9/27 Fur Ball PMPS 133 +2/59 +3/58 +6.5/67 +9/83 +11/82

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GregFurBall

GregFurBall

Member Since 2012
Good morning LL-
Previous Condo

Overall its been a good week. Fur Ball seems to be adjusting to the frequent testing but ran away from Greg this morning (he does most of the testing). I go into work later today so plan on getting a +2 before I leave.

Hope everyone 'surfs' well today.

Karen
 
Re: 9/27 Fur Ball AMPS/113

Thanks Jane and Courtney-

Jane: we were wondering when we could go down on (or even stop) Fur Ball's insulin. It seems like he has been doing pretty good on the .25U but I realize it hasn't even been a week since we figured out Lantis and got consistent w/ our dosing. Do we need to be more consistent in the greens before a trial of OTJ? Just curious.
Karen
 
Re: 9/27 Fur Ball AMPS/113

I am by no means any expert, but after having Marje, Sienne, and Jane coach me the other day through Kismet's mid green surf, it is my understanding that you earn a reduction when you dip below 50 (demonstrates that the dose is too high).

If Fur Ball was my cat, I would try doing a curve over the weekend or when you have a day just to see just how low he is going. I thought dipping below 50 was to be prevented, but it's not that bad of a thing if you're there to guide it back up with food and syrup. I'm planning on doing another curve with Kismet (depending on how the rest of the week goes) to see if he's ready for another reduction, too!

Good luck, I hope you get to an OTJ trial soon!
 
Re: 9/27 Fur Ball AMPS/113

This is from the protocol sticky viewtopic.php?f=9&t=1581
Reducing the dose:

If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

If an attempted reduction fails, go right back up to the last good dose.

Try to go from 0.25u to 0.1u before stopping insulin completely.
Click to expand...
 
Re: 9/27 Fur Ball AMPS/113

Thanks Courtney-
We are planning to do another curve on Sat. I have a couple things going on in the early AM and Greg is on call but I hope to be home the rest of the day to work w/ Fur Ball. I need to get MC and HC as we don't have any of that in the house right now. He transitioned so quickly from dry to raw that I didn't buy anything else. :) I printed off the hypo tool kit so am getting everything organized in hopes of never having to use them!

Fur Ball hasn't dipped below 50 yet (that we know of) so maybe we need to stay where we are for a bit longer.
 
Re: 9/27 Fur Ball AMPS/113

He may have and you just don't know. Kismet was going from mid 50s to high 40s within 30 minute intervals. Check with Jane, Marje, Sienne or one of the other advice givers, they will be able to give you the best advice and plan of action. I'm excited for you and will be watching for Fur Ball's progress!
 
Re: 9/27 Fur Ball AMPS/113

Hi Karen

Going over your past few condos and SS now - we like to do that before giving advice so we don't miss important details :smile:

Be right back, but in the meantime: Your next step, if and when Furball shows readiness, would be 0.1u, not an OTJ trial. It's best to give insulin as long as safely possible to ensure the strongest possible remission, if that is where the cat is heading. This whole process is normally a marathon, not a sprint - becoming too focused on egtting OTJ really fast isn't that helpful, I'm afraid, even when things look incredibly promising. Patience, grasshopper, k?

Jane
 
Re: 9/27 Fur Ball AMPS/113 +2/50

HI Jane-
Hope you are on. FB just hit 50 at +2. I have to leave for work in 30 min and don't want to over react. What should I do first? All I have in the house if Raw and a can of LC food.
 
Re: 9/27 Fur Ball AMPS/113

GregFurBall said:
We were wondering when we could go down on (or even stop) Fur Ball's insulin. It seems like he has been doing pretty good on the .25U but I realize it hasn't even been a week since we figured out Lantis and got consistent w/ our dosing. Do we need to be more consistent in the greens before a trial of OTJ? Just curious. Karen
Click to expand...

The short answer is: YES. You do need to be patient, and give the current dose a chance to show you what it can do for Furball. It's only your 8th cycle. The nadirs, which is what we base dosing decisions on for Lantus, have been nowhere near reduction-territory. (Generally, we will advise a reduction when the cat drops below 50, and certainly when the cat drops below 40.) Yes, you did get a 61 already - but it's a far cry from, say a 41 - KWIM (Know What I Mean)?

Also, I know it was a few days back, but I noted that you fed kibble. Please don't. Furball is done with that. Dry food is the very devil with assessing numbers - it takes too long too long to be "useful" to get a cat out of low numbers, and it stays in the system for far too long, skweing the overall picture. Please don't feed it anymore. Instead, use HC (high carb = anything over 15% carbs, see the food lists), or in a pinch, karo/honey/syrup. Ok?

I would encourage you to consider a few other LL-Kitties - look at Dale's Max and his SS, to get a sense of one example of a cat going OTJ, and the give-and-take process involved. Look at Peter&Devon/Mocha's case, for the opposite example, i.e. a cat that takes 2 whole years to go OTJ. And some cats never will. I'd also like you to review the Stickies when you have time, especially the New to the Group sticky and the Tight Regulation Protocol sticky. You'll hear a catchphrase often around here, about "It's a marathon, not a sprint."

Don't misunderstand - Fur Ball's progress is very encouraging. But there are no guarantees. I don't mean to seem discouraging. You really are doing great :mrgreen: And there's every reason to hope you will keep making progress! But let's take it a step at a time, alright?

Review the stickies, look at some other kitties, and come back with any questions, ok? And you've every right to keep in mind that with the TR protocol, the remission rate is "84% for cats started on the protocol within 6 months of diagnosis, and 35% for cats that began more than 6 months after diagnosis." There's LOTS of hope :-D

Hope this helps!
Hugs!
Jane
 
Re: 9/27 Fur Ball AMPS/113 +2/50

GregFurBall said:
HI Jane-
Hope you are on. FB just hit 50 at +2. I have to leave for work in 30 min and don't want to over react. What should I do first? All I have in the house if Raw and a can of LC food.
Click to expand...

Just saw this. No HC canned, huh? BUY some for next time :lol:

For now, mix a couple of drops of honey/karo/syrup into 2 tsp of LC, and re-test in 20 minutes. Can you do that?

Will Greg be home to re-test?
Jane
 
Re: 9/27 Fur Ball AMPS/113 +2/50

Hi Jane-
Yes, we are in no 'hurry' to push Fur Ball beyond what he is ready for. I quickly read your post and will review more later. Hopefully you saw my last post...need advice on what to do currently w/ his low number. Should I cancel a client and stay home another hour?
 
Re: 9/27 Fur Ball AMPS/113 +2/50

Courtney=
that was my concern too. Way too early in the cycle. He is eating LC w/ karo right now and I'll test again.
 
Re: 9/27 Fur Ball AMPS/113 +2/50

Karen

Re-test 20 minutes from feeding LC&karo, ok?

Can Greg re-test, or is he out, too?

Also, when you have a chance, you can remove the 911. It's not an emergency. You're fine. We'll help you.

Jane
 
Re: 9/27 Fur Ball AMPS/113 +2/50

thanks Jane-
I removed the 911. Just wanted to make sure you saw it.

FB ate about 1 tsp of the LC w/ Karo but is off the couch preening himself. I will test in 10 min and see where the number is.

I'm a therapist at a community mental health center and I'm not able to take off today. I am able to cancel my 10:00am appt however as he is not in crisis. Then hopefully Greg could come home for an early/long lunch and get him through the nadir.

Thanks for your help. I had just been telling Courtney that FB transitioned so quickly from dry to raw that we have not been to the store to get come MC/HC for emergencies.
 
Re: 9/27 Fur Ball AMPS/113 +2/50

Yup, saw it! Thanks :lol: And thanks Courtney, too, for being vigilant! Great stuff!!

Karen - put MC and HC on your shopping list, k? :smile:

We're all in different timezones (and I for one am in Africa) - please can you re-post saying at what (+ Hours) you can still test, and at what (+ Hours) Greg can jump in?

Jane
 
Re: 9/27 Fur Ball AMPS/113 +2/50

Happy to help! Jane, I didn't see your response to Karen's +2 update and wanted to make sure you saw! I think we all posted at the same time ohmygod_smile

Good luck, Karen! You're in great hands here. I'm off to work but will check in later. Hope you all have a good day!
 
Re: 9/27 Fur Ball AMPS/113 +2/50

almost +2.5 (5min early) is at 54. He ate some LC w/ Karo at +2.25.

I am supposed to leave now, but if need be can stay until +3.5 and then Greg could be here probably about +4
 
Re: 9/27 Fur Ball AMPS/113 +2/50

If it's at all possible to stay, I'd urge you to stay. The half-hour gap from when you leave to when Greg comes home is ok - you can leave out food. Let's see how we go. Re-test 20-30 minutes from last test, ok?

Did you feed again at last test? If not, feed now - LC & 1 drop karo, ok?

LC will last longer, karo will wear off quickly.

PLeas also upate the SS as soon as you can, as you go along. It will help anyone jumping in to know where we are. :smile:

How are YOU? Ok?

You're doing GREAT! :-D

Hugs
Jane
 
Re: 9/27 Fur Ball AMPS/113 +2/50

thanks Jane-
He is not interested in eating anymore. He had breakfast at shot time and just ate 1tsp w/ Karo at +2.25. Do I try to put karo on his gums or wait it out with him?

I called my +3 client and canceled so that gives me another hr at home and then Greg will be home by +4.

I'm doing OK. Its just hard juggling 'life' w/ a DC right now.

He's on the couch preening himself so doesn't seem to be in any distress.

And yes, the SS is updated.
 
Re: 9/27 Fur Ball AMPS/113 +2/50

Woohoo, you're a star for updating the SS! Wonderful job!

Karo on the gums isn't necessary at this point. He did eat some LC&Karo. Let's see where he is 30 minutes after the last test, and go from there. He seems to be surfing the 50s, and yes, we'd prefer surfing the 60s or so, but for now, he is safe, you are there, watching him, and you both are fine.

ARe you happy doing that, waiting until 30 minutes after last test? If not, test 15-20 later. 30 minutes is a good window for carbs to kick in, that's what I'm suggesting it.

You are doing beautifully!
Jane
 
Re: 9/27 Fur Ball AMPS/113 +2/50

Hi Jane -
+3 is on the rise: 75.
Does that mean he is going to be on the rise or will he lower again since this low was so early in his cycle?

I'm guessing I should test again at +3.25 and +3.5 and then hand him off to Greg for the +4 testing? should I pick up the food right now. he is only used to eating at AMPS and PMPS.

thanks. Karen

Oh yeah, Jane, the dry is gone. We only gave it that once and I've continued to read FDMB and we will not be doing that again. he does not need any kitty crack. :)
 
Re: 9/27 Fur Ball AMPS/113 +2/50 +3/75

GregFurBall said:
Hi Jane - +3 is on the rise: 75. Does that mean he is going to be on the rise or will he lower again since this low was so early in his cycle? I'm guessing I should test again at +3.25 and +3.5 and then hand him off to Greg for the +4 testing? should I pick up the food right now. he is only used to eating at AMPS and PMPS. thanks. Karen
Click to expand...

Nice, that 75. Remember though, this is a carb-boost, and Fur Ball may well wobble back down. It's early in the cycle. He's had nadirs at (+4) and (+5). We don't have a great deal of data yet.

You don't need to test in 15 minutes. You can wait 30 minutes, ok? You can feed 1 tsp of LC, as well, to encourage a surf.

So: Re-test at (+3.5), and ask Greg to test the (+4). I wouldn't leave food out for continuous access right now, because we want to be sure we have a handle of when he eats. (Free-feeding is always an option later, but we'll discuss that at a later point if you want.)

Are you still feeling ok? You've done a wonderful job!!

Any questions?

Hugs
Jane
 
Re: 9/27 Fur Ball AMPS/113 +2/50 +3/75

He's snacking on the LC w/ Karo that was left over from the first mix. I just exchanged it for LC so as to not give him that extra HHHC. Its hard giving him the extra carbs as I don't want him to bounce later. But I do want him to surf and stay safe. Of course, he's probably thinking this is something special as he is not used to eating during the day. :-D Plus, he's laying on the couch and I brought his food bowl to him. Oh the life.

I'll test him again at +3.5.

Still doing OK. Thanks for the encouragement. Just wish I didn't have to go to work. But so grateful Greg is able to tag-team this one. He's never posted though so we'll see if I can get him on board for that!
 
Re: 9/27 Fur Ball AMPS/113 +2/50 +3/75

GregFurBall said:
He's snacking on the LC w/ Karo that was left over from the first mix. I just exchanged it for LC so as to not give him that extra HHHC. Its hard giving him the extra carbs as I don't want him to bounce later. But I do want him to surf and stay safe. Of course, he's probably thinking this is something special as he is not used to eating during the day. :-D Plus, he's laying on the couch and I brought his food bowl to him. Oh the life. I'll test him again at +3.5. Still doing OK. Thanks for the encouragement. Just wish I didn't have to go to work. But so grateful Greg is able to tag-team this one. He's never posted though so we'll see if I can get him on board for that!
Click to expand...

Ok, great! The bouncing thing is something that will most likely just keep happening until it doesn't

Fast drops, or low drops, or a combo of both, any trip to a range out of that kitty's current "normal" comfort zone - all those can trigger bounces. Bounces are good. They show you the liver is working. I know they're worrisome for the bean. But they're a normal reaction, and often, they just stop at some point, which is then great.

I understand not wanting to leave him! It's such a tough spot to be in!! But you're doing so beautifully, and Greg will be there a mere 30 minutes later. Depending on the number at (+3.5), you can encourage him to eat another tsp of LC, to help tide him over until Greg arrives.

Let's see where he is at next test! You're rocking this! Good job :mrgreen: Please do tell Greg I promise we don't bite :lol: And we'd be so pleased to have him post to make sure we can help if he needs it!

Hugs
Jane
 
Re: 9/27 Fur Ball AMPS/113 +2/50 +3/75 +3.5/83

His +3.5 was at 83. I feel good leaving now knowing that Greg will be home at +4.

He's still lying on the couch and seems to be doing fine. I know part of its the carbs but since he was on the rise, he should be fine for 30 min...right?
 
Re: 9/27 Fur Ball AMPS/113 +2/50 +3/75 +3.5/83

Yes, he should be fine. Looks like he's gearing up to bounce off those 50s a bit.

If you're anxious, leave out a tsp of LC for him. And do encourage Greg to post if and when he wants any feedback, ok? We're here to help.

Hugs
Jane
 
Re: 9/27 Fur Ball AMPS/113 +2/50 +3/75 +3.5/83

Ugh. I just posted and must have been logged on to long as it kicked me out to the login page. Now I have to write all over again.

Greg was able to go home at +4 and got a reading of 141. He wasn't able to stay so was not into learning how to post. But he did go back home for the +5.5 reading of 95 (he only works 5 min away which is nice; I'm about 25-30 min). However, he had a conference call at +6 so was not able to stay at home and monitor. I also haven't been able to talk with him. I don't know if he left out any food (I'm suspecting not) but am a bit nervous and hoping FB's numbers don't crash right now.

Its been hard to focus on my clients when 1/2 my brain is at home. Then we had a fire drill during my only 15 min break when I was going to update FDMB and talk with Greg. Ughhh. Definitely feeling some of the stress of having a DC but not much I can do about it right now. Probably worrying for nothing. FB's hopefully just surfing and enjoying his afternoon with the extra food this AM.

Well, need to get back to work, but wanted to send a quick update.
Thanks for listening to my venting!!!
 
Re: 9/27 Fur Ball AMPS/113 +2/50 PMPS 133 +2/59

Oi - What a long day. Fur Ball had an interesting morning and it appears we are on for the same kind of cycle this evening.

Recap:
AMPS was 113 Gave .25U
+2 = 50 I started work late so was able to get a +2 and was surprised by the 50 reading
+2.25 = FB ate 1tsp LC w/ Karo
+2.5 = 54
+2.75 - FB ate .5 tsp LC w/ Karo
+3 = 75
+3.25 = 1 tsp LC
+3.5 = 83 I had to go to work so Greg tag teamed and got the next reading
+4 = 141 He had to go back to work so wasn't able to get any more readings until
+5.5 = 95 He had conference calls and meetings all afternoon so didn't get a reading until
PMPS 133 - He gave him his usual dose of .25 U

I just got home from work and was able to get the +2 reading and it is 59.

At this point what should we do??? I haven't given him any food but will test him again. Do we need a +2.25 or just wait until +2.5

Thanks for the help.
 
Re: 9/27 Fur Ball AMPS/113 +2/50 PMPS 133 +2/59

You can wait until +2.5 and just have some food ready to go if you see a lower number. HC gravy is a good choice because it will raise the BG without filling up Fur Ball's tummy too quickly. If you feel more comfortable with a test at 2.25, that's fine too.

Carl
 
Re: 9/27 Fur Ball AMPS/113 +2/50 PMPS 133 +2/59

Thanks for stopping by Carl-
I'm going to get the +2.5 reading. Sadly, since Fur Ball transitioned so quickly from kibble to raw I only have a can of nature's variety LC on hand. MC and HC were on my list to get this weekend. Ughhh, had no idea we would be at this place so quickly.

I'll keep you posted.
 
Re: 9/27 Fur Ball AMPS/113 +2/50 PMPS 133 +2/59

Do you have karo or honey in the house? A few drops of that mixed into LC can serve as MC/HC in a pinch.

Carl
 
Re: 9/27 Fur Ball AMPS/113 +2/50 PMPS 133 +2/59

Bob- that's what I did this morning when he dipped to 50 at +2. That's the plan for tonight as well. :)

Thanks, Karen
 
Re: 9/27 Fur Ball AMPS/113 +2/50 PMPS 133 +2/59

He's 65 at +2.5. I guess we will just test again at +3 and see what happens. Let me know if there is something else we should do.

Karen
 
Re: 9/27 Fur Ball AMPS/113 +2/50 PMPS 133 +2/59

nope, nothing else right now. It's pretty much up to him and what he tells you at +3 :smile:

Carl
 
Re: 9/27 Fur Ball AMPS/113 +2/50 PMPS 133 +2/59

He's back down to 58 at +3. Do we just wait it out and test again at +3.5? Do we need to feed him yet or wait until it gets lower?

Karen
 
Re: 9/27 Fur Ball PMPS 133 +2/59 +3/58

Karen,
We try to not feed them unless they dip below 50 if possible. Unless he would normally be given a snack at a certain time. In that case, then you would just proceed as normal. 50's are good. If he had started this cycle in the 200s, then that's a big drop. But it's not a huge drop when he started at 133.

Carl
 
Re: 9/27 Fur Ball PMPS 133 +2/59 +3/58

At +3.5 his BG is 60. Since he is still early in the cycle how soon/often should we test him through the night. Its past my bedtime but we'll do what we need to to make sure he is safe. He was pretty playful this past 1/2 hour but is not too keen on being petted.

also, will we need to make any adjustments to his dosing in the morning. I have to leave for work by +1.5 so won't be around to monitor him.

Karen
 
Re: 9/27 Fur Ball PMPS 133 +2/59 +3/58

Karen

When they get into green like this,you want to feed a couple tsp of LC food and then retest in 30 mins. If they are still in the 50s, do it again. If he comes up, as he had, then try just one tsp of LC to get him to flatten out and surf.

Unti l you have a lot of data and know him well, I'd test every 30 min until he's above 80. You need to test tonight until you get two, rising no food influenced numbers.

It's best to post a +10 or +11 number in the morning and ask for help. If he doesn't go below 50 tonight, he wouldn't have earned a reduction. Shooting a reduced dose in the morning won't mean the numbers will be higher in the a.m. Cycle. Because of the cumulative nature of lantus, one dose builds upon the preceding dose and so you get depot action from one cycle to the next.
 
Re: 9/27 Fur Ball PMPS 133 +2/59 +3/58

Thanks Marje-
I gave him 1 tsp LC at +3.75 after I got your post. Just tested him at +4 and he's at 67. Guess I will wait 30 more min and test again.

I keep trying to remember how the depot works. I'm just worried about him dipping again tomorrow after his PS like he did this morning and again tonight. We are not going to be able to be home in the morning to monitor him.

Thanks for being there for us. This is exhausting!
Karen
 
Re: 9/27 Fur Ball PMPS 133 +2/59 +3/58

He's 63 at 4.5
Do I need to feed 1 tsp LC and test again in 30 min or skip the feeding and test again in 30 min?

Karen
 
Re: 9/27 Fur Ball PMPS 133 +2/59 +3/58

Good job, Karen :-D

Let's go over the feeding. It's good to have some food on board before they onset. Having food on board before +2 might help with the drops he's seeing. If you know how much food he is supposed to get (calories) then divide it up into some mini meals for him. Wen numbers start to come into green, feed 2 tsp LC, wait 30 min, test.

The goal is to get him to slide gently down and into nadir, and then surf for a while in the mid green numbers. What you shouldn't do is feed HC or karo if he's above 50. We aren't trying to prevent reductions. We are just feeding his normal food in the normal amounts...In other words, you are managing his curve with food.

If he goes into the 40s, first, see if he will come back up with LC. If not, give him a little gravy. I'm not a big fan of karo unless they are in the 20s/30s and you need to get them up fast or you have no MC or HC in the house...then you can add it to LC if they drop below 50. Some cats don't tolerate gravy and so their caregivers have to use honey or karo.

The depot for lantus is in the subcutaneous fat. When you first start giving insulin, the initial shots go into the depot so the ct is not using them...that's why we have you hold the initial starting dose. Once the depot is full, then the kitty uses the shot you are giving. Each shot builds upon the preceding one. When the shot given is too much for the cat to use, it goes into the depot which will then be full and numbers drop and often a reduction is earned. The depot can affect up to six subsequent cycles...it doesn't always in every cat but it can.

Des that help? Where are we now on BG.
 
Re: 9/27 Fur Ball PMPS 133 +2/59 +3/58 Question

Just saw your note! Hes surfing! Don't feed and retest in 30. Where are you in the cycle?
 
Re: 9/27 Fur Ball PMPS 133 +2/59 +3/58 Question

Thanks Marje-
I appreciate the information. I’m not a fan of feeding Karo to myself so hesitated on giving it to Fur Ball. :smile: Since he transitioned so quickly from kibble to raw I was not prepared w/ MC or HC on hand but had planned to get it this weekend. I did have a can of LC that I have been using today.

His feeding schedule: After PS I will put down his food. He gets about 2.5 ounces of raw. I’ve noticed that he will eat a bit, wander off to preen himself and then come back in 15-20 min and repeat the same process. We leave for work so are unable to feed during the day but that seems to be his pattern in the PM; nibbles on it through +2 until it is gone.

Greg’s patience has waned quickly and he wants to just get Fur Ball off insulin since he thinks we are causing his low BG. I’m too tired to be able to really help him understand this process. So, I’m just doing the testing and hoping the numbers will let us know what is best for Fur Ball.

I haven’t fed him since +3.75. I just tested him at +5 and his BG is 68. Guess he is surfing. Hopefully I can stay awake for another 30 min test....
Karen
 
Re: 9/27 Fur Ball PMPS 133 +2/59 +3/58 Question

I usually set my phone alarm....buzz so it doesn't wake up Mike :-D I'll be waiting for your nest test.
 
Re: 9/27 Fur Ball PMPS 133 +2/59 +3/58 Question

BG is 72 at +5.5. Do you think I would be safe to go to bed now? I know you said 80s but at least he has been on the rise for about 2 hrs.
 
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