4/23 Mouse AMPS 278, +4 279,+6 305,+ 10 235/135 PMPS 255 Help with glucose toxicity

[Mouse & Me]

http://www.felinediabetes.com/FDMB/threads/upped-too-much.194508/
I'm trying to get guidance on getting Mouse through apparent glucose toxicity. So far, it looks like I might be upping her dose from 1.25 to 1.5 tomorrow morning.

Any advice going through this, so I can get her numbers into more healing numbers.

She has a tendency to surf around high 200s, bouncing into 300s, then goes low, bounces again, surfs again.

I will be checking her numbers every two hours for as long as she puts up with it today. Her poor ear is getting scarred/callous. I stick with one ear, since the numbers the other ear gives me can be as much as 60 points different, always lower. Which one is her REAL number, I don't know. I just wanted consistency with the readings, so I go with the left ear.

 

[Olive & Paula]

Let others weigh in, but I don't think you need to check so often as long as she is high today. Have you considered raising the dose? It's possible you are holding the dose to long.

 

[Wendy&Neko]

What food are you feeding, and when in the cycle? Your goal will be to try to get more insulin in her, but keep her safe. If you see her diving, you may need to give slightly higher carbs to keep her from bottoming out and earning a reduction, especially if it's the only green she's seen on that dose. In addition to battling glucose toxicity from holding a dose too long, you need to get her used to linger stretches of green. Food can help you do that.

For long term diabetics, which Mouse is, reductions are earned by going below 40, not 50. Some people have cats that don't keep reductions well. In that case they chose the alternative of three times below 40 on different days.

 

[Mouse & Me]

What food are you feeding, and when in the cycle? Your goal will be to try to get more insulin in her, but keep her safe. If you see her diving, you may need to give slightly higher carbs to keep her from bottoming out and earning a reduction, especially if it's the only green she's seen on that dose. In addition to battling glucose toxicity from holding a dose too long, you need to get her used to linger stretches of green. Food can help you do that.

For long term diabetics, which Mouse is, reductions are earned by going below 40, not 50. Some people have cats that don't keep reductions well. In that case they chose the alternative of three times below 40 on different days.

Her 55 number was her PMPS, so I skipped. I swear, a few times in the past, her nadir was at her preshot. Hard to figure out what to do when it's low at shot time

I only give her wet food: fancy feast pate, Bff & weruva, all from the list by Lisa Pierson. I occasionally make food, using her recipe, but I cook it slightly, using a sous vide method. It's more tender that way. The cats will take pieces of sous vide chicken sometimes. Yes, they are weird. They probably ate only dry foot until they came to live with me. They spit at wet food in fear, for three years until I finally won the battle.
I feed 1.5 oz wet food at shot times, and a tablespoon for reward during a curve,(or if I check multiple times a day), and 2-3 tb when I just check in between shot times. I add water to all wet food, to make sure she's getting enough.
If I give more food, say, an entire 3oz can of pate, her numbers will go up slightly, and she acts uncomfortable. Both her & sibling burp a lot, get hiccups if I give this amount. Not worth it. I think their digestive system demands small, frequent meals. Hey, just like me!
I load the autofeeder with homemade freeze dried food from Fancy feast turkey & giblet. three times during my sleep, 1/8 cup of "dry" food is dispensed.

For dives, I used to give her EVO dry food, a few kibbles. Since they no longer make it, I tried fancy feast kibble, same small amount. I don't think it's working like the EVO did - evo raised the number slightly. FF causes a rocket to go off. I have to find a substitute.
Gravy food took half a day to work on her, with her numbers continuing to go down. Weird.

 

[Mouse & Me]

Let others weigh in, but I don't think you need to check so often as long as she is high today. Have you considered raising the dose? It's possible you are holding the dose to long.

I am going to 1.5 tomorrow morning.

what is too long? I tried the tight regulation before, staying with the dosage three days....was that incorrect?

 

[Mouse & Me]

What food are you feeding, and when in the cycle? Your goal will be to try to get more insulin in her, but keep her safe. If you see her diving, you may need to give slightly higher carbs to keep her from bottoming out and earning a reduction, especially if it's the only green she's seen on that dose. In addition to battling glucose toxicity from holding a dose too long, you need to get her used to linger stretches of green. Food can help you do that.

For long term diabetics, which Mouse is, reductions are earned by going below 40, not 50. Some people have cats that don't keep reductions well. In that case they chose the alternative of three times below 40 on different days.

"In that case they chose the alternative of three times below 40 on different days."?
so, wait for her to get below 40 three times before a reduction? How much time apart?

 

[Olive & Paula]

TR is holding dose 6 cycles (3 days). Test before each shot and minimum 1 test in between shots. But no dry food on TR.

With dry food involved you would do SLGS which you raise dose every 7 days (14 cycles).

 

[Mouse & Me]

TR is holding dose 6 cycles (3 days). Test before each shot and minimum 1 test in between shots. But no dry food on TR.

With dry food involved you would do SLGS which you raise dose every 7 days (14 cycles).

I don't' normally do dry food. I gave a just a few kibble< evo or Young Again), when she went below 40, because it takes effect within 4 hours. the food with gravy or honey takes longer. While waiting for the gravy food to keep her from going lower, the numbers start to go lower. I can't handle numbers like 31, especially at night.
You'd think that the honey or gravy food would arrest the diving numbers within a hour or so, but it doesn't with her. I never could figure her out

 

[Stacy & Asia]

I am going to 1.5 tomorrow morning.

what is too long? I tried the tight regulation before, staying with the dosage three days....was that incorrect?

You wait at least 6 cycles before increasing, yes. Since you are dealing with glucose toxicity, you want to increase on every 7th cycle as long as it makes sense to do so. Hanging on to a dose any longer than that right now is just going to give her permission to stay in her pink/yellow comfort zone. No need to test her every 2 hours as long as her numbers are high. Looks like you can take a break for today, nothing is doing from the panic shot, whew!

Just about any kibble you feed is going to be high carb and raise her BGs, it will frustrate you to achieve regulation with dry food in the picture. If it’s possible to rid the kibble from her diet, she will be much easier to regulate. Per the published TR protocol as well, cats that are fed exclusively low carb wet food have the best odds at remission. If she just like crunchy things, the freeze dried chicken or whatever protein she likes is low carb and should work well.

It’s tricky when you get a low preshot, post and ask for help. After you do it a few times, you will get the hang of it and know how to handle them and what works best for Mouse.

You will get further if you take a reduction below 40, assuming she acts herself in the 40s and isn’t symptomatic.

You can use food to manipulate the numbers a bit and hang on to a dose longer, however, this will probably be quite tricky to do at the moment because you have to have some recognizable patterns and right now she’s a bit all over the place. Hopefully to be changed soon! Like Wendy said though, if you catch a sudden large drop, feed her something and see if you can slow it down a little.

 

[Stacy & Asia]

I don't' normally do dry food. I gave a just a few kibble< evo or Young Again), when she went below 40, because it takes effect within 4 hours. the food with gravy or honey takes longer. While waiting for the gravy food to keep her from going lower, the numbers start to go lower. I can't handle numbers like 31, especially at night.
You'd think that the honey or gravy food would arrest the diving numbers within a hour or so, but it doesn't with her. I never could figure her out

That is perfectly fine if you’re just using it to bring her up from a low number and it works.

 

[Mouse & Me]

You wait at least 6 cycles before increasing, yes. Since you are dealing with glucose toxicity, you want to increase on every 7th cycle as long as it makes sense to do so. Hanging on to a dose any longer than that right now is just going to give her permission to stay in her pink/yellow comfort zone. No need to test her every 2 hours as long as her numbers are high. Looks like you can take a break for today, nothing is doing from the panic shot, whew!

Just about any kibble you feed is going to be high carb and raise her BGs, it will frustrate you to achieve regulation with dry food in the picture. If it’s possible to rid the kibble from her diet, she will be much easier to regulate. Per the published TR protocol as well, cats that are fed exclusively low carb wet food have the best odds at remission. If she just like crunchy things, the freeze dried chicken or whatever protein she likes is low carb and should work well.

It’s tricky when you get a low preshot, post and ask for help. After you do it a few times, you will get the hang of it and know how to handle them and what works best for Mouse.

You will get further if you take a reduction below 40, assuming she acts herself in the 40s and isn’t symptomatic.

You can use food to manipulate the numbers a bit and hang on to a dose longer, however, this will probably be quite tricky to do at the moment because you have to have some recognizable patterns and right now she’s a bit all over the place. Hopefully to be changed soon! Like Wendy said though, if you catch a sudden large drop, feed her something and see if you can slow it down a little.

I don't give dry food, only did it when she went below 40 - she hit 31. The honey didn't work.
the freeze dried food is homemade. I take fancy feast turkey & giblet pate, and run it through my freeze dryer. I break it apart, and use it for overnight autofeeders. If you add water to the cubes of freeze dried food that I make, it turns back into fancy feast pate. Just like food that's in suspended animation. It's not high carb.

 

[Stacy & Asia]

I don't give dry food, only did it when she went below 40 - she hit 31. The honey didn't work.
the freeze dried food is homemade. I take fancy feast turkey & giblet pate, and run it through my freeze dryer. I break it apart, and use it for overnight autofeeders. If you add water to the cubes of freeze dried food that I make, it turns back into fancy feast pate. Just like food that's in suspended animation. It's not high carb.

It’s good that you found something that works to bring her up, that’s the most important thing! I didn’t have much luck with honey either, I got corn syrup and it made a world of difference. That’s very clever that you make your own freeze dried food! A lot of people also don’t realize you can use wet food in the auto feeders as well. You can either freeze the food so it thaws by mealtime or pop some ice cubes on top of it so they melt by food time, and bonus, add more water to the food.

 

[Wendy&Neko]

Oops, typo correction on the above. The three drops is below 50 on separate days, as the alternative for cats who don't hold reductions well.

 

[Mouse & Me]

I updated the title to the posting
At 6pm, I got 135, then tried to confirm the number, and got 235
This is typical for her.
I'll test at 7pm to see if she's dropping, and by how much.
She's acting hungry, but it is approaching mealtime. No other changes