7/24 Toeby AMPS 167, +2 166, +5 106, PMPS 119, +2 88, +3 56, +4 70, +6 108.

Friday's post: https://www.felinediabetes.com/FDMB...85-1-70-2-79-3-113-4-133.250240/#post-2823122

 

Good morning, Laura. Hope you and Toeby have a great Saturday.

 

Good morning Laura!

Continuing the conversation from yesterday's condo:

Not sure which sticky you have printed out, but in this one called Tight Regulation: Becoming Data Ready to Shoot / Handle Lower Pre-shot Numbers that's at the top of the forum list it says (important parts for you highlighted in purple):

When following the Tight Regulation Protocol, you'll want to become data ready and learn to safely shoot preshot numbers between 50mg/dL - 150mg/dL.

New members without much data collected, but are following the TR Protocol in the Lantus, Basaglar, and Levemir Insulin Support Group should ask for guidance when presented with a preshot number less than 150 mg/dL. Once you've collected data to support your decisions, the TR "no shoot" number is 50 mg/dL.​

There are lots of members here who have shot a 50 preshot number and the lowest I have ever shot is a 54 (and I should not have, see Ruby's SS on 5/19/21). In the end, the decision is up to you which number you feel most comfortable giving insulin to Toeby. No one would fault you for not giving a shot or giving a smaller dose when the number is lower than you'd like it to be at shot time. You hold the needle. When following TR, the only thing about 50 that is really recommended to follow is to reduce the dose by .25 whenever the cat drops below 50 because that is a safety measure. We never want a cat to be spending much time below 50. Some CGs reduce a cat's dosage above 50, say when a cat is going from high carb to low carb food and they are screeching down the dosing ladder, but for the most part we want a cat to stay between 50-80 as much as possible (what we call surfing) because it's been seen on this forum that cats who spend more time in that range have a better probability of healing their pancreas and potentially achieving remission. That's why we recommend feeding medium carb food if the cat is between 50-59 and low carb food for any number above 60 so as to not boost the number too high and miss the opportunity for that healing to happen.

Does this make sense?

Really glad that the everyday dose of budesonide is working better. I understand what your vet is saying about not trying to control too tightly--I'm going through a similar struggle to you with Ruby and her prednisolone. Thankfully Ruby doesn't drop into limes that often <anti-jinx>, and so far I think I've found a dose of insulin that works well with her dose of pred. But this changes day to day with the added variable of GI flares that cause her BGs to go up. In the end, we do the best that we can while trying to keep the cat safe.

 

Thanks so much for this, Katherine - I obviously have to re-read that information on that sticky and get more familiar with it.
It looks like it was right under the one I went to last night, and I didn't see it.
And yes, your explanation makes great sense.
I appreciate your taking the time to flesh out the reasoning on shooting lower numbers, and I think you understand my fears too, which is supportive.
We're all doing our best to make our cats better, and sometimes I fear pushing him too low.
I think that's understandable... and I think you get that too, so it's nice to know someone else gets it.

 

PMPS 119
Oddly, Toeby vomited a small amount of watery bile right before supper and testing tonight.
I'm hoping it was just because he is very hungry, not that the budesonide dose is too low, as he seemed to be doing so good on this.
He has vomited very infrequently in the last month or so, so I am not unduly concerned, but I will keep an eye on him.

 

I also hope that it's because he's really hungry.

 

+3 56
Gave him a teaspoon of Fancy Feast in Gravy Grilled, which the food charts show as being medium carb - 13%

I am happy that he seems to know to look for food when he is dropping.

 

Good boy Toeby! Ruby does that too. When she comes to me yowling for food I know it's time for a test and feed.