03/06 Merlin AMPS 365/ +3 283/+6 210/+9 422

Steve & Merlin

Steve & Merlin

Member Since 2019
We had an active night with a low dip progression 50 - 43 - 52 - 58 - 68. See the details on his spreadsheet. Those were 15 minute interval measurements. I intervened with some FF gravy at 43 (1 teaspoon) and he popped back up quickly. I stepped in at 43 because I just was not going to let him go into the 30s, which was where he was headed by the data slope if I did nothing. He did start dropping again (FF wearing off?) and I gave him a bit more (1/2 teaspoon) and then he slowly began rising. I gave him his AM dose a half hour ago and now have made 1.25u as Merlin's new dose. Merlin just had a very good breakfast and told me to go away as he is hoping to get some sleep. He didn't appreciate being wakened so much during the night. I am just thankful that he doesn't seem to care about ear sticks to get blood. I could use some sleep too. Why do these always happen at night?
 
Good catch on those lower numbers last night! Do you have any test numbers for yesterday's AM cycle and what dose did you give if any? When you skip a shot, put NS in the unit cell so everyone knows that no shot was given that cycle.

Something has changed for Merlin to start seeing these lower greens. Did you recently switch to low carb wet food ?

I would try to hold this dose unless he drops below 40 then you would reduce. Since he is a long time diabetic, you would reduce if they drop below 50 on a dose three times on 3 different cycles. So, last night was drop # 1. If he drops below 40 once, you would take the reduction the next cycle.

Kitties do tend to drop lower in the PM cycles. Looks like a bounce cycle today which is expected after a run in greens that he isn't used to being in.
 
Here's your last condo for continuity.

Did you feed at the 50? We would have recommended you feed to try and keep him above 50 and not earn a reduction. Actually, I didn't see if you confirmed if you are following SLGS or TR.

I also see 2 lines for 3/5/19. If you did that so you could fit all the numbers, you can do a text wrap within the cell so it's all in one cell. Try that so there is only 1 line per day.
 
I did two lines for the 5th so I could enter all of the number that letdup to the two hour delayed dose while I waited for his numbers to come up. There was no room on the original line for the actual PMPS dose. Sorry it led to the confusion. I was just thinking of how to enter it for my reference and wasn't thinking about anyone else. I am very self centered.

I want to try to manage him on the TR protocol. At his age, I think it would be better for him.

Merlin has always been on canned low carb food since he was diagnosed many years ago. For some reason in Jan. he went uncontrolled and has been a BG mess to deal with. As a result his coat looks awful and he has lost weight. His weight loss has been muscle mass as he is not as strong as he used to be. He has been exhibiting all the classic signs of hyperglycemia and not responding well. His original dose was 1.5 units for a few years and then it inched up to 2 units for the last 6. Our vet wonders if his pancreas is intermittently producing more insulin and so the addition is messing with trying to regulate him.

In the past early years there were a few times when it looked like he was playing around with remission, but he went back to his old self after a month or so of driving me crazy with reduced doses to keep him above 50. I was not following either TR or SLGS protocols, just a management guide given me by his original diagnosing vet who had a lot of feline diabetes experience and was one of the first vets to really push Lantus in the SW US. She retired and we moved to Montana shortly after and up here vets seem to only have a academic/textbook familiarity with diabetes. In fact, we introduced the use of Lantus to several vets up here and they have been surprised at how much better it has worked for their patients. PZI seems to be the favorite up here. Both TR and SLGS are actually new to me.

As far as any recent changes, the only change is giving him subq fluids. In pinching his skin to dose him, I noticed he seemed dehydrated. So I started giving him lactated ringers @ 100ml /day. I thought a dehydrated cat is not good and could easily complicate things. I suspect his more recent numbers might reflect better hydration. While he completely ignores BG testing pricks, he absolutely HATES getting subq fluids and neither of us enjoys the experience.

I just took his +3 and it is 283. The bounce seems to be wearing off.
 
Steve & Merlin said:
I was just thinking of how to enter it for my reference and wasn't thinking about anyone else. I am very self centered.
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That made me laugh out loud. Steve, if you were a self centered person, you wouldn't be managing a kitty with diabetes all this time and be researching and learning all that you have AND giving up sleep. ;)

Nice to see he is heading downwards again. Sometimes with a bounce the numbers wobble, up and down and up and down. You will know soon enough if the numbers continue to trend downwards.
 
Well he is no longer going down. His +9 422. In the past 3 hours he shot up 200 points. I hope he levels off. If not, that would put him at 600 for his next shot. I guess his liver is super easily panicked.
 
Steve & Merlin said:
What can I do to keep him from going that high?
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He just spent about 9-10 hours in green numbers which is the most to date according to the data you have on his SS. The liver was bound to panic after that. We have a saying around here, they bounce till they stop. After he gets more used to seeing normal numbers, he should start to bounce less and clear the bounces faster. And that said, some kitties bounce all the way into remission.

One thing you can do to help it is to follow the protocol with dosing and not let him hang in higher numbers too long. The bounce can take up to 6 cycles or 3 days to clear. Hopefully he will make his way back to green before then. If not an increase would be called for. He has had 2 cycles at this dose and the depot hasn't filled yet. Let's see what he does from here.
 
OK
We will keep with the dose tonight (in about 2 hours) and see what he does. I don't like him in the high number as he clearly feels bad. His +10 is now 471 so the rise is slowing a bit.
 
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