2/8 Disco PMBG 77,stalling,+12.5 66, +13 56,+13.25 56,+13.5 49,+13.75 49,+14 39,fed 2tsp LC

Sue and Luci said:
Since you're following TR and haven't seen a green in 6 cycles, it's time for an increase. Looks like 3 u is the next increment for Disco.
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Sue can you clarify for me (don't mean to hijack the thread)? I thought if you see green that you hold the dose for 10 cycles?

Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/
 
Judy and Freckles said:
Makes sense. Thanks for the clarification.
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All questions are good questions :) It just takes time to get to know your cat and what makes sense for you - when I'm feeling better I'll be increasing Luci's dose - although at this stage of the game remission is unlikely for her - but I do like to see her in lower numbers for her general well being.

However, Disco is relatively new at this and has a much better chance at remission - so now is the time to give him those pushes he needs. He has just recently seen some better numbers so we know he's capable of getting there...but sometimes these kitties need a little bit more of a push to get them back into those better numbers...and we do the sugar dance, up/down, up/down...adjust that dose until we hit the perfect dose and down the dosing ladder they go...until they hit the OTJ trial! Lots of kitties make it and the early days are the time to get there! It's always exciting to help the newbies across that line :)
 
Sue and Luci said:
All questions are good questions :) It just takes time to get to know your cat and what makes sense for you - when I'm feeling better I'll be increasing Luci's dose - although at this stage of the game remission is unlikely for her - but I do like to see her in lower numbers for her general well being.
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Thank you for your guidance, the days go by and I get a little muddled and I really appreciate the clarification. I will increase him tonight as I’ll be around most of the weekend.

I have a question and maybe I’m just pessimistic but I’m not sure if he will go into remission because he has some pancreas damage from his inflammatory bowel disease and one of his G.I. profile tests is always elevated. His labs from October are on his spreadsheet but I will look back and see what his previous tests were because we ran different panels where I used to work.

Previous labs attached, done in May 2019 (he had labs run every 6 months)
 

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Teri (Disco NoFurNo) said:
Thank you for your guidance, the days go by and I get a little muddled and I really appreciate the clarification. I will increase him tonight as I’ll be around most of the weekend.

I have a question and maybe I’m just pessimistic but I’m not sure if he will go into remission because he has some pancreas damage from his inflammatory bowel disease and one of his G.I. profile tests is always elevated. His labs from October are on his spreadsheet but I will look back and see what his previous tests were because we ran different panels where I used to work.

Previous labs attached, done in August 2019 (he had labs run every 6 months)
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I couldn't really read what the attached labs said - you may want to put that into your SS - under a new tab that you can name 'Labs'. I'm no expert either - but there are people on the forum who are more educated about those things and if it's there could be useful in the future for review.

In the meantime, don't give up on hoping for remission - kitties have the amazing ability to heal their pancreas' unlike us hoomans - once ours is damaged it is forever damaged - felines have the ability to re-grow new pancreatic cells! Also, I've accepted that although Luci may never go into remission - she's pretty healthy and happy and I still have her with me after two years - ok, so she needs medicine twice a day to stay alive and healthy - so do many other people and animals - it's ok...we have an understanding and she's a member of the family - so deserves our help to survive - I hope someone does that for me someday too :) She loves me for it (I think!)...sometimes I'm not so sure...but LOL - she's worth it!
 
Sue and Luci said:
I couldn't really read what the attached labs said - you may want to put that into your SS - under a new tab that you can name 'Labs'. I'm no expert either - but there are people on the forum who are more educated about those things and if it's there could be useful in the future for review.

In the meantime, don't give up on hoping for remission - kitties have the amazing ability to heal their pancreas' unlike us hoomans - once ours is damaged it is forever damaged - felines have the ability to re-grow new pancreatic cells! Also, I've accepted that although Luci may never go into remission - she's pretty healthy and happy and I still have her with me after two years - ok, so she needs medicine twice a day to stay alive and healthy - so do many other people and animals - it's ok...we have an understanding and she's a member of the family - so deserves our help to survive - I hope someone does that for me someday too :) She loves me for it (I think!)...sometimes I'm not so sure...but LOL - she's worth it!
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Thank you for your kind words and support! I added the last 3 lab panels Disco had run from the clinic I worked at in Virginia into his spreadsheet. Thx for recommending I do that. I've always felt that Disco loves me the most of the 3 kitties I have now, he purrs non-stop and demands loving and now that he has diabetes, that love has grown. I'm so glad he doesn't hide from me as I test him so often, but almost the opposite--he comes around when he hears the test strip container pop open--of course, treats are involved, LOL
 
Teri (Disco NoFurNo) said:
Thank you for your kind words and support! I added the last 3 lab panels Disco had run from the clinic I worked at in Virginia into his spreadsheet. Thx for recommending I do that. I've always felt that Disco loves me the most of the 3 kitties I have now, he purrs non-stop and demands loving and now that he has diabetes, that love has grown. I'm so glad he doesn't hide from me as I test him so often, but almost the opposite--he comes around when he hears the test strip container pop open--of course, treats are involved, LOL
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Isn't it amazing how they 'adapt' to the testing routine? I know a lot of folks have trouble in the beginning - I'm one of them...but these cats are smart and they adapt ... and next thing you know, they're practically leading the way! Gotta love it!
 
***Note—I meant to post this on Sat 2/8 not Fri 2/7***

After a day testing every 2 hrs, Disco’s PMPS is 77, so he’s going low in the evening just to trick me this cycle! Is this right—not feed him and test again in 30 minutes? If he is lower in 30 min, is that when I feed 2 tsp HC gravy or do I feed LC then unless he’s below 50. I will read over my notes again but I wanted to get this posted so I could get an answer so hopefully somebody will see this and help me.
 
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Although I'm not experienced enough to offer dosing advice, here is some info

from the sticky

How to Deal with Low Preshot Numbers (the following guidelines apply to those following the Tight Regulation Protocol only):
You just tested your cat’s preshot number, and there is a much lower than usual number staring back at you. What do you do?

There is no one-size-fits all answer, but there are some general guidelines. As with everything else, each cat is different (ECID) and each caregiver is different too.

The short answer is that most kitties can be shot at +12, almost regardless of the number, once you are data ready to do so. The exception is that shooting 30s or 40s is not recommended for most cats, so if a cat is lower then usually the best option is to wait until they are at a shootable number to shoot. What constitutes a shootable number will vary by cat, but we don't suggest or recommend shooting a preshot number less than 50. While you’re waiting, the depot is draining, so you want to get the insulin in as soon as it makes sense to shoot.

If it is your first time shooting green, then we will likely suggest that you stall the first time, even if the number is 80-100. That will let you collect data on what your cat will do when you stall. One thing you can do if you are having a low cycle is to get a +10 and +11. Those will give you a good idea of how quickly the cat’s numbers are rising (or not) when preshot time arrives.

Beyond the general guidelines, there are other factors we consider when we are helping someone with a low preshot.
  • If the low preshot is not part of that cat’s normal pattern or there is reason to think something might be wrong, we will be more conservative.
  • If the cat is not a food spiker or tends to have an early onset/early nadir then they may not want to shoot as low. If the cat has a late nadir, then they will HAVE to learn to shoot low.
  • We will also be more conservative in some cases because of the person – if you are not able to monitor then you want to be more careful, or if you are not sure that you can get back to the board to keep us updated throughout the cycle. Trust me, if you shoot low, we will be watching for your updates and we will worry if we don’t see them.
  • We have to be a lot more careful with the cats who eat only dry food, because they don’t have access to the tools the rest of us use to keep our cats safe.
  • Also, when it comes to very low preshots, there is an unwritten rule that whoever helps that person shoot low should expect to sit with them through any low parts of the cycle. There have been times when I knew a cat’s number was likely shootable, but I also knew that I could not be around to help if the shot resulted in low numbers later in the cycle. For safety’s sake, if I could not find someone else who would be available to support for the next several hours, I would most likely suggest that the shot be reduced or skipped. I will not encourage someone to shoot low and then abandon them.
  • There are a lot of other scenarios, and you always want to keep your cat in mind.
Some general rules when stalling (ECID):
  • 50s or higher – don’t feed. The number will bump up on its own soon due to the insulin wearing off.
  • 40s or lower – you have a couple of choices.
    • When 40s occur at the end of the cycle, it can be beneficial to withhold food and test in 15-20 minutes to determine if kitty is on the rise or hasn’t reached nadir yet.
    • If they are hanging in the 40s for a while, or if they are still dropping, it is ok to feed a tsp or two of LC and retest. This is very tricky. You want to avoid feeding too much while you’re waiting for them to go over 50, because you don’t want to artificially inflate the number with food.
      • Example: if kitty is 43 and you feed a whole meal, or feed some HC, and the number bumps up to 52, is that the cat’s natural end-of-cycle rise, or is it food spike? What if it is food spike? Then if you shoot the 52, when the food wears off he might drop back to the 40’s (and when insulin kicks in a couple of hours later, you might have a problem). If the 52 is the cat’s natural rise, then he will probably keep rising for the next few hours until insulin kicks in. If you can’t tell whether the number is food spike or natural rise, it’s safest to wait. Your data will help you here. Study the spreadsheet. How much food spike does the cat usually get? How many hours after the shot does the insulin’s onset usually occur in this cat? At what number is the cat likely to be when onset occurs? If the cat does drop, how easy/hard is it to regain control of the numbers? How carb sensitive is he?
  • Test often (every 15-20 minutes, or at most every 30 minutes). You want to catch the rise the minute it starts. With most of our cats, once they start to rise they will really zoom. You want to get the insulin in as soon as possible, because it will be another 2-3 hours before the insulin kicks in and you don’t want to let the cycle get too far ahead of you.
http://www.felinediabetes.com/FDMB/...y-to-shoot-handle-lower-pre-shot-numbers.147/
 
Teri (Disco NoFurNo) said:
After a day testing every 2 hrs, Disco’s PMPS is 77, so he’s going low in the evening just to trick me this cycle! Is this right—not feed him and test again in 30 minutes? If he is lower in 30 min, is that when I feed 2 tsp HC gravy or do I feed LC thrn unless he’s below 50. I will read over my notes again but I wanted to get this posted so I could get an answer so hopefully somebody will see this and help me.
***Note—i meant to post this on Sat 2/8 not Fri 2/7***
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No food. Stall and test and see if he is headed higher. He is probably breaking a bounce and so heading lower fast. Feed only if he drops below 50. Test every 20 minutes so you can catch him rising and shoot then.
 
Bandit's Mom said:
No food. Stall and test and see if he is headed higher. He is probably breaking a bounce and so heading lower fast. Feed only if he drops below 50. Test every 20 minutes so you can catch him rising and shoot then.
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Stalling and I can test every 20 minutes somehow half an hour went by when I just re-tested him but I’ll do it every 20 minutes now I promise
 
Teri (Disco NoFurNo) said:
Updated spreadsheet, he still dropping he’s 56 now at 8:55pm
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Wow! He is on a tear!

Some general rules when stalling (ECID):
  • 50s or higher – don’t feed. The number will bump up on its own soon due to the insulin wearing off.
  • 40s or lower – you have a couple of choices.
    • When 40s occur at the end of the cycle, it can be beneficial to withhold food and test in 15-20 minutes to determine if kitty is on the rise or hasn’t reached nadir yet.
    • If they are hanging in the 40s for a while, or if they are still dropping, it is ok to feed a tsp or two of LC and retest. This is very tricky. You want to avoid feeding too much while you’re waiting for them to go over 50, because you don’t want to artificially inflate the number with food.
      • Example: if kitty is 43 and you feed a whole meal, or feed some HC, and the number bumps up to 52, is that the cat’s natural end-of-cycle rise, or is it food spike? What if it is food spike? Then if you shoot the 52, when the food wears off he might drop back to the 40’s (and when insulin kicks in a couple of hours later, you might have a problem). If the 52 is the cat’s natural rise, then he will probably keep rising for the next few hours until insulin kicks in. If you can’t tell whether the number is food spike or natural rise, it’s safest to wait. Your data will help you here. Study the spreadsheet. How much food spike does the cat usually get? How many hours after the shot does the insulin’s onset usually occur in this cat? At what number is the cat likely to be when onset occurs? If the cat does drop, how easy/hard is it to regain control of the numbers? How carb sensitive is he?
  • Test often (every 15-20 minutes, or at most every 30 minutes). You want to catch the rise the minute it starts. With most of our cats, once they start to rise they will really zoom. You want to get the insulin in as soon as possible, because it will be another 2-3 hours before the insulin kicks in and you don’t want to let the cycle get too far ahead of you. The
 
Bandit's Mom said:
Wow! He is on a tear!

Some general rules when stalling (ECID):
  • 50s or higher – don’t feed. The number will bump up on its own soon due to the insulin wearing off.
  • 40s or lower – you have a couple of choices.
    • When 40s occur at the end of the cycle, it can be beneficial to withhold food and test in 15-20 minutes to determine if kitty is on the rise or hasn’t reached nadir yet.
    • If they are hanging in the 40s for a while, or if they are still dropping, it is ok to feed a tsp or two of LC and retest. This is very tricky. You want to avoid feeding too much while you’re waiting for them to go over 50, because you don’t want to artificially inflate the number with food.
      • Example: if kitty is 43 and you feed a whole meal, or feed some HC, and the number bumps up to 52, is that the cat’s natural end-of-cycle rise, or is it food spike? What if it is food spike? Then if you shoot the 52, when the food wears off he might drop back to the 40’s (and when insulin kicks in a couple of hours later, you might have a problem). If the 52 is the cat’s natural rise, then he will probably keep rising for the next few hours until insulin kicks in. If you can’t tell whether the number is food spike or natural rise, it’s safest to wait. Your data will help you here. Study the spreadsheet. How much food spike does the cat usually get? How many hours after the shot does the insulin’s onset usually occur in this cat? At what number is the cat likely to be when onset occurs? If the cat does drop, how easy/hard is it to regain control of the numbers? How carb sensitive is he?
  • Test often (every 15-20 minutes, or at most every 30 minutes). You want to catch the rise the minute it starts. With most of our cats, once they start to rise they will really zoom. You want to get the insulin in as soon as possible, because it will be another 2-3 hours before the insulin kicks in and you don’t want to let the cycle get too far ahead of you.
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I am so anxious I’m shivering, trying to read and absorb everything
 
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