2/24 - Sami - PMPS 124; +2 76; +3 58; +4 52

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Tina & Sammy

Tina & Sammy

Member Since 2010
Good morning everyone,

Yesterday's Condo

We had quite a night last night. After the whole Sex Change, anal gland expression, and the 43 BG it was probably the most dramatic, traumatic, and shocking day EVER!
 
Oops, posted before I finished my thoughts. I know this is a lot of information, but I hope you will take the time to read through the history and help me decide about dose reductions.

Anyway, we did reduce to 2 units this morning. I am trying to make a plan for future reductions. I can tell you that last night when Sami was at 43 I was barely able to get that test. When we got home from the vet Sami was like a shark circling his pray. I had not choice but to give him a bit of food before the test and even after that little bit of food trying to get him to sit still so I could get a blood sample on the strip was ALMOST impossible. So the thought of having to have him drop below 40 for a reduction just sounds like it will be impossible to get a reading.

I know Sami is still considered a long term diabetic because he was originally diagnosed back in September 2009. Here is the break down as far as how long he was on insulin each time. I can really use a little advice on this, and making a determination if it would be okay to stick with the Newly Diagnosed protocol for reductions, under 50 - reduce dose by .25.

September 2009 (don't know exact dates) - started taking Vetsulin and was on it for 3 weeks and then had normal BG again. There was no home testing at this time, and the diet was strictly DRY food. Total time on insulin - 3 weeks

November 17, 2009 - re-diagnosed - Started Lantus - Home testing and spreadsheet available on link below - See tab 2009-2010 True Results and 2010-2014 Relion. Diet was strictly DRY food until January 12, 2010. Found FDMD on January 7, 2010 and learned so much in just a couple of day. By February 3, 2010 after the implementation of MiniMeals, Sami went racing down the dose scale and in just 5 days he went from a dose of 1.25 to .25. At which time we tried to slow down the reductions and hold them as long as possible to provide as much healing time as possible. On the evening on February 15, 2010, Sami started his OTJ trial. - Total time on insulin - 3 Months

Sami was :otj: for nearly 5 years.

Sami had a couple of wobbling moments with HIGH BG. In September 2013, after the passing of one of our other furbabies, Sami had some high sugar and after just 2 shots, his BG was back to normal without insulin. (see 2010-2014 spreadsheet). In November 2014, after months of another Furbaby loosing more and more weight and having health issues, Sami had another bout of high BG. At the time we still had some insulin left over from the 2013 incident so I went ahead and gave that insulin, but after a couple days of no response we got a new prescription and within one dose the BG was back in the somewhat normal range and we discontinued insulin again.

January 9, 2015, Sami was showing high BG again and we started insulin yet again. After a couple of days of dose changes and skipped doses, the vet recommend that we take Sami off insulin to see if he was having a Smoogiei (spelling?) effect. At this point I had forgotten about FDMD, and followed the vets orders. After nearly a week increasing numbers the vet recommended going back on insulin. Then on January 19, 2015, Cody, our furbaby that had been having health issues went over the rainbow bridge :rb_icon:.


On January 27, 2015, I finally came back here and as you can see from the spreadsheet things started to improve almost immediately. No more up and down the dose scale for no reason at all. I tried to stick with TRP as much as possible, but if you read some of the earlier condos from this year I was still taking advice from the vet at the same time and it was making me feel very conflicted. Once I stopped listening to the vet completely things got even better. That was on February 9, 2015, I know I am a bit hard headed at times.

Sometime between February 9, 2015 and last week, I started re-reading all of Sami's old condos from 2010 to see if there were any revelations that might help me to determine how we went :otj: before. I discovered a post from February 3, 2010, where I implimented MiniMeals and after that point, Sami had phenomenal numbers, he only had a couple of tests that were over 100, and most of them were only over by a couple points, which could very well be meter variance.

So on February 22, 2015, I re-implemented the MiniMeals, and so far, you can see from the spreadsheet, Sami's numbers have yet again been phenomenal.

To make it a bit easier here is the breakdown of how long Sami has been on insulin:
3 weeks - September 2009 - but this was on a DRY diet
3 months - November 2009 - February 2010 - but only 1 month of regulated dosing and wet food diet
5 weeks - January 2015 - present - but the first few weeks dosing was not regulated per the tight protocol

I am sort of inclined to not include the weeks and months that Sami was on DRY food only (2 months 3 weeks), and the time where the dose went up and down per the vets advice and against TRP. Others will probably disagree with me here, but that is just how I feel

So technically, Sami has really only been on insulin for approximately 1 month in 2010 and 1 month in 2015.

Thanks for taking the time to read through this and to provide your input on whether or not I should hold out for the UNDER 40, long term diabetic, or if would be okay to stick to the UNDER 50, for dose reductions. I also know that I could do the under 50 3 times on the dose, and I might be okay with that if that is what is the best protocol to follow.





 
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Marycatmom said:
It's surprising to me that no vet ever checked out his bottom. Mine always looks it over. Poor Sami is going to need all new toys and beds. All the pink girlie one's will have to go. I guess you'd better start knitting!!! Wendy from Wendy Knits has a great cat bed pattern. You might not have the right yarn in your stash, though. Not to worry, I can direct you to several online yarn stores. :) You, Julie, Wendy, and I, along with all other knitters and quilters on this board, should meet up in Center Harbor, NH to go to Keepsake Quilting and Patternworks (yarn store) ROAD TRIP!!!
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I love the idea, give me a date.

julie & punkin (ga) said:
we LOVE a road trip!!!

Well . . . once a cat has been diagnosed with diabetes, if they become diet-controlled they are still considered diabetic. I think technically he has been diabetic since 2009, so 6 years. That's why I said others might have other advice. I don't think this is clear-cut. I suspect there is a difference between a cat that has constantly been on insulin for 6 years and a cat that's been diet-controlled all except for a couple of months of that time.
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Yeah, that is sort of what I am hoping to figure out today.

Wendy&Neko said:
Looks like Sammy is really liking the green. :D So, what was your reaction when the vet told you?

Have you double checked the other cat? ;)
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I was a little perplexed at first, but having thought he was a boy myself at the beginning it didn't surprise me. Sami is actually the first cat that we have not gotten as a kitten and the first cat that was already neutered/spayed before we got them. I did look at Crystal this morning, and yeah, I can clearly see the difference now.

tiffmaxee said:
OMG. This is too funny. Reminds me of when I was a kid. We got two kittens, one for me and one for my sister. My "male" cat was Puff and my sisters "female" cat was Muff. Puff was very friendly. They were outdoor cats. Puff went missing and found me a few weeks later on the playground of my elementary school several blocks from our house. A few weeks later Muff had kittens. A few weeks later Puff had kittens. Yep, he was a she!! My dear wonderful dad found homes for all 11 by insisting everyone take two. I guess this happens more often than we think.
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Wow! that is a lot of kittens. What a little surprise. I guess when they are really young it is sometimes harder to tell, but you would think that the vet who has gone to school, I don't know how many years for their degree, would be able to tell the difference.
 
I thought my first kitty, Mr Kitty, was a girl when I first got him...he was too tiny to tell for sure! In a few weeks, I realized my mistake....I had to change his name from "Pidge" (the female dog in "Lady and the Tramp") to a boy's name....but I was stumped. So, he ultimately ended up Mr Kitty. I guess I didn't handle the sex change as well as you did...I didn't know what to name the poor boy once I found out "she" was really a "he"!

LOL on checking out Crystal...I hope she wasn't offended!
 
Amy&TrixieCat said:
I thought my first kitty, Mr Kitty, was a girl when I first got him...he was too tiny to tell for sure! In a few weeks, I realized my mistake....I had to change his name from "Pidge" (the female dog in "Lady and the Tramp") to a boy's name....but I was stumped. So, he ultimately ended up Mr Kitty. I guess I didn't handle the sex change as well as you did...I didn't know what to name the poor boy once I found out "she" was really a "he"!

LOL on checking out Crystal...I hope she wasn't offended!
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The naming worked out perfectly, because like I said, I original thought Sami was a boy to begin with and I was set on naming him Sam!

Yeah, Crystal wasn't too happy about it and the first time I tried to look she just wasn't having it, but then I caught her when she wanted a belly rub and I was able to look more closely.
 
I have no advice with regards to dosing, however, it seems like that the mini meals have been improving Sami's #s. I'd say keep up with the mini meals and listen to what the others have to say about the dosing. I'm wishing for Sami to have another OTJ Trial period very soon, and get OTJ permanently. :D
 
tiffmaxee said:
FWIW I would have taken it. You can always go back up at any time.
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This is very true, and don't get me wrong, I am not second guessing my decision, I know it was the right one under the circumstances. I am only nervous right now because at +6 he is 92, sure I know this is an awesome number, but yesterday he was 72 at this time, as long as he doesn't keep going up from here to PMPS we should be okay. We will take it one day at a time and if we are not getting back down into the 60's during the next cycle I will take suggestions about going back up to 2.25 units, or maybe even fattening up the 2.0 unit.

Also, there is a possibility that I might have given a Skinny 2.0 this morning, I wasn't as through this morning in making sure it was exact with no bubbles. I knew the shed would need to empty a bit also. I will be more precise tonight and see how that cycle goes, and I won't be jumping too quickly, because the 43, and Sami's anxiety to eat at that number yesterday, really threw me for a loop.
 
It is about that time for another test, although I am nervous to see what that number will be. Sami was at 113 at +8, and YES still an amazing number considering what we were looking at just a few days ago, but I am just nervous that we took that reduction too soon. Maybe Sami is one of those cats whose BG goes lower when stressed rather than up, not really sure. Only time will tell. Hopefully when I test at +11 he (still really hard to say HE instead of SHE) will be surfing right around that 113 from +8. I would get a +10, but that is due now and Sami is sleeping soundly right now. Okay, maybe not so soundly, there are a few snores coming from that side of the office.

Anyway, I hope he takes the reduction well, and we can see a longer span of GREEN in his PM cycle today.
 
I think you're totally justified considering Sami to be a "newly" diagnosed cat

Even with cats diagnosed over a year ago, it's more of a suggestion to wait for 3 under 50 or 1 under 40, not a hard and fast rule, so just watch Sami's numbers and if you take a reduction that fails, go back up to the last good dose!

Remember, ECID so just watch Sami's numbers and let them be your guide!
 
Chris & China said:
I think you're totally justified considering Sami to be a "newly" diagnosed cat

Even with cats diagnosed over a year ago, it's more of a suggestion to wait for 3 under 50 or 1 under 40, not a hard and fast rule, so just watch Sami's numbers and if you take a reduction that fails, go back up to the last good dose!

Remember, ECID so just watch Sami's numbers and let them be your guide!
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Thank you. I does make me feel much better about this decision knowing that at least some of the experts are in my corner on this.

My goal is to get Sami into the 50-90 range all the time and hold there as long as possible to give him the best change to go into remission again. When Sami went into remission before this range was where he was for the last 10 days he was on insulin, with only a couple times where he was above 100, only by a couple of points. So I think if we can successfully mange this and try to decrease a slow as possible then we have a fighting chance to return to the FALLS.
 
Things went quite well today. Sami didn't stay in the GREEN as long as I would have liked, but she surfed the low BLUEs nicely for the rest of the afternoon. Tonight I am giving fluids so we will see where that takes us. I am not expecting a drastic drop this evening, but I will probably get a an hourly test through +4 to make sure. Then determine the next test based on the numbers I see. Last night was really hard getting an hourly test through +7, but I really felt it was necessary to make sure he wasn't going to dip back down into the 40's again.
 
+2 and already green. I like it. I will still be monitoring closely as I really don't know how the fluids will play into this. We had a big drop with fluids on 2/22, but I think that was more the work of the bounce clearing then fluids because on 2/20 and 2/17 we didn't see a lot of movement with fluids. But then again we also had other factors in play, on the 2/17 we had the whole DUCK issue and on the 2/20 we were at the start of a bounce.
 
+3 = 58

I still can't figure out how to update the title from my phone.

Anyway, I am very tempted to give a tiny bit of medium carb to low down this drop. We just had a reduction this morning and there is probably some shed action still happening. In addition the fluids might be helping a bit.

I think I will test again in 30 minutes instead of waiting 60. Does anyone have any recommendations on whether I should give a little medium carb food?
 
Well, we just might be doing what we did the last time Sami was on insulin. He raced down the dose scale. He is currently at 50 at +3.5. I just gave another MM at +3.5, this was an extra not in the normal schedule. I will test again in 30 minutes to see if he is still dropping quickly.

I know we just took a decrease this morning, but I am wondering if we should take another in the morning, or is it possible that the fluids are doing more than we think here. I guess I will make that determination in the morning. If we are back up to approximately were we were this morning then more than likely I will stick with this dose, but if by any chance we surf these 50's for most of the night and are well under 100 tomorrow morning, I just don't know what to do.

Need scenarios and what if situations and how to handle them.
 
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Hi Tina. I can't really advise you, since I don't have much experience, but I will share that I've been told that if Mikey gets to 50, I should give HC or LC with a bit of Karo or honey. I'm sure someone who knows more will come along soon, but I'd have the HC on the ready, test soon, and use the HC if he's not staying above 50, if no one with more experience gets here fast enough. Remember the rule "Better too high for a day than too low for an hour." We have to keep our BOY safe.

It sounds like you're heading for a PJ party. Ugh!
 
We don't generally take reductions so soon since the shed can still be effecting things but if he's low in the morning and you can't test, it's better than risking him going too low when you're not there.

I think the fluids are effecting the numbers, but there's no real way to prove it

Sorry I wasn't here earlier, but what I would have suggested at +2 would have been a couple of teaspoons of his regular low carb food and then if by +3 he hadn't slowed his drop, a teaspoon of MC at that time

Now that he's right on the edge, I'd retest and if below 50, go ahead and give him a little HC food and retest in 30 minutes
 
Thanks Mary @Marycatmom

I just gave Sami a bit of MC food, even though he had come up to 52 in the last 30 minutes, but there is still a long time in the cycle and he sort of turned his nose up at the regular LC stuff. I will test in another 30 minutes just to see what that food did, it was only about a teaspoon of 8%, which technically is still considered LC, but is higher carb that was Sami has been getting in regular meals.

@Chris & China I will keep that in mind for next time. I was thinking about doing medium carb at +3 when he was at 58, but I didn't know if that would be right since he wasn't under 50. I just fed a teaspoon of 8% so we will see how that impacts the sugar. I would like to see him over 60 and rising before I put more time between tests. Right now I will test again in 30 minutes to see if the 8% helped bring him up a bit, and if so I might go back to bed for an hour and then test again. Sami really would have two more MiniMeal at +5 and +6, but we gave an extra MM at +3.5 so it might be okay to skip the +6 MM if the number is comfortably higher, say in the 70's. And if he is still in the 50's at the next test I will give another tsp of 8%.
 
What you have to remember when they're that close to 50 is to keep testing until it's been at least 2 hours since the last time you fed or you get at least 3 rising numbers

Feeding props up the numbers, but they can come back down again....once he's into the high 60's or 70's, it's usually OK to lengthen the time between tests to 45-60 minutes

I'm glad to see he's not sitting right on that 50 now!
 
I wouldn't take another increase tomorrow morning. The depot can affect from 4-6 cycles after the reduction. Of course if he'd hit the 30's that would be a different story. And I presume you are still taking him to work so you can keep an eye on him tomorrow. If you agree he's not earned a reduction, then it's OK to feed the 50's with a little higher carb food to get him up so you can sleep. FWIW - I often find that the second cycle after a reduction is an exciting one.
 
I have been testing every 30 minutes. Sami is still in the low 50's. He got up to 53 but now back down to 51.

I just gave 1 tsp HC over 20% so I hope that helps bring him up over 60.

I am posting from my phone so I will update the spreadsheet in the morning.
 
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