1/17 Miss Kitty AMPS 441; +3-343; +6-312

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Olivia & Miss Kitty

Member Since 2025
Hello,

I am new here but a member of the Facebook group and I have posted there a few times. I am struggling with what is going on with Miss Kitty's numbers. It seemed by early December she might have been headed in a good direction [slowly], but now I feel like we're going backwards and it might be my fault completely. I am not trying to be non-compliant with advice but I do panic a little and I am confused on how I should be handling what is going on.

I tried to sum up the important parts of all my posts on FB and included a few questions and her daily menu and schedule.

June 26-Aug 28:
  • Diagnosed with BG of 597. Immediately began switching to canned food and decided next day we would do the insulin and not the pill (she was 100% switched within 3/4 days).
  • Vet did a curve and prescribed 1 unit of Lantus
  • Miss Kitty wouldn’t eat much leading up to the 4th of July holiday and all vets were closed during that time. I wasn’t comfortable giving insulin for fear of a hypo event and the closest place to take her is over an hour away is an emergency clinic in Auburn, so the vet told me to wait on the insulin and gave me a bag of subQ fluid to give to her through the weekend.
  • Got Libre put on. I had a scare with the Libre: Either Miss Kitty was going hypo from 350 within 3-4 hours or libre was a giving me false lows.
  • Kitty had a night where she was vomiting everything up, including water. Got her into the vet that day (this was 4 days before I had my baby), and they said she had some ketones (0.8 on Aug 08) but she wasn’t in DKA or pancreatitis. We got fluids, Cerenia, and sent home and she was SO much better that day.
  • I decided to home test and not use the libre
Nov – Current
  • Using spreadsheet. You can see she drops from purple and red into blue and even green. Then some days she only gets to yellow, and four times she got below 90. I understand there would be bounces.
  • This is where you’ll see different dosages. I was recommended to try TR a few weeks ago on the FB group and I read through this site on that but instead of waiting 6 cycles I adjusted dosage at 5 cycles. And some dosage changes were because of my paranoia that another dose of 1.25 might cause her to drop lower than the last time even if the number wasn’t below 50 (example: Dec 25 she dropped to 69 and I only gave her 1 unit the next dose).
  • I’m positive this is where I’ve screwed everything up.
  • Since NYE I haven’t recorded any green numbers and her PS numbers are still pretty high with more 500s
  • Now suddenly she is hardly dropping throughout the cycle.


Questions:
  • There were many times she dropped FAST within 3 hours of the cycle – not really much change to her food intake or activity. Does that say anything about the dosage? It’s also no longer doing that these days.
  • Did I screw things up from a biological stand-point? Will we get back to positive progression on just 1.25 units? Should I increase to 1.5?
  • Can anyone provide me with a plan at the moment on how to handle TR? I work from home, and we rarely leave town (although we are at the end of this month for 2 days) so I can keep a pretty good eye on her most of the time.


Her current diet and daily schedule:
  • FF Chopped Grill Feast 98kcal/can [P=41; F=56; C=3]
  • FF Tender Liver and Chicken 93kcal/can [P=43; F=55; C=2]
So her calorie intake on the lower end is 232.5kcal/day (if she hypothetically ate only 2.5 of the liver and chicken) and 294kcal/day on the higher end (if she hypothetically ate all three of the chopped grill feast).

  • AMPS BG TEST 7:45/8:00
  • Breakfast 8:00 - typically she eats about half of a can and then snacks on it until close to 10:00/11:00. But she eats all of it
  • AM Poke by 8:15
  • BG check 12:15 - this is +4 and it seems it is when the insulin peaks
  • Lunch 1:00/2:00 - 1/2 can. She is usually hungry enough to eat it all. Note: She cannot do 2 meals/day and go 12 hours without eating or she will vomit clear liquid (she's done this since she was 2 years old, so I don't believe it is diabetes related, just probably gets so hungry she get nauseous?)
  • PMPS BG TEST 7:45/8:00
  • Dinner 8:00 - Like breakfast, usually 1/2 can. Then snacks on it for a little bit.
  • PM Poke by 8:15
  • Midnight snack 1:00/2:00 - 1/2 can

Thank you so much for reading and for your help if you've made it this far.

Spreadsheet: Miss Kitty's spreadsheet (Olivia Blake Thomas)
 
Hi Olivia! Welcome to the forum! The moderators usually like first time posts to go on the main board rather than the Lantus board so that people don't get overlooked on this busier Lantus board, so don't be surprised if your post gets moved. (It's also possible that they might leave it though because it looks like you've gotten everything set up in terms of your spreadsheet and signature.)

Can you go back to the spreadsheet and note when she was on TR and when she was on SLGS. If you'll look at Jude's sheet from late 2024, you'll see how I noted his switch to TR with a line noting the change.

Also, on your spreadsheet, can you please click and slide the 2026 tab to the left so that your spreadsheet opens into the 2026 spreadsheet.

Is it possible that Miss Kitty is having any health issues? Teeth okay? Inflammation and infection can drive up bg numbers. Have you made any changes to her diet that could affect the numbers?

And regarding eating, you mentioned two meals not working for her: we suggest that kitties get frequent small meals throughout the day, rather than just two meals a day (sort of like a human diabetic). The one caveat is that when they are first diagnosed, and when we are gathering data, we withhold food a couple of hours prior to shot time so that we can get an accurate, non-food/carb-manipulated number prior to the shot.

I don't have an answer for why she is bouncing and not seeing those lower numbers. She very likely could use some more juice, but let's wait until someone more experienced with dosing guidance weighs in to make any changes.

@Christie & Maverick @Bandit's Mom
 
Mary has given you some good preliminary suggestions, and I’ll just add a few thoughts. You have held 1.25u for 15 days, and even with SLGS, since you are seeing nadirs over 150 you’d want to increase. Dose needs can change from time to time, and sometimes doses just fizzle out; it’s not that you have done anything wrong.

If you’d like to follow TR, you are testing enough and feeding a low carb canned diet; however, you’d have to be comfortable with getting into ranges lower than what caregivers who follow SLGS would usually, which is to achieve nadirs in the 90-149 range, with preshot numbers typically being higher.

I’d suggest going up to 1.5u and see how she does, but when following TR you will want to hold the dose and not reduce unless she goes under 50.
 
Welcome to the site!
While I'm not one of the pros, I'd definitely be taking mine up at those numbers. +0.25 isn't a drastic change and will hopefully bring some of those numbers down. We can only adjust and wait to see to know. The scariest part is shooting with low numbers to most. I must've read the different sticky threads at least 3x each and was still nervous each time his numbers got lower. In the grand scheme of things, we want them on the lowest cost they can be while still seeing good numbers. But 1.5 still isn't high. My big has gone up to 3.75 and even that's far from the high end.
As for the clear vomit when not eating often enough, a likely culprit would be the acid building up in the stomach and causing acid reflux. It took forever before we realized one of mine was going through this and needed to eat about every 4hrs to keep that from happening. It always happened between 4-5am when someone mentioned her needing food between that late night pm feeding and first am. And as diabetics, they need to be fed more often anyway. So you're doing perfect there.
Good luck with the increase & know both you and your baby now have your own cheerleading section here.😊
Hopefully you'll get sorted out here.
 
Mary & Jude said:
Hi Olivia! Welcome to the forum! The moderators usually like first time posts to go on the main board rather than the Lantus board so that people don't get overlooked on this busier Lantus board, so don't be surprised if your post gets moved. (It's also possible that they might leave it though because it looks like you've gotten everything set up in terms of your spreadsheet and signature.)

Can you go back to the spreadsheet and note when she was on TR and when she was on SLGS. If you'll look at Jude's sheet from late 2024, you'll see how I noted his switch to TR with a line noting the change.

Also, on your spreadsheet, can you please click and slide the 2026 tab to the left so that your spreadsheet opens into the 2026 spreadsheet.

Is it possible that Miss Kitty is having any health issues? Teeth okay? Inflammation and infection can drive up bg numbers. Have you made any changes to her diet that could affect the numbers?

And regarding eating, you mentioned two meals not working for her: we suggest that kitties get frequent small meals throughout the day, rather than just two meals a day (sort of like a human diabetic). The one caveat is that when they are first diagnosed, and when we are gathering data, we withhold food a couple of hours prior to shot time so that we can get an accurate, non-food/carb-manipulated number prior to the shot.

I don't have an answer for why she is bouncing and not seeing those lower numbers. She very likely could use some more juice, but let's wait until someone more experienced with dosing guidance weighs in to make any changes.

@Christie & Maverick @Bandit's Mom
Click to expand...
Hi there. Thank you for your response. I updated my spreadsheet with your requests.

There have been no changes to her food, but I suppose she is due for a vet check so maybe that might tell me something. It was just so disappointing to see her slowly trending downward and now we're trending back up.
 
Christie & Maverick said:
Mary has given you some good preliminary suggestions, and I’ll just add a few thoughts. You have held 1.25u for 15 days, and even with SLGS, since you are seeing nadirs over 150 you’d want to increase. Dose needs can change from time to time, and sometimes doses just fizzle out; it’s not that you have done anything wrong.

If you’d like to follow TR, you are testing enough and feeding a low carb canned diet; however, you’d have to be comfortable with getting into ranges lower than what caregivers who follow SLGS would usually, which is to achieve nadirs in the 90-149 range, with preshot numbers typically being higher.

I’d suggest going up to 1.5u and see how she does, but when following TR you will want to hold the dose and not reduce unless she goes under 50.
Click to expand...
Hi Christie - Thank you. I have been considering increasing her dose. I am sure I can get her into the vet this week to check for any other health issues that could be causing her BG to rise (as Mary mentioned). I was going to try to follow TR but my panic caused me to intervene I suppose. Now that she has been diagnosed diabetic for over 6 months I know our chances of remission have drastically dropped according to the information I've read.
 
Olivia & Miss Kitty said:
Yes, Auburn, AL. That is the closest emergency vet to me when our vet offices are closed. Even then my vet said if she were to go into DKA that is where they would send us.
Click to expand...
I asked about Auburn because I'm about 30 minutes north of Dothan--hey 👋 neighbor! The university clinic is a wonderful option for you!

Absent anything medically going on with Miss Kitty, Christie's comment about the ups and downs of a cat's bg is spot on--sometimes a cat's pancreas just needs more insulin. And you don't want to hold them too long at an inadequate dose. Take a look at Jude's spreadsheet. He came out of remission in October of 24, and he was up and down for a good while until he started to come into regulation around February 25. It happens that a lot of kitties just take some time getting into regulation at the beginning of dx. But for Miss Kitty to see some consistent greens and then not, sort of makes me wonder if there is something underlying, so it's just a good idea to check. Jude came out of remission because of a UTI and he periodically suffers from them along with feline idiopathic cystitis flares which cause his numbers to spike until I can get the flare under control. When his numbers go up, there is often a medical reason. It may/may not be the case with Miss Kitty. Also, Jude is currently on 3U. You'll notice that at times in the past he was receiving 3U, but it was too much insulin for him at that time. A cat's insulin needs can fluctuate--insulin is a hormone, treating a hormonal deficiency; it's not a medicine.

Don't worry too much about the remission within six months deadline. We have other kitties on the board who have gone into remission past that time; some have even gone into and out of remission a couple of times :) But the TR dosing method is the one that is cited for successfully getting kitties into remission (though Jude went into remission (once his food was changed) on SLGS).

One other thing to mention that could cause erratic numbers: how old is the insulin vial/pen? Have you been storing it properly--keeping it refrigerated? Is it possible you need a new vial/pen?

You asked these questions in your initial post, and I want to make sure we've answered them for you:

"There were many times she dropped FAST within 3 hours of the cycle – not really much change to her food intake or activity. Does that say anything about the dosage? It’s also no longer doing that these days."
Some kitties do this--I've seen some much more erratic than Miss Kitty in terms of those nose-dives from the preshot (e.g., take a look at Pip's spreadsheet). To try and mediate those huge drops, we encourage a +1/+2/+3 test to determine if the cat is dropping rapidly, and if he/she is, we suggest feeding the nose-dive to try and flatten it out--starting with LC and then testing in about 20 mins. to see how the cat is responding and then moving up in carbs if necessary as that drop is occurring. This, again, helps to prevent the sharp drop, which is important because those sharp drops can lead to bounces up into higher numbers later. Here is a discussion about feeding the curve: 8/10 TASHIE pmps=HIGH! +Questions***. The only connection to the question "does that say anything about the dosage" might relate to the fact that she is currently not getting enough insulin. But cats change their responses to insulin--right now Jude is having some of the flattest (classic Lantus) surfs I've ever seen him have. Yesterday, he dropped one point from shot to onset.​

"Did I screw things up from a biological stand-point? Will we get back to positive progression on just 1.25 units? Should I increase to 1.5?"
I believe Christie answered the dosing question for you.​
I think you'll begin to see lower numbers again, but I think Miss Kitty, at the moment, is needing more insulin. If you go to the doctor and determine that Miss Kitty does have some underlying issues (infection or inflammation, etc.) that are driving up her numbers, once she is treated, her insulin needs might go down and you can readjust.​

"Can anyone provide me with a plan at the moment on how to handle TR? I work from home, and we rarely leave town (although we are at the end of this month for 2 days) so I can keep a pretty good eye on her most of the time."
If you work from home and can monitor, following TR should be fairly easy for you. First, to follow TR, kitties must be fed a wet-food-only diet--no kibble. Then, as Christie mentioned you are testing enough to follow TR. You need to be able to test at least twice a cycle: one test at the preshot, and at least one other test during the cycle. Most people following TR test more than twice in a cycle, especially as they get started and are gathering data. Twice is the bare minimum. I follow TR, and I work away from home. I test Jude at his shot, and then I try to grab a +2 before I leave to go to work. That +2 helps me know if he is trending downward before his onset, and if he is, I can leave higher carb food for him. That's how we do it, but a lot of how I follow TR is based on how I know Jude typically responds (people here have a saying "know thy cat"). And another saying, "ECID" (every cat is different). What can get scary is when they start getting into the lower numbers (blues/greens--healing numbers for the pancreas beta cells), but this is the goal! You'll become much more comfortable with those lower numbers overtime. I'm sure you've probably read this, but here are the explanations for both dosing methods: Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)​
​
Finally, please add one other thing to your spreadsheet/signature: what is Miss Kitty's dob?
 
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