? 03/24 Blanche 416@AMPS, 226@+3, 87@+5 (ate), 76@+5.30 (ate), 69@+6 (ate + honey), 171@+6.30, 313@+7.30

[Blanche]

Hello fellow sugar kitties!
I hope that you behave and that you surf safely not like Blanche who really love roller coaster and decides that my life isn't exciting enough so she can help.

Today she had a deep red AMPS for no reason at all and she dive at +5 not at +3.
She dive and I couldn't bring her up only with food so the third time I use some honey (maybe too much). So for sure we will have a deep red PMPS.
I don't understand. Is the dose not enough and she cannot attend a duration? Or is the dose too much and she cannot help the diving?
Normally and by the protocol I should reduce. To what really?

Is it something that I can do differently and at least be stable enough for me to go to work? (And not in danger of a heart attack?)

Here, lounging innocently after all the morning excitement!

 

[Albert & Xander]

I don't have any advice I could offer but wanted to say she is beautiful

When Xander was early in his diabetes treatment, it took a bit of time to get him to a dose where he wasn't too low at nadir yet not really high at preshots. She'll get there! I'm sure someone may have some helpful advice shortly.

 

[Staci & Ivy]

Hi Athanasia, Blanche is really responding well to the insulin! She's seeing green nadirs so plenty of insulin!
She's bouncing, I assume from the lows and then she goes high.
The good news is she doesn't stay up there for long!
@Mary & Jude what do you think?

 

[Mary & Jude]

Hi Athanasia, Blanche is really responding well to the insulin! She's seeing green nadirs so plenty of insulin!
She's bouncing, I assume from the lows and then she goes high.
The good news is she doesn't stay up there for long!
@Mary & Jude what do you think?

I looked at Blanche's sheet earlier and decided I'm not sure what is going on
It looks like bouncing from those greens, but I've also seen kitties that eat kibble have some difficulty seeing regulated numbers or their numbers seem more erratic (and that's not to put any pressure on you with the food issue--just an observation I've noticed). Perhaps it's one or a combination of both (or neither!)
Athanasia was right in predicting that red PMPS; it just came an hour early.
I'm also not sure about that drop below 90 today? Doesn't that earn a dose reduction under SLGS? I know that would put her down to the drop dose.
I think someone with more experience needs to hop on here @Bandit's Mom @tiffmaxee

 

[Blanche]

I don't have any advice I could offer but wanted to say she is beautiful

Indeed she is!

But if I'm to be honest, I never saw a cat who wasn't beautiful in her own way...

When Xander was early in his diabetes treatment, it took a bit of time to get him to a dose where he wasn't too low at nadir yet not really high at preshots. She'll get there! I'm sure someone may have some helpful advice shortly.

Thank you Albert!
I really need to believe it is possible! I live as a hostage and in fear that she might pass away if I leave for more than one hour...

Hi Athanasia, Blanche is really responding well to the insulin! She's seeing green nadirs so plenty of insulin!

Hello Staci! Thanks for passing by
I'm afraid that she respond too well and when she dives, she dives deep...

She's bouncing, I assume from the lows and then she goes high.
The good news is she doesn't stay up there for long!

I looked at Blanche's sheet earlier and decided I'm not sure what is going on

That make two of us!

It looks like bouncing from those greens, but I've also seen kitties that eat kibble have some difficulty seeing regulated numbers or their numbers seem more erratic (and that's not to put any pressure on you with the food issue--just an observation I've noticed). Perhaps it's one or a combination of both (or neither!)

We are of the kibbles three days now. Well, of the authorised kibbles. Yesterday she stole three or four from her sister's bowl...

I'm also not sure about that drop below 90 today? Doesn't that earn a dose reduction under SLGS? I know that would put her down to the drop dose.

Nor do I. And it happened again at the night cycle exactly at +5. 84!
It is like her nadir moved from +3 to +5! She is currently eating but it is terrifying that she didn't get up and search for food. I had to take her in my arms to go to the test site and then, when I saw the 84 and I put some MC wet RC, she ate. (She is currently eating).

@Sienne and Gabby (GA) try to warn me yesterday but I wasn't prepare for such inconstancy...

 

[Blanche]

Nor do I. And it happened again at the night cycle exactly at +5. 84!
It is like her nadir moved from +3 to +5!

Ok, the lack of sleep can be a nasty trickster... At +6 she dive not at +5
Already correct her ss

 

[Mary & Jude]

Athanasia, just for a frame of reference, those numbers: 84, 97, 76, even 69, are not that low. I wouldn't give Jude MC or even LC at 84 (I would allow him to graze his LC, but would feed nothing higher than that in terms of carbs). The MC food is going to elevate Blanche's bg at a time that she doesn't really need that boost if her numbers are too high. I know those are lower numbers to you, and they are below the dose reduction threshold for SLGS, but they aren't a "threat of hypo" numbers. So there is a difference between the take action number for a dose decrease and the take action number for a possible hypo. The take action number to boost a kitty out of a hypo is really dependent on the kitty. I've actually seen some kitties here that have symptomatic hypos at relatively higher numbers (like ~60). Here is a discussion about this: Info - How Low Is Too Low?. For me, I begin to feed MC when Jude drops below 60, but I also understand his response to carbs, and I know that due to his carb sensitivity, he will rebound fairly quickly from lower numbers with a bit of MC. I've occasionally had Jude hit the 40s, and I bring out the HC when this happens. Of course, I test again in 20-30 mins. after feeding a higher carb food to ensure he is going up at that point and continue feeding if he's not. I'm not suggesting you follow what I do for Jude; you need to know and do what Blanche needs. This is one of those "every cat is different" scenarios. What you might do is look at some other spreadsheets and see how others handle lower numbers. Here is another discussion about low numbers (note: here, they refer to low numbers as those below 50): Sticky - Don't Panic! or How to Handle Low Numbers

Finally, you are being so diligent and such a good and careful caregiver to keep an eye on her! She's so lucky to have you.

 

[Blanche]

Mary, you are such a dear!
I understand very well the difference between below the dose reduction threshold for SLGS and below the safety threshold, but at the moment of such a steep drop I subconsciously try to stop it, not to let her be near the safety line, not to let her suffer from bounce later. And when the drop continued I was scared, not of the number per se, but of her inhability to came up.
And I think I'm frustrated because I tick all the boxes to follow TR and can't do it because of the MC food. And I'm seriously sleep deprived and behind all others obligations and maybe (for sure) I'm not thinking clearly.
I will go to catch 3h of sleep until the next shot is due, and who knows, tomorrow is an other day...

Thank you and give a kiss to Jude's nose from me please.

 

[Bandit's Mom]

What you are seeing is typical of newly diagnosed, unregulated cats. She is dropping to greens and bouncing from there. Its quite a roller-coaster ride for the CG. But the good news is that she is seeing greens every day now which means she is clearing bounces quickly. Today, she saw green in both cycles! As her body gets used to greens, the bouncing will reduce. I know it's hard for you, but you're doing such a great job.

Her numbers are also responding to the tapering off of the pred. I have no experience with steroids, but I have read here that folks can see numbers being affected on days they give (or don't give) the steroid. I believe even when you give the steroids in the cycle matters.

Most importantly, food is affecting her numbers. If you feed carbs later in the cycle that will affect duration and contribute to bouncing - which leads to higher numbers at the end of the cycle. I'm sorry, but I haven't kept up with what you are doing as far as food transition is concerned. This morning, that dive of almost 200 points at AM+3 is when I would have fed something to slow her down. Feed the MC to slow her down in the first 2-3 hours of the cycle. When she hits high greens later in the cycle, see if you can get her to surf greens with just LC. That might be possible if you've slowed her down with MC early in the cycle. By feeding MC/honey etc later in the cycle, you are reducing the action of insulin in the second half of the cycle, which is why you are seeing numbers shoot up from greens to pink or red. While bouncing is contributing to that, the carbs are aggravating the bounce.

Remember that she in normal numbers when she is over 50 and you want her spending as much time as possible in them.

See what Sienne says, but I'm not sure I would reduce below 0.10U just yet. Try feeding her at +2 and +3 and see if you can get flatter cycles.

 

[Blanche]

What you are seeing is typical of newly diagnosed, unregulated cats. She is dropping to greens and bouncing from there. Its quite a roller-coaster ride for the CG. But the good news is that she is seeing greens every day now which means she is clearing bounces quickly. Today, she saw green in both cycles! As her body gets used to greens, the bouncing will reduce. I know it's hard for you, but you're doing such a great job.

Thank you Bhooma! I really needed to hear this.

Her numbers are also responding to the tapering off of the pred. I have no experience with steroids, but I have read here that folks can see numbers being affected on days they give (or don't give) the steroid. I believe even when you give the steroids in the cycle matters.

She is of the pred. I vow not to give her another ¼ tab, if her life is not in the line. The asthma has made his appearance, but we are lucky, the cold weather holds and for the moment she is ok. Later if (when) her coughing will start to bother her I'll give a try to budesonide nebuliser suspension and we will see.

Most importantly, food is affecting her numbers. If you feed carbs later in the cycle that will affect duration and contribute to bouncing - which leads to higher numbers at the end of the cycle. I'm sorry, but I haven't kept up with what you are doing as far as food transition is concerned.

She is of the HC kibbles. Only MC and LC wet food.

This morning, that dive of almost 200 points at AM+3 is when I would have fed something to slow her down. Feed the MC to slow her down in the first 2-3 hours of the cycle. When she hits high greens later in the cycle, see if you can get her to surf greens with just LC. That might be possible if you've slowed her down with MC early in the cycle. By feeding MC/honey etc later in the cycle, you are reducing the action of insulin in the second half of the cycle, which is why you are seeing numbers shoot up from greens to pink or red. While bouncing is contributing to that, the carbs are aggravating the bounce.

Duly noted!

Remember that she in normal numbers when she is over 50 and you want her spending as much time as possible in them.

See what Sienne says, but I'm not sure I would reduce below 0.10U just yet. Try feeding her at +2 and +3 and see if you can get flatter cycles.

Duly noted as well!

Thanks again Bhooma