03/21 Richard - dose increase? AMPS 259 +5 338 PMPS 358

Alex&Richard

Alex&Richard

Member Since 2026
03/20

I was not able to do extra checks today, but overall Richard's BG seems similar to yesterdays. I'm still not sure regarding nadirs - it does look like at night it is around +6 AND +9. During the day closer to +5 or +6 potentially, with some drop around +9 as well. It does look like BG drops lower at night.

It is the 7th day with current dose, so I guess it is time to increase to 1U, right? Or should I do a curve tomorrow before attempting increase? Don't think I'll be able to make a night one though, but can at least check at around pmps+9 if needed.


Regards,
Alex
 
Hi Alex, I don't see any numbers for the past couple of nights. Are they just missing or were you unable to test? Looking at those blues he experienced in his PM cycle on 3/17, it's possible that he is dropping lower at night--it's hard to know without the tests.

Also, it looks like Richard might occasionally be experiencing a double nadir which means a second nadir in the cycle that is typically not as low as the first. That can lead to some confusion about when he is hitting his nadir.
 
Mary & Jude said:
Hi Alex, I don't see any numbers for the past couple of nights. Are they just missing or were you unable to test? Looking at those blues he experienced in his PM cycle on 3/17, it's possible that he is dropping lower at night--it's hard to know without the tests.

Also, it looks like Richard might occasionally be experiencing a double nadir which means a second nadir in the cycle that is typically not as low as the first. That can lead to some confusion about when he is hitting his nadir.
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The CGM failed so doing just pre-sleep check for now. Richard's skin is kind of damaged due to adhesive from patch, so we've decided to let him rest for a while. I can probably do an extra check at night if it would help (e.g. at +9?).
Also, he is still stuck on medium carbs food, which might contribute to higher numbers during the day. It is really hard to force a cat who has been eating same brand the whole life to switch to something else 😟. On the other hand. I don't know how carbs sensitive he is. Maybe, some additional carbs percentage does not really matter in this case, and it is just the fact of having food that matters... (he sleeps all night, but grazes up to ~+6 during the day. I try to remove food after that.)
 
Alex&Richard said:
The CGM failed so doing just pre-sleep check for now. Richard's skin is kind of damaged due to adhesive from patch, so we've decided to let him rest for a while. I can probably do an extra check at night if it would help (e.g. at +9?).
Also, he is still stuck on medium carbs food, which might contribute to higher numbers during the day. It is really hard to force a cat who has been eating same brand the whole life to switch to something else 😟. On the other hand. I don't know how carbs sensitive he is. Maybe, some additional carbs percentage does not really matter in this case, and it is just the fact of having food that matters... (he sleeps all night, but grazes up to ~+6 during the day. I try to remove food after that.)
Click to expand...
@Staci & Ivy, can you offer Alex some guidance related to the skin damage from adhesive???

Alex, I would try to grab at least one other test at night. As I mentioned earlier, he could be going lower at night and bouncing in the day time--it's hard to know without tests. Let's see if @Sienne and Gabby (GA) is around to give dosing advice.

In terms of his food, forgive me if I'm repeating this information, but have you tried a lower carb food mixed into his regular food--to try to gradually ease him off the MC? Also, have you tried a LC food with some tasty food toppers? I don't know what is available in Lithuania. Jude uses a product called FortiFlora, which is marketed as a probiotic, but it's not a really great one. It is very tasty, though, so we use it to sprinkle on his food. Also the Stella and Chewy freeze dried Magical Dinner Dust is quite tasty to kitties.
 
Mary & Jude said:
@Staci & Ivy, can you offer Alex some guidance related to the skin damage from adhesive???

Alex, I would try to grab at least one other test at night. As I mentioned earlier, he could be going lower at night and bouncing in the day time--it's hard to know without tests. Let's see if @Sienne and Gabby (GA) is around to give dosing advice.

In terms of his food, forgive me if I'm repeating this information, but have you tried a lower carb food mixed into his regular food--to try to gradually ease him off the MC? Also, have you tried a LC food with some tasty food toppers? I don't know what is available in Lithuania. Jude uses a product called FortiFlora, which is marketed as a probiotic, but it's not a really great one. It is very tasty, though, so we use it to sprinkle on his food. Also the Stella and Chewy freeze dried Magical Dinner Dust is quite tasty to kitties.
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Hi Alex, what kind of patch are you using on the Libre?

I hope you’re not using any kind of glue to adhere the Libre to Richard’s skin.
Glue can really damage the skin.
You don’t need any glue to apply a sensor.
Do you cover the sensor with a tee shirt (if he tries to remove them?)

If you need to remove a sensor you can use organic coconut oil on a cotton swab and gently go around the sensor to loosen it.
You can also use Brava spray (if you can find that).

If the skin is raw, you can try some coconut oil to soothe the skin.

I hope this helps!
 
Mary & Jude said:
@Staci & Ivy, can you offer Alex some guidance related to the skin damage from adhesive???

Alex, I would try to grab at least one other test at night. As I mentioned earlier, he could be going lower at night and bouncing in the day time--it's hard to know without tests. Let's see if @Sienne and Gabby (GA) is around to give dosing advice.

In terms of his food, forgive me if I'm repeating this information, but have you tried a lower carb food mixed into his regular food--to try to gradually ease him off the MC? Also, have you tried a LC food with some tasty food toppers? I don't know what is available in Lithuania. Jude uses a product called FortiFlora, which is marketed as a probiotic, but it's not a really great one. It is very tasty, though, so we use it to sprinkle on his food. Also the Stella and Chewy freeze dried Magical Dinner Dust is quite tasty to kitties.
Click to expand...
I'm using tuna loaf pieces a toping (it is zero carbs). Royal Canine does not have really low carb options, and other brands texture is very different, but yes, I'm trying to slowly switch him to lower carbs, though not much success for now. Will try FortiFlora, thank you for the suggestion.
 
Staci & Ivy said:
Hi Alex, what kind of patch are you using on the Libre?

I hope you’re not using any kind of glue to adhere the Libre to Richard’s skin.
Glue can really damage the skin.
You don’t need any glue to apply a sensor.
Do you cover the sensor with a tee shirt (if he tries to remove them?)

If you need to remove a sensor you can use organic coconut oil on a cotton swab and gently go around the sensor to loosen it.
You can also use Brava spray (if you can find that).

If the skin is raw, you can try some coconut oil to soothe the skin.

I hope this helps!
Click to expand...
The defalt patch and t-short. No extra glue lately, but during hospital stay Vets had used it and Richard has not completely recovered from it yet - even the fur color is different at spots where the glue was. And he hates t-short :)
 
Alex&Richard said:
The defalt patch and t-short. No extra glue lately, but during hospital stay Vets had used it and Richard has not completely recovered from it yet - even the fur color is different at spots where the glue was. And he hates t-short :)
Click to expand...
What is the default patch?
Can you show a photo?

There are alternatives to a tee shirt.
Did Richard pull the Libre off?
Ivy wears a “tube” top (no arms) and she doesn’t mind it.
She doesn’t like a tee shirt.
IMG_6947.jpeg
IMG_9613.jpeg
IMG_5512.jpeg
 
Staci & Ivy said:
What is the default patch?
Can you show a photo?

There are alternatives to a tee shirt.
Did Richard pull the Libre off?
Ivy wears a “tube” top (no arms) and she doesn’t mind it.
She doesn’t like a tee shirt.
Click to expand...
Bondage is even worse - he bites it constantly. With T-short he struggles to jump and move properly, or at least acts so. Without restriction - he tries to bite the CGM off.
Here is how the patch looks like - basically just a sticky piece around the CGM.
20260209_190944.jpg
 
Richard did not have a single spot below 150 with current dose. I will try to check BG around +9 tonight to see how low it will be. If it is 200+, when dose increase to 1U from tomorrow with checks at ~+5-+6 and ~+8-+10 (both AM and PM) for a few days.
Does this sound right? Or better to stick to the current dose for a few more days?
 
Alex&Richard said:
Richard did not have a single spot below 150 with current dose. I will try to check BG around +9 tonight to see how low it will be. If it is 200+, when dose increase to 1U from tomorrow with checks at ~+5-+6 and ~+8-+10 (both AM and PM) for a few days.
Does this sound right? Or better to stick to the current dose for a few more days?
Click to expand...
I think this sounds like a good plan. If you increase, be sure to plan on testing more frequently to ensure his numbers do not go too low. His numbers started dropping when you went to .75, so I would suspect that the increase is going to begin taking him a bit lower.

Do you have a high carb food option in your hypo kit? You'll want to have some high carb on hand to feed him in case his numbers drop into an unsafe range--you'll use food to boost his blood glucose. Honey/syrup are also important to have on hand. Also, be sure to have plenty of testing strips, etc. so that you can adequately monitor.
 
Mary & Jude said:
I think this sounds like a good plan. If you increase, be sure to plan on testing more frequently to ensure his numbers do not go too low. His numbers started dropping when you went to .75, so I would suspect that the increase is going to begin taking him a bit lower.

Do you have a high carb food option in your hypo kit? You'll want to have some high carb on hand to feed him in case his numbers drop into an unsafe range--you'll use food to boost his blood glucose. Honey/syrup are also important to have on hand. Also, be sure to have plenty of testing strips, etc. so that you can adequately monitor.
Click to expand...
Yes, I have maple syrup and some 22-24% gravy wet food, as well as ~30+% dry food. We've started the journey with some lows (with CGM though), so I'm somewhat familiar with the process.
 
Alex&Richard said:
Bondage is even worse - he bites it constantly. With T-short he struggles to jump and move properly, or at least acts so. Without restriction - he tries to bite the CGM off.
Here is how the patch looks like - basically just a sticky piece around the CGM.
View attachment 77494
Click to expand...
Some have used a soft cone around the neck to keep them from biting the sensor.

Hopefully he would get used to it.
If not, are you able to do blood tests?
 
I think he looks good for an increase to 1U. It's been 7 days on this dose and I don't think you're missing any significant lows that would require you to hold the dose. Especially with a history of DKA, you want to get him to a good dose, sooner rather than later.
 
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