03/19 Sly, AMPS 166, +1 111, +2 76, +3 77, +4 92, +5 81, +6 86, +9.5 134, PMPS 228, +4 248

https://felinediabetes.com/FDMB/thr...40-9-5-181-pmps-218-2-167-4-130-5-115.275405/

Good morning!

 

Nice blue start!

 

Yes, glad I have no reason to go out this morning!

 

I wondered if he'd stay blue all night Paws crossed for some green today!

 

I have a feeling he did. I was going to set an alarm for +9 or 10, but fell asleep.

Very similar to the 03/17 AMPS, so I'm not giving MC at +1, I'll use LC, and only use MC if we hit 80 or lower. Trial and error, right?

 

Good for you!

Sounds good to me. I would also look at 'how fast' is the drop when deciding what to feed and when. Bounces are from lower numbers and also steep drops .

ETA also feeding carbs later in the cycle even with an 80 but after nadir can reduce duration and contribute to bouncing.
Such a delicate balancing act

 

Someone scarfed and barfed, I just found it... who it was? Either Sly or Keebler.

Sly isn't interested in wet food RN, so, not sure, he ate some dry, but he's already at 111!

 

That's enough of a drop that I might feed a little MC @Bandit's Mom what do you think?

 

When did you feed MC on 3/17 (you want to start noting it down on the SS for future) reference. I think you can do some now, but go easy if he is flat at +2. He went up from there on 3/17.

 

He's watching me at the window, while im feeding the squirrels. He hasn't gone up on the perch and looked out the window in 2 months!!

 

I thought he'd want to eat, he wouldn't eat anymore wet at +1

 

I even tried a different food. @Bandit's Mom I fed MC on 03/17 at +1 and he went up fast.

 

Did he eat some dry at +1 this AM? If he's not eating wet...

 

Yeah after I found the puke, I called him back downstairs and offered wet, he went to his dry bowl and I gave him some and he gobbled them...

Like I said, it could have been his brother Keebler who puked. I usually give wet, do insulin and then let him have dry. After I gave him his initial dry, I went to brush my teeth, and they were all running around again, so not sure... Keebler was in the area of the puke, but at this point is sort of moot. Lol

 

LOL. OK. Let's see the +2.

 

Ok so I checked him at +1.5. He's 74.

I gave 1 tsp. HC he licked half of it, and wants dry food

Refeeding 1 tsp LC with fd chicken on it, because he won't eat it any other way.

 

I added it to the SS, I had it written in my log book.

 

I'm just watching him now bc Jessie went upstairs and he followed her. Usually that means he wants to chase and run around. Dollars to donuts, that's why he probably upchucked this morning ( if it in fact was him).

 

+2 holding at 76, hungry boi...

I gave him a tspn of his dry, because I'm thinking he was the scarf and barfer.

He needs to stop playing after breakfast! Maybe I'll feed him his wet, shoot insulin, then wait until I'm dressed to go outside for the rescues and that's when I'll let him have the dry.

Because after dry he drinks water, so its too much all at one time. I'll also set my alarm for +7 in the PM Cycle and throw down a tspn of dry so he isn't a maniac in the morning.

 

If there is a long gap between meals at night, that could be causing stomach acid build-up. Puking in the morning, drinking a lot of water and then puking could all be signs of that.

 

Yep, too much acid/ bile in the stomach. I have had this happen with other cats. I already set an alarm for +7pm to give him some crunches. I was doing it, and then stopped because I thought it might be inflating his AMPS, but if he needs it, I'll just have to work around it.

Plus honestly, at 6%, its not much of a bump. He's still "getting there", so I'm still learning if he's truly; bouncing, clearing, having a food spike, etc.

 

I also need to remember that 73 on a human meter is really closer to 90/95 in actual terms of BG. I keep forgetting this.

I have had experience with a hypo, in addition to catching a 39 or 42 on the AT2 with Luigi, so I also need to breathe and not get over excited at the sight of 70s... I just don't want fast drops and hard bounces, because he appears to be improving in that arena.

 

Did you notice that yesterday his nadir seemed to be at +6 instead of+4 in both cycles? I found that unusual, unless the modification I made with his feeding schedule created that pattern.

He's just getting a little less dry overall for the day now, so I can give him more wet. Yesterday we had no deviation from a normal feeding schedule because he never dipped below 100. Just an observation.

 

Nice greens you’ve got there! Surf safely, sweet Sly

 

Thanks Karen! Still holding at +3!

 

Out of sheer curiosity, at +3 I got enough blood for 2 tests, so I checked the AT2 and it was 81, so now I see the ratio is much tighter at lower readings.
Knowing this, I think holding him in the high 70s on the human meter may be the lowest I want him to drop. My Vet looked back at all his pre-DX BGs and they were between 95 and 120.

 

Good to see you in the green zone, Sly! Mikan is following his suit today (at +5 69). Let's drive safely and stay in the dark green!

 

Go Mikan!!! I hope you sail safely all day!

We're up to 92 at nadir, his post breakfast scarf and barf skewed everything (I think?). We'll try an extra feeding overnight to see if that balances everything out.

 

He dipped a little back down to 81 at +5

I'm honestly surprised, but not complaining.

 

Hopefully tomorrow, his middle of the night snack will help his tummy acid, and eliminate him filling up on water. He needs to stop inhaling breakfast too!!

If you remember, over a week ago, when you stayed with me and I stalled the 30 minutes, he was trying to drink because he was Mr. Hangry Pants...

 

I remember . That's adorable.

Great cycle and fabulous job so far today!

 

Thanks Ang! I do like these numbers, but I'm honestly on the fence and thinking about taking a 1/4U reduction.

To me, low 70s are a little low, at least for him. He's never had BG in the 80s or 90s (in terms of actual BG prior to DX).

I won't know unless I go back down to the 5.25, and at the worst, I'll have to look at ugly numbers for a week.

Part of this consideration, is the fact that he had his diet cut back too, so maybe this dose TRULY is a bit high based on what he's eating. If he didn't need to drop a few pounds, it wouldn't be a factor.

What are your thoughts?

 

With a diet change, less dry more wet I would err on the side of caution and reduce. But by how much??? I'm out and about but will definitely brain storm with you and some others in a bit.

 

@Deb and Sylvester I've been thinking about your question all afternoon/early evening.
I reread the sticky on SLGS and I think you should lower the dose. See excerpt from SLGS:

"As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change)." emphasis added.​

I'm going to tag more experienced members to advise on the dose since Sly is currently at 5.5 units - @Wendy&Neko @Bron and Sheba (GA) @tiffmaxee and @Bandit's Mom please see post #32.

​

 

Hi Ang! Yes, I already decided that I'm going back down to 5.25 tonight. I'll let him do his bouncy thing from today's green streak and see where he lands..? I can always go back up next Sunday if the reduction fails, so, I'm ok with that.

My concern also lies in the fact, that he would have absolutely went below the 70 marker I set, had I not intervened.

 

I took the reduction.

Let's see what he does with it this week

 

Angela was correct that a decrease was earned with the bg under 90 with SLGS. Congrats.

 

Paws crossed!

 

Typically it is suggested that dose adjustments when above 5u are done by 0.5u. I see that there were some previous cycles where you didn’t take a reducie per SLGS although you got under 90. I’d suggest you go back down to 5u instead of 5.25u.

 

Deb is using a lower reduction of 70 and Sly has definitely earned (Go Sly ) a reduction. Deb tests a lot! I'm just wondering if she should go down from 5.5 to 5 bc
(1) as @Christie & Maverick pointed, Sly is on 5+ units;
(2) Sly is getting LESS dry food per post 32 and
(3) she intervened to keep him above 70 today per post 35.

 

As far as I can see, there being a different reduction point of 70 isn’t mentioned anywhere and on pm of March 17th that wasn’t followed anyway? It makes it somewhat difficult to offer suggestions . Dry food is still in the mix, and it is one of those unknown variables in terms of how kitty’s BG is influenced and for how long.

As for my original comment, that hasn’t changed, I’d go down to 5u.

 

I didn't reduce

My apologies for not noting the reduction point on our SS, I just added it. The only reason I didn't reduce on that day was because I thought it was possibly influenced by the combination of the dose increase, and daylight savings creating a slight dose increase.

I chose to reduce by the 1/4U, as I personally feel moving in smaller increments is safer, especially as I'm trying to get Sly to slowly lose weight.

 

It’s good you noted the lower reduction number on your signature as I did not know that. I would still have suggested a .25 reduction since your increases are in .25 increments however if he decides to race down the dosing scale larger reductions may be needed.

Why do you feel reducing is safer in .25 increments? I disagree. If he starts getting low green with you feeding less dry .50 increments might be safer.

 

I should have clarified my statement,
I feel it's safer going UP in .25 increments, and the reasoning for me going back down in the .25 increment is so I don't necessarily pass a good dose. I am not averse to going down further to 5, if his numbers prove that would be a better dose.

Also, the additional food change is not extreme, I modified a heaping 1/3 cup to a level 1/3 cup, so I can feed a little more wet in conjunction with the dry, and not go over his calories for the day while we are trying to lose weight. We are doing it very slowly.

 

Sounds good and actually my feeling too in your case although others disagree. Cats that are not seeing green do need larger increases at higher levels to make an impact. every cat is different. Thanks for clarifying.

 

Of course.

This week will probably reveal a slightly different pattern than where he was when we were at the same dose a few weeks back.

I have also noticed that just within the last several days, that his nadir is a little later than where he was peaking originally. Is that a result of regulation, or perhaps just that the duration of the dose is better?

Thanks for all your support,
Deb