10/9/20 - Squeaky! AMPS 287 +8 = 193 (PMPS 290 +6.5= 350 )

[Jan D & Squeaky]

https://felinediabetes.com/FDMB/threads/10-8-20-squeaky-ambg-52-9-415-pmps-290.236557/#navigation

Whoops seems I screwed up yesterday, but I posted and put a question mark, did not get a reply. Am I asking wrong? Seems like there are a LOT of sugar cats these days and perhaps moderators are stretched thin. Thank you all for when you do help; would making a donation help out?

Anyway Thanks To Tanya who marked the post and Thanks To Wendy who instructed me. Oh I see what I did wrong, will catch that next time. Numbers are getting lower and I'm getting nervous!

So..... we had our first active cycle several nights ago and it was heck-on-wheels, although the coaching was great, the loss of sleep screwed me up royally. Next day bad, night after that (right now), my insomnia came back worse than before. I am hoping we can avoid such nights.....

Wendy says if the number is too low to shoot, wait 20 minutes, do not feed, test again and see if the number is high enough to be comfortable shooting. It was a 163 that caused that troublesome active cycle. I shot at 163 and it was too low, started an active cycle. What number do y'all think would be better to aim for to avoid this kind of pandemonium?

Thanks a bunch. I see it takes a while to learn the ropes and am grateful for all this assistance. Good news the vet approved the budesonide and my mom sent some money to help with expenses.

I hope y'all have a great day and know that Squeaky and I are sending hugs of gratitude.

 

[JaxBenji]

Hi Jan! With people with various schedules and timezones, one may not be able to give answers when we need them - it's never personal as everyone here wants the best for every kitty. I make sure I read (and re-read) all the stickies at the top of the board - there is one for shooting low (linked -->):
Tight Regulation: Becoming Data Ready to Shoot / Handle Lower Pre-shot Numbers

It was a 163 that caused that troublesome active cycle. I shot at 163 and it was too low, started an active cycle. What number do y'all think would be better to aim for to avoid this kind of pandemonium?

What you call pandemonium, I would call opportunity for healing numbers I can't advise as to what # for you to shoot but if your'e following TR, anything 50 or above is shootable provided one can monitor and test as needed. It's always nice to remember those blues and greens are exactly what Squeaky's body needs to help heal that pancreas. More time in those numbers, more healing and less bouncing. As you shoot and get used to testing and monitoring, your personal threshold for shooting a number will lower.

Hope that helps some - I'm sure others may stop by. Have a great day!

 

[thebigfuzz]

Hi Jan,

Im sorry you didn’t get a response sooner yesterday, it seems busy on the forum lately and several kitties have been sick lately, so perhaps that is why. Keeping your thread title updated helps. Donations don’t put kitties in priority over others, so don’t worry about that. (Although this site is awesome and I’m sure would be welcome. If one is able, but not an expectation, of course)

Sorry to hear about the insomnia...that must be difficult. I work shift work, so my sleep schedule is all over the place. Luckily my hubby is an awesome partner and we take shifts looking after Cosmo

One thing that is helpful, is to check in on other people’s threads and spreadsheets to learn about trends and other tid bits of information. I have learned so much by learning what others are doing and going through

I was going to bring this up the other day, but then my work schedule changed and was unable to. I was wondering if it might be good to revisit which dosing method you might like to go forward with. SLGS or TR. Here is the sticky for reading when you have a moment.
https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

The goal is to regulate Squeaky in safe and healthy range numbers. TR is a more aggressive method (although super successful) which requires more testing, faster dosing changes (where needed either up or down), and aims ultimately to have kitty between 50-90 numbers wise. It is not uncommon, once kitties regulate and find a good dose for them, to need to test often and feed the curve for several hours to make sure kitty isn’t dropping under 50. Many cats, I’ve heard, have experienced being in the 40’s or even 30’s without having Hypoglycemic symptoms, though above 50 is where we want to be. I would check out @Butters & Lyla or @JaxBenji and their spreadsheets to see what it looks like once you see more and more green numbers. Not a ton of sleep there!

SLGS can be better lifestyle wise for many caregivers. Less testing required and the desired range for blood sugar is a little higher and less scary, for some. Desired range is 90-150 with reductions taken if numbers drop below 90. I do SLGS because my Cosmo needs a special diet to treat a secondary condition that excludes him from TR. I think @carfurby does a form of SLGS too (long term diabetic).

With either method, a safe, and good cycle is desired as our goal with our diabetic kitties is to help them into the desired range and keep them there as long as we are able. It’s hard to remember sometimes that we want to see those blues and greens on our spreadsheets.

I hope this helps and that I explained things well? Hope you have a great day!

 

[Jan D & Squeaky]

Hi Jan! With people with various schedules and timezones, one may not be able to give answers when we need them - it's never personal as everyone here wants the best for every kitty. I make sure I read (and re-read) all the stickies at the top of the board - there is one for shooting low (linked -->):
Tight Regulation: Becoming Data Ready to Shoot / Handle Lower Pre-shot Numbers


What you call pandemonium, I would call opportunity for healing numbers I can't advise as to what # for you to shoot but if your'e following TR, anything 50 or above is shootable provided one can monitor and test as needed. It's always nice to remember those blues and greens are exactly what Squeaky's body needs to help heal that pancreas. More time in those numbers, more healing and less bouncing. As you shoot and get used to testing and monitoring, your personal threshold for shooting a number will lower.

Hope that helps some - I'm sure others may stop by. Have a great day!

Suzanne, thank you for your reply. Yes it does seem busy and I understand that. I read all the articles but I have a particular neurological condition, makes doing stuff like this (including understanding the articles) really hard and I forget things. I have read and re-read that article and others. Still I'm very very nervous, and as you can see I have made that mistake the other day even though I was told, because I'm not able to think and respond as quickly as other people. I'm very slow, and I forget things. Getting older and being home alone every day is NOT helping. And I don't always understand things quickly, which makes me seem like a real dummy, repeating things is often necessary, and people get frustrated with me. However, I do my best. Read when necessary. Ask questions when I need and hope I don't bother folks too much.

So what's hard for me now about the blues and greens is that the amount of insulin we are giving seems high, 1.75. Seems that would create large highs and lows. If we were working with smaller amounts of insulin, it seems it would be less sudden scary changes that I might not be able to react to in a timely way.

Is that the difference between TR and GLGS? I read about an 84% success rate with TR and nothing about GLGS's success rate. Of course I am eager for remission asap so I am attempting TR.

Yes good for numbers, but the pandemonium is when I don't rest well, it messes up everything else about my life. Actually the FD put my whole life into a tailspin, my stress level is over the roof.

Okay trying to find solutions. I bet if I had answers on the spot when I need them, I could do better and less stress. Vet is not responsive enough. Do you think I could find a couple of people on this board and pay them to be able to call them for immediate answers? That would probably be the learning curve I would need to not make mistakes. I guess I don't have confidence to act by myself right now.

This is no criticism of the board, everyone is a volunteer who graciously donates their time and they are wonderful to do so. And I really get how many diabetic cat parents are pulling on them. Volunteering is so often like that.

I just need to figure out the right way to do this. And hopefully, get Squeaky well (instead of accidently killing him).

Thank you for listening and for responding. I hate to feel like the person who needs hand-holding, but I have to face my personal difficulties in the face of this challenge.

 

[Jan D & Squeaky]

Hi Jan,

Im sorry you didn’t get a response sooner yesterday, it seems busy on the forum lately and several kitties have been sick lately, so perhaps that is why. Keeping your thread title updated helps. Donations don’t put kitties in priority over others, so don’t worry about that. (Although this site is awesome and I’m sure would be welcome. If one is able, but not an expectation, of course)

Sorry to hear about the insomnia...that must be difficult. I work shift work, so my sleep schedule is all over the place. Luckily my hubby is an awesome partner and we take shifts looking after Cosmo

One thing that is helpful, is to check in on other people’s threads and spreadsheets to learn about trends and other tid bits of information. I have learned so much by learning what others are doing and going through

I was going to bring this up the other day, but then my work schedule changed and was unable to. I was wondering if it might be good to revisit which dosing method you might like to go forward with. SLGS or TR. Here is the sticky for reading when you have a moment.
https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

The goal is to regulate Squeaky in safe and healthy range numbers. TR is a more aggressive method (although super successful) which requires more testing, faster dosing changes (where needed either up or down), and aims ultimately to have kitty between 50-90 numbers wise. It is not uncommon, once kitties regulate and find a good dose for them, to need to test often and feed the curve for several hours to make sure kitty isn’t dropping under 50. Many cats, I’ve heard, have experienced being in the 40’s or even 30’s without having Hypoglycemic symptoms, though above 50 is where we want to be. I would check out @Butters & Lyla or @JaxBenji and their spreadsheets to see what it looks like once you see more and more green numbers. Not a ton of sleep there!

SLGS can be better lifestyle wise for many caregivers. Less testing required and the desired range for blood sugar is a little higher and less scary, for some. Desired range is 90-150 with reductions taken if numbers drop below 90. I do SLGS because my Cosmo needs a special diet to treat a secondary condition that excludes him from TR. I think @carfurby does a form of SLGS too (long term diabetic).

With either method, a safe, and good cycle is desired as our goal with our diabetic kitties is to help them into the desired range and keep them there as long as we are able. It’s hard to remember sometimes that we want to see those blues and greens on our spreadsheets.

I hope this helps and that I explained things well? Hope you have a great day!

Hi Tanya,

Oh I was not thinking about a donation for priority, but just would it help out those who are so graciously helping all of us. But I did see others were getting answers and I was not, just wanted to be sure I was doing it right. I can be a dummy at times.

Yes I have started reading other people's posts and spreadsheets trying to understand more, as I have time.

Yes after 40 years of insomnia, and hoping to have an opportunity to heal it, this diabetic challenge is not optimum.

Yes I have read and re-read the difference between the two, and I have asked questions. What I've understood is TR has 84% success rate and there is no success rate for GLGS. Both require lots of ear pricking. I think I might be able to do TR if I had the intensive coaching like we had the other night for a while. Because my mind is a bit fuzzy these days and I am slow to pick new things up.

Or I might have to just try to change my entire life to accommodate this.

I just do not want to cause my kitty harm. But continuing to be diabetic is not great, I would like to see him healed.

Well we have to get to the FD routine now so I better get going. Thank you for your reply and for helping so much!

Best,
Jan

 

[Jan D & Squeaky]

Maybe I should do GLGS until his numbers improve overall and we are using less insulin to have smaller bounces? Then switch to TR?

Am I understanding this well?

Oh the other thing is, in about 5 days we will be getting the budesonide and starting to get off the prednisilone. That should change things too....... see now this is getting complicated for me to understand.

 

[thebigfuzz]

Maybe I should do GLGS until his numbers improve overall and we are using less insulin to have smaller bounces? Then switch to TR?

Am I understanding this well?

Oh the other thing is, in about 5 days we will be getting the budesonide and starting to get off the prednisilone. That should change things too....... see now this is getting complicated for me to understand.

You can choose whichever method you like and the nice thing is you can always change back, if it isn’t working.

TR does seem to have a nice success rate, but there are kitties who can go into remission or at least regulate well on SLGS too. Like you mention, you could go SLGS until you find nice regulation and dose and switch to TR once ready for the more aggressive approach. Maybe others might have a different advisement?

As for dose...I have learned that where one cat may need 1 unit for a desired effect, another could need 2, 3 or 4 units. Just depends on the cat. Cosmo is on 3.5 units and that’s right for him, right now.

If you were following SLGS, the next time Squeaky had a number under 90, you would reduce by 0.25 units. Then, you find the good dose to regulate within 90-150.

No need to say sorry, we are here to help! Ask all the questions you want. That’s the beauty of the board, is that we can come, participate, ask questions and learn at our pace. Great group of people here. I’ve had nights and days helping or being helped like the other night. That is normal course

 

[thebigfuzz]

@Jan D when ready, would you like to update your thread title with the am cycle numbers?

10/9 Squeaky AMPS (insert number here)

I am working today, but if you need help, just post and I’m sure someone will check in and help if they can

 

[Jan D & Squeaky]

You can choose whichever method you like and the nice thing is you can always change back, if it isn’t working.

TR does seem to have a nice success rate, but there are kitties who can go into remission or at least regulate well on SLGS too. Like you mention, you could go SLGS until you find nice regulation and dose and switch to TR once ready for the more aggressive approach. Maybe others might have a different advisement?

As for dose...I have learned that where one cat may need 1 unit for a desired effect, another could need 2, 3 or 4 units. Just depends on the cat. Cosmo is on 3.5 units and that’s right for him, right now.

If you were following SLGS, the next time Squeaky had a number under 90, you would reduce by 0.25 units. Then, you find the good dose to regulate within 90-150.

No need to say sorry, we are here to help! Ask all the questions you want. That’s the beauty of the board, is that we can come, participate, ask questions and learn at our pace. Great group of people here. I’ve had nights and days helping or being helped like the other night. That is normal course

They only have a "like" button. They need to have a "love" button.....

Okay I will wait and see if others comment about this sequence of: doing GLGS for a while, getting him regulated 90-150, getting him off the pred (looks like that will take about 2 weeks to accomplish that), and stabilizing everything for a while? Then changing to TR? Does that sound right to you?

I just posted his numbers. Because we play with the mouse before beginning the routine, some days he want to play more than others and I am never going to discourage that! So sometimes we end up shooting later even if I had planned to do it earlier. This morning it was 9:30. He didn't play this morning at all. Not feeling well.

Thank you so much.[/QUOTE]

 

[carfurby (GA)]

So what's hard for me now about the blues and greens is that the amount of insulin we are giving seems high, 1.75. Seems that would create large highs and lows. If we were working with smaller amounts of insulin, it seems it would be less sudden scary changes that I might not be able to react to in a timely way.

The problem with lowering the amount of insulin to try and stop bouncing is that you end up with higher, flatter numbers. The idea with giving insulin is to get the numbers down to normal numbers so his body can heal. Bouncing is part of the process. Since his body is used to higher numbers, when he gets into more normal numbers his liver panics and sends out hormones that raises his numbers. The idea is to get him to spend more time in normal numbers so his body will adjust and get used to them and then the bouncing should settle down.

You can switch to SLGS if you want or do TR. It is entirely up to you. Some cats have gone into remission with SLGS, but usually you see cats going into remission on TR. I do SLGS with Furball because I can't come home to test during the day when I work. With SLGS you hold the dose longer than TR and then do a curve every 7 days to see if the dose needs to be adjusted. Dose decreases are taken under 90 instead of under 50 with TR.

 

[Jan D & Squeaky]

The problem with lowering the amount of insulin to try and stop bouncing is that you end up with higher, flatter numbers. The idea with giving insulin is to get the numbers down to normal numbers so his body can heal. Bouncing is part of the process. Since his body is used to higher numbers, when he gets into more normal numbers his liver panics and sends out hormones that raises his numbers. The idea is to get him to spend more time in normal numbers so his body will adjust and get used to them and then the bouncing should settle down.

You can switch to SLGS if you want or do TR. It is entirely up to you. Some cats have gone into remission with SLGS, but usually you see cats going into remission on TR. I do SLGS with Furball because I can't come home to test during the day when I work. With SLGS you hold the dose longer than TR and then do a curve every 7 days to see if the dose needs to be adjusted. Dose decreases are taken under 90 instead of under 50 with TR.

Thanks for the explanation. The more I understand, the better this will go and your description was helpful. So the idea is to get him to spend more time in normal numbers. But that is challenging.

Okay so with the 52, what if I had tested again and the number remained the same? Was I correct in skipping the shot?

He just tested at 193 +8, which is blue and rather low, so I'm wondering if that means another challenging night?

I am going to pay folks to help me around the house to try to free up my energy to be able to take on this challenge. If my life were easier, this would be easier so I'm going to scramble and see what kind of help I can get for myself.

 

[carfurby (GA)]

Okay so with the 52, what if I had tested again and the number remained the same? Was I correct in skipping the shot?

That was the best thing to do under the circumstances. Most people skip if the number is in the 50s. If you are going to switch to SLGS you don't shoot anything below 90. Some experienced members have worked their way to being able to shoot a number in the 50s or 60s because they know what their cat will do and are able to monitor all day. For now you don't need to worry about that.

Things will get easier as you get more experience.

 

[Jan D & Squeaky]

That was the best thing to do under the circumstances. Most people skip if the number is in the 50s. If you are going to switch to SLGS you don't shoot anything below 90. Some experienced members have worked their way to being able to shoot a number in the 50s or 60s because they know what their cat will do and are able to monitor all day. For now you don't need to worry about that.

Things will get easier as you get more experience.

Thanks Carla, I am going to try to stick to TR for now. As long as I have the help and the nerves!!!!!