10/08 Regs +6 156 AMPS 335 +1 417 +6 362 +10 287 PMPS 244 is he already breaking the bounce?

[Britta and Regs]

Yesterday

Regs and I had a pretty eventful night, he did have a steep drop again and was down to 156, what I know is absolutely normal just scary for me. I might have made the not so smart decision to give him a very small amount of MC food (0.6oz) I don't know why I cant make smart decisions at night when he is dropping. Now he is bouncing again but I did increase his dose today from 2.25 to 2.5 units. Please keep fingers crossed for us that this will work out.

BTW How are all of you manage without sleep? I was awake most of the night to watch him and now I cant get enough coffee to be able to go to work

I assume Regs had a very good sleep, look at him....

 

[Connie & Parker & Moonie]

Handsome boy looks even more handsome after his beauty rest!

It's ok that you gave him some MC yesterday. Next time, you'll give him LC. The food is out of his system so it's all good and part of the learning process

In the very beginning, I didn't get a whole lot of sleep. I was always on edge that Moonie could "drop at any moment" and I was also trying to figure out her patterns. I think you should ask someone experienced to take a look at Regs' spreadsheet to help figure out some of his patterns and establish some rules in the pm so that you can get some uninterrupted sleep. If we weren't running a more aggressive version of TR right now, I would guess that we could get uninterrupted sleep pretty much every night with Moonie (though disclaimer - every cat is different). One thing that did help me though was trying to test in 1.5 hr intervals if possible since a full sleep cycle is 90 mins. But my #1 suggestion is to get a mentor to take a look at Regs' SS so that in the evening, you are only doing the tests that you absolutely need to do. The other potential option is - would your husband be comfortable with taking on some of the tests or learning to do them? That would give you more opportunity to sleep.

 

[Britta and Regs]

Handsome boy looks even more handsome after his beauty rest!

I would say between him and me that makes one of us I’m more like a zombie at work today

Handsome boy looks even more handsome after his beauty rest!

It's ok that you gave him some MC yesterday. Next time, you'll give him LC. The food is out of his system so it's all good and part of the learning process

In the very beginning, I didn't get a whole lot of sleep. I was always on edge that Moonie could "drop at any moment" and I was also trying to figure out her patterns. I think you should ask someone experienced to take a look at Regs' spreadsheet to help figure out some of his patterns and establish some rules in the pm so that you can get some uninterrupted sleep. If we weren't running a more aggressive version of TR right now, I would guess that we could get uninterrupted sleep pretty much every night with Moonie (though disclaimer - every cat is different). One thing that did help me though was trying to test in 1.5 hr intervals if possible since a full sleep cycle is 90 mins. But my #1 suggestion is to get a mentor to take a look at Regs' SS so that in the evening, you are only doing the tests that you absolutely need to do. The other potential option is - would your husband be comfortable with taking on some of the tests or learning to do them? That would give you more opportunity to sleep.

Thanks Connie,
I really don’t know why I can’t think straight at night. And feed him crab, at least it was not the whole can again, just 2 teaspoons

Exactly how I feel at night, as soon as he drops a little I worry that he is in danger and if not I worry what happens if he does drop later when I’m sleeping.

I did not know that a sleep cycle is 90 min, that’s good to know. Since Rob was sleeping next to me like a baby and I was unsure what to do I asked AI and that told me to measure every 30 min or he could die and I should already look at a ER in case he is not eating (more or less the wording). I guess my testing last night was a little more than necessary, poor ear

I do have the cool Petlibro feeder with 3 different bowls, maybe in the active nights I should use it and put 2 additional portions in. He gets a snack at 4 am but maybe I should program it to get him a lc snack at 2 earlier time points when the +2 is diving.

If someone could help me with his patterns that would be great but I have the feeling I ask way too much already.

 

[Connie & Parker & Moonie]

I would say between him and me that makes one of us I’m more like a zombie at work today




Thanks Connie,
I really don’t know why I can’t think straight at night. And feed him crab, at least it was not the whole can again, just 2 teaspoons

Exactly how I feel at night, as soon as he drops a little I worry that he is in danger and if not I worry what happens if he does drop later when I’m sleeping.

I did not know that a sleep cycle is 90 min, that’s good to know. Since Rob was sleeping next to me like a baby and I was unsure what to do I asked AI and that told me to measure every 30 min or he could die and I should already look at a ER in case he is not eating (more or less the wording). I guess my testing last night was a little more than necessary, poor ear

I do have the cool Petlibro feeder with 3 different bowls, maybe in the active nights I should use it and put 2 additional portions in. He gets a snack at 4 am but maybe I should program it to get him a lc snack at 2 earlier time points when the +2 is diving.

If someone could help me with his patterns that would be great but I have the feeling I ask way too much already.

Don't feel bad asking - I asked so many questions in the beginning (and still do). And I think creating a routine that is sustainable for you and Regs both should be the #1 priority. You're no good to him if you're a tired zombie all the time - he only has one mom

Definitely ask someone actually experienced in feline diabetes - but taking a quick look at Regs' SS - the vast majority of nights where you saw a food bump at +1 and +2 was flat to up, you would have been good to sleep. The two exceptions to that rule I see are 9/6 and 10/3 where he gave you a very benign +2 but ended up dropping late into his cycle as he was breaking a bounce. It looks like though +6 was a really good determinant of whether he'd continue dropping, so if you wanted to really err on the side of caution - you could always grab PMPS, the occasional +1 to confirm food bump, +2, go to sleep until +6 if +2 is flattish to up, and sleep through to the morning if +6 is flattish (which would at least let you get 6 hours of uninterrupted sleep - maybe more if Rob could take on the +2 test and wake you only if it's down).

 

[Wendy&Neko]

The way to better sleep is more data on Reg's patterns, and most importantly, what he does with out food intervention. Because that is what is going to happen at night. Last night, once you saw him go from 156 to 187 and if he didn't have anything other than LC, that would be a sign his numbers were on the normal rise and you could get to sleep. Meaning you didn't need that +9 test.

I don't know if anyone has shared the +2 guideline with you. If the +2 test is higher than the preshot, it's going to be a quiet cycle (ie probably bounce) and you can go to sleep with that. Note, two nights ago as an example. The rule with FD, get sleep when you can! If the +2 is about the same as the preshot, it's a regular Lantus cycle with some downward movement. If the +2 is quite a bit lower than the preshot, it's a very active cycle needing even more attention and monitoring. The thing about this guideline, is that you have to figure out how this works for Reg. The +2 timing didn't work for Neko on Lantus, the +3 was better for her. She had a late onset. Some cats onset earlier so the +2 will see more action than it would with other cats.

There are other cycles like those where he's breaking a bounce that are going to look at bit different, with later nadirs, like 10/3 PM.

Regular snacks are OK with the feeder and once you know when it's likely to be his nadir, that's a good time to feed.

I often got naps late afternoon when Neko was on the rise, if that is something that works for your schedule. That hour or so really helped.

Good luck with the increase. As a cat gets into better and better numbers, you'll start to see more patterns in their numbers. By patterns, I mean patterns across several cycles and you'll start to get better at guessing where he is going. With Neko, I learned a 3 cycle pattern (think colours) that meant she was going to dive the next cycle. That came in very handy. Every night I spent some time staring at the spreadsheet before bed, seeing if I could predict what she was going to do that night. Hubby called it staring at the tea leaves. . Once I started seeing some patterns, I'd test myself by playing guess the BG, before I did a poke.

Other things help you predict where kitty is such as their behaviour. Neko was in horribly high numbers to start and low 300's was her comfort zone. That's when she'd start playing with her catnip toys. As she got used to lower numbers, playtime thankfully moved to upper greens, low blues.

 

[Britta and Regs]

Don't feel bad asking - I asked so many questions in the beginning (and still do). And I think creating a routine that is sustainable for you and Regs both should be the #1 priority. You're no good to him if you're a tired zombie all the time - he only has one mom

Definitely ask someone actually experienced in feline diabetes - but taking a quick look at Regs' SS - the vast majority of nights where you saw a food bump at +1 and +2 was flat to up, you would have been good to sleep. The two exceptions to that rule I see are 9/6 and 10/3 where he gave you a very benign +2 but ended up dropping late into his cycle as he was breaking a bounce. It looks like though +6 was a really good determinant of whether he'd continue dropping, so if you wanted to really err on the side of caution - you could always grab PMPS, the occasional +1 to confirm food bump, +2, go to sleep until +6 if +2 is flattish to up, and sleep through to the morning if +6 is flattish (which would at least let you get 6 hours of uninterrupted sleep - maybe more if Rob could take on the +2 test and wake you only if it's down).

Thanks so much for looking into my SS Connie. Wendy already wrote a very long post that I also really appreciate.

Before we came back from California I barely thought about checking the +1 or 2 but I just wanted to gather more information about his cycles, and I’m so glad I found out that the plus 2 gives me an idea if I can sleep or not.
I looked into the two exceptions you mentioned. On September 6 he was still on 2.5 units of Lantus, and yes, it seemed that this cycle was a bounce breaking cycle. but this one was the cycle that scared me most, because he just continued dropping and dropping. But that was also in the time before we had the feeder, so with an additional meal at +9 this cycle could have looked different, at least I hope.
On October 3, if I remember right, and I should get better in taking notes, I did not do anything and his night snack bumped him back up to normal numbers. Even seeing his +6 I knew there was something up with his sugar so I was a little cautious

If I can sleep from +2 to +6 and maybe to +9 after I’m happy and that’s enough, just staying up and measuring every hour is something that I cant do forever. But I guess even last night I could have slept longer and there was no need to check on him every half hour- stupid AI

Even Regs is Rob’s cat officially (but of course looong adopted by me) he mostly stays out of the testing, I think he is not good with needles or blood or so. Maybe I can show it again to him, but in the past he just refused to do it

 

[Britta and Regs]

The way to better sleep is more data on Reg's patterns, and most importantly, what he does with out food intervention. Because that is what is going to happen at night. Last night, once you saw him go from 156 to 187 and if he didn't have anything other than LC, that would be a sign his numbers were on the normal rise and you could get to sleep. Meaning you didn't need that +9 test.

I don't know if anyone has shared the +2 guideline with you. If the +2 test is higher than the preshot, it's going to be a quiet cycle (ie probably bounce) and you can go to sleep with that. Note, two nights ago as an example. The rule with FD, get sleep when you can! If the +2 is about the same as the preshot, it's a regular Lantus cycle with some downward movement. If the +2 is quite a bit lower than the preshot, it's a very active cycle needing even more attention and monitoring. The thing about this guideline, is that you have to figure out how this works for Reg. The +2 timing didn't work for Neko on Lantus, the +3 was better for her. She had a late onset. Some cats onset earlier so the +2 will see more action than it would with other cats.

There are other cycles like those where he's breaking a bounce that are going to look at bit different, with later nadirs, like 10/3 PM.

Regular snacks are OK with the feeder and once you know when it's likely to be his nadir, that's a good time to feed.

I often got naps late afternoon when Neko was on the rise, if that is something that works for your schedule. That hour or so really helped.

Good luck with the increase. As a cat gets into better and better numbers, you'll start to see more patterns in their numbers. By patterns, I mean patterns across several cycles and you'll start to get better at guessing where he is going. With Neko, I learned a 3 cycle pattern (think colours) that meant she was going to dive the next cycle. That came in very handy. Every night I spent some time staring at the spreadsheet before bed, seeing if I could predict what she was going to do that night. Hubby called it staring at the tea leaves. . Once I started seeing some patterns, I'd test myself by playing guess the BG, before I did a poke.

Other things help you predict where kitty is such as their behaviour. Neko was in horribly high numbers to start and low 300's was her comfort zone. That's when she'd start playing with her catnip toys. As she got used to lower numbers, playtime thankfully moved to upper greens, low blues.

Thanks for that long answer Wendy, I have the feeling at the moment I have constant questions about Regs sugar.

Today he seems to be stuck in the bounce since he is in his mid 300 all day, or it could be the new dose wonkiness or something in between. But most important is that he is pretty active, playful and hungry today and he is not acting if his sugar is in the mid 300. But I also see that if Regs gets under 200 in the pre he is even more active and plays with the plastic cap of the syringe and the cotton ball and is more hungry. I’m sure he feels great then.

I know last night I could have handled the food better with low carb pate instead of mc Sheba, but I always get nervous when he is dropping fast. Now I start wondering how low he would have dropped if I would have not given him food, he was not lower than 156, so we still had a buffer.
Maybe next time he has a lower +2 I will put 1-2 small pate meals in the feeder, monitor but not do anything else, unless I have to.
At the moment I’m catching the low numbers because I’m testing so much, in the past I did test way less at night, so I assume the drops were there I just did not know about them. And of course our vet always say I should just test the Pres and nothing in between that’s not going to happen.

I think someone shared the +2 guideline but I could not remember it, so thank you so much for sharing again, took a screenshot of it before I loose it again. On the two nights now where he was dropping a lot the +2 was really valuable because I was prepared.
Sometimes I really realize that I still have no idea about diabetes and don’t see enough patterns, but I hope that will come if he gets better regulated, hope I will get him there, feel a little hopeless at the moment.

Now he always gets the snack at +9 because sometimes he seemed to drop very late in the cycle and the pate snack seems to buffer it a little bit.
I really hope with some work we can move Regs more into the blue and maybe a little green- not too much in the beginning. Tea leaves? I’m sure you were accurate in your predictions after a while, how long did it take you to see where she was going?

I know you mentioned right in the beginning that Neko had CHF too. Was it much more difficult to get Neko regulated?

 

[Connie & Parker & Moonie]

Thanks so much for looking into my SS Connie. Wendy already wrote a very long post that I also really appreciate.

Before we came back from California I barely thought about checking the +1 or 2 but I just wanted to gather more information about his cycles, and I’m so glad I found out that the plus 2 gives me an idea if I can sleep or not.
I looked into the two exceptions you mentioned. On September 6 he was still on 2.5 units of Lantus, and yes, it seemed that this cycle was a bounce breaking cycle. but this one was the cycle that scared me most, because he just continued dropping and dropping. But that was also in the time before we had the feeder, so with an additional meal at +9 this cycle could have looked different, at least I hope.
On October 3, if I remember right, and I should get better in taking notes, I did not do anything and his night snack bumped him back up to normal numbers. Even seeing his +6 I knew there was something up with his sugar so I was a little cautious

If I can sleep from +2 to +6 and maybe to +9 after I’m happy and that’s enough, just staying up and measuring every hour is something that I cant do forever. But I guess even last night I could have slept longer and there was no need to check on him every half hour- stupid AI

Even Regs is Rob’s cat officially (but of course looong adopted by me) he mostly stays out of the testing, I think he is not good with needles or blood or so. Maybe I can show it again to him, but in the past he just refused to do it

The other thing I wish I would have done early on is - at the end of each week, you could probably ask for an experienced person to quickly review and ask if they would have tested differently for that week. Like were there days where they would have tested more or less? And why?

But the +2 rule is a big one and hopefully one that saves you some sleepless nights. You've got this!

And if you can, I'd suggest trying to coax Rob into testing. You can always start by making him the churu / treat holder as you test, reinforce both cat and man with praise, and then slowly ease him into the testing. Speaking from personal experience, it helps a lot when there's a second adult to do the testing even if you're the primary.

 

[Britta and Regs]

The other thing I wish I would have done early on is - at the end of each week, you could probably ask for an experienced person to quickly review and ask if they would have tested differently for that week. Like were there days where they would have tested more or less? And why?

But the +2 rule is a big one and hopefully one that saves you some sleepless nights. You've got this!

And if you can, I'd suggest trying to coax Rob into testing. You can always start by making him the churu / treat holder as you test, reinforce both cat and man with praise, and then slowly ease him into the testing. Speaking from personal experience, it helps a lot when there's a second adult to do the testing even if you're the primary.

You think someone would be willing to look at my SS every week?

Ok I should not be unfair, Rob is holding the Churu when I give him the Lantus every evening, almost But maybe you are right some positive reinforcement for both can not hurt with that.He should learn it anyway, what would happen if I'm not home for a day or two?!

Moving forward I will always rely on the +2 number, especially in the PMPS cycle. He nicely came down this evening to 244, I just hope that the bounce is slowly going away not that this is another heavy drop night tonight followed by another big bounce. I need a night in between to sleep

 

[Wendy&Neko]

stupid AI

Truly, don't listen to it. I've seen some dangerous answers from it.

I know you mentioned right in the beginning that Neko had CHF too. Was it much more difficult to get Neko regulated?

She was already regulated before she got the CHF. The CHF came 4 years into her diabetic journey. She was already stage 3 CKD at the time, and got a diagnosis of small cell lymphoma at the same time as the CHF. She had a bunch of new meds added at once. I found that it took her body a little while to get settled with the new meds and there was a blip where her numbers got worse before she got settled in. She didn't do Lasix at first, as that was damaging to her already bad kidneys. Just Vetmedin and Plavix for her heart.

Moving forward I will always rely on the +2 number, especially in the PMPS cycle.

Experiment first, let's see if that +2 really is an indicator or whether it makes sense to move it to +1.5 or +2.5.

You think someone would be willing to look at my SS every week?

Yes, I asked about every 3-4 days and got help. We all remember how hard it was until you get your cats figured out.

The last part of a week, you've seen mid blues at night, then 3 cycles of bouncing, then repeat blues at night followed by 3 cycles of bouncing. With the addition of a dose increase, that pattern may be broken.

 

[Britta and Regs]

She was already regulated before she got the CHF. The CHF came 4 years into her diabetic journey. She was already stage 3 CKD at the time, and got a diagnosis of small cell lymphoma at the same time as the CHF. She had a bunch of new meds added at once. I found that it took her body a little while to get settled with the new meds and there was a blip where her numbers got worse before she got settled in. She didn't do Lasix at first, as that was damaging to her already bad kidneys. Just Vetmedin and Plavix for her heart.

Oh, Neko had been diabetic for quite a long time before the CHF diagnosis. With all her other health issues on top of that, it must have been so much for both of you to go through. What a brave little girl she was. She was so lucky to have you by her side through it all.

Experiment first, let's see if that +2 really is an indicator or whether it makes sense to move it to +1.5 or +2.5.

He did not have a food bump tonight, so far he always had he even dropped from 244 to 240. I'm afraid we will have another active cycle ahead. I should really test less and not every 30 min, just to get some sleep. Just glad it is Friday tomorrow. I start wondering if that earlier drops could be more his pattern that he slowly start showing since I see many cats dropping early. And that I could not see it so far because he was always bouncing so hard.

And yes I know AI is lying to us but last night I needed someone to give advice. And I'm always just glad when I bring him through a difficult cycle.

Really can't believe how nice and helpful everyone here is, looking through a spreadsheet is so much work.
The beginning is really hard and I'm so glad that I get so much help, especially because out vet is none. It is incredibel you saw immediately that he had 3 bounce cycles between the lows at night. When you said he might have broken the pattern, does that mean he maybe has a gentle drop and not as steep as he was in the last low nights?

 

[Wendy&Neko]

240 and 244 are the same number, well within meter variance. I wouldn't say he's dropping yet but rather flat. Let's see what +2 says.

When you said he might have broken the pattern, does that mean he maybe has a gentle drop and not as steep as he was in the last low nights?

It means that New Dose Wonkiness, which if it appears shows in the first couple cycles, could be a factor to change what he did before.

 

[Britta and Regs]

240 and 244 are the same number, well within meter variance. I wouldn't say he's dropping yet but rather flat. Let's see what +2 says.


It means that New Dose Wonkiness, which if it appears shows in the first couple cycles, could be a factor to change what he did before.

I guess I started worrying too much too early, his plus 2 is 313, he ate his second portion a bit later today so maybe the bump was a bit delayed.

Do you think a plus 6 or 7 makes sense?

 

[Wendy&Neko]

Do you think a plus 6 or 7 makes sense?

No, I would get some sleep if all he has had is LC so far tonight.