2/1 Simon AMPS 77, +3 48, +3 1/2 58, +5 71

KarrieK

KarrieK

Member Since 2019
It's a relief to see more blues and greens on my boy's spreadsheet. According to the TR guidelines, we need to see numbers under 100 overall for at least a week before reducing his dose, from what I have been reading on some of the threads it seems he is in an unusual category by still being on 3 units. I would appreciate any advice on when I should attempt a reduction, and by how much? Thank you!
 
Hey Judy, thank you for your reply. I guess I call it "modified" mainly because of the way his diabetes treatment started. He was released from the hospital on a high dose of Vetsulin and his numbers were averaging very high for the first 4 - 6 weeks. I was trying to learn as much as I could to manage this disease, including trying to learn about "dosing methods", while taking care of my other terminally ill kitty. Someone on this forum (after looking at Simon's spreadsheet) recommended that I was closer to the TR method but since I am not following it exactly as written I thought I better say it was "modified". I am still confused about all of the variables involved in both methods - and welcome any and all advice!
 
Sounds like you have a lot on your plate right now that you juggling but just the fact that you are here, asking questions and learning speaks volumes! As you may have discovered already, the people on this forum are EXTREMELY generous with their time and experience. I, personally, have benefited so much already and there's much more to learn.

Here is a link about reductions that you may find helpful. Did you find the information on this website about the SLGS and TR? Tight regulation has a better track record of getting kitties to remission but they have to be OFF of dry food, and the caregiver must be able to test more often during the cycle (always before shots and at least 1 more in each the AM and PM) cycle. Are you able to get a test in before bed? Your handsome Simon may still be dropping tonight.
 
I totally agree with what you are saying about the people on this forum, and how much I have learned. I just read (and re-read) the information on TR, as well as the articles on how to handle low numbers, etc. My Simon hasn't had any dry food in years, as I put both my kitties on a mostly home cooked diet about 5 years ago due to his sisters IBD. I do always test before shots, and before I go to bed. Also I try to spot test as often as I can.

Right now I am concerned that he is dropping tonight (he was at 48 about an hour ago - lowest yet) so I'll stay up a bit later and check him again to see if I need to give him a little bite of a carb.

Thank you again for your interest - it really helps to connect with other cat parents in the same situation!
 
You bet. You may want to put the ? in your title as that will draw more experienced eyes onto your thread and help give advice especially with Simon dropping tonight. If you tested 1 hour again, can you do another test now?
 
Kerrie, Simon has earned a reduction in dose down to 2.75 units with that 48@+3 tonight.
Congratulations.
I would test again 30 mins after the 48 to see it is rising.
Did you give Simon some food after the 48?
 
Bron and Sheba (GA) said:
Kerrie, Simon has earned a reduction in dose down to 2.75 units with that 48@+3 tonight.
Congratulations.
I would test again 30 mins after the 48 to see it is rising.
Did you give Simon some food after the 48?
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He was still at 48 @+4, and he does have food on his plate. He's always been more of a grazer - especially in his senior years. I will reduce to 2.75 tomorrow am, thank you for your help!
 
KarrieK said:
He was still at 48 @+4, and he does have food on his plate. He's always been more of a grazer - especially in his senior years. I will reduce to 2.75 tomorrow am, thank you for your help!
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What carb food did you give Simon?
If he is still at 48 I would give him a teaspoon of medium carb and test again in 30 mins. You are only at +4
 
Didn't give him any carbs as he wasn't in the danger zone, and he was acting fine. Now this morning at +11 he's 55, so I'm thinking if he's still there pre-shot I'll proceed with a .25 reduction? I am off today so I can check him often.
 
First, there is no such thing as "modified" TR.

If your cat's numbers drop below 50, PLEASE give some food, preferably medium or high carb, to bump the numbers up. 48 is a number you do not want to mess around with -- it IS in the danger zone. You waited an hour without testing (or feeding) and numbers could have dropped to the 20s and Simon may have been completely asymptomatic. You really don't want to wait to see symptoms of hypoglycemia. Please read the sticky on managing low numbers. I'm being a bit stern since we're all about keeping your cat safe. Luckily, this was a nonevent. There is an art to steering low numbers and it's good to get some practice before Simon throws you a big surprise.

Also, it doesn't matter where the pre-shot number is today, the 48 necessitates a dose reduction.
 
I'm afraid I'm still confused; the TR guidelines advises to wait until we see numbers under 100 for an entire week before attempting a reduction. However, it also says that if the kitty drops below 50, to reduce the dose by .25 units. Which is it?

It also talks about cats with "high dose conditions" and the need to reduce in whole units. What are considered "high dose conditions"?

I have read the managing low numbers article several times (including at midnight last night), but it sounds like there are so many variables I guess I am not sure what to do when. As you said, there is an "art" to steering low numbers and I sure understand why.

Thank you again for your help - I do welcome any and all advice!
 
Although Freckles has never earned a reduction, I feel confident in answering this question but if other more experienced folk want to chime in, that's great.
KarrieK said:
I'm afraid I'm still confused; the TR guidelines advises to wait until we see numbers under 100 for an entire week before attempting a reduction. However, it also says that if the kitty drops below 50, to reduce the dose by .25 units. Which is it?
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It's both. Some kitties will coast along at 80, 65, 70 etc (numbers below 100) for a week(s) but never make it below 50. So if they are below 100 for a week they get a reduction.
If a cat drops below 50, that's an indication that the insulin dose may be too high and it needs to be knocked back a bit so you reduce by .25u. As Marje's thread indicates, it's important to try and catch these lows (test often) to keep your cat safe.

KarrieK said:
It also talks about cats with "high dose conditions" and the need to reduce in whole units. What are considered "high dose conditions"?
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Good question. When a cat keeps requiring more and more insulin (it looks like the insulin is not having the effect that it should - like my Freckles) the caregiver increases the dose. So once a cat gets to about 5-6.0 u, instead of increasing by .25, which if you look at is percentage wise, is actually quite a small dose increase, you need to increase more than .25u (.5u instead of .25 u increase). If the cat is up even higher and receiving say 10u of insulin, increases would be higher too. So when increases get higher, I would imagine so would the decreases (but like I said before, my cat has not earned a reduction yet, so I can't speak from experience). Because I posted frequently throughout this diabetic journey, the experienced people were able to get to know Freckles more and as I approached higher numbers, they were there to offer support and advice all the time - which is really appreciated.

KarrieK said:
I guess I am not sure what to do when.
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You aren't alone here. That's why it is so important to post your questions, read other threads and see what the advice is for other people so a person kind of 'gets the hang' of the diabetes 'dance'. Looking at other people's spreadsheets and seeing what they did and asking them questions is also a valuable learning experience. When you aren't sure of something, are in a dilemma, feel you know what to do but just want to double check, you are strongly encouraged to post and ask for help/guidance.
 
Thank you so much Judy. At this point in time I feel like me "getting the hang of it" is a long way off. If ever! He was just at 48 again, at +3, so I gave him a little food with gravy in it - one of those Merrick Grain-Free pouches - which he inhaled. Half an hour later he crept up to 58. Thankfully I am off work today so can test him frequently. In addition, I did reduce his dose by .25 this morning. We'll see. I sure appreciate hearing from you, and I did peek at your kitty's spreadsheet. It's great that you can test him so much, and he must be very cooperative. Simon has gotten much better with that, thank God.
 
So that 58 is likely because of the food that he ate and the increase may be short lived. It's important to test frequently (like in 20 minutes). I have to go pretty quick so let's hope someone who is more experienced with steering lows will stop by.

Start a new thread for today. Link this thread to it. In your title put the ? and list your AMPS and all the results of the tests you give him. It's important to keep your title and your spreadsheet up to date so people can keep an eye on you to help Simon.
 
Just saw the tag from Judy & Freckles.

First of all that <50 today 2/1/20 "earned" your cat another reduction in dose, down another 0.25U

Not sure who else is on today to help guide you with the low numbers.
When did you last test?
When did you last feed?
Would you please go up to your title and change the title to today's date, and put the low numbers you are getting FOR TODAY in the title heading.

Upper right, click on edit thread, drop down list will let you change the title. Save your changes.

We would consider your cat a Newly Diagnosed diabetic. <1 year since diagnosis. TR vs SLGS guidelines don't say that, but that is what I remember.

40'S ARE THE DANGER ZONE. FEED THE 40'S
 
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Good job getting Simon back up over 50. I'd still get another test to make sure he's staying over 50 a couple hours after that higher carb food - which can wear off in two hours.

Simon did NOT earn a reduction today with that 48. It was likely the result of the effect of the 3.0 unit depot. Those larger depots can influence 4-6 cycles after a reduction. We don't generally do what is called back to back reductions because of that depot.
 
I hope I did that correctly, as it was also suggested I start a new thread and then copy this one into it. Both make sense to me - just want to do it correctly so our progress is easy to follow.

I last fed Simon when he was at 48 (or +3 1/2) and gave him a little food containing gravy, as I was concerned about the drop under 50. (Spreadsheet is updated).

Both of my cats have to be "free fed" as they are both grazers, both picky and tend never to eat much at one time. However, I do try to pick up their food 2 hours before the AM and PM preshot test.

Thank you again, and I will definitely remember to "feed the 40's".
 
Wendy&Neko said:
Good job getting Simon back up over 50. I'd still get another test to make sure he's staying over 50 a couple hours after that higher carb food - which can wear off in two hours.

Simon did NOT earn a reduction today with that 48. It was likely the result of the effect of the 3.0 unit depot. Those larger depots can influence 4-6 cycles after a reduction. We don't generally do what is called back to back reductions because of that depot.
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I understand. That makes sense. I plan to check him again soon. Also will keep him at 2.75.
 
KarrieK said:
I understand. That makes sense. I plan to check him again soon. Also will keep him at 2.75.
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Hey there , I would hold the dose as he was probably still under the influence of the 3 units as it can take 4-6 cycles for the depot to drain.

And as far as earning reductions when the BG’s are overall under 100 is only one way of earning reductions. That usually happens when they are well regulated. Right now you’ll be looking for a drop under 50 to earn a reduction.
 
Bobbie And Bubba said:
Hey there , I would hold the dose as he was probably still under the influence of the 3 units as it can take 4-6 cycles for the depot to drain.

And as far as earning reductions when the BG’s are overall under 100 is only one way of earning reductions. That usually happens when they are well regulated. Right now you’ll be looking for a drop under 50 to earn a reduction.
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By "hold the dose" do you mean keeping him at 2.75 - or - not giving him an injection when he's due at 7pm?
 
Hold the dose means, stay at the same dose.

As an aside, we have seen kitties in the neighbourhood of two+ units hit all green and work their way down the dosing scale, one week at a time.
 
He was at 179 PMPS and I gave him 2.75. Kind of disappointed he went up that high after being in the green earlier today. He didn't eat much this evening, either - I offered him 3 different things and all he did was nibble at each one. Hoping it's just an "off" evening appetite-wise. Will check him again shortly, before I go to bed. Thanks so much for the help today, it is greatly appreciated!
 
Yes, you'll want to watch him because with little food in his belly tonight, there aren't much carbs to influence his numbers and counteract the insulin. .
 
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