Scratchie'smom said:
I just need to be comfortable and need to decide what will do that.
Amen!
I just read through yesterday's thread, and I hope you don't mind me adding some comments.
First, here is my analysis of your spreadsheet:
1. First, I don't think you need to get up all night to test right now, while he is still in fairly high numbers. There will probably be some times when you need to test more at night, but right now it doesn't seem to be needed. If he is high/flat at +3, I would go to bed and sleep. Get more tests on the weekends when you're able. Give yourself a break. I-)
2. Scratchie was getting some good numbers at about 5-5.25 units, then started earning reductions. Most Lantus cats hit a breakthrough dose, then start earning a series of reductions. Sometimes (usually) after a couple of reductions they will sort of stall out and have to go back up in dose a bit again to get a new breakthrough, but usually there is a pretty clear breakthrough point. Then at some point they will either settle into nice flat numbers at some dose, or they will keep getting reductions and go OTJ.
3. Scratchie earned a couple of reductions after 5.25u. At 4.75u, the reduction
might have failed. There aren't many daytime spot checks on that dose so it's hard to tell for sure. The procedure for a failed dose reduction is to go back up to the last good dose. You increased the dose again to 5u, which brought him back to green, so that makes makes me think (again) that 5u was about right.
4. At this point, you probably could have just started reducing by protocol again and he would have been fine. 4.75u wasn't quite enough insulin, and 5u was good or possibly a bit much (but not a lot too much because 4.75 wasn't enough). So you know his good dose (at that time) was in that range
because you have the data that proves it.
If you had stayed the course, he probably would have started earning reductions again at 5 or 5.25u. You can look at my Lucy's spreadsheet to see that she had a breakthrough at 4.25u, got some dose reductions but eventually lost it and I had to work back up in dose again, all the way back to 4.25u, then she started earning reductions again and this second time around she did much better. Some cats take a false start or two before they head down the dosing ladder for real.
5. After that second breakthrough, you reduced his dose to 1 unit and started over. You have increased according to protocol and haven't seen anything but yellow and pink. I see no indication of bouncing and no indication that he has passed his good dose. You're not quite back up to his original breakthrough dose yet, but getting close.
I agree wholeheartedly that too much insulin can look about the same as too little insulin, especially when you are looking at a spreadsheet that doesn't have much data. When you DO have the data, as you do, it helps to break down the whole picture and see what you can find. And yes, the Whole Cat Report too. 20 minutes of Hide & Seek is sooooooo cute! So Scratchie must be feeling pretty good.
Where do you go from here? It's up to you. You can try starting over again if you want, or you can plug along and look for another breakthrough. What might work (it's worth a try) is when you get to that next breakthrough, instead of reducing in increments of 0.25u maybe try reducing by 0.5u to be a bit more conservative. See how that works. If it works, great, if it doesn't, then split the difference, increase by 0.25u and see what happens. Play around with that method and see what kind of results you get. Just a suggestion, but it's an idea that seems logical to me. The protocol allows for 0.5u reductions. Most of the time we find that 0.25u reductions work better, but once you have learned the protocol then it is perfectly fine to tweak it so it works best for you and your cat.
I'm single and work and it can be tough sometimes. It doesn't have to be hard ALL the time, though. Lucy was really, really hard for because she was a drama kitty. I was lucky that she usually dropped at night and bounced during the day so I could leave her to go to work. Many times I thought I would like to find a dose that would keep her flat and a little higher so I could get some rest, but I never figured out how to do that because she didn't believe in flat (and it turns out that was because she wanted to go OTJ, and once I figured that out I decided it was worth the tradeoff). Jazzy was much easier because I could more easily predict what she would do and I was ok with testing less and leaving her alone during the day.
Some of it depends on the cat, some depends on how well you know your cat and how well you learn to apply what you know. You're doing fine, keep learning about Scratchie, keep asking questions, and you'll find a solution that works for both of you.
