6/12 Nikki PMPS 405; +3 344; +8.5 357

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Re: 6/12 Nikki AMPS 353

It looks like a bounce. Just be patient.
He could have even been lower than that 138 earlier.
 
Re: 6/12 Nikki AMPS 353

I have a question about bounces. More of an academic one than necessarily relating to Nikki. I want to make sure I understand the process behind this. From my understanding, the goal is to have cats spend as much time as possible in "good" numbers so that their pancreas has a chance to heal, correct? In terms of arriving at those numbers, is it better to try and stabilize cat on a dose that holds them relatively flat, even if that flat level is say in the 200-250 range and then gradually raising dose so that their flat level comes down to healthy numbers? Or are we trying to achieve those greens and blues as quickly as we can, regardless of whether they spend some time in the pinks/reds from a bounce? As I said, more of an academic question than a dosing question specific to Nikki. I'm just curious to have people weigh in on the issue. I haven't had the time yet to peruse the Think Tank clearly. :-D
 
Re: 6/12 Nikki AMPS 353

Sounds like a good question for the Think Tank. Wish I had an answer, seems the more I learn the more confused I get. :? :lol:
 
Re: 6/12 Nikki AMPS 353

In my mind, keeping the kitty on a more even keel, to keep the bounce from going too high is better.

That is what Deb is trying to do with Lucian. It's harder than it looks.

It's the steep, fast drops that people are trying to control. This is where the use of some food, usually earlier in the cycle, at +1, +2, +3 can come in handy.

One definition of fast that I have seen is >50 points an hour, or no more than a 50% drop from pre-shot to +2.

If you have about a 50% drop, from pre-shot to nadir, that is about right. More than a 50% drop, expect a bounce.

It's not so much trying to keep the cat in the 200-250 range, but halting those steep drops.

You might want to look at Sienne and Gabby's condo over in TR and Gabby's SS. Sienne uses food to stop Gabby from plummeting early in the cycle. Since Gabby is gluten sensitive, she uses karo mixed in with LC food instead of a gravy type food.
Here is a link to Gabby's condo from 6/12 http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=97438

And here is a comment on the food management that Marje made in Shadow boys's hypo condo http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=97223
I posted some info on Tashie's condo about feeding lower numbers and maybe it would also help you.

The other day, we fed Tashie HC at 54 @+3.5. Usually we say, feed LC unless they are below 50. But....there are exceptions:

•a fast drop to a lower number
•a new kitty with little data and a nervous caregiver
•a low number really early in the cycle

Take a look at Gabbys SS. Gabby generally has an early nadir and likes to drop early and fast. You can see how Sienne uses HC with her to slow her down.

The goal in a newly dx cat (dx less than one year) is NOT to prevent a reduction; it's to keep them safe and try to minimize the bounce that comes with a really fast and steep drop.

If you get a 54 midcycle from a glide down, you would use LC food. You will also learn what Tashie reacts to best. For instance, I used alot of HC gravy, food, karo when Gracie was newly dx and on Lantus. But then I figured out she responded really great to 10% food. I never use HC or gravy and restrict the use of karo to really really low numbers (20s/low 30s) when I want her up fast. ECID...learn what Tashie responds to and use what she needs.

If you get a 54 late cycle, you might not need to feed OR a tiny bit (1 tsp) of LC might work beautifully. So consider:

1. How fast is she dropping
2. Where is the number in the cycle
3. How does she respond

And lastly....feed the 40s. If you get a 40s number at PS, do not feed, retest in 15 mins. If she is not above 50, feed 1 small tsp LC and retest in 20 mins. In the meantime, you will be posting and asking for help :-D


I think managing any curve with food becomes an art. The tricky part is learning how your cat responds to food. As you feel more comfortable with low numbers, then you can develop a "chart" like Dyana has. She knows JD well and knows when to feed what. We also have figured out the same with Gracie and Sienne has with Gabby. It just takes time and patience to see how they respond and to learn what they need.
Click to expand...

Hope my grabbing some of these comments and data from various sources helps you. Just my 2 cents worth.
 
Re: 6/12 Nikki AMPS 353

The only negative side to trying to control drops and spikes, is the crazy amount of testing required. I'm sure Lucian feels like a pin cushion at this point in his treatment. :o But there is no way around that. You absolutely must know where their BG's are if you are going to control them. I hate it! Seriously! Thankfully, although Lucian was determined to fight me tooth and nail for the first several weeks, he adjusted and really could care less anymore. Now I think it bothers me worse than him when I have to test a lot.

I'm pretty sure that the majority of cats don't require the testing that Lucian does, nor an unorthodox treatment plan. But Lucian is a unique example and will probably take a unique treatment plan to get him under control. In the 6 months we've been on the boards, I've seen several cats, respond by the book and are OTJ. Many that came in after we did. ECID and some MORE different than others, i.e. Lucian. :lol:

My personal feelings are that you have a very good chance of getting Nikki regulated, if not OTJ in the near future. There is a real good chance of that here and I wish you the best of luck in doing so. As much as I'd like Lucian to do the same thing, we'll still attend the OTJ party for Nikki :-D even though Lucian is probably in for the long haul. :roll:
 
Re: 6/12 Nikki AMPS 353; PMPS 405

Aw, thank you! That's good to hear on a day when all I see is red and pink. :? If I can only get her off the HC food, I think she stands a chance at remission. Hopefully her intestines/pancreas/liver will get with the program! :lol:

I hope that Lucian settles down a bit for you! I wish I was home to test as much as you can, although I suspect Nikki is happy I'm not. :-D
 
Re: 6/12 Nikki AMPS 353; PMPS 405

Oh Nikki, c'mon back down now. Seriously. This is a continuation of the bounce from yesterday OR she went low sometime today. She's hungry, happy, playful, preening, and purring so at least she feels ok.

I'm going to get a before bed (+3) and am debating which one to get +7, +8, or +9....
 
Re: 6/12 Nikki AMPS 353; PMPS 405

I think any of those times would be useful data, since you have few of them. If me, I'd go for +7, in a choice of 7,8,9. But that's just me. :-D

Just a question, does your work schedule change a lot? Is there any way to be a little more consistent with the shot times? I don't know your circumstances, that's why I ask. I do know that consistency is, by far, one of the most important aspects of getting them stable. Consistency in dose and shot times.

Any way we can help you with that? :YMHUG:
 
Re: 6/12 Nikki AMPS 353; PMPS 405

I know, I've struggled with shot times a bit. I leave around 7:45 am consistently. Coming home on the other hand...I technically work only until 5, but often stay late to get work done. Then I have a commute that lasts anywhere between 40 minutes and an hour plus, depending on traffic and whether the bus shows up. :? I had her shot time right before I left for work for a while, but I was taking a class on Mondays (changing to Wednesday next week) that keeps me out of the house from 6:10 until about 9:45 pm. So I'm not sure if I should go back to a 7:30/7:30 schedule and just shoot early the one night or what. Then there are the nights when my friends in the city want to go out and I can't get home and back to the city, so I just stay in the city. I try and keep that to one night a week, but it's a bummer having to say no to people. :sad:

I do want to do what's best for Nikki, but it's hard when I'm young(ish) and single and still want to go out (and possibly even date one of these days :smile: ). So I'm struggling to find that happy medium. I wish I was wealthy so that I could have a live-in cat nanny. That would solve a lot of my problems! :lol:
 
Re: 6/12 Nikki AMPS 353; PMPS 405

:lol: Lord hon, we all wish we could afford a cat nanny!

Staying out over night isn't that big a deal, if you shoot before you leave and get home by AM shot time. As long as Nikki isn't giving you crazy low numbers you need to monitor, I see no problem there.

Mornings, I'm guessing, aren't too hard to shoot on time right? Focus on that, try to make sure she gets her AM shot at the same time every morning. At least that way, if the evening shots vary a few minutes either way, at least the AM shot is consistent, rather than them both varying, know what I mean?

I know it's got to be hard for you, you still want a life besides being a cat care giver, I understand that. The fact that I am old and have no life to start with, it's not an inconvenience for me. It HAS been very hard for me to adjust my sleep schedule and I've had to change my meds to make it easier to get up during the night, when I need to. I never thought I'd be able to do what I do now, 6 months ago, believe me.

You're doing a great job and putting an effort into finding a satisfactory middle ground, no one could ever fault you for that. Nikki is lucky to have you. Some kitties aren't so blessed.

Hang in there, it'll get easier with time. :YMHUG:
 
Re: 6/12 Nikki AMPS 353; PMPS 405

Thank you! We do joke around about Nikki ending up in a pretty good place. :-D She's been a really difficult cat. She's aggressive and dominant and spent lots of time biting/scratching me for no apparent reason. She's had digestive issues pretty much since I got her and we spent last fall trying to figure them out (and failing) as they got worse. I never expected to end up tied to a sick cat, but I wouldn't give her up for the world! She does the silliest things that make me laugh and that's worth so much to me...

I think that's a great idea to try and hold my shot time in the AM more steady. It will give me something that's fairly easily accomplished to work towards. :-D I appreciate the input!
 
Re: 6/12 Nikki AMPS 353; PMPS 405

Makes sense to me, if you can get half the shots consistent, you're halfway there! Much better for her than all of them being inconsistent, right? If half is all you can manage, then you are doing your best and that's all you can hope for. :thumbup

Besides, I think you'll find, that if the morning shots are always at the same time, at least half the PM shots will be consistent, just the law of averages. :-D

None of us ever expect to be caring for a sick kitty, anymore than a sick child. But it happens and because we made a commitment, we do it anyway. We wouldn't 'throw away' a sick kid. Although some heartless individuals will do it to an animal, you're not that type or you wouldn't be here, you would have dumped her at the SPCA somewhere. :YMHUG:

If it ever comes down to it, something in your life changes and you are no longer able to care for her, there is always the option of rehoming her with someone who can care for a diabetic, it happens often. Mel has ended up with a couple of them, as fosters. ( :lol: Yeah, right! As soon as she got them, they had forever homes! :-D ) Don't ever think you have no alternatives. Everyone here will help in any way they can, even if it's just moral support. :-D

OK, I'm off my soapbox. :lol:
 
Re: 6/12 Nikki AMPS 353; PMPS 405

I thought about fostering for about a minute, but I just can't see letting her go. That doesn't stop me from wishing this was easier! :lol:

Thanks for the pep talk, it helps remind me that I'm not failing her because some things in my life have to come ahead of her. It's easy to forget that I don't have control over her pancreas and start to blame myself for not taking good enough care of her. ohmygod_smile It's so great to have the people here to boost you up on a down day. :-D

And for what it's worth, I think you do a great job with Lucian. I don't know what I would do if Nikki was that tough! :YMHUG:

In the meantime, I think Nikki is feeling good tonight. She's all :dizcat and poor Dee is getting tired of being chased around the house. bcatrun_gif

:-D
 
Re: 6/12 Nikki AMPS 353

Nikki's Mom said:
From my understanding, the goal is to have cats spend as much time as possible in "good" numbers so that their pancreas has a chance to heal, correct? In terms of arriving at those numbers, is it better to try and stabilize cat on a dose that holds them relatively flat, even if that flat level is say in the 200-250 range and then gradually raising dose so that their flat level comes down to healthy numbers? Or are we trying to achieve those greens and blues as quickly as we can, regardless of whether they spend some time in the pinks/reds from a bounce? As I said, more of an academic question than a dosing question specific to Nikki. I'm just curious to have people weigh in on the issue. I haven't had the time yet to peruse the Think Tank clearly. :-D
Click to expand...
"generally speaking", the sooner you can pull kitty back into normal numbers the better chance of remission. it's the whole idea behind the Tight Regulation Protocol. pull kitty into normal numbers and ignore the bounces.

from the STICKY: LANTUS & LEVEMIR - TIGHT REGULATION PROTOCOL:
"The tight regulation protocol was tested in 55 diabetic cats for Lantus/glargine and in 18 diabetic cats for Levemir/detemir from the
German Diabetes-Katzen Forum. Owners measured blood glucose an average of 5 times daily and adjusted insulin dose based on the protocol. An overall remission rate of 64% was achieved in the cohort. Significantly higher remission rates were observed if good glycaemic control was achieved soon after diagnosis: 84% for cats started on the protocol within 6 months of diagnosis went into remission, and only 35% for cats that began more than 6 months after diagnosis."

however, following the TR Protocol is not always the best fit for a caregiver for one reason or another. historically, some kitties have and will continue to go into remission following the Start Low - Go Slow Approach. we've also had kitties go OTJ after receiving insulin in excess of 2 years, so don't let the statistics sway you from choosing a method that works best for you and your family.

besides, truth be told, some kitties will go into remission pretty much no matter what the caregiver does or doesn't do.
and then there's some kitties who will never go OTJ, but will live happy and healthy lives because their caregiver chose to treat their diabetes.
 
Re: 6/12 Nikki AMPS 353; PMPS 405

You are so right! You have no control over her organ's actions, all you can do is take it a day at a time. Bet you never thought you'd be in a '12 step program' huh? :lol: One day at a time! :-D

In reality, some cats will go into remission and some won't and there's not a whole lot you can do about it. As long as your girl is healthy and happy, you've done your best.

She's sassy tonight huh? My granny used to call that 'Full of P*ss and Vinegar', :lol: Love it when you can tell they feel better. dancing_cat
 
Re: 6/12 Nikki AMPS 353; PMPS 405

Is it possible to follow TR given that I can only test 4 or so times a day? Or I guess I should say that I'm only willing to test that much, as I'm barely functioning as it is now that I get up once per night to test.... :?

I'd be happy if I can get her regulated. If we get remission that would be fantastic, but I have a suspicion that her gastro issues and the FD are tied to some kind of malfunction with her in general. It's fascinating to me that we've had the least diarrhea when she has the lowest BG. She wasn't diabetic (according to the vet) last fall but even the pred didn't help her as much as insulin has in terms of her stool. I'm hopeful that I can begin switching her food starting this weekend to get her on something lower carb than the z/d.

Thanks for stopping in! I love to learn and I'm working on that master's degree in FD as Deb calls it! :-D
 
Re: 6/12 Nikki AMPS 353; PMPS 405

nckitties3 said:
You are so right! You have no control over her organ's actions, all you can do is take it a day at a time. Bet you never thought you'd be in a '12 step program' huh? :lol: One day at a time! :-D

In reality, some cats will go into remission and some won't and there's not a whole lot you can do about it. As long as your girl is healthy and happy, you've done your best.

She's sassy tonight huh? My granny used to call that 'Full of P*ss and Vinegar', :lol: Love it when you can tell they feel better. dancing_cat
Click to expand...

Yeah, I'm a control freak, so I'm totally out of my element here! :lol: I want to force her pancreas into following my way. :lol:

She's definitely full of P & V! It's nice to see her feeling so good after so many months of not feeling good. I often wonder if part of her general nastiness over the years is because she wasn't feeling well. It isn't really normal that a cat just walks up and bites you for no reason. :?

At any rate, she's headed down and I'm off to get some sleep so I can get that +7. Hope Lucian doesn't keep you up tonight! :-D
 
Re: 6/12 Nikki AMPS 353; PMPS 405

Nikki's Mom said:
Is it possible to follow TR given that I can only test 4 or so times a day? Or I guess I should say that I'm only willing to test that much, as I'm barely functioning as it is now that I get up once per night to test.... :?
Click to expand...
i'll be honest...
there are times when you have to/want to test more especially when kitty is traveling in low numbers and/or you're trying to figure out your cat's response on a given dose. there are other times when testing 3 - 4 times a day is sufficient.
 
Re: 6/12 Nikki AMPS 353; PMPS 405; +3 344

That makes sense. I'm still trying to get past her need to bite when I handle her, but I'm hoping we get better at testing so that I can do it more often when I need to. One day at a time, right? :-D
 
Re: 6/12 Nikki AMPS 353; PMPS 405; +3 344

absolutely! :mrgreen:

things do get better in time... they really do. alex has been on and off insulin due to other illnesses over the last several years. imho, we've developed such a tight and strong bond. i swear the two of us can read each other's minds! she's as in tune with me as i am with her. :lol:

it didn't happen overnight though. it happened one day at a time...
 
Ugh, what the heck? Either she dropped a lot over the last 5 hours or she's flat pink. Do not like. Meanwhile, I set my alarm for 2 am and it didn't wake me up until 3:30. :oops: At least I got a test in? :lol:
 
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