4/13/21-Squeaky!!! AMPS=120!!! +6.5 = 93 PMPS = 393 Considering what to do

https://felinediabetes.com/FDMB/thr...-278-6-247-pmps-252-7-198-dosing-okay.246094/

What is the difference between a cat and a comma?
.....A cat has claws at the end of paws and a comma is a pause at the end of a clause.

HAHA!

Wow Squeak was 120 this morning..... and as typical when his numbers are low, wouldn't eat much at pre-shot.

I know you guys love it when we do +2's or +3's, but for us it is a BAD day if we have to test more than 4 times.

Suggestions to get him to eat?

And is it time to change dosing and is it time to change back to SLSG? @Wendy&Neko @tiffmaxee @Bandit's Mom

Thanks a bunch! I'm so happy he's starting to get better again. I feel better about our upcoming trip to Albuquerque....

(I think his last flareup and subsequent high numbers was because I gave him some chicken and carbs because he wasn't eating much..... he loves them but he's allergic.... it set off a bad chain reaction..... I won't make that mistake again but how to get him to eat at shot time?)

Have a happy day everyone! We have snow here and I had to light our wood stove this morning!

 

Let us see what Wendy and Elise say, but would you consider a modified SLGS protocol with reductions at a lower number - like 70?
His nadirs have been largely above 150 for almost 2 months. You may want him to spend more time in the 80-120 range.

 

Do you have any freeze dried treats or parmesian cheese? You can try sprinkling it on his food.

 

I agree with Bhooma. When you reduced at 90 you eventually ended up with glucose toxicity with too many reductions too close together.

 

Wow you guys are amazing, coming up with new ideas!!!!

Carla, he stopped eating the legal (non-allergic) freeze dried treats -- darn! Parmesian cheese? Hmmm, interesting idea, I could try and hope it works. I guess if he can't eat dairy we'll find out soon enough!!!!

Bhooma, Elise, how do you know it was glucose toxicity? I thought it was a pancreatitis flare up from giving him chicken and kibble with some carbs -- because his diarrhea also came back. I stopped the illegal foods, and his gut got better, no more diarrhea. -- Until yesterday. He wouldn't eat much, I gave him JUST ONE pellet of Duck Duck Goose and bam. Instant diarrhea.

Bhooma, yes I could do a modified protocol if it is spelled out for me, but please. Don't ask me to test him more than 4 times a day. We both get upset. Wow your knowledge amazes me.

 

It could be from pancreatitis but he went high for so long. That tends to happen when too many reductions are taken quickly. There’s no way to know for sure. Max had chronic pancreatitis but was tightly controlled.

 

It's the same as SLGS. You hold doses for a week. Instead of reducing when he drops below 90, you reduce if he drops below 70.

 

Thanks Elise, could you tell me more about how to control the pancreatitis tightly? Thank you.

 

Oh! That would be easy! And it makes sense to me. Thank you for this strategy.

 

You can’t control pancreatitis tightly. His bg was tightly controlled so I never had long periods of higher numbers. Sorry if I wasn’t clear. For Max gave him support meds at the first sign of trouble. He didn’t have IBD though. I also was very slow to stop support meds and weened him gradually.

 

Hi Jan, I can understand it can be difficult to find the right balance. I'd like to offer you my opinion on the idea of personalizing SLGS. If you read the dosing methods sticky, it does say that SLGS is a general guideline. There certainly are caregivers who after some time gathering enough data to really understand how their kitty responds to insulin and carbs, make a decision to personalize and reduce the threshold for when they take a reduction. In my opinion, I'd like to see that a caregiver knows some key aspects on how their kitty responds to carbs and insulin like:

-How much of a food bump does kitty usually get after their main meal?
-How easy is it to bring your kitty up when the numbers are lower? What carbs does it take, how carb sensitive is he?
- do you feel you have a good idea of when your kitty onsets, nadirs and how much duration they get on a certain dose?
- what is the reason for needing to modify the general guideline?

Because both of the dosing methods we follow here on the forum have certain safeguards built into them, when one strays from the usual guidelines, it should be clear that there is increased risk, and a responsibility on the caregiver to make sure you do what you need to keep the kitty safe. That may mean doing more testing, when you get a particular active cycle. That's also one of the reasons why when I see this come up from time to time, I don't personally suggest to a caregiver what their reduction number should be. It has to be up to you, factoring in everything I've said above, and what you know about how your cat responds to insulin and carbs, and then determining what you may or may not be comfortable with.

Again, just my 2 Canadian cents.

 

You really can’t deviate much if you can’t test more if needed. It’s just not safe. JMHO.

 

I agree with Elise, I think it is important first and foremost, to Know Thy Cat, before taking on the possibility of making any adjustments or personalizing the guideline, and then be fully on board with the fact that it may require additional testing (as I noted, because modifying can bring on a certain amount of risk) in the event that cycles warrant more testing. As Elise said, when additional tests are not possible, for whatever reason, it isn't safe to deviate.

 

Wow. Thank you everyone for the feedback. I can do occasional additional testing. But not all the time. So what is the conclusion, how can I keep Squeaky safe and give him the best possible chance at remission?

Please, don't think I'm being difficult about doing more testing. My own health condition (neurological), plus I'm single and alone with no family support and trying to do not only manage Squeaky's illness, but manage my life, all by myself, and I'm definitely getting older ..... It's about all I can do to stay steady and balanced in my life right now, when getting only 4 BGs a day. It already screws up my sleep patterns and I find it difficult to accomplish my daily tasks. I can do occasionally a few more tests but not regularly.....otherwise, it stresses me (and Squeaky) out so much, it is not very workable. And I'm not always home. And I can't always make quick decisions about what to do. Everyone else I know that has diabetic cats thinks I'm crazy for doing this 4 times a day... they test BG once a month or so. Or test when more peeing happens. I appreciate that I'm in the company of experts!

I trust and appreciate you guys and hope you can help me understand my next steps. Sadly, (with my neurological condition) I don't seem to be capable of understanding all the nuances and details to be able to make good decisions all the time, so I need help figuring this out and making it fairly simple for me. And I really appreciate your help. Thank you so much. (I'm also currently in the process of trying how to figure out how to simply the cooking, and the housework..... so I can go back to work soon and have a balanced life.)

So we had a 93 at +6.5. Given that we are doing TR we should hold the dose until he gets to 50. However, I can't do a lot of additional tests if his numbers get very low. So what is the next possibility, please? And THANK YOU. @Wendy&Neko @Bandit's Mom @thebigfuzz @Vyktors Mum

 

Where do you live, Jan? I really enjoy your jokes! Darcy does the same thing when his numbers are low... he's really not that interested in eating. It worries me. Tonight he didn't want to eat... then he did eat... then he threw up.... then he dropped to 69. I don't want him that low.

 

Even with SLGS you would hold the dose with a nadir of 93.

 

I agree with @Christie & Maverick and @tiffmaxee

For example, we are following SLGS for Cosmo, and have decided to take reductions at 70 based on data, knowing our kitty well, ability to test very frequently and having ability to monitor basically around the clock, when it is needed.

All situations are different. Safety is #1 and one needs to consider a variety of factors in making these decisions, including our own caregiver factors.

 

Hi Suzanne, I'm so glad you enjoy the jokes! I don't write them, I just pull them off cat joke websites to keep y'all entertained! I live in Colorado.

Yes it is frustrating when they won't eat. Squeaky will usually eat baby food if I spoon feed him, at shot time. He enjoys making me work more LOL. This week Amazon sent me 3 cartons of chicken baby food instead of what I ordered, ham..... so I couldn't feed it to him and now we're waiting for the replacement!

Yes it can be nerve-wracking when they are low. Gets more challenging to manage. And stress. Let us all hang in there and do the best we can!!!!

 

Oh yes! Ham baby food is THE FAVORITE. I know my cats are sick if they won't eat ham baby food. Have a great night and I hope Squeaky will have a good, safe one, too!

 

Thanks Gals! I do get we would hold the dose with either method.

Okay, so we have the data we have, and Elise said: "It could be from pancreatitis but he went high for so long. That tends to happen when too many reductions are taken quickly." So if I do the exact thing I did before, won't there be a high chance that the same thing would happen again?

So I was not knowledgeable enough to even know about glucose toxicity AND I sure am not able to understand and manipulate the nuances of onset, nadir, etc. So there is no way I can make an informed decision, all I can do is just guess and hope for the best. If you all can help, that is great....... What if we did the reductions at 80 instead of 90? @Bandit's Mom I do not understand how that would help anything, or hurt anything, but seems what we did before didn't work so what do you think?

(Yes I do get that sometimes I need additional testing, like if he is very low right at preshot, I need to monitor and make sure I can keep his numbers steady. If it doesn't happen all the time, I can do it sometimes.) @Christie & Maverick

THANK YOU EVERYONE!!!!!!

 

I sure am glad that you are able to test Squeaky more often than your friends/acquaintances with diabetic cats! You've been at this long enough to see that you could lose him if he went too low and you were unaware of it. I see that you have a lot of conditions to manage with Squeaky. I'm impressed with how you are doing it all.