7/28 Moonie AMPS 97, +2 80, +6 122, PMPS 123, +2.5 160

[Connie & Parker & Moonie]

7/27 Moonie AMPS 247, +2 186, +10.5 116, PMPS 135, +2 91, +3 97

I had a big realization yesterday thanks to Marje that maybe I’ve loved Moonie a little selfishly. I’ve been pushing her body for better and better numbers, waking her up every hour or two with pokes. All while knowing that remission is just a very low probability outcome for us given we’re at year 2 of Moonie’s diagnosis.

So who am I really doing this for?

Moonie is relying on me to weigh the costs and benefits and make the right decisions for her. And any reasonable person looking at the situation objectively would say that I need to optimize for her quality of life so she can sleep in peace, so her ears aren’t sore, so we’re doing fun things together instead of doing pokes and shots all the time.

It’s just a hard pill for me to swallow. I’ve always been intensely competitive, and if I have a goal in mind, I don’t count the personal costs to myself if it means I can get it. It’s come back to bite me a lot in recent years and I didn’t realize that I was channeling that energy into Moonie’s care at her expense.

It’s just hard to change. As you know, we’ve been trialing a dose reduction at 2.75u. Parker thought it would get her bouncing to stop and hopefully flatten out at “good enough” numbers, and I hated the idea but I knew Moonie’s ears needed a break.

This morning we got 97, which means she was probably flat high greens all night. It’s basically what Parker wanted. I was honestly angry because I was looking forward to getting her back on 3u (telling myself that I’d reduce if we have to test too much). I spent the morning basically threatening Parker that he’ll be begging Satan to take him down to the depths of hell for his own safety if he stands between me and 3u tonight

But now I’m realizing - isn’t this what I said I’d do for Moonie? This is a dose that seems like it’ll keep her in 100-200 with minimal testing 4x a day. It just burns inside for me to accept. I feel very conflicted. I really want to go back to 3u and see if I can test infrequently enough (less than 6x a day) to make it work. But I can’t tell any more if that’s selfish, loving Moonie the way I want to love her rather than loving her the way she wants to be loved.

This is Moonie at her happiest, licking her little lips sniffing for human food she really shouldn’t be eating

 

[squeem3]

Not all cats go into remission. Take a look at Leroy. Squishy didn't go anywhere close to remission for 4 years and three different insulins and he had way less other issues than Leroy did. And I was ok with it. I knew I was doing everything right. I just had two lemons Don't feel bad if Moonie has her own ideas on what she wants to do on her FD journey

 

[Connie & Parker & Moonie]

Not all cats go into remission. Take a look at Leroy. Squishy didn't go anywhere close to remission for 4 years and three different insulins and he had way less other issues than Leroy did. And I was ok with it. I knew I was doing everything right. I just had two lemons Don't feel bad if Moonie has her own ideas on what she wants to do on her FD journey

Thank you so much! That makes me feel a lot better to know there were other happy loved kitties that walked the same path.

Can I ask - how did you know you were on the right dose? If you're not chasing remission and you want to optimize quality of life - did you aim for a dose that would get them <200 with 4-5 checks a day? I guess it was much more clear-cut when I was just going for the lowest possible nadirs in the 50-60s.

 

[squeem3]

Whatever dose kept bgs within or as close to the normal range as possible. With both lemons, there really wasn't one dose that worked for very long. I was always adjusting.

 

[Staci & Ivy]

Whatever dose kept bgs within or as close to the normal range as possible. With both lemons, there really wasn't one dose that worked for very long. I was always adjusting.

I completely agree with this!!
We do the best we can.
Sometimes remission is in the cards.
Sometimes not.
Quality of life for everyone is very important.
And keeping Moonie in the best numbers you can

I’ve been here 4 years trying to balance all of the conditions and Ivy’s temperament.
We do all we can.

You’re doing a wonderful job Connie

 

[Connie & Parker & Moonie]

Whatever dose kept bgs within or as close to the normal range as possible. With both lemons, there really wasn't one dose that worked for very long. I was always adjusting.

They sure knew how to keep you busy! Thank you.

I guess I'll just have to take Moonie's lead. Of course she has firm opinions about how to manage her diabetes too, just like everything else in life!

 

[Connie & Parker & Moonie]

I completely agree with this!!
We do the best we can.
Sometimes remission is in the cards.
Sometimes not.
Quality of life for everyone is very important.
And keeping Moonie in the best numbers you can

I’ve been here 4 years trying to balance all of the conditions and Ivy’s temperament.
We do all we can.

You’re doing a wonderful job Connie

Thank you so much for your kind words, Staci! I think I've just been so focused on the numbers that I haven't been keeping that in balance with her quality of life. I don't really care about my own, but I wish I'd thought more about whether the incremental poke was really worth it. So we'll be going with a new approach going forward and taking more of Moonie's lead

 

[Mary & Jude]

You know, sometimes there's magic with FD, and a kitty goes into remission, and other times there's just a caregiver over there trying their best, day in--day out. I often find myself saying, in relation to FD, I don't know. I look at all the kitties and watch how they handle the insulin. Some bounce up and down all day; some bounce at the end cycles and have greens in the middle; some make the caregiver dance all around the dose that remains steady for a good while and then suddenly drops a cat dangerously low--and when they take the decrease, the cat goes back up high. When they say ECID, that's probably all I do know, that and the fact that FD is a disease of uncertainty! It's a baffling disease, and I truly dislike it.

This morning when I got up for Jude's shot, I stood in front of his testing kit, about to get everything ready, and said aloud, "I'm so tired of doing this." And then I looked over at my gentle, sweet, "fluffy" little fella, laying on the couch looking up at me so trustingly, and I thought, imagine how tired he is of this!

My thoughts are rambling. I hope you find the magic for Moonie. I think we can have a part in the treatment plan, and you're doing your very best, but an awful lot of it depends on what her pancreas decides.

 

[Connie & Parker & Moonie]

You know, sometimes there's magic with FD, and a kitty goes into remission, and other times there's just a caregiver over there trying their best, day in--day out. I often find myself saying, in relation to FD, I don't know. I look at all the kitties and watch how they handle the insulin. Some bounce up and down all day; some bounce at the end cycles and have greens in the middle; some make the caregiver dance all around the dose that remains steady for a good while and then suddenly drops a cat dangerously low--and when they take the decrease, the cat goes back up high. When they say ECID, that's probably all I do know, that and the fact that FD is a disease of uncertainty! It's a baffling disease, and I truly dislike it.

This morning when I got up for Jude's shot, I stood in front of his testing kit, about to get everything ready, and said aloud, "I'm so tired of doing this." And then I looked over at my gentle, sweet, "fluffy" little fella, laying on the couch looking up at me so trustingly, and I thought, imagine how tired he is of this!

My thoughts are rambling. I hope you find the magic for Moonie. I think we can have a part in the treatment plan, and you're doing your very best, but an awful lot of it depends on what her pancreas decides.

Thanks Mary - you're totally right. Of course, like in all things, cat does what cat is going to do

It's both the most frustrating and magical part about living with a kitty. And I guess feline diabetes is no different!

I think it's hard to admit that you don't know, may never know, and that so much is outside of your control. It's something that I've always tried to work on, and I guess now is the perfect opportunity thanks to Miss Moons

 

[Marje and Gracie]

Thanks Mary - you're totally right. Of course, like in all things, cat does what cat is going to do

It's both the most frustrating and magical part about living with a kitty. And I guess feline diabetes is no different!

I think it's hard to admit that you don't know, may never know, and that so much is outside of your control. It's something that I've always tried to work on, and I guess now is the perfect opportunity thanks to Miss Moons

An excellent condo today and lots of good input. These are really nice numbers so see where she takes you after this. There is no rush to increase the dose. You always have it in your back pocket. Although Aunt Marje is not thrilled with Miss Moonie when she contradicts “rebound checks don’t work” by staying in nice numbers

A higher dose can affect up to six subsequent cycles and this is the sixth one. But she might just really like it right here and those are very decent numbers.

It’s a tough one, this FD dance. And as much as you are like me where I was willing to push myself to the edge of exhaustion, it took me about a year after Gracie passed to regain my health. Almost six years of little sleep, high anxiety really stressed my adrenals. We have to remember we can’t take care of them if we are beyond exhaustion.

 

[Connie & Parker & Moonie]

An excellent condo today and lots of good input. These are really nice numbers so see where she takes you after this. There is no rush to increase the dose. You always have it in your back pocket. Although Aunt Marje is not thrilled with Miss Moonie when she contradicts “rebound checks don’t work” by staying in nice numbers

A higher dose can affect up to six subsequent cycles and this is the sixth one. But she might just really like it right here and those are very decent numbers.

It’s a tough one, this FD dance. And as much as you are like me where I was willing to push myself to the edge of exhaustion, it took me about a year after Gracie passed to regain my health. Almost six years of little sleep, high anxiety really stressed my adrenals. We have to remember we can’t take care of them if we are beyond exhaustion.

I KNOW! I was also so mad when I saw the 97 this morning and took it all out on poor Parker . Of course she shows me a green when I need to prove my point and never when I really want her to!

If you don't think it's crazy, I probably will go back to 3u either tonight or more likely tomorrow am (since I can work from home and monitor more closely). But this time, I'll be taking Moonie's lead and reduce if she starts signaling that she needs a testing break again. And we'll never go back to a dose where I'm chasing the lowest possible dark greens and doing 10-15 tests a day. My goal is to be able to sustain her in mostly blues and greens with 5-6 tests a day, or 4 if she signals that she needs it. I do think she's been more affectionate this week because we've had so much more quality time together vs. just a groggy me poking her ear.

And I hear you on the health thing. I spent most of the last 10 years working crazy hours and as I approach my late 30s, it's really starting to catch up with me and I've been spending a lot more time focusing on my health. Before this latest stretch with Moonie I mean . And you're right, I've made mistakes already with the kitties being so tired, and it's important that I'm thinking clearly to make the best decisions for them.

Thanks again for everything Marje

 

[Marje and Gracie]

I KNOW! I was also so mad when I saw the 97 this morning and took it all out on poor Parker . Of course she shows me a green when I need to prove my point and never when I really want her to!

If you don't think it's crazy, I probably will go back to 3u either tonight or more likely tomorrow am (since I can work from home and monitor more closely). But this time, I'll be taking Moonie's lead and reduce if she starts signaling that she needs a testing break again. And we'll never go back to a dose where I'm chasing the lowest possible dark greens and doing 10-15 tests a day. My goal is to be able to sustain her in mostly blues and greens with 5-6 tests a day, or 4 if she signals that she needs it. I do think she's been more affectionate this week because we've had so much more quality time together vs. just a groggy me poking her ear.

And I hear you on the health thing. I spent most of the last 10 years working crazy hours and as I approach my late 30s, it's really starting to catch up with me and I've been spending a lot more time focusing on my health. Before this latest stretch with Moonie I mean . And you're right, I've made mistakes already with the kitties being so tired, and it's important that I'm thinking clearly to make the best decisions for them.

Thanks again for everything Marje

You’re welcome! Yeah exhaustion makes us do crazy things. I read you put your iPhone in the frig. Well, one morning instead of warming the rice sock in the microwave, I warmed the glucometer. 🫪 I was waiting at CVS at 7:30 when they opened to buy another. Important tip : always have more than one glucometer you trust.

She has room for an increase so I think it’s whenever you want to do it. I always think mornings are best because sometimes that first extra shot of insulin results in Lowe numbers and you are up all night but it’s really up to you and Parker. Or you . Sorry Parker.

 

[Connie & Parker & Moonie]

You’re welcome! Yeah exhaustion makes us do crazy things. I read you put your iPhone in the frig. Well, one morning instead of warming the rice sock in the microwave, I warmed the glucometer. 🫪 I was waiting at CVS at 7:30 when they opened to buy another. Important tip : always have more than one glucometer you trust.

She has room for an increase so I think it’s whenever you want to do it. I always think mornings are best because sometimes that first extra shot of insulin results in Lowe numbers and you are up all night but it’s really up to you and Parker. Or you . Sorry Parker.

Thanks Marje! I think mornings are best too just because I feel more confident in my ability to watch her.

Microwaving the glucometer! That is just too funny! I'm just glad the microwave didn't explode or something

 

[Seth&Bell]

You’re welcome! Yeah exhaustion makes us do crazy things. I read you put your iPhone in the frig. Well, one morning instead of warming the rice sock in the microwave, I warmed the glucometer. 🫪 I was waiting at CVS at 7:30 when they opened to buy another. Important tip : always have more than one glucometer you trust.

She has room for an increase so I think it’s whenever you want to do it. I always think mornings are best because sometimes that first extra shot of insulin results in Lowe numbers and you are up all night but it’s really up to you and Parker. Or you . Sorry Parker.

This made me spit out some tea

 

[Seth&Bell]

Good stuff all around. I will just add that you don't have to make a decision and stick with it forever. Experiment and find a good balance for you (I should prolly take my own advice here). There have been plenty of folks here who have bounced between TR and SLGS depending on where they were at in their life.

 

[Christie & Maverick]

A little late to the party, but I’ll add something I haven’t ever shared. When Mav was diagnosed I was adamant that I could get him to remission. Because after all, that’s the goal right? So we jumped through every hoop. Remove dry food . Adjust dose per required dosing methods . So here’s what I’ve never mentioned. I used to work downtown (a solid 30 minute drive both ways) and was absolutely distraught at the idea that I didn’t know what his BG was on Lantus around nadir, so I’d drive home, check his levels, then drive back. All with the goal that I was sure I could get him to remission. I did that for four months then actually quit my job because it was killing me, literally a massive mental breakdown. The job actually sucked too which made the decision pretty easy . So what am I saying? I never could get Mav to remission, but after a few years I was okay with that, and all I wanted was a happy and healthy cat. It can mess with you a bit here, watching cats go into remission, or when cats just snap into place and lo and behold, beautiful numbers, without much effort. Some cats are just easy. Doesn’t mean you aren’t doing everything right, and maybe that’s the ultimate message.

 

[Seth&Bell]

Thanks for sharing that Christie, and I’m sorry you went through it. That reminds me of the trajectory my current work situation is on. 15 minute commute instead of 30 for me. It is wearing on me big time

 

[Connie & Parker & Moonie]

A little late to the party, but I’ll add something I haven’t ever shared. When Mav was diagnosed I was adamant that I could get him to remission. Because after all, that’s the goal right? So we jumped through every hoop. Remove dry food . Adjust dose per required dosing methods . So here’s what I’ve never mentioned. I used to work downtown (a solid 30 minute drive both ways) and was absolutely distraught at the idea that I didn’t know what his BG was on Lantus around nadir, so I’d drive home, check his levels, then drive back. All with the goal that I was sure I could get him to remission. I did that for four months then actually quit my job because it was killing me, literally a massive mental breakdown. The job actually sucked too which made the decision pretty easy . So what am I saying? I never could get Mav to remission, but after a few years I was okay with that, and all I wanted was a happy and healthy cat. It can mess with you a bit here, watching cats go into remission, or when cats just snap into place and lo and behold, beautiful numbers, without much effort. Some cats are just easy. Doesn’t mean you aren’t doing everything right, and maybe that’s the ultimate message.

Thank you so much for sharing this, Christie.

I admit I’ve been deprioritizing a lot of other aspects of my life because even the smallest hope of remission was enough for me to single-mindedly pursue it at any cost. I was convinced that I was going to send a one year update to Moonie’s shelter that Moonie was now in remission. I admit, I’ve also rushed home in the middle of the day (30-40 min commute one way) just to check on Moonie because I was so paranoid about her numbers.

You’re right that it does mess with you when you’re trying so hard and not seeing the numbers reflect your efforts even when you are “doing everything right.” And then you start questioning yourself and everything you’re doing. And then the blood glucose numbers almost become a real time scoreboard or indictment of you as a caregiver. You’re right that process and outcome, while often correlated, are not the same thing. You can still do everything right and have bouncy diabetic numbers.

I think for a bit I forgot what my end goal is - which is what you said - to have a happy and healthy cat. And I’m going to be asking myself that question every day instead of just mindlessly trying to get her to the lowest dark greens possible. I want to spend more time petting her, chasing her around the yard, and giving her belly rubs. I don’t like that most of our interactions in the past month have been tests. When I think about Moonie, I want to think first and foremost about her little sugary powder lips that come up in a smile when she sleeps in the sun, or her insane ability to creep up behind you when there’s food around. I don’t want my first thought of her to be what number she was just at.

Thank you again for sharing your hard earned wisdom