5/21, Susie, 282 AMPS, 258 @+2, 241 @+4, 238 @+6

Summer and Susie (GA)

Member Since 2020
https://felinediabetes.com/FDMB/threads/5-20-susie-79-at-10.247578/#post-2792983

Another wild day yesterday. On one hand I am happy to see her in better numbers. On the other hand it is disturbing how quickly she falls and the amount of food I am having to feed her to get her up. Poor cat needs to lose weight and these crazy days are just adding to it.

I will have to reevaluate my SLGS reduction point of 70. I thought it was the better thing to do to allow her to get into lower numbers but now I am no so sure.
 
One of the reasons to personalize SLGS reduction points is when a kitty has repeatedly failed reductions, which Susie hasn't really done yet. If you haven't tested a reduction point of 90 to see if it works, how do you know it doesn't? Perhaps something worth considering.

@Christie & Maverick You don't think that Susie has been failing her reductions? Maybe I don't understand what that means. I thought a failed reduction was when kitty continued to drop lower than desired even after a decrease in a dose. I think Susie is failing a lot of reductions and that is why I keep having to reduce. Maybe you can better explain it to me. Also, if I go back to the standard reduction point of 90 wouldn't that just keep her in higher numbers?
 
When a reduction fails it's the other way around. A failed reduction is when kitty goes higher and not seeing good numbers.
No matter which protocol the point is to keep them in healthy numbers.
Oh, I was misunderstanding. Also, I think someone told me the other day that there are no "failed reductions" with SLGS and you have to hold the dose a week unless they drop below the reduction point. That I understand.
 
Oh, I was misunderstanding. Also, I think someone told me the other day that there are no "failed reductions" with SLGS and you have to hold the dose a week unless they drop below the reduction point. That I understand.
Exactly. So with SLGS you'll have to live with high numbers in a week, if it happens. On the other hand, if Susie wants to go OTJ she will. Sometimes they reach a point where they just don't want to be a part of this game anymore, and rushes down the dosing ladder.
 
In this context, what you want to know is whether after taking a reduction under 90, can Susie maintain a range of BG values where her nadirs are between 90 and 149. If you are finding that you are repeatedly taking a reduction under 90, only then to go back up in dose after a week, then in that case, you would say 90 as a reduction point doesn't work. I wasn't referring to it in the same fashion as failed reduction per TR.

Bear in mind, the general feel of SLGS is different, it is less aggressive, since you are holding a particular dose longer, and the numbers you are striving for are in general are going to be higher, with often cases that preshots may be around 300.
 
She's been clearing these bounces pretty fast, perhaps a test at +3 and some food to slow her down if needed?
Hi Melissa. I just got a test at +4 (241) and she is still high but a little flat. I did give her some food at both +2 and +4 (1/4 can l/c). She will eat again at +6 and then get no more meals until PMPS (unless she starts to drop which I am not anticipating today).
 
I thought a failed reduction was when you reduce and then they go back up into numbers that are too high so you end up having to increase their insulin again?

She's back in the lemon tree today :-( I hope she won't want to go camping up in that tree.
That is true but when following SLGS the way it’s written, there’s no such thing as a failed reduction.
 
I was going to ask you about her weight. It seems like she's been eating a lot of food lately. Do you have a scale to weigh her on? I know you've had your hands full trying to keep her from going too low lately! You're going to be the feeding the curve pro around here soon!
 
I thought a failed reduction was when you reduce and then they go back up into numbers that are too high so you end up having to increase their insulin again?

She's back in the lemon tree today :-( I hope she won't want to go camping up in that tree.
You are right and Sasha pointed out to me my misconception of a failed reduction. Yes, she is back in the lemon tree. Might be a bounce. Might be the result of the reduction. Might be both. Only time will tell.
 
That is true but when following SLGS the way it’s written, there’s no such thing as a failed reduction.
Oh no. I wasn't implying that Susie had a "failed reduction"... what do I know about it... my cat is a crazy high dose cat and that's all I know since the very beginning. We don't do reductions... we do increases only... that's the way we roll ... (just kidding, after the cabergoline he did need reductions... but they were only because of the cabergoline suppressing the growth hormone... and -- like everything else, Darcy does reductions big time...

I do like to watch and learn about what happens with other "normal" diabetic cats though! :)
 
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You are right and Sasha pointed out to me my misconception of a failed reduction. Yes, she is back in the lemon tree. Might be a bounce. Might be the result of the reduction. Might be both. Only time will tell.
But hopefully Susie will get a break then today and you will get a break today and she won't need to eat as much food! I hope you have a wonderful day, Summer!
 
You are right and Sasha pointed out to me my misconception of a failed reduction. Yes, she is back in the lemon tree. Might be a bounce. Might be the result of the reduction. Might be both. Only time will tell.
That was my fault, I was a bit tired last night, and mentioned the idea of repeatedly failing reductions. What I should have said was repeatedly earning reductions, although some folks lately have quibbled about that wording :p. Perhaps instead let's say having to reduce repeatedly because the cat is under your threshold number :)
 
One point I wanted to bring up to you, Summer, is about SLGS and managing expectations. I found this interesting quote in the Myths Debunked condo from Kristen Roomp of Roomp & Rand (who developed the TR protocol):

I personally have to fight overly cautious dosing much more than rebound checking, but it is also very, very tedious. In the vast majority of cats Lantus/Levemir won't allow you to achieve regulation without having daily nadirs <80 or <100. If you try to avoid nadirs <80 or <100, the cat generally ends up with long periods above the renal threshold each day. I've also come across a few people who believe that they can pick an upper and lower threshold that fit their personal comfort zone and easily maintain the BGs of their cat within that range. Aside from the fact that this is only rarely doable, in cases where it works there is still a slight level of hyperglycaemia present which IMO has a negative effect on the pancreas. You really have to work *with* these insulins and accept that euglycemia is part and parcel of how they work.

My takeaway from this is that if you avoid low numbers, those less then 80 or less than 100, a cat is simply going to be above renal threshold (numbers greater than 250) some of the time, which further damages the pancreas. Susie will continue to see pinks unless you can help her surf in those green numbers by feeding her (tiny spoons of) low carb food when she is above 60 and only use MC when she is below 50 or when you see her dropping quickly early in a cycle. You haven't had any failed reductions as Susie keeps dropping below 70 each time you have reduced recently. This is a very good sign as it shows the insulin is working.

I guess what I'm saying is that in order to get her into those flat blues that you want, you would have to consider doing TR again with the reduction point at 50. Maybe I'm wrong about this, hope someone with more experience can correct my interpretation here.

Big hugs to you, cat mama! :bighug::bighug::bighug:
 
Oh no. I wasn't implying that Susie had a "failed reduction"... what do I know about it... my cat is a crazy high dose cat and that's all I know since the very beginning. We don't do reductions... we do increases only... that's the way we roll ... (just kidding, after the cabergoline he did need reductions... but they were only because of the cabergoline suppressing the growth hormone... and -- like everything else, Darcy does reductions big time...

I do like to watch and learn about what happens with other "normal" diabetic cats though! :)
I didn't think you were implying a failed reduction but she very well may have one. I just felt with that 51 two days ago and the 68 (which wasn't a bad number) yesterday I should reduce. I probably will regret it. I've already dropped her SLGS reduction point from 90 to 70 so I am making an effort to get used to the lower numbers. I'm really trying hard to make the decision to switch to TR but I can't get past the fact that you can't reduce until they hit 49 or lower. That one is a tough one for me to swallow.
 
I was going to ask you about her weight. It seems like she's been eating a lot of food lately. Do you have a scale to weigh her on? I know you've had your hands full trying to keep her from going too low lately! You're going to be the feeding the curve pro around here soon!
Yes, I have a scale and weighed her on May 18th. She was 14 lbs. Up from 13.9 on the 8th and 12.96 on April 24. Prior to that she was 13.7 on April 10th. I wondered if the Convenia had something to do with her weight loss on the 24th.
 
But hopefully Susie will get a break then today and you will get a break today and she won't need to eat as much food! I hope you have a wonderful day, Summer!
Thank you, Suzanne. We are both enjoying this break. It has been a wild week for both of us. Have a great weekend! I'm going to look for a post from you today on Mr. Darcy. I hope he is better and your back, too. :bighug:
 
One point I wanted to bring up to you, Summer, is about SLGS and managing expectations. I found this interesting quote in the Myths Debunked condo from Kristen Roomp of Roomp & Rand (who developed the TR protocol):

I personally have to fight overly cautious dosing much more than rebound checking, but it is also very, very tedious. In the vast majority of cats Lantus/Levemir won't allow you to achieve regulation without having daily nadirs <80 or <100. If you try to avoid nadirs <80 or <100, the cat generally ends up with long periods above the renal threshold each day. I've also come across a few people who believe that they can pick an upper and lower threshold that fit their personal comfort zone and easily maintain the BGs of their cat within that range. Aside from the fact that this is only rarely doable, in cases where it works there is still a slight level of hyperglycaemia present which IMO has a negative effect on the pancreas. You really have to work *with* these insulins and accept that euglycemia is part and parcel of how they work.

My takeaway from this is that if you avoid low numbers, those less then 80 or less than 100, a cat is simply going to be above renal threshold (numbers greater than 250) some of the time, which further damages the pancreas. Susie will continue to see pinks unless you can help her surf in those green numbers by feeding her (tiny spoons of) low carb food when she is above 60 and only use MC when she is below 50 or when you see her dropping quickly early in a cycle. You haven't had any failed reductions as Susie keeps dropping below 70 each time you have reduced recently. This is a very good sign as it shows the insulin is working.

I guess what I'm saying is that in order to get her into those flat blues that you want, you would have to consider doing TR again with the reduction point at 50. Maybe I'm wrong about this, hope someone with more experience can correct my interpretation here.

Big hugs to you, cat mama! :bighug::bighug::bighug:
Thanks for the info, Katherine. I was telling someone earlier that I am very close to switching back to TR. Especially with my experiences this week with lower than desired numbers. It is the reduction point at 50 which frightens me. I'm going to wait to see how she does on this latest reduction. If it fails (and I know you can't have a failed reduction on SLGS) I will certainly give TR more consideration. Hope little Ruby is doing well. I'm getting ready to check in with some of my favorite beans and their kitties soon.:smuggrin:
 
I think it's about balancing what you're afraid of and what you want ultimately for little Susie. You say you're not shooting for remission, but it sounds like that's because you're afraid. The fear is real. Not going to discount that at all. There was a lively discussion a few weeks back in the Think Tank forum about how low is too low, and that was around the issue of having to "earn" reductions (dropping below 50) before taking them in TR. That 50 reduction point makes a lot of people really uncomfortable and worried for their kitties, especially when they are climbing down fast from the dosing ladder. There is a concern that if you took a dose down before the cat "earns" it, then it will be frowned upon here. That is simply not true. You hold the syringe. Always. If you're following TR and Susie hits 59 and you're like, no way, not doing that again :stop:, you can always reduce. It might mean however that you have to take her back up again if she starts seeing higher numbers (the dreaded failed reduction), but that is always something that is within your power to do. :bighug::bighug::bighug:

ETA: Cherryl and Mouzer are a great recent reference point for what I'm talking about. Thankfully it worked out really well for them, but it doesn't always, so you have to know what you are doing and why.
 
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Hi!
Just a quick example of low numbers. I don't believe Tina ever went down to 43 as she earned reductions, BUT I got a 43 reading when she was off insulin!
As closely as you watch Susie, I feel you might accomplish what I did!
While on SLGS, reduction(s) when under 90 failed which turned me toward TR.
As has been said (by Sasha for one, I believe), if kitty wants a reduction, he/she will make it clear.
You have learned SO much since starting Lantus for Susie.

Plus I love what Katherine said about it all being Your decision. I trust my intuition quite a lot; use yours as warranted.
 
I think it's about balancing what you're afraid of and what you want ultimately for little Susie. You say you're not shooting for remission, but it sounds like that's because you're afraid. The fear is real. Not going to discount that at all. There was a lively discussion a few weeks back in the Think Tank forum about how low is too low, and that was around the issue of having to "earn" reductions (dropping below 50) before taking them in TR. That 50 reduction point makes a lot of people really uncomfortable and worried for their kitties, especially when they are climbing down fast from the dosing ladder. There is a concern that if you took a dose down before the cat "earns" it, then it will be frowned upon here. That is simply not true. You hold the syringe. Always. If you're following TR and Susie hits 59 and you're like, no way, not doing that again :stop:, you can always reduce. It might mean however that you have to take her back up again if she starts seeing higher numbers (the dreaded failed reduction), but that is always something that is within your power to do. :bighug::bighug::bighug:

ETA: Cherryl and Mouzer are a great recent reference point for what I'm talking about. Thankfully it worked out really well for them, but it doesn't always, so you have to know what you are doing and why.
Thank you for that. I appreciate your understanding and it is nice to know that my head would not be cut off if I deviated, slightly, from TR. If I went with TR I would abide by the 49 or lower reduction point (I think). The other concern about trying to get Susie into remission is the constant testing. I can certainly handle it in the daytime but I just don't know how I could be up all night testing. I have no one to help me and I know there are others in the same boat that push through all the required testing (Sasha) day and night and I honestly don't know how they do it. When do you sleep? And, I have a really hard time taking naps. Plus, if I get up in the middle of the night I have a heck of a time getting back to sleep. I guess on TR, and pushing remission, getting back to sleep would not be an option anyway. Thanks for giving me some power. I know I should not "step out of bounds". I do think about how wonderful it would be to get Susie into remission. Not just for her health but for me too. Getting up at 5:30 every day for five months now is taxing. By the way, I just had a PM with Cherryl. We stay in touch. She is funny. She also believes Susie has a good chance at remission and I need to get over my fear of TR. She is always very supportive - like everyone on this site.
 
Hi!
Just a quick example of low numbers. I don't believe Tina ever went down to 43 as she earned reductions, BUT I got a 43 reading when she was off insulin!
As closely as you watch Susie, I feel you might accomplish what I did!
While on SLGS, reduction(s) when under 90 failed which turned me toward TR.
As has been said (by Sasha for one, I believe), if kitty wants a reduction, he/she will make it clear.
You have learned SO much since starting Lantus for Susie.

Plus I love what Katherine said about it all being Your decision. I trust my intuition quite a lot; use yours as warranted.
Thank you, Jan. It is easier to make the tough decisions when a little bit of the pressure is off. Thanks for stopping in to check on my girl!
 
Thank you for that. I appreciate your understanding and it is nice to know that my head would not be cut off if I deviated, slightly, from TR. If I went with TR I would abide by the 49 or lower reduction point (I think). The other concern about trying to get Susie into remission is the constant testing. I can certainly handle it in the daytime but I just don't know how I could be up all night testing. I have no one to help me and I know there are others in the same boat that push through all the required testing (Sasha) day and night and I honestly don't know how they do it. When do you sleep? And, I have a really hard time taking naps. Plus, if I get up in the middle of the night I have a heck of a time getting back to sleep. I guess on TR, and pushing remission, getting back to sleep would not be an option anyway. Thanks for giving me some power. I know I should not "step out of bounds". I do think about how wonderful it would be to get Susie into remission. Not just for her health but for me too. Getting up at 5:30 every day for five months now is taxing. By the way, I just had a PM with Cherryl. We stay in touch. She is funny. She also believes Susie has a good chance at remission and I need to get over my fear of TR. She is always very supportive - like everyone on this site.
I understand your sleep issues, I have them as well. If you look at Ruby's SS, I don't stay up all night. That's a young person's thing. :p I have stayed up until +6 if I've had to do it because Ruby throws me a limey at +4, and if I can't, I make sure she has MC or HC in her bowl to munch on when she needs it because Ruby gets hungry when she goes low. People go to work full time and do TR; you can do TR and sleep. :)

No heads will ever get lopped off. At least not unless you're putting Susie in danger by not reducing when you're supposed to. Then someone will say something and rightly so, but I don't think you would ever let that happen.
 
I didn't think you were implying a failed reduction but she very well may have one. I just felt with that 51 two days ago and the 68 (which wasn't a bad number) yesterday I should reduce. I probably will regret it. I've already dropped her SLGS reduction point from 90 to 70 so I am making an effort to get used to the lower numbers. I'm really trying hard to make the decision to switch to TR but I can't get past the fact that you can't reduce until they hit 49 or lower. That one is a tough one for me to swallow.
Set your reduction point higher as Katherine suggested. Anyway, really feel that you are doing an amazing job!
 
Do you mean set your reduction point lower? I was thinking 60 instead of 70. Sorry I haven't visited your site yet. My brother stopped by and we had a nice visit.
I think Suzanne means setting your reduction point at TR higher, but I don't think you should do that. It's not suggested to modify TR like you can SLGS. In my earlier post I said for example if following TR and Susie drops to 59 you might consider reducing, but I should add that it's only if you're giving her MC, then HC and her numbers don't budge upward for a long time. The 50 reduction point is there for a good reason, but you can take each situation on a case by case basis and make an informed decision about what to do. If she's at 59 and you give her a spoonful of LC and she pops up to 75, a nice safe number, then a reduction may not be necessary.
 
@Bandit's Mom Susie is down to 211 at +10. The lowest she has been all day. You have a "crystal ball" regarding my girl. Can you give me some advice on what I can expect tonight and maybe what I should do this evening? I know her numbers are really high but I would appreciate any advice.
 
227 at PMPS not bad. I'm guessing this may follow the same trend as the 16th and 17th where she breaks the bounce at AMPS +1/+2. If it were me I'd get a +2 or +3...if flat I'd let her go, maybe a +5/+6 for good measure. If she's dropping, well you're in for another night :confused: I swear these cats are worse than newborns, even my 3 month old lets me get 8 hrs of sleep!
 
I believe I've been told TR can't be modified, BUT there's an exception to the reducing rules, that if kitty is hard to keep up with HC that could be a reason for reducing too.

Another point. Doing what you're doing now, and you do test enough for TR, that won't necessarily change. Susie is 8 years old, so potentially you could do this for 10 more years. Let's say you do TR and succeed you might only need to do this 6 months...or less. That's how I'm thinking about it.

I'm still scared of the 50's. And I don't know why. A non diabetic can go as low as 29. No juice no hypo. The 50 is only there for safety, I know that but I'm still anxious about it..

Last thing, I promise! :p
I've been thinking about changing Mauers shot time. If I don't want PJ parties, then it could be smart to shoot so that the "dangerous" part of the cycle is in early morning and early evening. That does mean I have to get up in the middle of the night to shoot, but it would give me more sleep. Shooting at 10 makes the funny part happen at 2 and 3, which means I'm housebound until it's past. Shooting at 6 will get me the fun part where I usually shoot and actually give me a full day.
I don't know, just thinking out loud :eek:
 
I think it's about balancing what you're afraid of and what you want ultimately for little Susie. You say you're not shooting for remission, but it sounds like that's because you're afraid. The fear is real. Not going to discount that at all. There was a lively discussion a few weeks back in the Think Tank forum about how low is too low, and that was around the issue of having to "earn" reductions (dropping below 50) before taking them in TR. That 50 reduction point makes a lot of people really uncomfortable and worried for their kitties, especially when they are climbing down fast from the dosing ladder. There is a concern that if you took a dose down before the cat "earns" it, then it will be frowned upon here. That is simply not true. You hold the syringe. Always. If you're following TR and Susie hits 59 and you're like, no way, not doing that again :stop:, you can always reduce. It might mean however that you have to take her back up again if she starts seeing higher numbers (the dreaded failed reduction), but that is always something that is within your power to do. :bighug::bighug::bighug:

ETA: Cherryl and Mouzer are a great recent reference point for what I'm talking about. Thankfully it worked out really well for them, but it doesn't always, so you have to know what you are doing and why.

I felt fortunate that it did work for Mouzer.
When I gave Mouzer an 0.75 reduction, we had already been exhausted with coming down from 2.0 to 1.25. I was getting no sleep. My hand hurt so bad with an issue, I could not lift my coffee pot and I was struggling to do the work I have to do for so many animals, which requires use of hands and feet.
I was dragging my right leg because my foot suffers plantar fasciitis and I was in such great pain, just from all of the walking, dragging my leg, dealing with Mouzer. I was worn out and broken. I had to do something because if I go down, so does every animal in my care go down.

So, we went from the 1.25 down to 0.25 with in mind that, at this point, I'd rather have to go up .25 at a time, than to continue on as it was going with the fight and my body breaking down, as Mouzer kept rushing down the ladder faster than we were going, And in the midst of all that was going on, I had the TR 30 Protocol thrown at me - Like, we dont care that you are falling apart, we dont care about you, just keep it up for the sake of the TR 30 Protocol, do or die.

If that is 'modifying TR', then so be it - If you think about it, Mouzer is the one who modified it lol I just went along for the ride.
I let my body get in dreadful shape, just keeping Mouzer above the 40's. The Care Giver had to take care of self, so that the Care Giver could continue providing the care. And I am not even going to apologize for that I had to take care of me. To hades with that TR 30 Protocol and letting the Care Giver break down, all for the sake of the 'Protocol'. That is total bull malarkey.

We stuck to the 'TR Protocol' based on the 'Particular Cat'. Keeping the cat safe and the Care Giver well, both have to be taken into consideration.
All I can advise anyone to do is to learn all you can and get to know your cat and how it reacts to food, honey and insulin, so that you can make wise decisions on your own, because it is not your job to please anyone else. It is up to you to keep BOTH your cat and you safe and well, no matter the 'protocol'.
 
All I can advise anyone to do is to learn all you can and get to know your cat and how it reacts to food, honey and insulin, so that you can make wise decisions on your own, because it is not your job to please anyone else. It is up to you to keep BOTH your cat and you safe and well, no matter the 'protocol'.
Cherryl, you will forever be my hero for doing what you needed to do for you and Mouzer at that time. It made an impression on me that you know your cat, know yourself, and could make the most sensible decision for both of you. I am so glad Mouzer is in remission now. Hugs to you and scritches to Mouzer. :bighug:
 
Cherryl, you will forever be my hero for doing what you needed to do for you and Mouzer at that time. It made an impression on me that you know your cat, know yourself, and could make the most sensible decision for both of you. I am so glad Mouzer is in remission now. Hugs to you and scritches to Mouzer. :bighug:

Wow! That is like a very kind thing to say! Thank You!
I dont know it all, none of us do, but I have learned to follow my gut over anything in this world, no matter what that is, the gut knows LOL
Mouzer is doing more of his cool ways with me again. I look at him sometimes and I could swear he is stoned hahaha It is like the normal bg has him all chilled out, cool like :D He is so cool! He is my 70's cat :joyful: Just put some hippy clothes on him and all would be purrfect haha
 
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