26/4 Alice AMPS180, PMPS 522!

[Julie and Alice]

viewtopic.php?f=9&t=117768

Hi everyone,

Its be a funny couple of days. Alice all over the place, thinking she would NEVER settle - I was exasperated! Trapped Alice in the door as hubby walked in & I tried to shut the door quickly before she escaped! So theres me, a blubbering tired wreck with no hope. That evening (last night) her PMPS was only 115. Yes I know that a good number, for Alice though on a previous day with the same reading in the evening, she plummeted over night. the same happened only earlier in the cycle which was worrying. She was dropping fast and so I started to offer small feeds. Eventually had to give her high Carb food & then a couple of drops of Glucogel. I was so pleased once the panic was over,and happy to see a much lower and consistent line. She did well for 1 & half days. she clearly did very well on a reduced dose insulin.

Tonight she has suddenly shot into the black - I cant see how this could be another bounce. Is there any explanation? Plan to increase her insulin very slowly and carefully.

Gotta go as falling asleep!
Juliexx

 

[Marje and Gracie]

Julie

I think you have two things going on.

First, you've reduced the dose twice when she hasn't earned it so the high numbers are due to not enough insulin plus a bounce.

If you get a number that scares you at PS, don't feed, and then post here for help. We need to have you shooting lower and lower to help her flatten out a bit.

 

[Elizabeth and Bertie]

Hi Julie,

I agree that it looks like there was too little insulin.
In the 26/4 AM cycle the numbers held but they didn't drop. And then as the insulin in the system diminished further the BG shot up. That factor alone could account for last night's high preshot number. I'm not convinced that there was a 'bounce' (in the sense of Alice reacting to the lower numbers) because Alice usually bounces much sooner than this after hitting a 'trigger' number.

You know, just because you're using Lantus that doesn't mean you have to follow a Tight Regulation protocol. TR isn't for everyone.
And if you feel that TR isn't for you, or, that it isn't for you at this point, then you do have the option of trying the gentler SLGS (Start Low Go Slow) approach. If you wanted to try that then you could post for advice on dosing in the "Relaxed" Lantus forum here:
viewforum.php?f=32

Nobody will mind if you do that.
This is about you and Alice, and finding a way that works for you.

Just wanted to make sure you're aware that you do have choices.

Eliz

 

[Sienne and Gabby (GA)]

There is a third option regarding TR vs. Relaxed. There are many people who follow the more relaxed approach (SLGS - start low, go slow) that post here. The Relaxed Lantus forum does not have that many subscribers and is not busy. If you need help, this is a very active board and you will get the help that you need in a very timely way.

 

[Elizabeth and Bertie]

There is a third option regarding TR vs. Relaxed. There are many people who follow the more relaxed approach (SLGS - start low, go slow) that post here. The Relaxed Lantus forum does not have that many subscribers and is not busy. If you need help, this is a very active board and you will get the help that you need in a very timely way.

Oh, that's interesting.

So... How does the advice differ here for those opting to do SLGS rather than TR?

 

[julie & punkin (ga)]

On the new PDF that is posted (Tight Regulation sticky, 5th paragraph down "Management of Diabetic Cats Using Long-Lasting Insulin") the first section is for people using once a week monitoring.

I would just add that if your hope is for Alice to go into remission, Tight Regulation is her best chance. But that's not the goal for everyone, and if it's not your goal, just say so and we can change strategies! I have a bias towards TR, because although the word "relaxed" sounds infinitely more enticing, the truth is that TR gives a newly diagnosed cat the best chance of becoming diet-controlled. According to that PDF, recent studies have shown that 90% of newly diagnosed cats have the potential of becoming diet-controlled if they get into TR asap. The point of Tight Reg is to get a cat into normal non-diabetic cat blood sugar numbers (68-160ish AT) and to keep them there. When their blood sugar is in normal numbers, their pancreas can heal and begin putting out insulin again. You are testing more than enough to follow tight regulation - i think you just need a little more confidence that having her in lower numbers is going to be ok for her. You'll get there!

Julie, the beginning weeks of taking care of a diabetic cat are the most intensive and stressful! It does get easier! Make sure you give Alice a treat every time you poke her and she will learn to accept things. And for you - let us support you when you want to rant and wail. Lean on us! We've all been new and totally get how hard this is!! Sending you a gazillion hugs. :YMHUG: A glass of wine and some chocolate for you doesn't hurt either! Can I join you?

If I were you, I'd go back to the 1.0u that was getting her into great numbers and then hold it unless you see a number 68 or less. If you see that, give a few drops of that glucose goo along with 2 teaspoons of regular low carb food, wait 20-30 minutes for it to get into her blood stream and then retest. Post here and ask for more help and someone will hold your hand and guide you through it. We do it for everyone! Once you've done the low numbers thing a couple of times, it becomes no big deal. You'll gain confidence that you can steer her blood sugar with this technique, she will respond, and then it won't be nearly so scary. more hugs!

BUT - elizabeth is right. you can decide you don't want to follow Tight Regulation, you can still post here, and we will still help you. There is no judgement on it - you have to make this work in your life and we all get that. Sometimes people's work hours make TR impossible. There are several people not following TR that post here and we help them just as much. I'm trying to explain the pros of it and encourage you, but i'm not meaning to pressure you. i hope you can read my words in that way.