? 09/18 Sibon AMPS 79 - justified reduction to 1.5u?

[Elinor & Sibon]

Previous post from last night

I've been shooting Sibon with 2u for a week. His BG dropped to 90-63 two night ago (I hope not lower while I was asleep), and last night he ranged between 53-72. I was asleep during +8, +9 and +10 and during that time he vomited all over the sofa. He didn't show any other alarming symptoms. He did look at me puzzled every time I turned on the light to look at him but he always looks that way whenever it's pitch black and then the light is turned on.

I know that TR protocol calls for reduction only if Sibon dropped below 50, but I don't feel comfortable with this. I'd hate to know that his body feels somewhat bad with dropping to ~60s.

By looking at my spreadsheet in the recent days, would you advise to reduce his dose back to 1.75u?

Thanks.

 

[Elinor & Sibon]

Update:
My vet called and wanted an update on Sibon because we didn't speak for 3 weeks since she recommended to bring his dose down to 1u.
I informed her that his BG was flat and high on 1u, and provided her with his numbers all throughout 1.5u and 2u. She got mad and said that I was "playing vet", and that any number below 150 is dangerous for him. I asked her "Well, what is the normal range for BG?" and she said we're not trying to get him there, and that he should be above 150.
Now she said she forbids me from checking his BG any time between cycles for an entire week and by the end of the week to perform a 12h curve. I asked her if just 1 cycle can really say anything about all previous cycles with the same dose and she agreed that it can't, but these are her orders. At first she said she didn't even want me to test him even before his shots and I told her I will not follow that.

I would really like some reassurance from any of you regarding how I'm working around all of this.

 

[Christie & Maverick]

I would be concerned if I had a conversation like that with my vet. I'm not as familiar with TR so I hope you will get some advice soon. Just a question, is the Accu-Chek Performa meter a pet meter or human meter? If it is a pet meter, I believe the reduction number is actually 80 on TR? Someone more experienced can correct me if I am misleading you.

Perhaps if you change your thread title to show a question mark, and add a question like "should I reduce" then people will see that you need some help.

Sorry that the vet wasn't very supportive of your progress, that advice from the vet is very troubling. That said, the vet won't know if you are checking, so I say check away , do whatever YOU are comfortable with to keep Sibon safe. Just keep a separate spreadsheet to report back to your vet with the 12 hour curve they asked for.

More experienced people usually pop in, hopefully some will be around later in the day, I'm sure you will get some help, hang in there.

 

[Elinor & Sibon]

Thank you for your help, Christie!

Just a question, is the Accu-Chek Performa meter a pet meter or human meter? If it is a pet meter, I believe the reduction number is actually 80 on TR? Someone more experienced can correct me if I am misleading you.

It isn't, it's sold to human diabetics in my local pharmacy.

Update - I reduced to 1.5u just so my temporary () vet will have her way this week until I audition a new one and I can sleep soundly at night knowing he's not dropping and vomiting in the living room.

 

[Wendy&Neko]

It's fine if you want to reduce to give yourself a break. Just be aware that the cycle after a reduction can still be active, due to the depot. So please, for Sibon's sake, keep testing like you have. Just smile and not at the vet and let her words flow in one ear and out the other. You are not playing vet. Human parents test their diabetic children too. It's all about keeping Sibon safe. I'm glad you are looking for another vet.

As far as keeping a cat below 150, what also has to be considered is what high blood sugar does to the cat. If nadirs are above 150, the chances are the cat is spending the majority of it's time over renal threshold, which is very hard on the kidneys. As long as you test like you do, and have higher carb food to manage any low numbers, you are doing what is best for the cat. If a person was not testing at all, I could see a vet getting nervous at numbers below 150.

If it is a pet meter, I believe the reduction number is actually 80 on TR? Someone more experienced can correct me if I am misleading you.

The Accuchek is a commonly used human meter in Canada too. And a correction, the reduction point for TR on a pet meter is 68.

 

[Christie & Maverick]

The Accuchek is a commonly used human meter in Canada too. And a correction, the reduction point for TR on a pet meter is 68.

Thanks for confirming, Wendy. I was thinking of the AAHA Diabetes Management Guidelines 2010 where I recalled reading a recommendation for reductions when < 80mg/dl.

 

[Sienne and Gabby (GA)]

I agree with Wendy. Frankly, you are paying your vet. The vet works for you. How can she "forbid" you to give Sibon the best possible care? You may want to see if she is familiar with Tight Regulation.