8-Jan: Tyler &M: AMPS=290: +2=223: +3=146: +4=124: +7=212: PMPS=292: +1=299: +1.5=263: +2=214:+3=158

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PussCatPrince - GA

Member Since 2017
Yesterday Condo 7th Jan.

In this morning's non-cat news. The husband is back to normal hours after the Xmas/NY shut-down and no longer on-call. After the storms of the past week the weather is rather glorious.
The silence about the house is ------> insert word of choice ------> deafening/golden :p

In pusscat news. Ty did a good poo out in the garden. How do I know that? He brought much of it back stuck to his ahem. I've tackled that single handed with a very firm grip. Just need to track down the poopetydoop to see if a squished log or a soft walnut whip.

The things we do. :cat:

Meant to write :
He got fed as usual at his AMPS & I fed a mini meal at his +2.
 
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I finally made it over to look at Ty’s SS and see if I can offer some thoughts.

Please forgive me if I repeat things you’ve seen before. I don’t get around to every condo and don’t have time, right now, to read all the way back to day one with Ty. :rolleyes:

I’m sure I sound very repetitive but I see too many members not grabbing a +2 test every cycle that they can. I have members tell me their cat doesn’t do anything until +3 but then I see these huge drops which tells me that they onset at +2 (or maybe even earlier like Asia does).
Big drops = bounces which is a cycle that can be preventable and will also help you hold a dose longer.

You’ve done a great job of getting those +2 tests lately and I encourage you to keep it up every cycle that you can. If the +2 is more than meter variance higher than the PS, it’s likely to be a slow cycle. If it’s about the same or lower (within meter variance), you will likely see the BG come down, nadir, and go back up. If it’s more than meter variance below (like 1/7), it’s likely to be a very busy cycle.

Are you aware of his onset, nadir, and duration? Can you look at his SS and see what these are? That’s all very important for you to know in order to help him.

As @Stacy & Asia said yesterday, the goal is to feed consistently in order to stop those big drops so he doesn’t just bounce again like he did yesterday. She’s also correct that when they clear the bounce, they often do it with a little drama (e.g. that 58 yesterday) and can drop below the reduction point. What I learned about my Gracie early on is if I gave her a reduction for a BG just under 50 on a bounce clearing cycle, she didn’t hold the reduction. If she dropped into the 40s or below, I reduced for safety.

The goal is to hold the dose as long as you can, safely, so the kitty can get into green healing numbers. We can hold the dose longer, safely by:
  • feeding consistently with LC food (although a few kitties, like Girlie, needed MC food) early in the cycle to slow the drop. When you start out trying to do that, I think it also helps to get a +1 to see if he has a food spike before he drops or when he actually starts dropping. Stacy found out with Asia that she started dropping with +1.
  • watching for patterns; flat yellow typically means an active cycle coming up. You can see this on the evening cycle of 1/3 when he was flat and then cleared the bounce the next cycle.
  • watch for the “high before the break”. Good example is also 1/3 where he was flat the evening of 1/3 and then the AMPS popped up (high before the break) and then he came down. Not all cats do this and the ones that do, don’t necessarily do it consistently. It can also be much more remarkable than Ty’s. In other words, the “typical” picture of it (for example) is kitty goes up into pink, comes down to low yellow (you think....awww...good numbers coming), and then goes back up to high pink or even red followed by a big drop down.
  • watch for early loss of duration which can be spotted when the BG goes up fast in a cycle (often before mid cycle for Lantus) after lower numbers but then comes back down after the next shot. Some people think it means they bounced and cleared quickly. And some cats will clear bounces quickly as the dose gets closer to being a good dose. However, if the BG goes back up really fast and then comes back down after the next shot, it’s likely a duration issue.
Again...sorry to ask you a question that I am positive you’ve answered (and no pressure here, I’m just curious), you are testing plenty enough for TR. Any reason why you are doing SLGS instead?

Ty looks pretty good to me for one who hasn’t been dx and on insulin for long.

Please let me know if this is helpful, if you have questions, etc.
 
Please let me know if this is helpful, if you have questions, etc.

@Marje and Gracie .
Thank you so much for coming by Ty & me & running your knowledgeable eyes over our efforts. Incredibly helpful . I keep on reading it to see if I can get it to stick in my head.
Sometimes I can see the pattern thing and then not.

Marje & Gracie said:
Are you aware of his onset, nadir, and duration? Can you look at his SS and see what these are?

I've understood the nadir is the lowest point in the cycle and for Tyler with the AMPS cycle this will be earlier rather than later.
Not sure about the duration or how to know . unless it is how long the numbers lower before they start to rise? Whether with food/no food.
Onset - I suppose it must mean the point when the numbers dip after the insulin is given ? If so , I need to ear test earlier than +2 as I feel he almost immediately dips.
Don't quite understand why a PMPS cycle will differ to an AMPS cycle unless it is because it is overnight.

I really don't mind repetition and questions if it helps me understand more easily . It's all about Tyler and I am just so grateful and pleased that people like you are there for me and Tyler as we travel along this road together.

Re TR and SLGS.
I wasn't really sure what I was doing at all, then someone asked as there was nothing in the SS. Looking at what was required I felt it was more SLGS. I'll list the reasons as that is easier.
1 - TS states a low carb diet. Tyler's food is 10 or 12 carb . I would like lower but that is all I can get of wet canned food here in NZ, despite best efforts to source the foods other people can give. I t needs to be low phos as poss coz of the CKD. I would be looking at a home made food diet to get the carbs lower but the time of year has been wrong for that the past few weeks. I also need to source supplements and pay attn to the CKD with any diet I do. Bron and Sheba have written a diet I can look at and hope to copy but I need the time to achieve that.

2 - The TR testing asks for every 3 hours which concerned me as good sleep for both myself and husband is important to stay safe - particularly husband . I can do tests most days with a rearranged personal work schedule but overnights would be a tough call. I cannot make the AMPS earlier than an 8.30am at the moment. That makes PMPS 8.30pm. If we both have to rise early then we won't be up late but the insulin dosing needs to be rigid. Working day one could be looking at sleep around 9.30/10pm. it is the matching of our schedules with Tylers needs that needs to settle to what will work.

3 - I liked the firm instructions and guidelines but lack the confidence to know I would not mess up by being forgetful , missing something or just being eyes off the ball.

4 - Syringes. So far no luck with half measure syringes. In New Zealand there can be little choice and availability with all manner of items. It is down to supply and demand. Hence the issues over the foods that most everyone can easily get. The meters. The costs for strips. Even getting the darn strips. I will keep trying.

5 - Some things still need sorting for Tyler. The vet's approach for one thing. Pain meds - which may /may not be available. This does not effect my doing home testing and dosing for Tyler but I think pain meds - if I can get them - will effect Ty's well-being and so his BG. I may have that wrong.

6 - I am attracted to the TR though as it has a great rate of success re diabetes. I know I know ECID just like people. lol

Pleeeaaaaaasssseeeeee do drop by us again . I think it is my concern to cause Ty harm that holds me back on understanding what it is I need to see. I'm too close.

I'd give you a shiny thank you star smilie but there isn't one. So just know I have printed off your post and thank you so much.

.....& thanks to all of you that help me and Ty. You are all lovely. :bighug:
 
2 - The TR testing asks for every 3 hours which concerned me as good sleep for both myself and husband is important to stay safe - particularly husband

I'm not sure where you heard this....TR only requires testing at Pre-Shot and at least 1 other test somewhere mid-cycle.

Yes, some of us are testaholics but it's not required to do TR.

If at all possible, if you can get a mid-cycle on the AM cycle (like 5-7 hours after the shot) and a "before bed" test on the PM cycle, that's more than enough.....although sometimes there are going to be PM cycles where you will just have to either stay up later or set an alarm to get up and test to keep Tyler safe....this is where the extra tests come in handy....learning how quickly Ty responds to both the food and the insulin will help you to know when it's safe and when you need to get more tests in.

That's why we like that +2 so much....generally speaking, if the +2 is about the same as the PS, it's going to be a pretty normal cycle....gradually down to nadir and then back up again.

If the +2 is higher than the PS, that's usually the signal that a bounce is beginning and it's OK to take a pokey break and not test as much.

If the +2 is lower than the PS, that's your "early warning" that Ty might be going a lot lower later so it's important to either be able to get more tests in later in the cycle or leave some high carb food down to keep him safe.

Yes, the more you can test, the quicker you'll see the "patterns" we try to look for, but it's absolutely not necessary to test every 3 hours every cycle!
 
Ah ! I may have misread the every three hours as re-reading it seems to be for a new dx ?

REQUISITES WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR:
  • Kitty should be monitored closely the first three days when starting Lantus or Levemir.
    Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
    More monitoring may be needed.
  • It will be necessary to test kitty's blood glucose levels multiple times per day.
However, therein lies an issue over night testing. I have been able to get night tests whilst we have both been off work as you can see. Doing this now will need some thinking.

Re. leaving food down. That will be gromphed straight away. A timed feeder may be possible .

Anyway, off to prepare our own before bed meal and sort Tyler out. Tiz 8.15pm here & husband needs his sleep soon as up at silly o'clock.
 
So. Tested close after PMPS.

Fed at PMPS

Onset = around 90 minutes from insulin dose?

+1 was even. +1.5 was lower.

Fed a small amount in water. A sort of gruel / soup of food. It will be Iams grain free. Which is 8/10 carbs.

PMPS was Iams grain free with the methyl B12 etc. + a mix of raw chicken which he is accepting.
 
+2 still dropped. So will feed some Iams food again mixed with a little Royal Canin renal wet which is known as high carb.

Caveat. I can only work with what food is available to me at this time.

Anyone wish to help with a list of % carbs for canned foods , that would be so helpful , however this may not be available in NZ. Not much is.
 
Ah ! I may have misread the every three hours as re-reading it seems to be for a new dx ?

However, therein lies an issue over night testing. I have been able to get night tests whilst we have both been off work as you can see. Doing this now will need some thinking.

Re. leaving food down. That will be gromphed straight away. A timed feeder may be possible .

Anyway, off to prepare our own before bed meal and sort Tyler out. Tiz 8.15pm here & husband needs his sleep soon as up at silly o'clock.
The +3, +6, +9 tests refer to a kitty whose CG just started insulin. It wouldn’t apply to you and Ty.

My hubby is sick today so I’ll have to come back and respond to the other questions. Perhaps tonight after he’s gone to bed. I’m sorry for the delay and thanks for your patience.
 
The +3, +6, +9 tests refer to a kitty whose CG just started insulin. It wouldn’t apply to you and Ty.

My hubby is sick today so I’ll have to come back and respond to the other questions. Perhaps tonight after he’s gone to bed. I’m sorry for the delay and thanks for your patience.


Sick husbands . Ugh.

Someone bumped a long helpful post/ thread today & I read this. Maybe I have seen it several times but with all the info flashing around it didn't stick.

I have looked at the foods listings many times and come to the conclusion that most is not available to me and Ty. I think that perhaps 8-10 carbs in a food would be seen as medium?
High is that Royal Canin renal wet pouch.
Low carb? I can get Applaws pouches which are no carbs at all and low phos. Most low carbs available (FF) are very high in phos.

Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose,
Peak/Nadir - the lowest point in the cycle,
Duration - the length of time insulin continues to lower blood glucose,
 
Sick husbands . Ugh.

Someone bumped a long helpful post/ thread today & I read this. Maybe I have seen it several times but with all the info flashing around it didn't stick.

I have looked at the foods listings many times and come to the conclusion that most is not available to me and Ty. I think that perhaps 8-10 carbs in a food would be seen as medium?
High is that Royal Canin renal wet pouch.
Low carb? I can get Applaws pouches which are no carbs at all and low phos. Most low carbs available (FF) are very high in phos.
8-10% carbs are LC. In fact, many, many diabetic cats do better with carbs in that range than in the lower end (0-4%). Gracie did horrible on 0-3% carb foods and much better on the ones around 6-10%.
 
That's heartening to know thanks @Marje and Gracie given that what can be obtained is very limited. Has given me a little lift this morning.
You’re very welcome.

The point with TR is you don’t want to be feeding HC gravy or dry food all the time. We all understand there are limitations especially when you are trying to find a LC, low P food. It makes it more of a challenge. I know you are doing the absolute best you can for your boy!
 
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