5/15/24 Mazi AMPS 128A/172L + 2.5 64L +4 68A/69L +8 74L PMPS 100A +2 84L +4 96A/101L +9.5 58L

This is the 0.25 units dose talking. I think I'd reduce to 0.1 units. I suspect the 64 Libre was below 68 AT, given the comparison you got at +4.
 
Part 2 - responding to late yesterday and grouping common questions together:
Mazi's Mom said:
1. What is a failed reduction?
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If the new reduced dose does not have nadirs in normal BG range.

Mazi's Mom said:
2. Based on the SS, how would I know Mazi is close or has a good chance of remission?
3. Based on Mazi's numbers he's producing now, do you think he has a good chance of remission?

I know its hard to predict, and you ladies don't have a crystal ball, so I understand if you don't feel comfortable answering that question. Some days based on Mazis green numbers I think he's close to remission and also bc he continues to go hypoglycemic. I get hopeful that he's making his own insulin. However, then other days, I just think I'm getting too hopeful and its really just that the 0.5U dose is too high and thats why he's going low. Additionally, when I see his blue preshot numbers or more recently on the 0.25U dose when I see him creep up to blue at +10/11 I lose my hope and tell myself, nope his pancreas isn't making his own insulin and its all the Lantus giving me those lovely green numbers. With that said, that leads me to my next question.
6. Can some cats be on extremely low doses, like Mazi and never reach remission?
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The trend is good, but we never know for sure until they earn the reduction down to 0.0 units. Some cats go a long time on just a small bit of insulin. Right now he's regulated, and that's a prerequisite to remission. The rest is up to Mazi's pancreass. Most of his blues are still in the normal range for at AT.

Mazi's Mom said:
4. Mazi has higher preshot numbers (blues) sometimes gets a blue at +10/11, but will dip down to mostly all greens after onset and stays there till right before the duration ends. Is that good? What exactly does that tell me besides he spikes when the duration of action of the insulin is over?

If I had to guess, that tells me he's still pretty reliant on insulin injections. And the medication is still doing most of the job keeping his blood sugars within normal range or in greens (which are the healing numbers you want to be in) instead of his pancreas starting to make its own insulin to keep him within normal limits of a healthy cat. I think I may have just repeated myself.
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There is a thing called the Lantus double dip, where they have the first curve, then can do a little mini curve down at the end of the cycle, but not as low as the first curve goes. You could be seeing some of that. See the 13th AM cycle. Duration is apart of it, especially if he dives down quickly the following cycle. Another part of the equation is food and if he gets any food after nadir, which can shorten duration.

Mazi's Mom said:
5. If he continues to produce blues after a certain amount of cycles would he have to go back to 0.5U, even thou 0.5U was dropping him low? If so, how many cycles or days of blue before I would increase the dose and go back to 0.5U?
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As I said above, he's earned a reduction to 0.1 unit. Look at the nadirs, not the preshot values. We determine how to change the dose based mostly on the nadirs.

Mazi's Mom said:
7. Am I correct in saying that the more time a cat spends in green numbers, the better chances of the pancreas healing and in turn the better chance of remission REGARDLESS OF THE DOSE?
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Think of it as "more time a cat spends in normal BG numbers". Which is green in a human BG meter, which you aren't using. The AT has some blues in it's normal range.

Mazi's Mom said:
8. For example, and my next question, can a cat reach remission on a 6, 3, 1, 0.5U dose? Or do they have to work their way down to 0.1U or less in order to reach remission?
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Never say never on the first scenario, cause I can make up a story to fit it. Like the poor kitty in Alaska whose vet started him out at 10 units! :eek: Or the one whose caregiver thought he couldn't get dry food the other cats could reach, until she banned it from the house. Though that was more like 5.5 units to 0 in either 24 or 36 hours. I should remember, I sat with her for that. They are rare. In the case of a cat that is diabetic because their pancreas isn't functioning 100% and not some other reason, which also includes secondary endocrine conditions like Neko had, cat works their way down. Though some go faster down that others.

Mazi's Mom said:
9. Is remission possible no matter if the cat has had diabetes for years? I know the earlier you diagnose DM and treat it the best chances for remission. But I'm just curious if you've seen a cat who was a diabetic for 5+ years finally reach remission. Or does a long term diabetic have very little chance to reach remission due to the destruction of the beta cells in the pancreas over the years?
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I've seen it happen. Again, the story can be complicated. Once it was a cat who got cancer (which likes carbs), another time was a cat with acromegaly and a working pancreas, also seen it with insulin auto antibodies. After 3 years seems to be more likely than 5+ years.

Mazi's Mom said:
10. I understand what bounces are, its when a cats BG'S drop too fast or they drop too much to numbers that the kitty is not used to and the liver then compensates and releases stored glucose which then increases BG numbers. How high does a bounce or rebound of high blood sugar go? I'm having trouble identifying bounces on Mazis spreadsheet. Im looking for the obvious big bounces where numbers increase a 100 or more points than their normal pattern of numbers. Are their subtle bounces where a cats bounce is only like 50 points, and maybe hard to identify?

11. Do you see any bounces in Mazis spreadsheet that you could identify to help me better spot them?
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Bounces can go so high the meter doesn't register any more. Check out Neko year 1. :rolleyes: Eventually the height of the bounces will reduce. After year 1 of diabetes Neko's bounces were in the 300's. That was a victory.

4/11 to 4/13 AM were bounces due to the low on the 10th. Shortly after his bounces seem to be the yellows, then blues - yes low bounces can happen. And eventually cats can stop bouncing.
 
Again. Thank you for all your education and your expertise.

Last question, how do I you draw up 1.1 unitnknk it dose
 
Mazi's Mom said:
Again. Thank you for all your education and your expertise.

Last question, how do I you draw up 1.1 unitnknk it dose
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@Mazi's Mom
It's really not hard to do :cat:
 
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@Diane Tyler's Mom youre awesome that you were able to make out what I was asking, I literally fell asleep when writing the middle of that question. LOL


That po9c you just sent me, already looks like my 0.25's haha
 
Sounds good, I will do the very best that I can in the AM.

Is 0.1U the lowest dose you go for TR?

I was looking at someone else's spreadsheet and I saw she was dosing only a drop. That was pretty impressive! She was abbreviating her dose DD under the units column on the SS.
 
I'm exhausted, but I have to stay awake to check Mazis PM+4 (another 45 mins) and heat up a little pate snack for him.

In order to stay awake that means I need to have a midnight snack. Eating is the only thing that will keep me awake. Haha! I hope you ladies have a wonderful night and day tomorrow.

I'll be sure to check in with mazis BGs tomorrow. Hoping for all greens!
 
@Wendy&Neko

We dropped to a BG of 58 on the Libre this morning on yesterday's PM +10.5 cycle. That was 630 am this morning when my boyfriend Joey scanned him on the Libre.

He woke me up, I was disoriented (lol), and had only told him to give Mazi the high carb food we already had opened in the refrigerator. Never told him to check the 630 am reading against the alphatrak and didnt tell Joey that when he did his recheck after the snack to check BGs against both meters.

I know technically we should have tried a low carb or medium carb at the most at first, but the HC friskies pate was already opened in the refrigerator and had to be used up.

I was only on 4 hrs of sleep, and never told him how much to give him, just to give Mazi some of the higher carb food in the refrigerator.

When I woke up this AM at 8, I asked how much he gave Mazi at 630 this morning. He told me whatever that was left in the can, he estimated about 1 to 1.5 tbs. When he rechecked Mazi at 7am, mazi had a BG of 70 Libre.

I wrote in my notes that today's 5/16/24 AMPS BG may have been influenced by the 630 am high carb snack.

His AMPS BG at 830 am was 132A/108L and I gave 0.1U. I lined my plunger to where the top of the plunger just touches the bottom of the 0U marking. When I turned the syringe over to where there are no markings, I could see there was definitely some insulin in the syringe. When I injected Mazi this morning and pushed the plunger down, I made sure to keep the syringe in and pushed down for a good 10 seconds to make sure that all the amount of insulin that was in the syringe got into subcutaneous tissue.

So I think the decrease in insulin the AM was a good choice, im curious to see what the tiny 0.1U will do to his blood sugars today.

Will keep you and my SS updated today.

Have a great day and as always thank you for your guidance!

Mazi sends hugs, cuddles, and head butts!
 
I was confused in the gap between meters this AMPS.

I had read somewhere that the Libre has a 20 minute delay on BG's.

I was wondering if the Libre was reading lower at 830am of 108 compared to Alphas 132, bc it hadn't caught up yet to the changes in blood sugar related to the 630/640 am snack.

Not sure, just trying to think of things that might cause a 24 point gap between meters. The BGs weren't that elevated where I would expect to see a big variance between BG values.
 
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