1/5 - Gen, AMPS >400, +1 361 - stubborn highs/dosing concerns

[Allie & Gen]

Yesterday

Well, yesterday's AM cycle did not go at all like I expected from the early part of it, and Gen's been up in outer space again. I hate it so much. Patience pants time, I guess. He's also on a weird every-other-day pooping schedule right now (more or less), and I'm not sure if I should be worried about that.

Today's my first day back in the office post-holiday break, and I'm just hoping for a quiet day.

Have a great Monday, friends - safe surf to all your kitties.

 

[Allie & Gen]

Looking over Gen's spreadsheet, I'm feeling a bit frustrated and worried. Gen has a lot of high numbers almost all the time. Sometimes, he'll start to get some lower numbers, but then he'll have a sudden plunge and we'll take a reduction, and the lower numbers disappear. Anytime he gets into the blues or greens, he either bounces sky-high, or takes a dive and earns a reduction. We can't stay in low numbers.

I take the reductions at a lower number than is standard for SLGS, because of the Libre and its tendency to exaggerate low numbers, but even so. I'm really starting to question whether this protocol can work for us at all. I know the dental infection may be interfering too much for this pattern to change until he has his surgery. The reductions still keep feeling like a mistake. Does that make sense? Can anyone with more experience offer any insight?

To be clear: I'm not looking for instruction so much as I'm hoping someone might have time to look at his numbers over time and help me understand what's happening in relation to following protocol, if that makes sense. @Christie & Maverick @Wendy&Neko @Sienne and Gabby (GA)

(I am hoping to have him off the dry food within a couple of weeks. That said, I don't know for sure how long it will take, and I also don't know if switching to TR is likely to work better. I'm game to try anything that might help, though.)

 

[Monster's Mom]

I know I'm no expert by any means but I do agree with you. He stays so high all the time, and I'm sure the dry food has something to do with that. Have you tried just taking it away completely? He can't prefer it if he doesn't have it. He will eventually eat what is given him ( I would think).
As far as his dose goes.... I would hold the dose and not decrease when he earns it. That makes it hard when he gets into lows that aren't normal for him, especially on the line of hypo. I could be totally wrong with all of this but that's what my gut says. You may see improvement once his dental issues are dealt with. But I'm sure once you have him off dry food, it'll help him more too.
Just my opinion, as much as it worth!
I really do hope you can get him into better, more stable numbers and so he can feel better too

 

[Monster's Mom]

Allie, I just wanted to add....
Since you are doing a modified version of SLGS you could wait to take a reduction until Gen falls below your set number on 3 different days. I know it states that for TR protocol for kitties who don't hold reductions well. Not sure if SLGS follows that same guide, but it's not impossible to incorporate for your own needs in a custom dosing Method. ECID!

 

[Tyleete]

I'm sure this is wrong. But yesterday I saw someone with but one low number, and they immediately took a reduction. I'm starting to wonder if perhaps the knee jerk reaction is the opposite of what cats need sometimes. I mean, if you've got a cat that's showing consistent high numbers, you raise the first, and within a few days you have only 1 number that goes into 'hypo' numbers, but then they all raise again? Taking the immediate reduction seems counter-intuitive to me. Were it me, I'd leave the cat on that number so long as it's not below 40. Watch to see what happens. It could be trying to adjust. We all know about the wonky numbers that can occur. And the ever fun bouncing. Due to all of that, I would be hesitant to put the kitty back up to the dose that previously wasn't working for them to begin with.
And please know that my feelings on this, are just my guesswork and instincts on the matter. And have no scientific backing to them. It's just what I've seen from watching threads and seeing how the cats seem to respond. This is just my take.

 

[Allie & Gen]

I know I'm no expert by any means but I do agree with you. He stays so high all the time, and I'm sure the dry food has something to do with that. Have you tried just taking it away completely? He can't prefer it if he doesn't have it. He will eventually eat what is given him ( I would think).

I mean ... I'm not actually sure if it's contributing? It's only about 3.5% carbs, after all. Cutting out dry food has a variety of health benefits, but in this case I don't know that it would make a significant difference to has BG. If I understand correctly (and honestly there's a fair amount of material I haven't read yet), the reason that you're not supposed to feed dry food for TR has more to do with the speed at which the cat's system processes it (which was not taken into account in formulating the method). There are other arguments for giving up dry food more generally, of course, but I'm not sure they're as directly linked to BG. But also, I may be drawing some fairly confused conclusions! I'm just not sure.

The reasons I haven't wanted to just take it away from him entirely are that a) if he refuses to eat much wet food and I give him a shot, his BG could take a dive when I'm at work, and b) he's already pretty significantly underweight and just starting to gain back towards where he's supposed to be, so I'm balancing different health factors. That said, I might try it when I'm home on Wednesday or Saturday, and see what happens.

Your thoughts, and @Tyleete's, on not taking reductions strictly according to the SLGS method make sense to me, and I appreciate your input and support! I also know that a considerable amount of work and testing went into putting the method together, and that I am still struggling to understand what I'm seeing with Gen's cycles. While customization can be necessary and ECID, I'd really like some input from people who have been around awhile (and have therefore seen a lot of different cats' spreadsheets), especially those who have specifically encouraged me to take reductions, like @Christie & Maverick or @Wendy&Neko.

(I'll be talking to my vet about all this as well, probably tomorrow! She has tended to support waiting a week between dosage changes to give them a chance to fully kick in, although she's also been somewhat dubious about some of the reductions and the .25u increments for increases.)

 

[tiffmaxee]

I’m wonder if the low greens were not real and caused by the wacky Libre?

 

[Allie & Gen]

I’m wonder if the low greens were not real and caused by the wacky Libre?

I'm not currently able to do a comparison to verify, but even if it was registering a bit lower than a blood test would, that's just a matter of degree; I don't think they're wildly incorrect. I've checked all my sensors to see if they were affected by the recall, and none were. And I update my spreadsheet whenever the Libre data self-corrects (sometimes it will give a low reading and then revise itself a little while later).

If you're looking at the AM cycle from January 2nd specifically, the Libre's behavior after giving me those low greens (shutting down for 8 hours) doesn't seem to mean that those numbers were inaccurate. It matches an experience @Staci & Ivy has had a number of times, when a Libre sensor happens to be installed while the cat is in greens. Because Libres are calibrated for humans, who generally shouldn't be in those ranges, the theory goes that detecting those numbers right at the start of a sensor's installation winds up triggering a self-diagnostic process. (I find the numbers especially convincing in this case because there were three hours of greens before the shutdown, and because the app did adjust its numbers several times during that period - they initially read as going a bit lower than the final recorded values.)

One way or another, for the timebeing the Libre is all I have to go on, so I have to be willing to make decisions based on it. I did adjust my SLGS method to accommodate by assuming a 20-point variance (making the reduction threshhold 70 instead of 90, to accommodate potentially exaggerated low readings). But even so, my questions about the overall pattern stand. I hope that makes sense!

 

[Tyleete]

I mean ... I'm not actually sure if it's contributing? It's only about 3.5% carbs, after all. Cutting out dry food has a variety of health benefits, but in this case I don't know that it would make a significant difference to has BG. If I understand correctly (and honestly there's a fair amount of material I haven't read yet), the reason that you're not supposed to feed dry food for TR has more to do with the speed at which the cat's system processes it (which was not taken into account in formulating the method). There are other arguments for giving up dry food more generally, of course, but I'm not sure they're as directly linked to BG. But also, I may be drawing some fairly confused conclusions! I'm just not sure.

The reasons I haven't wanted to just take it away from him entirely are that a) if he refuses to eat much wet food and I give him a shot, his BG could take a dive when I'm at work, and b) he's already pretty significantly underweight and just starting to gain back towards where he's supposed to be, so I'm balancing different health factors. That said, I might try it when I'm home on Wednesday or Saturday, and see what happens.

Your thoughts, and @Tyleete's, on not taking reductions strictly according to the SLGS method make sense to me, and I appreciate your input and support! I also know that a considerable amount of work and testing went into putting the method together, and that I am still struggling to understand what I'm seeing with Gen's cycles. While customization can be necessary and ECID, I'd really like some input from people who have been around awhile (and have therefore seen a lot of different cats' spreadsheets), especially those who have specifically encouraged me to take reductions, like @Christie & Maverick or @Wendy&Neko.

(I'll be talking to my vet about all this as well, probably tomorrow! She has tended to support waiting a week between dosage changes to give them a chance to fully kick in, although she's also been somewhat dubious about some of the reductions and the .25u increments for increases.)

I never said don't take reductions. I said I wouldn't go back up just for the 1low number, and it not even being that low to begin with

 

[Allie & Gen]

I never said don't take reductions. I said I wouldn't go back up just for the 1low number, and it not even being that low to begin with

I know, sorry, I was trying to summarize/paraphrase. I said "not taking reductions strictly according to the SLGS method" - the SLGS method says that you are supposed to take an immediate reduction if your cat drops to anything below 90 (I know - not low at all). I revised it to 70 to account for the Libre giving exaggerated lows.

Taking the immediate reduction seems counter-intuitive to me. Were it me, I'd leave the cat on that number so long as it's not below 40. Watch to see what happens. It could be trying to adjust.

You're not saying "don't take reductions," but your hypothetical scenario would be "not taking reductions strictly according to the SLGS method." Which is exactly what I'm wondering about! I was just hoping for some input from some of our more long-term members who have given me advice that is strictly in line with SLGS.

Am I making sense? I wasn't casting aspersions on your thoughts; I am questioning the same things, and trying to get perspective from the people whose past advice I'm potentially disagreeing with, or at least not sure about given what's been happening.