? 5/9/17Sprocket,AMPS/263, +2.75/281, +4.75/236.PMPS/142, +1/163.+2/124, +3.2/120.+4.8/97,dose/am?.

[Darnell & Sprocket (GA)]

http://www.felinediabetes.com/FDMB/...75-292-5-2-304-see-notes.177593/#post-1958979

Lets see how this cycle does.
He ate well this am after an odd 3am not wanting to eat 2 flavors of food. Opened a new and he ate half a can.
This am found a furball on floor.
I am thinking it was him.

He ate 2oz 3carb plus .5oz of 2carb
Had all meds in at 646am.
Now lets see how today goes as to going up on his dose.

???
Food intake...anyone else on yesterdays discussion of food intake with calories, amount, amd carbs???

???
He now ready for increase????

 

[Jill & Alex (GA)]

Hi Darnell. I haven't been on the board much. Just seeing your tag from yesterday. I did not read through the entire thread because of time constraints. Instead, I chose to address the basics when it comes to using food to manipulate the curve. Perhaps it's already been covered, but if not, here you go...

Regarding feeding: Feeding food with different percentages of carbs depending on what's happening in a normal cycle drives me bonkers. IMHO, it's unnecessary and creates a whole lot of work... not to mention chains you to the cat. I prefer to to keep things as simple as possible (except, of course, for feeding low numbers). Initially, I suggest deciding on a set amount of food (count calories, not volume) and feeding foods that have about the same percentage of carbs (eg. 4%-5% carbs).

From Tashie's condo from way back when, "when using food to manipulate the curve, i generally recommend starting with dividing up the normal amount of food your kitty should be eating into 8 mini-meals to be fed at preshot, +1, +2, and +3 of each cycle (4 mini-meals per cycle). however, that recommendation is strictly a starting point. a plan customized for YOUR cat is YOUR goal. frequent testing and learning how YOUR cat responds not only to food, but to the insulin itself will help you tweak the plan."

Front-loading a Lantus cycle and not feeding after nadir (generally around +6) works for most cats. Front loading helps prevent or attempts to smooth out early/fast drops. When you feed after nadir it usually tends to put the brakes on whatever action is left on the insulin. To put it another way, feeding after nadir will often cut the duration of the insulin in that cycle. I know you were told to feed a lot right when Sprocket was throwing ketones, but that was then. Unless he begins to throw ketones again, it's time to start treating him like all the other diabetic kitties.

In that same post, I quoted Libby/Lucy. She makes some good points about learning how your cat responds to varying amounts of carbs. This is where the tweaking comes in... if and only if it's necessary.

In order to implement a solid feeding plan that works, one has to fall back on and utilize the very basics of insulin use. Unfortunately, most caregivers today tend to skip over this part of the process. It's a shame because there is no one more familiar with their cat and all their kitty's idiosyncrasies than the individual caregiver.

Therefore, I strongly suggest the following:

Learn how YOUR kitty is responding to insulin

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose

• Peak/Nadir - the lowest point in the cycle

• Duration - the length of time insulin continues to lower blood glucose

A full understanding of the following concepts will go a long way in helping you regulate your kitty's blood glucose when using Lantus or Levemir:

• Carryover - insulin effects lasting past the insulin's official duration

• Overlap - the period of time when the effect of one insulin shot is diminishing and the next insulin shot is taking effect

• Insulin Depot - a "spare tank" of insulin, which has yet to be used by the body

• LANTUS & LEVEMIR: WHAT IS THE INSULIN DEPOT?

• Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

Getting a good handle on the all of the above will give you the information you need to individualize any and all treatment plans for YOUR cat.



Just my thoughts based on my own attempt to flatten out Alex's food spikes as well as keeping her ketone free by safely getting as much insulin as I can into her without letting her bottom out... hope they help.

 

[Jill & Alex (GA)]

He now ready for increase????

See how the rest of the cycle plays out. He may stay flat today and then drop tonight or he could drop into a nice PMPS number. You'll have to decide what you want to do when you have more information.

That said, in my opinion if you're not afraid of low numbers, there is wiggle room for a dose increase, but it boils down to being your decision since you'll have to factor in your ability to monitor and your own comfort level.

Just my thoughts...

 

[Darnell & Sprocket (GA)]

Helpp....gota shoot at 8 mins.
142 at pmps!!
Cant shoot 3.75 again. This happesd sunday.
Cant do anoher 6 hrs of making him eat n testing evrry hour.

 

[Nan & Amber (GA)]

He did great that night, even if it was nerve-wracking for you! All those numbers were safe and pancreas-healing.

If you are nervous about shooting, you could stall for 15-20mins and get another test to see if he's headed up. But, really, I think you are fine to shoot either way-- you've got this!

 

[Jill & Alex (GA)]

142 at pmps!!

Beautiful!

Cant shoot 3.75 again.

Then what dose are you comfortable shooting?

This happesd sunday.

Yep! Awesome! He cleared his bounce after 3 cycles! Woot! This is what you want to happen... what you're working towards.

Cant do anoher 6 hrs of making him eat n testing evrry hour.

If you can't, you can't, but again, this is exactly what you want to happen.

But, really, I think you are fine to shoot either way-- you've got this!

I agree, but as always... you hold the syringe!
Good luck with whatever you decide!

 

[manxcat419]

I would shoot. He may be getting ready to try for a reduction and it would be a real shame to back off on the dose every time he gets close to that. I think I would also start getting a +10 test where possible so you can tell easily in future whether he's heading up or down towards the end of the cycle.

 

[Jill & Alex (GA)]

I think I would also start getting a +10 test where possible so you can tell easily in future whether he's heading up or down towards the end of the cycle.

Amen!
Those +10s yield so much information. I tried to get them whenever I could!

 

[Darnell & Sprocket (GA)]

I shot 3.5 at 6:50pm.
He ate 2oz of 7carb.
Took his meds after insulin.
Had @30ml fluids at 220pm. Ursodiol at 230pm
I am crying. And shaking.

Idk what is going on?
Why is he going down at preshot??
What is going on?
He coughed up a hairball this morning. He didnt want to eat 2 flavors at 3am but i opened a 3rd and he ate half a can.

I am a mess. I am probably losing my only extra income job of petsitting because I cant he reliable. My health is havig issues lately. Sleeping is a mess. Getting dizziness. My back hurts. Stress is very bad for my conditons.
I need to figure out something.
I cant feed numbers every few days.

I am having trouble getting enough blood to come from his ear lately.
My stupid cell phone keyboard cant type the right letters so that is annoying as tryig to type while crying or not.

Either food is making a differnce even with small changes or something else.
Idk

 

[Darnell & Sprocket (GA)]

Beautiful!

Then what dose are you comfortable shooting?

Yep! Awesome! He cleared his bounce after 3 cycles! Woot! This is what you want to happen... what you're working towards.

If you can't, you can't, but again, this is exactly what you want to happen.

I agree, but as always... you hold the syringe!
Good luck with whatever you decide!

Ok
I get what your saying but what to do when this happens??
I wrote all my concerns in last comment.

I dont get this down at pmps times.
I shot 3.5.
So now what do i do with dosing? Somehing odd is happenig?

 

[Nan & Amber (GA)]

Great job shooting! I think he's going to do well tonight.

Take a step back and look at Sprocket's spreadsheet-- look how far you guys have come! It used to be a lot of red and pink, now you're all in yellow and blue with the occasional green. You've made fantastic progress, and are doing an amazing job taking care of him!

I do think you need to try to take care of yourself, too... Take little break, treat yourself with something-- a nice walk, a sweet treat, a hot bath (my favorite-- the best for relaxing!), whatever works for you. The FD road is hard and stressful, you have to find a way to do it that works for you. You've already got a very demanding schedule of medications to administer, and you've added on pretty close monitoring of food intake on top of that. If I were you, I'd back off on trying to interpret responses to food from day to day and making yourself responsible for that, too. Maybe one way to think of it is this: you are using insulin to try to manage his numbers, and food to keep him safe. I don't think it's worth the amount of stress it is causing you to try to connect the numbers to the food-- it doesn't really work and you've got other things to occupy your attention. You've got bigger fish to fry.

Ok
I get what your saying but what to do when this happens??
I wrote all my concerns in last comment.

I dont get this down at pmps times.
I shot 3.5.
So now what do i do with dosing? Somehing odd is happenig?

I don't think there's anything odd going on-- really, this is exactly what you want to see. If you'll look at my Amber's spreadsheet, we were stuck in yellows until I started shooting the occasional blue pre-shot she gave me. Then I started to see more blues, and then greens, and then she went OTJ. Lantus is really good at keeping low pre-shot numbers low in nice flat cycles-- eventually you will see these low pre-shots as a gift, because shooting these is the best way to get Sprocket to spend a lot of time in good, safe, pancreas-healing numbers.

Hang in there! It's stressful and frustrating, but you are doing a great job!

 

[Darnell & Sprocket (GA)]

And i have to say I am a little concerned that people are looking at his colors for bg without reading what is keeping him up at those colors so he didnt drop.
I worry that some people are not reading anf just lookig at colors.
Ya have to see all of it to give advice please.

 

[Tricia Cinco(GA) & Harvey]

And i have to say I am a little concerned that people are looking at his colors for bg without reading what is keeping him up at those colors so he didnt drop.
I worry that some people are not reading anf just lookig at colors.
Ya have to see all of it to give advice please.

Darnell, did you read Jill's post near the top of this thread? I think you are concentrating on the food too much. I don't see any numbers on your SS lately that really required intense food steering. I know the greens on the 7th were new to you and therefore scary, but honestly, it was pretty safe. It was early in the cycle, but the drop wasn't super dramatic, and I suspect that, had you simply fed the way you normally would, Sprocket would have still surfed. I understand how stressful all this is for you, but I do think you need to step back just a little, and as Nan said, take some deep breaths. Sprocket is looking so much better! You've done a great job and he is responding well to the insulin. This is all good!

 

[Tanya and Ducia]

And i have to say I am a little concerned that people are looking at his colors for bg without reading what is keeping him up at those colors so he didnt drop.
I worry that some people are not reading anf just lookig at colors

What drops? Can you point me out to a single drop in his SS in the past 2 - 3weeks? He barely out of the Yellows.

 

[Darnell & Sprocket (GA)]

Darnell, did you read Jill's post near the top of this thread? I think you are concentrating on the food too much. I don't see any numbers on your SS lately that really required intense food steering. I know the greens on the 7th were new to you and therefore scary, but honestly, it was pretty safe. It was early in the cycle, but the drop wasn't super dramatic, and I suspect that, had you simply fed the way you normally would, Sprocket would have still surfed. I understand how stressful all this is for you, but I do think you need to step back just a little, and as Nan said, take some deep breaths. Sprocket is looking so much better! You've done a great job and he is responding well to the insulin. This is all good!

But I did feed those drk greens!! Thats what i am saying!! He is not surfing on his own. I am feedig that so he doesnt drop!!

 

[Tricia Cinco(GA) & Harvey]

But I did feed those drk greens!! Thats what i am saying!! He is not surfing on his own. I am feedig that so he doesnt drop!!

Yes, I know, and I'm saying I don't think you really needed to feed him so carefully. He might very well have surfed without the extra carbs. It's very common for new members to react strongly to green numbers, but trust me, they are your friends.

 

[Darnell & Sprocket (GA)]

What drops? Can you point me out to a single drop in his SS in the past 2 - 3weeks? He barely out of the Yellows.

The dark greens I fed so he would not drop lower.

 

[Tanya and Ducia]

The dark greens I fed so he would not drop lower.

He is Blues right now. Not green. Not near it. Not with the 500 Kcal you fed him.
Let him him be there.Let him heal.
He IS safe now.
You have best help ever.
Hold on that food - there is plenty of time ahead to serve it to him.
You ARE safe now.

 

[Jill & Alex (GA)]

I think Nan gave you awesome explanations. I would have said the same myself. Tricia also made some excellent points. Take the time to soak in all that's been said in this thread.

What I can do is comment on this:

And i have to say I am a little concerned that people are looking at his colors for bg without reading what is keeping him up at those colors so he didnt drop.
I worry that some people are not reading anf just lookig at colors.
Ya have to see all of it to give advice please.

The FDMB is a peer-reviewed board and this is EXACTLY why. Even when someone does miss something... there are others around who are also reading who feel a responsibility to step in when something is amiss. For example, I've been around here probably longer than anybody else on the board these days. I read most threads, but I don't post unless someone asks me something or I have something to say that hasn't yet been said. It's a checks and balance system provided by peers. Trust in the system, but also read and learn as much as you possibly can.

The dark greens I fed so he would not drop lower.

Yep. The first run of green numbers is scary. I remember feeding HC dry food to Alex's first dip into double digits... a 70! LOL! Everything we do is a learning experience. Remember for next time because there's always a next time.

BTW, Sprocket was never in danger... not even close on those last greens. Next time you'll know you won't have to feed so much. Eventually, you'll probably be upset if he's not in green.

That said, what are your goals? How can we help get you there?

 

[Darnell & Sprocket (GA)]

He is Blues right now. Not green. Not near it. Not with the 500 Kcal you fed him.
Let him him be there.Let him heal.
He IS safe now.
You have best help ever.
Hold on that food - there is plenty of time ahead to serve it to him.
You ARE safe now.

The drk green is from sunday night.
What 500 kcal?? I never said that.
I said every day has been different but when i must feed the numbers then he has to eat more. What else am I to do?

 

[Tanya and Ducia]

I have not been totaling calories lately.
Its about 400-500. Each can is about 80-95calories each.

Last post

What 500 kcal?? I never said that.

You said it yesterday - you feed him 500 Kcal a day. Here is the link .

Honestly, Darnell, what are your objectives?
It looks to me that they are different from what ppl who are helping you are.
Do you want Sprocket in Yellows, flatly, forever? Is that it?
I am just tying to understand.

 

[manxcat419]

Part of the problem seems to be that you're assuming that Sprocket will keep dropping once he hits normal numbers unless you feed him a lot. But the combined experience of people here is that often once a cat gets into the normal range they level right out. Just as he started to do 2 nights ago before you gave him the MC food - the drop had already slowed right down at that point. I think you need to be prepared to let the normal range numbers ride without extra carbs unless he does dip too low - I feel as though you don't trust the advice we're giving you but at the same time the only way for you to see how it works is to try it out for yourself.

As regards running a ketone prone cat permanently in the 200s, I feel that's a much bigger risk than running him in normal range and handling the occasional drop if one shows up which is still perfectly safe and which you are more than capable of doing.

 

[Darnell & Sprocket (GA)]

Great job shooting! I think he's going to do well tonight.

Take a step back and look at Sprocket's spreadsheet-- look how far you guys have come! It used to be a lot of red and pink, now you're all in yellow and blue with the occasional green. You've made fantastic progress, and are doing an amazing job taking care of him!

I do think you need to try to take care of yourself, too... Take little break, treat yourself with something-- a nice walk, a sweet treat, a hot bath (my favorite-- the best for relaxing!), whatever works for you. The FD road is hard and stressful, you have to find a way to do it that works for you. You've already got a very demanding schedule of medications to administer, and you've added on pretty close monitoring of food intake on top of that. If I were you, I'd back off on trying to interpret responses to food from day to day and making yourself responsible for that, too. Maybe one way to think of it is this: you are using insulin to try to manage his numbers, and food to keep him safe. I don't think it's worth the amount of stress it is causing you to try to connect the numbers to the food-- it doesn't really work and you've got other things to occupy your attention. You've got bigger fish to fry.



I don't think there's anything odd going on-- really, this is exactly what you want to see. If you'll look at my Amber's spreadsheet, we were stuck in yellows until I started shooting the occasional blue pre-shot she gave me. Then I started to see more blues, and then greens, and then she went OTJ. Lantus is really good at keeping low pre-shot numbers low in nice flat cycles-- eventually you will see these low pre-shots as a gift, because shooting these is the best way to get Sprocket to spend a lot of time in good, safe, pancreas-healing numbers.

Hang in there! It's stressful and frustrating, but you are doing a great job!

Thanks Nan, I do see how good he is doing compared to a month or so ago.
And from what i have learned these bgs would be good if he was not ketone prone.
I looked at your ss, and I do notice you were shooting alot less in dose.
Thats the part that freaks me out with Sprocket now. Its not the blue at pmps, its the high dose of insulin he is on at that blue pmps.
Then for next 5 hours or so I will test and feed so he doesnt drop too much. That is what freaks me out.
I am glad I shot a little less tonight. (I did 3.5 instead of 3.75).
And now he will probably bounce.
So now i dont know if I should stick with 3.5 or go back to 3.75?
I was going to go up to 4units tomorrow before this happened.
But now this shows me the dose is working and the bounce is just acting weird I guess.
Now I dont feel like 4units will be an option as he is now getting into lower blues like we wanted.
I know everyone says to wait till he earns a reduction by going under certain bgs but if I am feeding so he doesnt go too low I would think that is same thing?

I cant just sit and let him drop to show people how low he can go. That doesnt sound very safe or responsible to me.

My poor little guy is so exhausted. We both are. I wake him alot to feed or test.
He does have less meds now. He takes 3 after insulin at am& pm.
He has ondansetron, cyproheptidine, famotidine.
Then about 2pm he gets fluids (he only has a few days left till he stops that) and his ursodiol after fluids or about 2pm hour.
So he has reduced in 3 or 4 meds. Plus all his meds are compounded into liquid now.

Reason i have been talkig food issues is because it was appearing the carb was playing a part in his higher bgs in 200s.
Now i dont know what is happening.
I am trying to figure out a daily plan for having certain carb counts at same times each day.

Suggestions are helpful.
Thanks

 

[Tricia Cinco(GA) & Harvey]

I am trying to figure out a daily plan for having certain carb counts at same times each day.

I think that is an excellent idea and would make it much easier on you! You can't get yourself burned out, or you won't be any good to Sprocket.

We are all interested in getting him into lower numbers, and with DKA in his history, that makes getting his body used to those numbers so much more important.

I cant just sit and let him drop to show people how low he can go. That doesnt sound very safe or responsible to me.

That's not what you'd be doing. As long as you are monitoring - and you are - you can intervene when necessary. We are just telling you that you are doing so sooner than you need to. His body will never get used to normal numbers if every time he gets to them you take him right back up. The more time he spends in green, the more his pancreas has a chance to heal. You have the tools you need to keep him safe, so there is no risk in "letting him drop". You know you can pull him up if needed, so how is that irresponsible? It would only be irresponsible if you did were not monitoring and prepared to step in.

 

[Darnell & Sprocket (GA)]

Last post
You said it yesterday - you feed him 500 Kcal a day. Here is the link .

Honestly, Darnell, what are your objectives?
It looks to me that they are different from what ppl who are helping you are.
Do you want Sprocket in Yellows, flatly, forever? Is that it?
I am just tying to understand.

I have not calculated the calories for awhile.
500 was on days when I was feeding bgs cause I ended up giving more food on those days.
I have been writing the amount of food each day with carb counts.

I have been trying to get him into blues but I cant change dose based on him bouncing every time he goes into blues and greens.
He has been bouncing for a long time. At least he is bouncing not as high and for not as long.
Remember he is a cat that his body was used to bgs in 300-500 for along time so I have been told by many that it takes awhile for his body to stop bouncing n get used to good numbers.

Thats what I am doing.
I have barely left my house for 2 months except for shopping for cat supplies, vet appts, my doc appts, funerals, and one event of my bfs.
I am probably gonna lose my only extra income that i need because I cant be reliable anymore so i am doing my best I can do since I already have alot of health issues of my own too.

 

[manxcat419]

Thanks Nan, I do see how good he is doing compared to a month or so ago.
And from what i have learned these bgs would be good if he was not ketone prone.
I looked at your ss, and I do notice you were shooting alot less in dose.
Thats the part that freaks me out with Sprocket now. Its not the blue at pmps, its the high dose of insulin he is on at that blue pmps.
Then for next 5 hours or so I will test and feed so he doesnt drop too much. That is what freaks me out.
I am glad I shot a little less tonight. (I did 3.5 instead of 3.75).
And now he will probably bounce.
So now i dont know if I should stick with 3.5 or go back to 3.75?
I was going to go up to 4units tomorrow before this happened.
But now this shows me the dose is working and the bounce is just acting weird I guess.
Now I dont feel like 4units will be an option as he is now getting into lower blues like we wanted.
I know everyone says to wait till he earns a reduction by going under certain bgs but if I am feeding so he doesnt go too low I would think that is same thing?

I cant just sit and let him drop to show people how low he can go. That doesnt sound very safe or responsible to me.

My poor little guy is so exhausted. We both are. I wake him alot to feed or test.
He does have less meds now. He takes 3 after insulin at am& pm.
He has ondansetron, cyproheptidine, famotidine.
Then about 2pm he gets fluids (he only has a few days left till he stops that) and his ursodiol after fluids or about 2pm hour.
So he has reduced in 3 or 4 meds. Plus all his meds are compounded into liquid now.

Reason i have been talkig food issues is because it was appearing the carb was playing a part in his higher bgs in 200s.
Now i dont know what is happening.
I am trying to figure out a daily plan for having certain carb counts at same times each day.

Suggestions are helpful.
Thanks

It isn't that his numbers would be good if he wasn't ketone prone - normal numbers are the only ones we really consider to be good. But you might be able to get away with them a little more without ketones in the picture.

For dose I think he needs to go back to 3.75. Although you reduced tonight you still have the full 3.75 depot in play and he's barely touched the very high end of normal range. Which begs the question of why you would reduce when he didn't actually really get to where he needs to be even with a full depot.

 

[Darnell & Sprocket (GA)]

What is normal range?
I recall many differnt ranges.
Been told...
150-250
100-200
80-120
80-150
60-120
Is it based on TR or SGSL?
Cause i been trying to do slow one but no one wants me to.
Others say its my choice but its really not.

 

[manxcat419]

40-120 is normal on a human meter. No matter what protocol you follow, normal is normal. We treat anything below 50 as a potential hypo so they very rarely actually go under 40.

 

[Tricia Cinco(GA) & Harvey]

If you are doing SLGS, you would decrease the dose when Sprocket drops below 90, so 3.5 would be your current dose.

The reason we discourage SLGS in cats with a history of DKA is that it leaves them in higher numbers longer, and that is a recipe for disaster.

 

[manxcat419]

If you are doing SLGS, you would decrease the dose when Sprocket drops below 90, so 3.5 would be your current dose.

The reason we discourage SLGS in cats with a history of DKA is that it leaves them in higher numbers longer, and that is a recipe for disaster.

Would we reduce on a single drop under 90 for a long term diabetic? If we make TR cats drop under 50 three times should we really allow a higher reduction point and have the cat reach that number fewer times?

 

[Jill & Alex (GA)]

Would we reduce on a single drop under 90 for a long term diabetic?

Yes, we would.

However, IMHO, Sprocket falls into a gray area... a ketone prone cat that isn't currently throwing ketones. If he were mine, I wouldn't take a reduction because of a drop to 77, but I'm comfortable with low numbers.

Although.................... there's only one way for a caregiver to get used to low numbers and that's to overcome the fear by allowing kitty to experience green numbers when kitty can be monitored.

This falls into the area where a caregiver has to decide what they want to do... keep ketones at bay or take a calculated risk.

 

[Jill & Alex (GA)]

Yes, we would.

I know that probably doesn't make sense to many, but SLGS is a more relaxed protocol in that it lets kitties run higher than those whose caregivers are trying to tightly regulate their cats. SLGS or TR? It's a caregiver decision.
We "can" suggest reasons for not following SLGS as TRicia has done, but it's the caregiver's choice.

 

[manxcat419]

Thanks @Jill & Alex (GA) I just wanted to check because to me it makes no sense to do that for a ketone prone cat.

 

[Jill & Alex (GA)]

Thanks @Jill & Alex (GA) I just wanted to check because to me it makes no sense to do that for a ketone prone cat.

I totally agree, but ultimately it's the caregiver's decision as to how they want to proceed. Sprocket may never throw ketones again... or he may start throwing them again later tonight. Who knows? IMHO, ketones have a better chance of coming back when a kitty is allowed to run in higher numbers. However, if kitty continues to eat well maybe everything will be fine. If Darnell wishes to follow SLGS, my recommendation would be to test for ketones often... most certainly if anything seems the littlest bit "off".

 

[Darnell & Sprocket (GA)]

I need to do SLGS as I am not comfotable with TR even though I test alot. I test ketones everytime i see him pee which is mostly 1xa day or everyother day as he is getting sneaky with going to potty.

When someone tells me is my choice but then says its a high risk its like telling me I am hurting my cat. I am only person whom is caring for him so if I am not here because I end up in hospital then that wont help him. I am only home because I am on disability for my own health reasons so if I get sick it doesnt help him so dont make me feel guilty for trying to do my best to care for my cat.

I know many people are giving advice and i hear it and do listen but I can do without guilt trips.

He was getting ketones because of some infection/inflammation in his body.
So far so good since mid April.

He used to be in 300-500s before so these 200s are much lower than he ever had for a long time.
He is still bouncing but doing it for less cylcles and not as high so that must be good??

So please I do appreciate all advice and do listen to it but dont say its my decision then make me feel guilty for making a decision. Thats cruel.

I am trying so hard. This is all my life for past two months. I have missed alot so i trying so hard to regulate him.

I am trying to understand it all but when I think I got it then he does an odd thing like a bg of 150ish at pmps twice now.

So please be kind too. I have been as open as possible.
I have a memory issue/processing issue (not a normal aging thing)so its hard to understand but i am trying very hard.

 

[Tricia Cinco(GA) & Harvey]

He is still bouncing but doing it for less cylcles and not as high so that must be good??

Yes, that is good.

Darnell, we are not trying to be cruel. We are honestly trying to give you all the options, and explaining why we lean the way we do. We are not judging you, and whatever you choose to do, we will do our best to support and help you. Sprocket is your cat, and this is your life, and we can't possibly understand all you are dealing with, no matter how hard we try. Please do not think we are trying to make you feel guilty. We are not!!!

Hang in there and just keep asking questions and we will try to understand and be helpful. We want what is best for you and Sprocket and your family.

I have a memory issue/processing issue (not a normal aging thing)so its hard to understand but i am trying very hard.

I think you are doing very well. I would not have guessed you have this issue. Thank you for sharing what is really a very personal piece of information.

 

[Jill & Alex (GA)]

... so if I get sick it doesnt help him so dont make me feel guilty for trying to do my best to care for my cat.

... but I can do without guilt trips.

... but dont say its my decision then make me feel guilty for making a decision. Thats cruel.

I'm sorry you feel that way, but no one is trying to make you feel guilty, impose guilt trips on you, or be cruel. No one. If that were the intention, why would any of us bother trying to help after you've tagged us for help?

You've mentioned personal issues in the past, so I've been aware of them and frankly, it's one of the reasons I've been very careful to spell out your options as well as make it very clear to you and everyone else that all choices are yours to make.

There are different standards of care when it comes to our furry friends. I had a cat who was terrified of going to the vet's office despite my vet being one of the kindest and most gentle men I know. He bent over backwards when it came to trying to make her feel comfortable and secure during office visits, but Alex would have bitten his arm off if I hadn't been there with her. My point in telling you this is because of her fear, Alex did not receive the "gold standard" of care throughout her life... AND THAT WAS OK. As her person, there were many conscious and deliberate choices I made for for her... in her best interest... some of these choices may not quite be up to the standards of others, but for Alex, they were purr-fect. I'm sure you're doing the same for Sprocket or you wouldn't be here.

Whatever decisions you make for handling Sprocket's treatment are yours to make. Our "job" is to explain and offer suggestions based on our experiences. I believe we've accomplished this. Please don't shoot the messenger if you're not liking what you hear for whatever reasons.

I am trying so hard. This is all my life for past two months. I have missed alot so i trying so hard to regulate him.

Darnell, the same can be said for each and every caregiver who comes to this board for help. We get it. I think you may be surprised if you knew even half the issues and limitations many of our caregivers face on a day-to-day basis. Trust me, you're not alone.

I am trying to understand it all but when I think I got it then he does an odd thing like a bg of 150ish at pmps twice now.

Dropping to a BG of 150-ish isn't odd at all. The bounce broke. The numbers came down. They came down after 3 cycles this time! That's awesome... progress in it's finest! It's what you want to see. It's what you've been working your tail off to see. Shooting full doses on lower preshot numbers is what will eventually bring the entire range of BG numbers down... hopefully and with any luck --- for good.

Something we fail to say often enough... you're not going to see the same kind of drop from a high preshot number as you'll see from a lower preshot number. As an example, when Alex was on insulin I was less afraid to shoot a green preshot number than I was to shoot a blue preshot number. Shooting green preshot numbers tended to result in flat & lower cycles that required monitoring, but they eventually resulted in low flat cycles with little to no bounce. I know it's hard to wrap your mind around it, but once you do, you'll be amazed at the results. THAT's when you'll see the low, long, and flat cycles Lantus is known for.

Getting back to what I've been saying all along... you hold the syringe. We can offer suggestions and explain the reasoning behind our suggestions, but ultimately all decisions are yours to make. Take that at face value rather than interpreting it as laying a guilt trip on you. Please.


Edited to add:
Thank you for explaining how you feel. Doing so helps to clear the air, so-to-speak.