exceptional job managing it all - very impressed at how quickly you got up to speed with managing her, if I haven't said so before. I have no special advice to give at this point, but wishing you both the best always!

Thank you Allie!
I try to the best of my abilities to help her and restore a certain normalcy in our life...
Thank you for your encouraging words, it's important to know that I do the right thing.
Please give a sweet ear scratch to Gen for me!

 

[Mary & Jude]

Hi Mary,
When I saw the 87@AMPS, the NS was a no-brainer, especially after the yesterday's night cycle - a nightmare. I couldn't give her insulin and then pass all day try to feed the beast. Today, at 04.50am, she had a 66@PMPS +8 and I let her lick two fat drops of honey from my finger, I was desperate to catch even three hours of sleep. Half an hour later I test a 91@GM, and yet she dropped again 67@PMPS+9. Today she dropped again at 70@PMPS+4.20!
So, I will let the beast rest and wait. The one thing I don't know, am I on OTJ Trial? Or not yet?

Here is the protocol for the OTJ trial: Info - Reminder: *earning* reductions and starting OTJ trials. My question would be which dose do you go back up to in case her numbers begin creeping back up; I would guess the last dose, which is the drop dose, but let's let someone with more experience like @Bandit's Mom weigh in on that.

One thing I can tell you is this: the longer Blanche sits and marinates in those greens, the stronger her remission will likely be, so while I know OTJ is an exciting prospect (and you will find no greater champions of OTJ than all of us caregivers!), you want a good, strong remission that will last. For a great example of kitties that were kept in those greens for an extended period, who are now enjoying OTJ, look at @Karolina & Nestle (who is now working on his third remission) and @Kat & Trixie. Jude went into remission on SLGS, but because the dose decrease number was so high, he never really sat in the greens for a good while, and he lost his remission (due to a UTI) within about six months, and we haven't been able to get into remission again (note: he was a steroid induced diabetic and began dropping his bg considerably within a month after insulin treatment and food adjustment).

Remind me again: what is happening with her food??? Which Royal Canin is she on, and do you know the carb value?

 

[Blanche]

Here is the protocol for the OTJ trial: Info - Reminder: *earning* reductions and starting OTJ trials. My question would be which dose do you go back up to in case her numbers begin creeping back up; I would guess the last dose, which is the drop dose, but let's let someone with more experience like @Bandit's Mom weigh in on that.

Even if I've read the protocol too many times know, I'm still felling unsure about what to do and which protocol I really follow.
Let me explain: Blanche from 03/24/26 is on strictly LC wet diet. I gave her some MC wet only once or twice when she dived low.
So I think I have switched to a TR. That's why I reduce to a Dd when she dropped bellow 50 at 03/28 and that's why I held the dose even when she dropped several times below 90 the next days until she dropped again below 50.
I still dont know where is the treshold of going back. 200? More? And if the numbers begin to creeping back when I shoot? When the wrong number appears at the preshot time or at any time of the cycle? Let's say I have a 200@PMPS+8 and a 105@AMPS. What I do?

One thing I can tell you is this: the longer Blanche sits and marinates in those greens, the stronger her remission will likely be, so while I know OTJ is an exciting prospect (and you will find no greater champions of OTJ than all of us caregivers!), you want a good, strong remission that will last. For a great example of kitties that were kept in those greens for an extended period, who are now enjoying OTJ, look at @Karolina & Nestle (who is now working on his third remission) and @Kat & Trixie. Jude went into remission on SLGS, but because the dose decrease number was so high, he never really sat in the greens for a good while, and he lost his remission (due to a UTI) within about six months, and we haven't been able to get into remission again (note: he was a steroid induced diabetic and began dropping his bg considerably within a month after insulin treatment and food adjustment).

I totally agree with you, I was in no hurry to drop the insulin but could I hold that Dd after yesterday's cycle?
Blanche's diabetes is also a steroid induced and her BG began to drop considerably after the food adjustement.

Remind me again: what is happening with her food??? Which Royal Canin is she on, and do you know the carb value?

I'm so sorry Mary, my bad, I have to update the signature, it totaly slip from my (seriously sleep deprived) mind to change the food info. I'm doing it ASAP!

 

[Mary & Jude]

I'm so sorry Mary, my bad, I have to update the signature, it totaly slip from my (seriously sleep deprived) mind to change the food info. I'm doing it ASAP!

It's okay! No worries!

Even if I've read the protocol too many times know, I'm still felling unsure about what to do and which protocol I really follow.
Let me explain: Blanche from 03/24/26 is on strictly LC wet diet. I gave her some MC wet only once or twice when she dived low.
So I think I have switched to a TR. That's why I reduce to a Dd when she dropped bellow 50 at 03/28 and that's why I held the dose even when she dropped several times below 90 the next days until she dropped again below 50.
I still dont know where is the treshold of going back. 200? More? And if the numbers begin to creeping back when I shoot? When the wrong number appears at the preshot time or at any time of the cycle? Let's say I have a 200@PMPS+8 and a 105@AMPS. What I do?

If you are going to follow TR (as of 3/26), then she hasn't technically earned a dose reduction the last few cycles since the AM 4/2 cycle because she hasn't fallen below 50 (and you haven't met the other criteria for TR reductions). Since your spreadsheet said you were following SLGS, then we wouldn't have encouraged you to shoot below 90 at this morning's AMPS test.

I believe your choices at this point are to go back to giving insulin (and we'll wait until someone comes to offer guidance on that dose) and remain on TR, taking reductions only when she meets the requirements for a TR earned reduction (a single drop below 50 mg/dL or; after 3 drops between 40 - 50 mg/dL on three separate days for kitties who have shown they do not hold reductions well or; when she regularly has her lowest BGs in the normal range of a healthy cat (50 - 80 mg/dL) and stays under 100 mg/dl overall for at least one week).

Or you can go back to SLGS, which means she won't receive shots until her nadirs are above 90 or until her numbers are mostly in the range of a healthy cat (50 - 80 mg/dL), but under 100 overall... with only occasional readings in the 100 - 120 range.

I totally agree with you, I was in no hurry to drop the insulin but could I hold that Dd after yesterday's cycle?

Under TR and SLGS, she earned a reduction (for the 47) on AM 4/2, but you didn't take it. If you were following TR, she did not earn a reduction in the PM cycle (she did not fall below 50 in that cycle); under SLGS, she did earn a reduction for falling below 90, and you were right not to give her a shot this morning.


So, I have a question about the asthma: she's off the pred since 3/18. What is your thinking with treating her asthma?

 

[Blanche]

It's okay! No worries!

Already done it!

If you are going to follow TR (as of 3/26), then she hasn't technically earned a dose reduction the last few cycles since the AM 4/2 cycle because she hasn't fallen below 50 (and you haven't met the other criteria for TR reductions). Since your spreadsheet said you were following SLGS, then we wouldn't have encouraged you to shoot below 90 at this morning's AMPS test.

Just a moment because I think I'm confused. She didn't earn a reduction from Dd to NS for dropping bellow 50 at 04/02 AM cycle? You say I had to drop at 04/02 PM cycle and since I didn't I had to hold the dose until she drop again?

I believe your choices at this point are to go back to giving insulin (and we'll wait until someone comes to offer guidance on that dose) and remain on TR, taking reductions only when she meets the requirements for a TR earned reduction (a single drop below 50 mg/dL or; after 3 drops between 40 - 50 mg/dL on three separate days for kitties who have shown they do not hold reductions well or; when she regularly has her lowest BGs in the normal range of a healthy cat (50 - 80 mg/dL) and stays under 100 mg/dl overall for at least one week).

Or you can go back to SLGS, which means she won't receive shots until her nadirs are above 90 or until her numbers are mostly in the range of a healthy cat (50 - 80 mg/dL), but under 100 overall... with only occasional readings in the 100 - 120 range.


Under TR and SLGS, she earned a reduction (for the 47) on AM 4/2, but you didn't take it. If you were following TR, she did not earn a reduction in the PM cycle (she did not fall below 50 in that cycle); under SLGS, she did earn a reduction for falling below 90, and you were right not to give her a shot this morning.

So, I have a question about the asthma: she's off the pred since 3/18. What is your thinking with treating her asthma?

I discussed it with the vet and she propose to try Aerolin Inhaler 100mcg. The substance is Salbutamol. I don't know if it is commercialized under the same name in US. But I just bought the inhaler today. I didn't start yet the treatment.

 

[Mary & Jude]

Just a moment because I think I'm confused. She didn't earn a reduction from Dd to NS for dropping bellow 50 at 04/02 AM cycle? You say I had to drop at 04/02 PM cycle and since I didn't I had to hold the dose until she drop again?

Sorry to be confusing! Under TR (for a newly diagnosed kitty) a drop below 50 earns a dose reduction or for SLGS a drop below 90 earns a dose reduction. So when she dropped to 47, on April 2 AM+3, she earned a dose reduction at the next shot (no matter which dosing method you were following). Since then, she hasn't earned a dose reduction if you were following TR because she hasn't dropped below 50. I hope that makes sense.

 

[Mary & Jude]

@Bandit's Mom, what would you suggest Athanasia do in terms of dosing now that she is following TR??

 

[Bandit's Mom]

@Bandit's Mom, what would you suggest Athanasia do in terms of dosing now that she is following TR??

I'm wondering if she can try NS for a couple of days and see where that takes her once the depot (whatever there might be on a drop dose!) is depleted.

She is seeing some low blues, but those could be food bumps/bouncing.

@Blanche if she's not getting insulin, please don't feed her MC - even if she drops below 50. There is no danger of hypoglycemia if she's not on insulin. Some cats can have a lower range of normal numbers and we've seen OTJ cats have BG in the 30s and 40s!

She is off the Pred now, right?

 

[Blanche]

Sorry to be confusing! Under TR (for a newly diagnosed kitty) a drop below 50 earns a dose reduction or for SLGS a drop below 90 earns a dose reduction. So when she dropped to 47, on April 2 AM+3, she earned a dose reduction at the next shot (no matter which dosing method you were following). Since then, she hasn't earned a dose reduction if you were following TR because she hasn't dropped below 50. I hope that makes sense.

It' not you been confusing, it's the whole new world for me!
So,if I understood well this time, once a reduction is earned I have to take at the next cycle otherwise is lost and I have to earn it again.
Sorry for not replying immediately, I went to catch some sleep, for this morning's schedule was a very demanding one...

I'm wondering if she can try NS for a couple of days and see where that takes her once the depot (whatever there might be on a drop dose!) is depleted.

I already do this!. Is it possible that her numbers start to rise in pre-lantus levels once the depot is depleted?

She is seeing some low blues, but those could be food bumps/bouncing.

@Blanche if she's not getting insulin, please don't feed her MC - even if she drops below 50. There is no danger of hypoglycemia if she's not on insulin. Some cats can have a lower range of normal numbers and we've seen OTJ cats have BG in the 30s and 40s!

Now MC food for her! Last time was at 04/02 PM cycle and she was on insulin.
I have purchase microchip feeders for all of them to minimize the possibility of food stealing.

She is off the Pred now, right?

Yes! Since 03/18.

 

[Mary & Jude]

So,if I understood well this time, once a reduction is earned I have to take at the next cycle otherwise is lost and I have to earn it again.

If she earns a reduction, that could mean she is getting too much insulin, so you want to take an earned reduction in the next cycle after the earned reduction in order to keep her from falling into unsafe numbers.

It is possible that her numbers will start to rise when the depot is depleted. As Bhooma suggests, keep an eye on her numbers for a couple of days, and then post and ask for guidance. Fingers crossed that her pancreas will begin functioning on it's own. If it doesn't, and her numbers begin rising, it's okay; it likely just means she needs a little bit more assistance from the insulin.

 

[Blanche]

If she earns a reduction, that could mean she is getting too much insulin, so you want to take an earned reduction in the next cycle after the earned reduction in order to keep her from falling into unsafe numbers.

It is possible that her numbers will start to rise when the depot is depleted. As Bhooma suggests, keep an eye on her numbers for a couple of days, and then post and ask for guidance. Fingers crossed that her pancreas will begin functioning on it's own. If it doesn't, and her numbers begin rising, it's okay; it likely just means she needs a little bit more assistance from the insulin.

Thank you Mary!
I keep a close eye on her numbers. So far the higher on GM was an 122. Libre always reads higher than GM but she never had a higher than 159 (at the same moment GM read 103). Fingers crossed!

 

[Mary & Jude]

Very nice numbers today!!! Well done, Blanche!!
Sending kisses **

 

[Blanche]

Very nice numbers today!!! Well done, Blanche!!
Sending kisses **

Thank you Mary!
First time I didn't panic with a lime number!
She is sending kisses to Jude!

 

[Staci & Ivy]

Safe surfing Blanche and Athanasia, you’re doing great!

 

[Mary & Jude]

Thank you Mary!
First time I didn't panic with a lime number!
She is sending kisses to Jude!

Wow! She's really dropping into lower numbers without insulin, isn't she?!? As Bhooma said earlier, no need to panic when insulin isn't in play.
You might want to start a new post so that this one doesn't get too long. It looks like maybe you might be posting a daily OTJ countdown soon (anti-jinx!).

 

[Blanche]

Wow! She's really dropping into lower numbers without insulin, isn't she?!? As Bhooma said earlier, no need to panic when insulin isn't in play.

Yes! she always love diving deep

You might want to start a new post so that this one doesn't get too long. It looks like maybe you might be posting a daily OTJ countdown soon (anti-jinx!).

I will post a new one and fingers crossed!