12/24 Henry AMPS 87 +3.5 77 PMPS 96 +3.5 74 +5.5 77

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Robert --

Could you remember to included Henry's actual AMPS test result in your subject line. It let's us have an idea if there may be an issue with a kitty's numbers.

Also, I think you've been missing dose reductions. Henry's spreadsheet is about the greenest I've ever seen. He looks like a cat that's in remission. With TR, if your cat is in normal numbers for a week, you reduce the dose by 0.25u. From the dosing methods sticky note:

It looks like the only times Henry has been above 100 was when he had dental extractions -- an understandable amount of stress -- and. he dropped back down very quickly.

 

I tried the reduction protocol in September

He started creeping back up

With respect to AMPS post I fell asleep (very tired)

 

When does one conclude their cat is always going to be diabetic?

After certain number of failed reduction attempts?

 

Ideally, you try to keep the numbers like you're seeing them and reduce the dose. Waiting a week with green numbers is a slow, stable way of reducing. If the numbers start going out of normal range, you increase the dose. It can often be a few steps forward and a few steps back. Looking at Henry's numbers in September, his nadirs were good. His pre-shot numbers were largely below 120. FWIW, the pre-shot numbers are usually the last to fall into the green range. It looks like you were feeding Henry at +5.5. Sometimes giving a snack later in the cycle (e.g., +9) may help to bring the pre-shot numbers down. The snack stimulates the pancreas to produce its own insulin and it drops the numbers, much like what you're seeing during the cycle.

Regardless of what the numbers look like, once a diabetic, always a diabetic. However, cats that are in remission are diet controlled diabetics. If your cat starts sneaking carbs, numbers will increase. If there's stress on your cat's system from inflammation or infection or illness, numbers will rise.

You may also find that Henry is a cat that is a tightly controlled diabetic -- not in remission but just needs a small amount of insulin to keep him in good numbers. Tight regulation is a good thing. It keeps the BG numbers below renal threshold.

 

My view is Henry just needs a small amount of insulin (Which is relevant to body mass, Henry is 36 inches long very large cat my assumption is the 2.0 units would be a small amount due to his physical size) to keep him in good numbers

So how many failed reduction attempts could one finally conclude their cat is always going to be a tightly controlled diabetic?

I think Henry is a tightly controlled diabetic and his 2.0 units are relative to his physical size

To answer your question about a +9 snack not true at all

Last meal is @ +5.5 nothing more until the preshot meal

 

I wouldn't necessarily base the amount of insulin on body mass. If that were the case, we would be able to predict dose based on the kitty equivalent of BMI. Because insulin is a hormone, there are multiple factors that are in play and if it were solely a matter of body mass, there wouldn't be a great deal of day-to-day variability in the response to a dose. Henry is well regulated but I'd suggest taking a look at other kitty's spreadsheets to see how variable the same dose can be.

What might be worth taking a look at is whether Henry's pre-shot numbers begin to drop if you give him a snack late in the cycle. This is a strategy we often use when we see spreadsheets that look like Henry's. the late in the cycle snack may help to further flatten out his numbers.

 

I guess the cat owner will have to decide the answer to the question of "So how many failed reduction attempts could one finally conclude their cat is always going to be a tightly controlled diabetic?"

 

Sienne is more experienced than I am, but I've been following your journey with Henry and I know you have tried to reduce many times. However, given his recent dental, you may try what Sienne is suggesting regarding reducing after 7 days of green. Dental inflammation can highly impact BGs, and perhaps with the alleviation of any discomfort, the reductions might work this time. This is not the same scenario you were facing last September. It cannot hurt to try.

If it doesn't work, you can keep doing what you've been doing. Henry's a long term diabetic. The reality is that he may need insulin for the rest of his days. You are taking great care of him and giving him excellent quality of life.

 

OK Katherine I will try a reduction in a few days

Thank You both (Yourself & Sienne) for your support

 

The tiles below Henry are 1 foot by 2 foot Dimensionally. You can see Henry is a large cat

 

I love your big, ole', fat cat, Robert. Merry Christmas!

 

You too Summer Merry Christmas

 

That is one large but very happy looking cat!