6/22 Bartholomus AMPS 395,+5 95

Rebecca & Bartholomus said:
Well we nearly went hypo again last night so skipped dose and reduced dose AGAIN.. looks like we are headed down toward that trend tonight. I'm just confused, wondering how low we will go. If anyone wants to look at SS, give opinions, that would be awesome.

? - Hypo, 6/17 Bartholomus Overnight lows 46 for 2 hours Need advice on reduction
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We only use the term “hypo” if they have symptoms. He was at normal, safe numbers and not even what we would consider low.

Still, on SLGS, it was good you skipped and reduced the dose today. It’s hard to predict so you should test him about +9 so if he needs a LC snack because he’s close to 40s, you can give it.

What am seeing is you are missing testing opportunities which would allow you to manage his insulin with food so he doesn’t drop so drastically. All his lows come during a bounce breaking cycle which is when they can really be active. If you tested every +2, you would get an idea if he was going to come down and then you could feed appropriately with the insulin to get him to flatten.

The dives, bounces are not the way to work Lantus. You might want to look at Mister’s condos and SS as Elizabeth is working quite successfully to manage his numbers with food.
 
This has really given me food for thought, so to speak. I think I know what's happening now. It's hot. Very hot. He's sleeping through the afternoon/evening instead of eating on his normal free-feeding, consistent small meals throughout the day. Yes, he's eating his treats, but those are freeze dried with zero carbs. I need to figure out how to get him to eat more during the later part of the day. Thank you so much.
 
Think I'm just going to go post on reddit. The few times I e asked for help I get THATS NOT HYPO. oh sorry I was looking at the wrong person chart
YES ITS HYPO.
SORRY IF IM NOT PERFECT
IM ON A LOT OF MEDICATION AND DISABLED AND POOR AND OLDSO I DOBT GET TO DO EVERYTHING ID LIKE
KEEP PRAISING PEOPKE WHO RAISE INSULINF 3 UNITS IN 9 DAYS
 
If you are going to feed later in the cycle, try to make sure he's finished all his food by +10. I fed Neko at +9 so I had some buffer. The carbs from low carb food last a couple hours and then wear off. If he's in lower numbers, you want to see that preshot number that is not influenced by recent food, so you know it's a safe number to shoot.

I would also focus on trying to feed much earlier in the cycle, to prevent those steep dives. See on 6/17 PM and that steep dive to +2. Kitties who like to dive early can benefit from getting food at +1 and +2. That can slow down those dives.

I hope he came up more for you at PMPS time.

Which cat's spreadsheet shows raising insulin 3 units in 9 days? That would be very unusual.
 
Rebecca & Bartholomus said:
Oh and yeah I did finally go look at this elizabeth and Mister chart everyone e keeps mentioning. That is terrifying.
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I don’t see anything terrifying about Mister’s SS. I’m not sure to what you are referring.

My point was he needs to eat earlier in the cycle to slow down the big drops because then he bounces again. As Wendy said, you can feed him something LC later in the cycle ~+9 or so if he’s hungry or if his BG is low.

I’m not sure how or where I’ve upset you but I believe it’s just a communication issue? Perhaps I didn’t explain it well enough?
 
Look all I know is it took us 4 months to get to 3.5 units, and this person did it in 19 days. Then did half unit jumps. I don't get it. At all. I posted my curve days, was told I could go up .25, our reds and pinks all flamboyant on the ss, no suggestion of going higher faster for his health. I guess some people are exceptions to rules, and because they are getting results, they get pointed out to other members as paradigms of the community.

And again, as I've said in every post, Bartholomus free feeds, he can eat at any time he wishes. It's just now, as I said earlier, it's hot and he has no appetite in the afternoon/evening. I've attempted to fix that by crumbling his cat Crack onto his normal food so hopefully the pm numbers will adjust and we can increase again.
 
Hi Rebecca - I hope Bartholomus recovers his appetite with the upgraded menu and shows you more steady surfs in the pm!

I think maybe there was a little bit of miscommunication - it’s always a little awkward when you’re writing messages out and tone doesn’t get across as well.

When some of the moderators were saying it wasn’t hypo, I don’t think they meant it wasn’t important or worthy of action / notice. I think they just meant he doesn’t have immediate physical symptoms that would make it a dire medical emergency. If anything, I think they’re trying to say that it is important and you want to take action like you have today (with making his pm meals more appetizing) so that he can avoid dropping quickly to those super low numbers and then experiencing a bounce. So I think you were all saying the same thing, just using different words.

On Elizabeth’s SS, you’ll notice in the beginning she wasn’t using Lantus, so it might not be comparable. Also I think she would be the first person to say she’s made mistakes along the way, especially in the beginning, and has had to build courage and discipline to stick to a particular method. You’ll see that the great results people were referring to came once she started being extremely consistent adhering to TR, where she’s doing all the things you’re referring to like 0.25u dose increments. She’s also doing TR so she can make changes in 3 days vs a week for SLGS, which I think is what you’re following.

Elizabeth is a really thoughtful good person and cat mom, and I don’t think people are holding her up as some example because Mister’s numbers have been blues and greens recently. I think it’s that she’s made mistakes, learned a lot along the way, and has seen a lot of progress from continuing to make mistakes and learn. And I think Mister had similar bouncing that Bartholomus is experiencing and was able to improve that recently by smoothing with food, which is why her SS got recommended as an example to look at.

I hope this helps clarify the miscommunication a bit! Everyone here is rooting for you and Bartholomus!
 
Connie, this has nothing to do with Elizabeth, but everything to do with the mod recommending me look at her as an example. It was incredibly triggering for me. I wanted desperately to increase Felo's insulin to an amount that would start having any effect on him, but I followed the rules to a tee and it took months.
 
Rebecca & Bartholomus said:
Connie, this has nothing to do with Elizabeth, but everything to do with the mod recommending me look at her as an example. It was incredibly triggering for me. I wanted desperately to increase Felo's insulin to an amount that would start having any effect on him, but I followed the rules to a tee and it took months.
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I’m so sorry to hear that. It’s heartbreaking to watch our cats stay in high numbers. I’m too new to have the context, but I do think everyone here truly has the cats’ best interest in mind and I try to interpret their actions through that lens, giving people the benefit of the doubt in terms of their intentions at least.

I really hope that Bartholomus liked his food this evening and shows you a smoother surf! I’m rooting for you both!
 
Rebecca & Bartholomus said:
Look all I know is it took us 4 months to get to 3.5 units, and this person did it in 19 days. Then did half unit jumps. I don't get it. At all. I posted my curve days, was told I could go up .25, our reds and pinks all flamboyant on the ss, no suggestion of going higher faster for his health. I guess some people are exceptions to rules, and because they are getting results, they get pointed out to other members as paradigms of the community.

And again, as I've said in every post, Bartholomus free feeds, he can eat at any time he wishes. It's just now, as I said earlier, it's hot and he has no appetite in the afternoon/evening. I've attempted to fix that by crumbling his cat Crack onto his normal food so hopefully the pm numbers will adjust and we can increase again.
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First, you were doing SLGS and feeding dry food. SLGS does not say anything about increasing doses by 0.5u when nadirs are over 300 because the dry food complicates managing the curve. It is a much less aggressive method of regulation. I can show you SSs which look worse than his because the CG is doing SLGS.

Second, Mister had DKA and was fighting ketones. That means his dose needed to be fast-tracked and Elizabeth was doing TR with him which does allow raising the dose by 0.5u after every 4-6 cycles. There are no preferred members or us doing special things for certain members just because we want to. We look at each cat individually and consider medical conditions like DKA (which can quickly become deadly) or ketone-prone cats. Once a cat has had DKA, they are at risk for developing it again so we were trying to get more insulin into Mister as quickly and safely as possible and, his ketones, in fact, came down.

Finally, Elizabeth posts every single day without fail. I would not work with anyone to fast-track a dose if they aren’t posting every day.

I asked you to look at his SS so you could see how Elizabeth is feeding him and how it’s working with his insulin.
 
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