05/26 Mister AMPS 152 +1 109 +1.75 68 +2 75 +2.5 89 +3 92 +4.5 102 +7 143 PMPS 270 +1 274 +2 222

[Elizabeth & Mister]

05/25 Mister AMPS 272 +1 231 +2 187 +3 159 +5 182 +8.5 261 PMPS 250 +1 191 +2 96 +2.5 74 +3 78

Gonna be a long post I’m sorry, I almost slept through my alarm this morning. Thankfully my mom heard it from her room and woke me up. It had been going off for 30 minutes and I had no idea, just dead to the world.

I reduced Mister’s dose to 4u this AM because I need to get some rest. I’ve been running on E and I’m really starting to feel it. I struggle with a chronic illness and mental health and I’ve been having a hard time with brain fog and exhaustion and I’m terrified for how I’m going to handle things when I go back to work. I’m struggling even now to remember certain words as I type this. I can nap during the day now, but soon that won’t be possible and I don’t know how I’ll manage this. I’m Mister’s only caretaker. My mom is willing to feed him while I’m at work, I plan on prepping all of his meals ahead of time so she just needs to pull it out of the fridge and serve it. But as far as monitoring him, testing him, that’s all me. I tried to adjust my schedule to be home for the first few hours after his AM shot but that’s looking more and more like it’s going to be a problem. I’ve lost 2 job opportunities now due to scheduling conflicts. My bank account is running low, I barely have enough for a single vet visit if needed and I have multiple animals who also need care. I’m worried about Mister during the hours I’m not here. If he takes a fast dive like he did last night @ +1/+2 and my mom is only feeding him LC every couple hours, I won’t be able to handle the worry. But I need to be working soon or I won’t be able to afford any of this.

My question, what are the pros and cons to me switching to SLGS? I know the differences in reductions below 90 instead of 50, and requirements for BG tests, and that’s what I’m thinking would be better for me to handle right now. But I’ve noticed on other spreadsheets where the CG is doing SLGS and didn’t reduce with numbers under 90. Would a more custom dosing protocol be my best bet? I know green numbers are healing numbers, and I don’t want to do anything to harm him, but the stress of me worrying about him when I’m not here is overwhelming me. I know his numbers have been safe numbers so far, but some of that has been me feeding higher carbs to flatten the curve. As far as testing, I don’t know what my schedule will be just yet but i do know it will reduce the number of tests I’ve been getting and getting up throughout the night to test at the rate I have been is 50/50 and I can’t rely on those odds. I woke up in such a panic this morning after sleeping through my alarms.

I’m in tears just typing this, which I know is partially due to me just being tired and not feeling good. My brain keeps telling me that people make this work all the time and I’m just not doing enough but the logical side knows that’s not true.

Just something I’ve been considering and would love to hear other opinions.

 

[Elizabeth & Mister]

Dropping fast again. My anxiety is through the roof….im feeding HC

 

[Elizabeth & Mister]

He's going up/slowing down, but I've had to chase him around with food all morning. He's getting irritated with all the ear pricks too but he does let me get them. These fast drops are really hard on me. I have dogs that need walked and fed and I feel like I'm letting them all down. Myself, I'm exhausted too. I think I need to find a way to slow things down. Any advice would be so appreciated. Thank you guys for everything.

 

[tiffmaxee]

What you are seeing is super common fur newly diagnosed cats. It does get easier as you learn patterns. He is looking really good. I can tell you fear a hypo and I get that. However looking at your ss night tests I don’t think you need to test as late as you currently are doing. For example last night he was flat and I would have told you to stop at +5. I would have left out some lc and gone to bed. He’s not going to be as hungry in normal numbers. He has so far not been close to falling under 50. He is responding well though. It is early in your journey so my opinion would be not to try custom dosing. The thought of a hypo is scary but I know. Cats usually get super hungry when dropping low.His nadirs seem to be at +5 right now.

 

[Elizabeth & Mister]

What you are seeing is super common fur newly diagnosed cats. It does get easier as you learn patterns. He is looking really good. I can tell you fear a hypo and I get that. However looking at your ss night tests I don’t think you need to test as late as you currently are doing. For example last night he was flat and I would have told you to stop at +5. I would have left out some lc and gone to bed. He’s not going to be as hungry in normal numbers. He has so far not been close to falling under 50. He is responding well though. It is early in your journey so my opinion would be not to try custom dosing. The thought of a hypo is scary but I know. Cats usually get super hungry when dropping low.His nadirs seem to be at +5 right now.

Thank you so much for this. Yes I do fear that mainly because of how quickly he drops when he has lower preshots. For him to still be under 100 after all the HC and even syrup I gave him makes me nervous for what he would have dropped had I not been here. That’s my biggest concern. Soon I’ll have to return to work and won’t be able to test like I am now. I’m hoping I can at least be home for his +2 but right now I don’t know that. I just want to be prepared for when that time comes. I struggle with AuDHD and it’s got me running in circles lately. I need to try to find a good balance.
I was a bit confused on his nadir since I’ve been feeding his curve on a few cycles so i appreciate your insight on that that’s very helpful to me. I wasn’t sure if he might have an early one. My brain keeps wanting to make his nadir the average of his lowest numbers, instead of looking at it a cycle at a time. Definitely still getting used to looking at data/patterns. Thank you

 

[Marje and Gracie]

(((Elizabeth))) I’m sorry the future changes have you overwhelmed and I’ll see if I can also add some info to help.

First, today is a great example of what happens when you reduce the dose: His 4.25u depot is still in play so it’s u likely you will get much sleep until maybe late in the day. It’s why I’m not a fan of shooting a one-time reduced dose….the effects may not occur during the cycle you want them to and, if they do, it will usually be later in the cycle.

Before you jump from TR to SLGS, please read this great post from a former moderator on doing TR and working full-time. It has examples from several members who worked and did TR. I also worked full-time but if I had a day when I was worried about Gracie and her daddy wasn’t home (commercial airline pilot), I was lucky to either be able to work from home or take her with me. Instead of adjusting your work schedule, you might need to adjust his shot schedule like some of the members in the post did.

If you choose to switch from TR, I agree with Elise that it is too soon to do custom dosing. If a member who says they are doing SLGS is not using 90 as a reduction point, then they aren’t doing SLGS. SLGS will slow down the increases which will leave him at higher numbers longer and reducing at 90 means you might have to go up and down around a dose if he doesn’t hold the reduction but that’s ok. That can happen with TR as well.

I understand your fear 100% as Gracie was always so unpredictable, but got much better with Levemir. I just don’t want you to think SLGS is a panacea and will enable you to go to work and not worry. He can still drop lower on SLGS; not trying to make you worry about that but you need all the info to make a decision. He won’t know he’s on SLGS so his BG just won’t magically stop at 89 or 90

Is there any chance you can teach your mom to test or is he just too “spicy” sometimes and she’s afraid of that? I wouldn’t rely on him being hungry if he drops low. Do you see that pattern in him now? Gracie was not like that so while many do want to eat, not all will let you know.

You are a testaholic like me but one pattern I see is he often is already signaling at +1 if he’s going to drop. He has had two cycles where he started in yellow and dropped into green. He signalled at +1 that he was taking a steep drop so if you could move his shot earlier enough that you could get a +1, you would know whether to offer him some HC food then or have your mom do it at +2.

I would definitely be sure your mom knows the signs of a hypo, where your supplies are, and what to do exactly.

How about once you keep up with TR right now and once you get your work schedule, post it and we will help you come up with a schedule. If it still makes you uneasy, you can try SLGS. There is no issue in going back and forth so if you try TR for a couple weeks while you work, and it’s too much anxiety, try SLGS. Or if you start SLGS for a few weeks and you feel it’s really impeding his progress, you can switch back to TR.

 

[Elizabeth & Mister]

(((Elizabeth))) I’m sorry the future changes have you overwhelmed and I’ll see if I can also add some info to help.

First, today is a great example of what happens when you reduce the dose: His 4.25u depot is still in play so it’s u likely you will get much sleep until maybe late in the day. It’s why I’m not a fan of shooting a one-time reduced dose….the effects may not occur during the cycle you want them to and, if they do, it will usually be later in the cycle.

Before you jump from TR to SLGS, please read this great post from a former moderator on doing TR and working full-time. It has examples from several members who worked and did TR. I also worked full-time but if I had a day when I was worried about Gracie and her daddy wasn’t home (commercial airline pilot), I was lucky to either be able to work from home or take her with me. Instead of adjusting your work schedule, you might need to adjust his shot schedule like some of the members in the post did.

If you choose to switch from TR, I agree with Elise that it is too soon to do custom dosing. If a member who says they are doing SLGS is not using 90 as a reduction point, then they aren’t doing SLGS. SLGS will slow down the increases which will leave him at higher numbers longer and reducing at 90 means you might have to go up and down around a dose if he doesn’t hold the reduction but that’s ok. That can happen with TR as well.

I understand your fear 100% as Gracie was always so unpredictable, but got much better with Levemir. I just don’t want you to think SLGS is a panacea and will enable you to go to work and not worry. He can still drop lower on SLGS; not trying to make you worry about that but you need all the info to make a decision. He won’t know he’s on SLGS so his BG just won’t magically stop at 89 or 90

Is there any chance you can teach your mom to test or is he just too “spicy” sometimes and she’s afraid of that? I wouldn’t rely on him being hungry if he drops low. Do you see that pattern in him now? Gracie was not like that so while many do want to eat, not all will let you know.

You are a testaholic like me but one pattern I see is he often is already signaling at +1 if he’s going to drop. He has had two cycles where he started in yellow and dropped into green. He signalled at +1 that he was taking a steep drop so if you could move his shot earlier enough that you could get a +1, you would know whether to offer him some HC food then or have your mom do it at +2.

I would definitely be sure your mom knows the signs of a hypo, where your supplies are, and what to do exactly.

How about once you keep up with TR right now and once you get your work schedule, post it and we will help you come up with a schedule. If it still makes you uneasy, you can try SLGS. There is no issue in going back and forth so if you try TR for a couple weeks while you work, and it’s too much anxiety, try SLGS. Or if you start SLGS for a few weeks and you feel it’s really impeding his progress, you can switch back to TR.

Thank you , I was really looking forward to hearing from you on this. I was so tired and felt worn out this morning that I didn’t think of the depot until after the fact. I just knew I wanted to see him in some slightly higher numbers so I could relax, and thankfully at least that’s where we’re at so I’m going down for a quick nap.

I have read that link but just read through it again. I think my problem there is that I’m not nearly as comfortable “knowing my cat”, knowing all my options in certain situations or interpreting his data as I’d like to be, my mind feels really foggy and i think that’s the main thing driving me to want to slow down a little bit so I can be more confident in all of this, hence asking about SLGS. I’d like to be able to look at his sheet and notice things like his typical response to increases, how long he usually takes to break his bounce, etc. I tend to see things in the moment and have a hard time with “the big picture”. I hope that makes sense.
I appreciate you pointing out that he can still drop low using that method, and I also don’t want to do anything to cause him to start staying high either. With him being newly diagnosed and also bouncing I know I may be asking for too much right now. If he was more predictable I know I’d feel better about it. I just know the rate I’m going I need to approach this a little differently because I’m struggling really bad mentally.
I do think moving his shot time will help with my scheduling and availability. I was turned down at a recent interview due to my inability to be more flexible with my schedule. But I won’t compromise to the point it puts him at risk, he’s my priority there so I’m trying to prepare now. I think I’ll try moving him to 6a-6p instead of 7. What exactly is the “cut off” for times I might not be exactly on time? Is it preferably within 30 minutes? I noticed in that condo OP mentioned skipping a dose if she was going to be too late.

My mom is very against testing him, he’s friendly enough with her but he’s really only comfortable with me handling him so I can’t blame her there. But she’s been supportive in learning about how to use the hypo kit, what to look for, and rubbing karo on his gums if he’s symptomatic. She also is learning how to use the automatic feeder in case there’s a time she can’t be here. She will keep an eye on him to make sure he’s doing okay but also knows cats don’t always show their symptoms so there may be times he gets carbs when he might not need them. I can’t really say I notice him being hungrier when he’s lower. He’s always hungry in the mornings. But I’d rather him be safe than sorry so being home for his +2 is important to me, at least I’ll have an idea of where he’s headed. I tend to veer on the side of caution and probably overly so when it comes to him.

I’m going to stick with TR for now, until I’ve done more reading on SLGS. I want my decision to be backed by more information. I want to take advantage of being home with him 24/7 now while I can, and if the time comes for me to start work and I want to switch to see how it goes I’ll do that. I’m glad to know that’s possible, I wasn’t sure if it was very bad to switch back and forth with him being unregulated.

Whew, that was a mouthful. Thank you for being here for us. You mean so much to me. He’s curled up on my bed napping peacefully so I’m going to join him for a little bit and I’ll check back in shortly

 

[Mary & Jude]

Elizabeth,

One thing I've observed in my time on the forum is that newly diagnosed cats experience a lot of fluctuations. When they are diagnosed, our cats are completely out of range, and probably have been awhile before they became symptomatic. And then once diagnosed, we're correcting the diabetes with insulin, changing the dose frequently, trying to get to the right dose. And then there's the bouncing that so many newly diagnosed kitties experience. Lots of ups and downs in numbers. I mention this for two reasons: first, two weeks or a month from now, Mister will very likely not be in the same place he is now (keep this in mind when making decisions about the future--you don't really know that he is going to be diving at +1/+2 when you go back to work). Hopefully, he will become more accustomed to the dose, will experience more greens, and his bouncing will slow. Hopefully. And the second reason I mention this is because it's hard to see patterns at this point when things are fluctuating. This is where the forum was so helpful to me. Because I had never seen what insulin treatment looks like in a cat, the more experienced eyes could point out a bounce or a bounce-breaking cycle that I just didn't see, etc. It's how we learn. Don't beat yourself up for not seeing patterns yet or for needing guidance with decisions. You're at the very beginning of his treatment (just a little over one month), and you're learning every day.

Just a thought: in terms of going back to work and keeping an eye on Mister, have you considered getting a CGM? That way, when you go to work, you can monitor his bg. And if your mom is willing to help with feeding, if Mister goes too low, she can intervene with food. Again, it's possible that you wouldn't have to keep up the CGM long term, but just until you can get him to a more stable and predictable place (hopefully), where you're not worried about him pulling some crazy numbers out of his little cat hat while you're at work.

And FWIW, I cried a lot at the beginning of Jude's diagnosis for a variety of reasons, and lack of sleep was definitely one of them. It does get easier in time. That said, we're not in a competition here to be the toughest FD caregiver! You need to acknowledge your limitations and find ways to do what is best for you, first and foremost, and secondly for Mister. If you are not healthy (physically, mentally, financially, etc.), there will be no one for him.

 

[Marje and Gracie]

Thank you , I was really looking forward to hearing from you on this. I was so tired and felt worn out this morning that I didn’t think of the depot until after the fact. I just knew I wanted to see him in some slightly higher numbers so I could relax, and thankfully at least that’s where we’re at so I’m going down for a quick nap.

I have read that link but just read through it again. I think my problem there is that I’m not nearly as comfortable “knowing my cat”, knowing all my options in certain situations or interpreting his data as I’d like to be, my mind feels really foggy and i think that’s the main thing driving me to want to slow down a little bit so I can be more confident in all of this, hence asking about SLGS. I’d like to be able to look at his sheet and notice things like his typical response to increases, how long he usually takes to break his bounce, etc. I tend to see things in the moment and have a hard time with “the big picture”. I hope that makes sense.
I appreciate you pointing out that he can still drop low using that method, and I also don’t want to do anything to cause him to start staying high either. With him being newly diagnosed and also bouncing I know I may be asking for too much right now. If he was more predictable I know I’d feel better about it. I just know the rate I’m going I need to approach this a little differently because I’m struggling really bad mentally.
I do think moving his shot time will help with my scheduling and availability. I was turned down at a recent interview due to my inability to be more flexible with my schedule. But I won’t compromise to the point it puts him at risk, he’s my priority there so I’m trying to prepare now. I think I’ll try moving him to 6a-6p instead of 7. What exactly is the “cut off” for times I might not be exactly on time? Is it preferably within 30 minutes? I noticed in that condo OP mentioned skipping a dose if she was going to be too late.

My mom is very against testing him, he’s friendly enough with her but he’s really only comfortable with me handling him so I can’t blame her there. But she’s been supportive in learning about how to use the hypo kit, what to look for, and rubbing karo on his gums if he’s symptomatic. She also is learning how to use the automatic feeder in case there’s a time she can’t be here. She will keep an eye on him to make sure he’s doing okay but also knows cats don’t always show their symptoms so there may be times he gets carbs when he might not need them. I can’t really say I notice him being hungrier when he’s lower. He’s always hungry in the mornings. But I’d rather him be safe than sorry so being home for his +2 is important to me, at least I’ll have an idea of where he’s headed. I tend to veer on the side of caution and probably overly so when it comes to him.

I’m going to stick with TR for now, until I’ve done more reading on SLGS. I want my decision to be backed by more information. I want to take advantage of being home with him 24/7 now while I can, and if the time comes for me to start work and I want to switch to see how it goes I’ll do that. I’m glad to know that’s possible, I wasn’t sure if it was very bad to switch back and forth with him being unregulated.

Whew, that was a mouthful. Thank you for being here for us. You mean so much to me. He’s curled up on my bed napping peacefully so I’m going to join him for a little bit and I’ll check back in shortly

I appreciate all that info and just want to assure you that we are here to help when you are ready to start work but try not to worry about that right now. Just focus on resting and getting stronger and managing his FD as you can. You d been doing a great job and he’s come a long way.

I’m glad @Mary & Jude gave you some thoughts. In the time I’ve been here, I would say not all cats totally level out and that was the case with Gracie. If I was being really aggressive with her dosing, yes, she did. But you can look at her SS and see she was a very bouncy girl even after 5.5 years. In fact, I often used R to get those bounces flattened out. She was not the only cat like this.

It’s your decision on the CGM. I think Mary’s point is well taken that it would allow you to watch him and know when to have your mom test him. But there are some issues with them like becoming loose, reading too high when the BG is high, reading too low when it’s not that low. I feel it makes it hard to make the correct dosing decisions when relying on the CGM because it might indicate he is “LO” when he’s really in the 80s and then you want to reduce because your only point of reference is the CGM.

Having said that, it would definitely give you some comfort to be able to tell what he’s doing and have your mom feed accordingly.

 

[Staci & Ivy]

(((Elizabeth))) Marje and Mary have written so well what so many of us have experienced.
And what you are experiencing is so common and so normal. The stress is off the charts for us caregivers trying to figure out how to manage this disease.
And you were doing such a great job in learning and asking questions. It’s so important to voice your concerns and your feelings and just know there are many people here who have gone through exactly what you are right now.
And we are here to support you and help you.

As your situation evolves with a new job, we can help guide you with suggestions in how to manage Mister’s care.
Just wanted to let you know it’s very common how you feel and we “get it”.

Sending you both big hugs

 

[Elaine and Ember]

Big hugs from me and Ember! I just wanted to weigh in as someone who works full time and is a solo caregiver for Ember, (plus my own 5 kitties and another foster kitty at the moment.) I've stuck with SLGS for the last 7 1/2 months since I'm worried that the more aggressive dosing might be too dangerous since I'm away from home for 10 hours a day. But I question my choice all the time-- I keep wondering if she'd be regulated by now if I'd followed the more aggressive path. I think that would have been better for her, especially as a high-dose kitty. But the risk stopped me and some days I'm mad at myself about it and some days I think it's been the right choice. I hate that nothing about this is black and white- everything is shades of gray! I recently got a CGM and was hoping that would ease my anxiety about being away, and in some ways it has (I know she's alive even if I can't see her on my camera!), but until I learn how to interpret it, its lack of accuracy has definitely caused some stressful moments. I think it's a learning curve and once I get used to its patterns it will be very helpful. I wish I had actual advice to give, but as everyone else has said, you're not alone and on the days where I'm feeling down and overwhelmed, it helps to know that others understand.

 

[Elizabeth & Mister]

Elizabeth,

One thing I've observed in my time on the forum is that newly diagnosed cats experience a lot of fluctuations. When they are diagnosed, our cats are completely out of range, and probably have been awhile before they became symptomatic. And then once diagnosed, we're correcting the diabetes with insulin, changing the dose frequently, trying to get to the right dose. And then there's the bouncing that so many newly diagnosed kitties experience. Lots of ups and downs in numbers. I mention this for two reasons: first, two weeks or a month from now, Mister will very likely not be in the same place he is now (keep this in mind when making decisions about the future--you don't really know that he is going to be diving at +1/+2 when you go back to work). Hopefully, he will become more accustomed to the dose, will experience more greens, and his bouncing will slow. Hopefully. And the second reason I mention this is because it's hard to see patterns at this point when things are fluctuating. This is where the forum was so helpful to me. Because I had never seen what insulin treatment looks like in a cat, the more experienced eyes could point out a bounce or a bounce-breaking cycle that I just didn't see, etc. It's how we learn. Don't beat yourself up for not seeing patterns yet or for needing guidance with decisions. You're at the very beginning of his treatment (just a little over one month), and you're learning every day.

Just a thought: in terms of going back to work and keeping an eye on Mister, have you considered getting a CGM? That way, when you go to work, you can monitor his bg. And if your mom is willing to help with feeding, if Mister goes too low, she can intervene with food. Again, it's possible that you wouldn't have to keep up the CGM long term, but just until you can get him to a more stable and predictable place (hopefully), where you're not worried about him pulling some crazy numbers out of his little cat hat while you're at work.

And FWIW, I cried a lot at the beginning of Jude's diagnosis for a variety of reasons, and lack of sleep was definitely one of them. It does get easier in time. That said, we're not in a competition here to be the toughest FD caregiver! You need to acknowledge your limitations and find ways to do what is best for you, first and foremost, and secondly for Mister. If you are not healthy (physically, mentally, financially, etc.), there will be no one for him.

This is soooo kind and made me tear up, thank you. I realized I'm being a little hard on myself maybe, of course I'm not going to recognize everything all at once, I know each person on this forum who I turn to for help has also had to start somewhere. I think it gets a little harder when knowing that he depends on me so much, I just want to be able to do the very best for him, and not always knowing what that is can be so scary.
I have considered a CGM, but the reason I haven't considered it more heavily is honestly due to cost. I just simply don't have the extra money right now in case he rips it off or it stops working. But i am open to the idea of persuing that option later on if I think he needs one or I would be more comfortable. Maybe you're right and he won't even be in the same place when the time comes that I won't be with him 24/7.
Sending you hugs, thank you so much.

 

[Elizabeth & Mister]

I appreciate all that info and just want to assure you that we are here to help when you are ready to start work but try not to worry about that right now. Just focus on resting and getting stronger and managing his FD as you can. You d been doing a great job and he’s come a long way.

I’m glad @Mary & Jude gave you some thoughts. In the time I’ve been here, I would say not all cats totally level out and that was the case with Gracie. If I was being really aggressive with her dosing, yes, she did. But you can look at her SS and see she was a very bouncy girl even after 5.5 years. In fact, I often used R to get those bounces flattened out. She was not the only cat like this.

It’s your decision on the CGM. I think Mary’s point is well taken that it would allow you to watch him and know when to have your mom test him. But there are some issues with them like becoming loose, reading too high when the BG is high, reading too low when it’s not that low. I feel it makes it hard to make the correct dosing decisions when relying on the CGM because it might indicate he is “LO” when he’s really in the 80s and then you want to reduce because your only point of reference is the CGM.

Having said that, it would definitely give you some comfort to be able to tell what he’s doing and have your mom feed accordingly.

I took a look at Gracie's Lantus SS again more closely and wow, she was so much like Mister. From the quick drops and ups and downs. Even reading your notes from those days, they seem to mirror how things are going for me now. Little Gracie girl, she is still helping CGs and their kitties even now.
What is "R"? I've seen this mentioned, and referred to as 'human insulin' but isn't Lantus also a human insulin? The issues with the CGM are what turns me off of the idea a little bit, but then also I've seen on here how helpful they can be also. Depending on the cost I may be looking into this more.
Thank you again for being here for us, it means the whole world to me!

 

[Elizabeth & Mister]

(((Elizabeth))) Marje and Mary have written so well what so many of us have experienced.
And what you are experiencing is so common and so normal. The stress is off the charts for us caregivers trying to figure out how to manage this disease.
And you were doing such a great job in learning and asking questions. It’s so important to voice your concerns and your feelings and just know there are many people here who have gone through exactly what you are right now.
And we are here to support you and help you.

As your situation evolves with a new job, we can help guide you with suggestions in how to manage Mister’s care.
Just wanted to let you know it’s very common how you feel and we “get it”.

Sending you both big hugs

((hugs right back)) Staci thank you so much for this
I think sometimes stress and exhaustion can really take it's toll, and make me feel like I am drowning or like I am alone even when I'm not!

 

[Elizabeth & Mister]

Big hugs from me and Ember! I just wanted to weigh in as someone who works full time and is a solo caregiver for Ember, (plus my own 5 kitties and another foster kitty at the moment.) I've stuck with SLGS for the last 7 1/2 months since I'm worried that the more aggressive dosing might be too dangerous since I'm away from home for 10 hours a day. But I question my choice all the time-- I keep wondering if she'd be regulated by now if I'd followed the more aggressive path. I think that would have been better for her, especially as a high-dose kitty. But the risk stopped me and some days I'm mad at myself about it and some days I think it's been the right choice. I hate that nothing about this is black and white- everything is shades of gray! I recently got a CGM and was hoping that would ease my anxiety about being away, and in some ways it has (I know she's alive even if I can't see her on my camera!), but until I learn how to interpret it, its lack of accuracy has definitely caused some stressful moments. I think it's a learning curve and once I get used to its patterns it will be very helpful. I wish I had actual advice to give, but as everyone else has said, you're not alone and on the days where I'm feeling down and overwhelmed, it helps to know that others understand.

Oh gosh I appreciate this so, so much. You just said exactly how I've been thinking and feeling. I keep questioning myself even now, will this be better? Will that be better? What ifs and what abouts. Knowing that he depends on me, and like you said there being so much gray area in this disease, is so difficult. I'm sending you love, and we are all in this together even if our situations are all unique in their own way. The wackiness the CGMs can sometimes have has kept me from looking into them more, but knowing how anxious I get, even if like you said I could just know he is okay, might help. I really hope that you get accurate readings and a better interpretation of the numbers, I know it can be such a useful and wonderful tool to have.
Hugs

 

[Elizabeth & Mister]

I was able to take a much needed nap today, and just took a longgg shower. I’m feeling a little better about continuing TR. But just knowing myself and how bad my can anxiety get, I worry if he were having a big drop and I had to leave him, I wouldn’t be able to go and would stay home. That sounds horrible, I know it does. But I’m just being honest. Like everyone here, I just want him to be safe and okay. He depends on me for so much and I just want to do the best things for him. Not always knowing what that is is possibly the hardest part about all of this. But I’m worrying too much about the future, and like Marje mentioned to me earlier I can always switch if I want to if it comes to that. I do have a few questions from some things I’ve been reading though, I’d like to get a better grasp of things that confuse me. In the SLGS method it says:

“After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit”

So this means I would have to do a 12 hour curve test before increasing his dose, correct? Because Mister’s nadirs are kind of all over the place. Sometimes below 90, usually between 90-149, and over 150 when he’s bouncing. What if he happens to be bouncing at the time of 1 week on a dose and I increase the dose but the next day he breaks his bounce? Am I reading too far into this? Sometimes I feel like the more I read the more confused I become.

Another question and main concern, would this method put him at greater risk of ketones coming back by being in higher numbers longer? He has been negative (one blood test, the rest urine tests) since May 18th and I know these lower numbers prevent that happening. I don’t know if there is a number or point where they can return.

He’s bouncing now, I figured that he would. I think I’ll be able to sleep better tonight. Being sleep deprived is an awful, even scary, feeling.

I did keep his dose at 4u tonight, I don’t know if I should have done that. He did well on it today but I know part of that was probably the depot too right? I’ll be honest - the depot really confuses me. I've read the stickys and mentions of it in other condos, but it still confuses me. I may go back to that sticky tomorrow, I may have learned more of what I needed to understand it better than the first times I read it.

I appreciate everyone’s kind words today more than I can say. I don’t know what I would do if I hadn’t found this place. Mister and I are so grateful. And we'll just keep going when the going gets tough.

 

[Marje and Gracie]

I took a look at Gracie's Lantus SS again more closely and wow, she was so much like Mister. From the quick drops and ups and downs. Even reading your notes from those days, they seem to mirror how things are going for me now. Little Gracie girl, she is still helping CGs and their kitties even now.
What is "R"? I've seen this mentioned, and referred to as 'human insulin' but isn't Lantus also a human insulin? The issues with the CGM are what turns me off of the idea a little bit, but then also I've seen on here how helpful they can be also. Depending on the cost I may be looking into this more.
Thank you again for being here for us, it means the whole world to me!

Yes Mister is very like her although she was a dream to test and shoot

R (Humulin or Novolin) is a fast acting insulin. It’s usually in and out in about four hours but it can arrest a bounce and set the kitty up to start from a better place if used properly. There are a few of us still around with a lot of R experience including Wendy, Suzanne, and me. To use it, a new member would need one of us to train them.

You are truly welcome!

So this means I would have to do a 12 hour curve test before increasing his dose, correct? Because Mister’s nadirs are kind of all over the place. Sometimes below 90, usually between 90-149, and over 150 when he’s bouncing. What if he happens to be bouncing at the time of 1 week on a dose and I increase the dose but the next day he breaks his bounce? Am I reading too far into this? Sometimes I feel like the more I read the more confused I become.

No you aren’t reading too much into it. It is the downside of SLGS if you don’t have data. The nadir on that day is what you base your dosing on. That would be one pro for the CGM; you would not need to do a curve since you’d have real-time data so you’d be able to make a better decision when looking back a week.

Another question and main concern, would this method put him at greater risk of ketones coming back by being in higher numbers longer? He has been negative (one blood test, the rest urine tests) since May 18th and I know these lower numbers prevent that happening. I don’t know if there is a number or point where they can return.

This I can’t answer for you but “sometimes” kitties who have had ketone issues or DKA can be more prone to them. More so with DKA, though.

I did keep his dose at 4u tonight, I don’t know if I should have done that. He did well on it today but I know part of that was probably the depot too right? I’ll be honest - the depot really confuses me. I've read the stickys and mentions of it in other condos, but it still confuses me. I may go back to that sticky tomorrow, I may have learned more of what I needed to understand it better than the first times I read it.

i probably would have advised to take his dose back up but you hold the needle and know what you need to do to take care of yourself.

After you read, ask your depot questions. But think of it like a water hose slowly filling a bucket. The bucket is the depot. Eventually the cumulative effect of filling the bucket (aka depot) is that it overflows. That’s when a cat earns a reduction.