? 11/11 Simon AMPS 341 +3.5 314 +6 304 (Dose increase tomorrow?)

[Alexandra & Simon]

Buddy still stuck in the 300s

Today will be his 3rd cycle with the .25 increase. Since I decided to do TR I am thinking we need to increase another .25 tomorrow for a total of 1.5 units.

He has a follow up tomorrow with his Internist for a repeat ultrasound and they're going to replace his Libre then as well so hopefully I can start tracking if he is having some better dips. His last Libre it looks like he normally gets his lowest number around +6.5 after injection but he doesn't stay at a low number for very long so just thinking I'm not catching it with the manual checks I've been doing.

He was watching me wondering why I hadn’t picked him up yet to sit on the couch with me .

 

[Connie & Parker & Moonie]

Good luck with the dose increase! And the ultrasound!

Is Simon a couch buddy? I love watching TV cuddling with our kitties. He looks so confused that you haven't lifted him up yet!

Also sorry if I missed this, but is there any way that you could get in a test after your PM shot? Maybe one before you go to bed? Many kitties run lower in their PM cycles for whatever reason, so you'll want to do at least one test after the PM shot just to make sure he's not diving too fast. Though maybe this is a problem that solves itself with the Libre application tomorrow

 

[Alexandra & Simon]

Good luck with the dose increase! And the ultrasound!

Is Simon a couch buddy? I love watching TV cuddling with our kitties. He looks so confused that you haven't lifted him up yet!

Also sorry if I missed this, but is there any way that you could get in a test after your PM shot? Maybe one before you go to bed? Many kitties run lower in their PM cycles for whatever reason, so you'll want to do at least one test after the PM shot just to make sure he's not diving too fast. Though maybe this is a problem that solves itself with the Libre application tomorrow

He oscillates on being a couch guy! He likes to sleep on a weighted blanket I have on the ground under the coffee table or my big chair in the living room so I've taken to working from my couch instead of my desk so I can keep an eye on him.

I'll try and get a PM reading. Based on his previous Libre numbers usually his lower run comes around midnight with the lowest being between 2-3a!

 

[Connie & Parker & Moonie]

He oscillates on being a couch guy! He likes to sleep on a weighted blanket I have on the ground under the coffee table or my big chair in the living room so I've taken to working from my couch instead of my desk so I can keep an eye on him.

I'll try and get a PM reading. Based on his previous Libre numbers usually his lower run comes around midnight with the lowest being between 2-3a!

That is so cute. I love kitty supervisors! I'm sure he's very helpful when you're working

Over time as you get more readings, you'll be able to test more strategically based on Simon's patterns to minimize sleep disruptions. For many cats, for example, you can tell by +2 if you need to get in another reading. If +2 is flat to up, it's likely an inactive cycle and you're good to sleep. In the beginning, I found that I tested a lot more often just because I needed to learn Moonie's patterns.

 

[Wendy&Neko]

A requirement for following TR is to get a minimum of 4 tests per day, the two preshots plus one other each cycle. TR is a more aggressive dosing method with faster increases, so there are safety mechanisms build in that allow those faster increases. You have to know how low the dose is taking the cat. Without night time data, I can't see how low he's going on this dose. Many cats go lower at night. It is too soon for a dose increase. Let's see if you can get another day (and night's worth of data). Then re-evaluate.

• Should I Increase the Dose?

 

[Alexandra & Simon]

A requirement for following TR is to get a minimum of 4 tests per day, the two preshots plus one other each cycle. TR is a more aggressive dosing method with faster increases, so there are safety mechanisms build in that allow those faster increases. You have to know how low the dose is taking the cat. Without night time data, I can't see how low he's going on this dose. Many cats go lower at night. It is too soon for a dose increase. Let's see if you can get another day (and night's worth of data). Then re-evaluate.

• Should I Increase the Dose?

His internist says he needs to be fasted tomorrow for his ultrasound so no food after midnight tonight. I asked about his insulin and they said to just give him half a dose rounded down since he won't be able to eat tomorrow AM. That would be .5 tomorrow morning then fasted.

I think this might cause some funniness with his glucose numbers for a few days.

Without the Libre is there a right way to know when to test at night? Based on his prior Libre he was getting lowest between 2-3a but he doesn't stay at his lowest for more than a few moments so trying to understand how I can catch his low without manually testing every hour.

 

[Wendy&Neko]

What type of ultrasound is he getting? Neko never needed to be fasted for her GI ultrasounds. Admittedly, several of them were uplannned. But the radiologist did fine with her having had breakfast. Mostly the fasting is if they think they'll need anesthesia, which depends on the cat's temperament. New anesthesia guidelines for diabetics do not have them fasted as long. Can you call the vet office and confirm instructions. If it's just the receptionist who answers, get them to ask the vet and mention he's diabetic. I had to do that several times to get correct instructions.

If you are nervous, you can also do a half dose tonight. Better than skipping. And yes, that will impact his depot and cause higher numbers until the depot is rebuilt.

Without the Libre is there a right way to know when to test at night?

Libre's are pretty new relatively speaking. We never had the option in my day. We did curves to figure out when typical onset and nadir was for our cats, then tested strategically around that. For many cats, a +2 test will give you a clue whether it's going to be an active cycle. If the +2 is quite a bit lower than the preshot, then you should plan for additional test(s). A +2 higher means a quieter cycle. A +2 about the same as preshot means a normal Lantus cycle with some downward movement. Note, the +2 isn't the best test for all cats, but a good number of them. Finding the onset (when insulin takes effect) can help you figure out if the +2 works for you. You don't have to get the exact lowest point, but rather get a better idea of whether he's going low at all and get a number close enough will do.