? 12/9 - Gen, AMPS >400, PMPS >400 Libre - dosing question

Allie & Gen

Allie & Gen

Member Since 2025
Yesterday

I guess we're still bouncing? I hope it breaks soon. I hate seeing so much red.

And now for some musing on diet! Gen seems to like the chicken & liver pate best of the handful of FF classic pates we've tried so far. He seems to be pretty tired of the plain chicken already, indifferent about the turkey & giblets, and weirdest of all, he apparently hates salmon. Wouldn't touch it. (This, I suppose, explains why the freeze-dried salmon treats I tried with him in 2021 were a total dud, whereas he looooves the freeze-dried tuna.)

I think he's not going for the Tiki Cat broth topper, either, which is a bit of a disappointment. I was hoping it would help, but if anything he's been eating less of the plain chicken pate when I add it.

I'm going to try him on the FF tuna & whitefish pate tonight (ordered a couple of cans with my regular grocery order for the trial), and if he likes that, we may start on a regular rotation of that and the chicken & liver, because I need him to eat properly! And I am racking up quite a pile of cat food that I need to get rid of. 😅

Today's the second day I've given him a mix of Hill's m/d and Dr. Elsey's dry. Seems to be going all right. I will try him on the Dr. Elsey's by itself tomorrow, I think. (And the sooner I can get him to eat better with the wet food, the sooner I can drop the dry altogether. Or possibly consider switching to a freeze-dried option, though that seems kind of pricy and I want to reserve the tuna as a treat/high value item.)

Anyway, that's all for now. Have a pleasant (and cozy, if you're also experiencing these arctic temperatures!) Tuesday, and safe surfing to all your kitties!
 
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So we're at about +8.5 on the 6th cycle since the reduction, and most of those have been all red and pink, except for two cycles ago when he had some yellow. The lowest nadir he's had in that time was 212.

I'm inclined to give it one more cycle, and if tonight's doesn't trend lower, increase back to 0.75u for tomorrow morning's shot. (This will also be a good time for an increase, as Wednesday is my work from home day, when I can keep an eye on him in person all day.) @Wendy&Neko, what do you think? (And if you agree, what would you say I should look for to make the decision, more specifically? A lower nadir, lower numbers overall?)

Anyone else is also welcome to chime in, of course!
 
Christie & Maverick said:
With SLGS you hold the dose for 7 days before considering an increase, so you’ve got a few more days to go yet.
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I'll be honest with you - I'm considering moving to a hybrid of SLGS and vet advice. My vet, who is very good in general, wanted me to increase yesterday. I can't help thinking the reduction was a mistake, and that letting him stay up so high could do damage, especially since he has a history of DKA.

I respect all the work that has gone into these protocols and I'm not trying to be argumentative, but I'm just not sure in this case. I'm here to listen, though. I don't mean to be impatient. I just want to do what's best for my boy, who has been through a lot recently.
 
Ah, I wish I could provide advice! I know with TR the rules for increasing don't apply for a failed reduction, but I'm not too familiar with SLGS or vet advice. I can see why you'd want to increase, but again, I'm so used to the rapid pace of TR and increases happen much quicker. Sounds like you're almost at an entirely wet food diet, do you think you'll switch to something similar to TR when Gen is there?
 
If you want to follow your vet’s advice that’s really no problem, there are several different ways and methods out there to treat FD. I will note, at least from my POV and having been here for quite a long while and as one member who does offer dose advice, that it becomes difficult to offer safe advice when caregivers stray from the dosing methods we use here. There are safety measures built into our methods, so mixing and matching is not something I would recommend. Here a good read for you Info - Tight Regulation & SLGS: Myths Debunked

It seemed from your signature that the DKA was during your first go around with insulin, in 2021, correct? Not recently? Any chance your Libre 3 is one of the wonky ones? My biggest suggestion is to just get rid of the dry completely if you can, since you test enough via Libre and then you can follow TR ;) .
 
Briana + Binx said:
Ah, I wish I could provide advice! I know with TR the rules for increasing don't apply for a failed reduction, but I'm not too familiar with SLGS or vet advice. I can see why you'd want to increase, but again, I'm so used to the rapid pace of TR and increases happen much quicker. Sounds like you're almost at an entirely wet food diet, do you think you'll switch to something similar to TR when Gen is there?
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I'm hoping to do that, yes! But I think it may be a little while yet before I can take Gen completely off the dry, partly out of caution/not moving too many changes too fast, and partly because I'm not yet sure if he'll take to the tuna & whitefish yet. I'd rather have some variety in his all-wet diet, so I want to make sure I have at least a couple options that he consistently eats well. We'll see?
 
Allie & Gen said:
I'm hoping to do that, yes! But I think it may be a little while yet before I can take Gen completely off the dry, partly out of caution/not moving too many changes too fast, and partly because I'm not yet sure if he'll take to the tuna & whitefish yet. I'd rather have some variety in his all-wet diet, so I want to make sure I have at least a couple options that he consistently eats well. We'll see?
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Makes sense... you don't want to switch and then find he doesn't want to eat any of it. You'll get there!
 
Christie & Maverick said:
If you want to follow your vet’s advice that’s really no problem, there are several different ways and methods out there to treat FD. I will note, at least from my POV and having been here for quite a long while and as one member who does offer dose advice, that it becomes difficult to offer safe advice when caregivers stray from the dosing methods we use here. There are safety measures built into our methods, so mixing and matching is not something I would recommend. Here a good read for you Info - Tight Regulation & SLGS: Myths Debunked

It seemed from your signature that the DKA was during your first go around with insulin, in 2021, correct? Not recently? Any chance your Libre 3 is one of the wonky ones? My biggest suggestion is to just get rid of the dry completely if you can, since you test enough via Libre and then you can follow TR ;) .
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Thank you for your input and being willing to discuss with me! As I said, I appreciate the resources and advice here very much (really can't stress that enough), and if I decide to deviate it won't be a decision I take lightly. But I'm also inclined to give a lot of weight to my vet's advice, and when they disagree I need to at least consider carefully. I'm about to leave my office for the day and will read your link on my ride home (I don't think I've gone through that one yet).

Yes, the DKA was in 2021, but he has more health problems now (ongoing dental issues which I'm hoping we can address early next year), and it's my understanding that they exacerbate his risk. I've had some difficulty doing home ketone testing (I'm going to keep trying of course), but I'm expecting results from a blood test at the vet's yesterday (along with other labs). It's possible I'm being too paranoid about this (it was a truly horrible experience for both him and me).

As far as the Libre goes, the Abbott site cleared the serial number on the sensor I'm currently using, so I don't think that's a contributing factor. I hope.
 
You’re welcome :), I just happened to be around, and you’ve tagged Wendy, so I’m sure she can offer her opinion as well. I did see the issues with periodontal disease, that most certainly can affect BG numbers, and can bring cats out of remission, and of course Gen’s BG numbers are likely highly influenced by the Hill’s M/D dry which is high carb.
 
Christie & Maverick said:
You’re welcome :), I just happened to be around, and you’ve tagged Wendy, so I’m sure she can offer her opinion as well. I did see the issues with periodontal disease, that most certainly can affect BG numbers, and can bring cats out of remission, and of course Gen’s BG numbers are likely highly influenced by the Hill’s M/D dry which is high carb.
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I tagged Wendy because she's been giving us advice recently, but I appreciate input in general - and I certainly don't know everyone here, so I'm grateful you chimed in!

(It's so strange, you know ... Gen went into remission in 2021 on a steady diet of Hill's m/d, wet and dry, and stayed there with the same diet for years. But I'm glad to be getting him off of it and I really hope it helps!)
 
Sorry for the delay, it was cat at specialty vet day.

Christie is right that SLGS says hold the dose for 7 days. There are exceptions for special circumstances like presence of ketones. Are you testing him daily for ketones while in higher numbers? Not enough insulin + not enough calories + systemic inflammation or infection (needing a dental) are the formula for DKA. How is his appetite? I don't mean fussiness but volume or calories per day.
 
Wendy&Neko said:
Sorry for the delay, it was cat at specialty vet day.

Christie is right that SLGS says hold the dose for 7 days. There are exceptions for special circumstances like presence of ketones. Are you testing him daily for ketones while in higher numbers? Not enough insulin + not enough calories + systemic inflammation or infection (needing a dental) are the formula for DKA. How is his appetite? I don't mean fussiness but volume or calories per day.
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There's no need to apologize! It wasn't so urgent that I needed an immediate response or anything. (Also I hope the specialty vet appointment went well!)

I have been trying to do ketone tests but it's ... very much a work in progress. Gen gets flustered and stops/leaves if I try to get either a strip or a spoon under him, and that's if I manage to catch him at it. (I'm a little leery of pushing him on this because he's already peeing in my bathtub half the time instead of the litterbox for some reason, and in 2021 when he was first sick he started peeing in the corners of closets.) I'm gone for so much of the day, and he's been sneaky. The vet's including that in the blood tests she sent out, but obviously that's from yesterday and also I don't have it yet.

(I've managed one test, a few days ago, basically, and it wasn't ideal - run through a puddle in the bathtub where it could have been adulterated. It was hard to tell if it was "no ketones" or "trace ketones," as I find the colors very similar, but I am concerned that it may have been the latter.)

I don't count calories meticulously (I tend to measure in terms of cans and scoops), but I just did an average of the last four days and I'm feeding roughly 328 kcal/day. He rarely eats everything, and it's a bit difficult to measure what's leftover.

(Also he's really doubling down on going for the dry food right now, which is awfully frustrating. He has completely ignored the tuna & whitefish pate I fed him for dinner in favor of munching on leftover dry food from this morning. I know from experience that he'll probably eat at least some of the wet food overnight, but ... this is not helping me move in the direction I want him to go, i.e. no dry food.)

Sorry, some of this just feels like excuses. I'm exhausted, it's been a long day. If you think I should stick closely to the SLGS guidelines, can you help me understand why they're set up like this when it seems so counterintuitive not to try and bring his numbers down from such a high place? I understand that part of the point of going slow is to make sure not to miss the "right" dose, but letting his BG stay so high seems like it must be harmful. That seemed to be my vet's take as well when she advised me to increase to 0.75u. I'm sure I must be missing something.
 
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Allie & Gen said:
he's already peeing in my bathtub half the time instead of the litterbox for some reason
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Just a thought--have you considered plugging the tub (maybe just while you're home) to collect urine for testing? As long the tub was fairly clean--which I'm sure it is since you're already cleaning up after him in there--and you could go in right after he's done, that pee would probably be fresh enough and you could just dip the strip right in.
 
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