6/6 Alice PMPS 212 +3 98 / AMPS is 51/64, reduced dose by 1/8th.

@Tanya and Ducia thank you I saw you were online and was about to tag you.

Clinical signs are normal. Did I mess up by not getting another mid cycle test? :( I tried to do +6 but didn’t want to keep torturing her ears. Did not expect this value this morning. Retesting in the next 5 min.
 
Tanya and Ducia said:
Would be willing to give more than a token?

Can you stay home to test?

Do you have all supplies necessary like MC or HC gravy, honey, testing strips?

Your shot schedule may need to be moved. Is it ok?
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Yes. Schedule is flexible.
I am always supply stocked from syrup to freeze dried and in between.
 
She can eat more than half a can at once, so I could feed a quarter can of anything, I have 4%, 14% (gravy), (both friskies) and 20% (gravy, FF).
 
Give the following a few minutes to be looked by other ppl and to comment or CORRECT ME

I would give 3.5U BC recent DKA. Larger reduction then per TR.
I believe reducing more might hurt the DKA recovery progress.

Feed her soime thing higher than usual LC, usual portion - she needs to have appy thru some time.

Take another 45 min after the shot. I'll stick here.

what do you think?
 
If there is a food choice:

feed something lke 8% -9% carbs solid food (like Pate) and top it with 2 teaspoons of only gravy 14%. Pop the can, press the lid down, squeze the gravy onto the spoon. Do not feed whole food from 14% - only gravy. 2 t.
 
@Tanya and Ducia thank you for being here.

I honestly am not sure who to tag. I usually go look to see who is online then try to see if they have been around for at least a year. But not everyone knows Lantus, sooooo.
 
here is what I propose to do:

feed the mixture of pate and mc one to one, not too large of a portion (to preserve the appy for later), and take test in 45 min after eating. By then we should see the food spike and take it from there. If lower still (which I doubt) then we'll go to mc again .
 
I just saw where you said not too much, to preserve appetite, but I had already started a portion and given it to her. But unlike some cats I’ve seen on here, that girl can EAT. She’s still acting like she would eat more.
 
I noticed in the past when she was running high, she suddenly dropped at about +1.75, how long does it typically take for Lantus to “kick in” ?
 
AliceMeowliss&Cassandra said:
I just saw where you said not too much, to preserve appetite, but I had already started a portion and given it to her. But unlike some cats I’ve seen on here, that girl can EAT. She’s still acting like she would eat more.
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or the girl could be offered just Gravy alone and I know hardly a cat who passes such a treat.

I suggest the nest test at +0.75=45 min later.
then most likely, at +2.5 but let's see what the food spike is like first.
 
Alright, I was thinking +45 min too. Thanks! She usually gets snacks more through the night or partner gets up and does “last call” snack before fasting time.

Going forward I wonder if a dose reduction would be best.....? 3.75u perhaps?
 
I think this is where I get confused on TR and earning a reduction. I reviewed it again yesterday. She keeps hitting these lows though the past few days, intermittently. Also reduced dose to 3u one recent PM cycle because I was sick and she had gone so low the previous night too.
 
AliceMeowliss&Cassandra said:
Also reduced dose to 3u one recent PM cycle because I was sick and she had gone so low the previous night too.
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and the next AMPS was Red so 1 whole U reduction could have been too much.

AliceMeowliss&Cassandra said:
I think this is where I get confused on TR and earning a reduction. I reviewed it again yesterday. She keeps hitting these lows
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but none as low as to take a reduction. The 51 this AMPS was very close.

the thing is to not to lose good momentum by reducing too much: Alice's SS looks so much better as of late! Especially the PM part. And then there is DKA - it'll be hanging above Alice head like Damocles sword for a while and keeping the dose that produces green nadirs for as long as possible to do so safely is the answer.

We maybe able to see today where she starts going down and you can feed a little LC food to slow down that downslide.
Let's say she is always lower at +3. Some food at about an hour earlier would help. More to be typed later.
 
Nibble was probably about a teaspoon this time, yes.

I see a lot of people recommend these tiny snacks, usually her snacks and meals both are much larger than others, but we have been dealing with her being underweight and DKA. When she ate dry, pre-FD, she always regulated her eating very well and maintained a low healthy weight. I am trying to reduce her overall total intake at each feeding now as she gets much closer to being weight-restored. But she still can pack away a LOT for her size. I think she learned to stretch her tummy when she wasn’t getting the right treatment and was always hungry due to starving from the inside out.
 
AliceMeowliss&Cassandra said:
I am trying to reduce her overall total intake at each feeding now as she gets much closer to being weight-restored.
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very tricky to keep it balanced for post DKA cat - they need calories and perhaps even need to have some fat buffer, too but not to overweight. I shoot past Ducia's good weight for about pound and a quarter and all we managed to shed was 2.5 oz for over a year...:(
 
Tanya and Ducia said:
very tricky to keep it balanced for post DKA cat - they need calories and perhaps even need to have some fat buffer, too but not to overweight. I shoot past Ducia's good weight for about pound and a quarter and all we managed to shed was 2.5 oz for over a year...:(
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Awww Ducia! Dieting a cat is HARD! One of my ginger boys is overweight. He is the youngest (about 5-6years) and didn’t start gaining until after I neutered him. He is extremely food motivated. He also has some sort of allergy issue and licks off half his fur. Fecal score is never perfect either. I still don’t know what is up with him entirely.

I never expected my tiniest cat to develop FD, maybe the overweight one someday if I didn’t get it under control. And he’s only about 18lbs, I’ve heard of heavier cats!

Fortunately for Alice she can basically eat as much as she wants right now, since we need gain. But I want to encourage her tummy to be happy with less than the usual 1/2can plus a lot of water. That way later on she doesn’t get super huge.

You know, your mention of needing the fat to allow insulin like Lantus to work properly made a lot of sense. Maybe that’s why she’s going how she is now, because she has weight/fat again.
 
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If Alice is very high by PMPS you can shoot at your previous time – 45 min earlier.
Giving Lantus early was noticed to “increase” the dose and it should help a little with the high numbers which I am afraid she is going to throw at you tonight.

Hopefully prior to the PMPS someone will weigh in about dosage


..but I feel strongly inclined to say that I probably would return to 4U tonight. Surely, the rest of today AM cycle may tell you something different. Ask someone with greater knowledge about the dose. Alice SS does look up and down but you can try smoothing it by giving snacks just prior to known drop times instead of reducing.


That mixture of 14% solids and pate - which makes the whole meal around 7% - was too much (which I told you to feed. ) Sorry. ETA: I meant 9% (14+4 /2=9%).

Another (or better) option was to feed pate with a bit of gravy alone, no mc solids BC solid food stays in longer affecting the BG v. mc gravy alone which fast in and fast out. But then I’d have to ask you to poke every hour hunting down the time when gravy leaves and Alice don't drop again.
(It is very ecid – the carbs sensitivity, struggling myself with it.)
 
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It’s okay. I actually started her portion before I saw your next recommendation, and it was a 1/4 can 4% with about a teaspoon of the 14%, plus a little extra gravy and having her lick the spoon. And it’s okay. There are times I have propped her numbers. A little higher carb food will do her good and she is happy to have it. Better safe than sorry.

Everything I have read via actual studies indicates Alice is less likely to reach a point of remission based on date of DX and how dysregulated she has been through the process. So although remission would be wonderful, I’m mostly just shooting for healthy and happy for now. She needs the calories and the weight.

Going to do a +5 in 30 minutes, instead of waiting for +6. If I did have to test hourly, it wouldn’t have been the end of the world. She was crying for food earlier so it makes me wonder what her sugar is actually up to right now.

Many years ago I was casually reading for fun about glycemic load and glycemic index of foods. Human info, but I imagine some concepts are the same. The gravy will process faster than the rest of what she has, but if she has it with a mix of low carb, it will still slow her down a bit. And anyway, technically she still had LC at 9%. :)

I’m glad you were here to help. The worst is not knowing what to do as the minutes creep by and you panic wondering shoot or no shoot, feed or no feed, while kitty sits there sad or hungry or whatever. Thank you for making sure I wasn’t alone. :)
 
AliceMeowliss&Cassandra said:
The worst is not knowing what to do as the minutes creep by and you panic wondering shoot or no shoot, feed or no feed, while kitty sits there sad or hungry or whatever. Thank you for making sure I wasn’t alone
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:bighug:
AliceMeowliss&Cassandra said:
Everything I have read via actual studies indicates Alice is less likely to reach a point of remission based on date of DX
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There is someone from UK posting in Health from time to time whose cat Bertie had gone into remission after 11 years on the dose. It is the most dramatic example and huge debunker for the "4 months or no remission" myth. There are other cats who got OTJ after years on a dose. There even cats who bounced thru their way to remission (that I cannot grasp but it gives me hope)
 
Tanya and Ducia said:
:bighug:

There is someone from UK posting in Health from time to time whose cat Bertie had gone into remission after 11 years on the dose. It is the most dramatic example and huge debunker for the "4 months or no remission" myth. There are other cats who got OTJ after years on a dose. There even cats who bounced thru their way to remission (that I cannot grasp but it gives me hope)
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It’s statistically less likely, but I don’t doubt that there are exceptions, otherwise the stats would be 100%. I maintain hope but also am trying to realistically focus most on her quality of life in itself. Every extra day we get from this point on is a bonus, I feel. Buuuut I am also seeing just how tough she is! Her mother was tough, too. She was a stray we brought back to life many times. So I think of this now and I have “evidence” to still hope and try to achieve the best possible outcome. :) I believe a degree of hope is necessary in order to manage this sort of thing, anyway. I hope she is happy every moment that I can make that happen.
Ahhhh I think I got sappy. Ish. Testing.....
 
My favorite thing about her diet now (from dry to wet) is that often when she gets low in the bowl she uses her front right paw to help her scoop food out, much like a hand. It’s very cute.

....bowl empty. She’s looking around back and forth like, “where is the rest?”
 
if you don't mind pokes take +8. Would be usuful data for later (optional)

But +10 or +11 I think would be very helpful to look at when you have the PMPS in - will tell you where she is going.
 
Agreed. I hate poking her around fasting time and am most likely to have left the house towards the end of the cycle, but there are some days a +9 or later has helped me see a clearer trend in the evening without stalling, etc.

ETA SS updated
 
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