9/7 Tigger AMPS 283, +4 155, +6 143, +8 107, +10 126, +12 121, +12.5 134, +13 109/116 shot 1u only

Moms2Tigger&Blu

Member Since 2018
So it seems to me like Tigger is having a good cycle, but his bounce was also breaking (PMPS last night was 417 and +4 was 330). I'm known to play it safe, possibly TOO safe, but if he doesn't come up [quite] a bit I don't know how I feel about shooting 1.75 in 2 hours . . . :nailbiting: . . . any pre-advice?
 
Hmm, okay. So right off the bat the dose variation the past 3 cycles is gonna make this a little more guess than not. Looks like Tigger isn't completely new to blues but is still very bouncy. I'd guess there was a bounce yesterday that was breaking this morning. Lunch 2 was kind of late in the day today, so the 121 pmps could be the tail end of the food bump, but, lunch 1 probably kept it a little higher than it would have otherwise gone, so you're probably looking at a "natural" low of 90ish. I would not do 1.75 and stick with the 1.5. Not sure where to dose adjustments came from but you're seeing nadirs < 200 and a lot of bouncing so holding the dose until the breaks clear more is well within reason.
 
I would stick with 1.75 units, as long as you can monitor. You want greens, 1.5 wasn’t giving that to you.
 
I feel its important to also note that Tigger seems to be pretty carb sensitive. I have never had trouble bringing him up during a low even with small amounts of gravy and sometimes even just a squirt of whipped cream. I say this because, despite previous insistances that it doesn't matter, his food change (about a month ago) from about 3 carbs to 4-6 and even 7.5 at times does matter to him. Had he not had the lunch of 7.5 carbs today he would have def went lower. Under 68? Prob not . . .but under 90? Yes, especially as 107 and 90 are barely a different number in the grand scheme of things. I'm sorry to say I just don't think this TR protocol is right for me. It may very well be BETTER for Tig, but really whats more important than safety? I don't know if I can handle it! The bounces, the intermittent inappetence (from IBD and CKD), the inability to get a mid day test 3-4 times a week . . . perhaps we should go back to SLGS. There was longer time between dose changes to see patterns and bounce and breaks. . . .

As for tonight I can monitor all night and have ample supplies but the car is gone til almost midnight . . . that scares me.
 
Hmm, okay. So right off the bat the dose variation the past 3 cycles is gonna make this a little more guess than not. Looks like Tigger isn't completely new to blues but is still very bouncy. I'd guess there was a bounce yesterday that was breaking this morning. Lunch 2 was kind of late in the day today, so the 121 pmps could be the tail end of the food bump, but, lunch 1 probably kept it a little higher than it would have otherwise gone, so you're probably looking at a "natural" low of 90ish. I would not do 1.75 and stick with the 1.5. Not sure where to dose adjustments came from but you're seeing nadirs < 200 and a lot of bouncing so holding the dose until the breaks clear more is well within reason.

here is previous thread for reference

http://www.felinediabetes.com/FDMB/threads/9-2-19-tigger-amps-253-all-flat-cycles.218876/
 
Had he not had the lunch of 7.5 carbs today he would have def went lower.
Yes, this is what I was saying. If you had not fed lunch 1, you would have gone green. I still stand by my recommendation to do 1.5 and not 1.75. Forcing the lower BG too early is just going to trigger more bounce

I'm sorry to say I just don't think this TR protocol is right for me
There's nothing in TR that says you're supposed to increase so fast just because you didn't see a green. The minimum threshold for an early increase on TR is 200 after 3 days and the window for an increase with numbers under 200 is 3-5 days. If this came up a couple days ago it would be a different story but with the 1 unit shot the other day, the cycle count resets. If anything it just reinforces the lower dose since the depot is theoretically smaller right now yet you're getting lower numbers.
 
Yes, this is what I was saying. If you had not fed lunch 1, you would have gone green. I still stand by my recommendation to do 1.5 and not 1.75. Forcing the lower BG too early is just going to trigger more bounce

134 after 30 min stall
I still want to shoot, but my fear is 1.5 will even be too much . . . or at this point am I just messing him up completely
 
Keeping Tigger at a dose where he doesn’t see green, will lead to higher bounces. It is only by seeing green that he gets used to normal numbers and slows the bouncing. Some cats give you a hint of what the dose can do on the first cycle after an increase. Wouldn’t it be nice to be at a dose where he sees as much blue as he saw today?

You hold the syringe. You wanted to give TR a trial while you had time to monitor. 90 is still in the safe zone. Do you have plenty of tests strips and high carb food?

Been a while, maybe test again to see what he is doing.
 
134 after 30 min stall
I still want to shoot, but my fear is 1.5 will even be too much . . . or at this point am I just messing him up completely
You said you're around and able to test, and that he's very carb sensitive so honey/caro should be very effective in steering. I'd do the 1.5, test at +2 and see what it looks like. I think you more than have it covered. And if he goes low, then at least we know and can handle it properly.
 
LOL, typed at the same t8me. Glad he is going up. There is no reason to think 1.5 is too much.
 
And if it helps, I'll be around to offer emotional support and guidance if needed. I plan on getting a +5 on Sebastian tonight at least, and I've got suspicion that he's going to break low and need steering any time now, so we may be in it together tonight. But at the very least I'll be checking in on you mid-cycle.
 
109/116 after 60 min. feeding. everyone's angry at me lol
I guess I wish I would have waited to increase until he was not breaking a bounce. But it seems there is always a reason not too. First he was 250+ at preshot and I had a weird feeling about that day (9/4), then he wasn't eating well the next day (9/5), then he was pretty low at pre shot and we couldn't test or leave work at lunch (9/6), and then the bounce break this am . . . I feel like I am always waiting for the perfect set of circumstances and that is just not how this works.
 
He’s dropping now from lack of food.

Sometimes you just have to bite the bullet and try something. There may never be a perfect timing for shooting lower. The first few times, I crossed everything and shot. And she bounced up.:rolleyes: I suspect Tigger will too.
 
If he was eating like a champ I might go for it, but he's been super picky for a few days now. I can't do it. I shot 1 unit, and I am sure he will be bouncing sky high soon enough, but still . . . atleast its something
 
Fair enough. How are you on syringe feeding? Sometimes when sebastian doesn't want to eat I just syringe it. A lot of the times he'll lick it off a plate but ive had to force feed before and, with a little cerenia for nausea, it gets the job done
 
Fair enough. How are you on syringe feeding? Sometimes when sebastian doesn't want to eat I just syringe it. A lot of the times he'll lick it off a plate but ive had to force feed before and, with a little cerenia for nausea, it gets the job done
97 @+2 starting to worry . . .
never had to force feed. he usually gets his appetite back later in the day or atmost the next day.
 
97 @+2 starting to worry . . .
never had to force feed. he usually gets his appetite back later in the day or atmost the next day.
Problem is the wet food really doesn't stay in the system very long, only like 2-3 hours, that's why it's important to get then eating several meals throughout the day.

So it's a drop but a slow one, only 10 points. He did eat dinner right? Full meal? Didn't seem to be any food spike, unless I misunderstood the timing. I would test again in an hour.
 
Problem is the wet food really doesn't stay in the system very long, only like 2-3 hours, that's why it's important to get then eating several meals throughout the day.

So it's a drop but a slow one, only 10 points. He did eat dinner right? Full meal? Didn't seem to be any food spike, unless I misunderstood the timing. I would test again in an hour.

no that's part of our problem - he has never eaten a full meal. the best he'll do is maybe 1/4. then come back and eat another 1/4 in an hour or so. I figure most of the time it works out cause he keeps getting little carb boosts. but it's nerve wracking. and there's no obvious reason. we know it's not tooth pain - he had all those removed including fangs. he has been the pickiest eater for 15 years. drop a piece of human dinner on the floor though and watch him chow! I think he had lots of people food when he was young (he was a stray living in a ditch behind our apartments when we rescued him. once saw him eat a bean burrito. no lie.)
 
the best he'll do is maybe 1/4. then come back and eat another 1/4 in an hour or so. I figure most of the time it works out cause he keeps getting little carb boosts.
Yeah that works and can help smooth things out.

So is the 97 at 1 or 2 hours after the dose? I see you delayed by an hour so I'm not 100% clear on where we're at. Onset is usually between 2 and 3 hours from dose so that's when you'll be wanting to watch for the drop speed to pick up. If it does start to increase you'll want to feed some carbs to try and slow it down. Not a lot, maybe like 1/2 a teaspoon of HC or 1 or two teaspoons of MC. It's a bit of trial and error to figure out how much carbs it takes to slow the drop without turning it into a rise at this point in the cycle.
 
Yeah that works and can help smooth things out.

So is the 97 at 1 or 2 hours after the dose? I see you delayed by an hour so I'm not 100% clear on where we're at. Onset is usually between 2 and 3 hours from dose so that's when you'll be wanting to watch for the drop speed to pick up. If it does start to increase you'll want to feed some carbs to try and slow it down. Not a lot, maybe like 1/2 a teaspoon of HC or 1 or two teaspoons of MC. It's a bit of trial and error to figure out how much carbs it takes to slow the drop without turning it into a rise at this point in the cycle.
The 97 was +2 after the shot
just now 81 @ +3
he's dropping steady but not plummeting thank goodness. im so happy i went with 1 unit but now im worried even that was too much
 
Keep note of how much whipped cream you fed. It'll come in handy in the future if you're wondering how much to feed to steer him.

Looks like it bumped him up. I'd test again at +6, whipped cream will start wearing off by then. Other than that it looks like you've got it.
 
Thanks for checking in on us. It's nice knowing someone else is out there.
126 @+6. Heading to bed though I may get a +7 too just to be extra safe. I can sleep tomorrow, right?!
 
Nice run in the lagoon last night...even though it kept mama up half the night...it was good to see him in the cool healing waters of the lagoon... You did good keeping watch and keeping him safe :)
 
Yeah, good run of numbers. Hard to tell exactly how big the depot was at that time but the 1u dose worked. Not entirely sure what the dose should be right now
 
Yeah, good run of numbers. Hard to tell exactly how big the depot was at that time but the 1u dose worked. Not entirely sure what the dose should be right now
I wasn't sure either. I expected a bigger bounce, but when he came up 243 (4 hours after 188) I decided to play it safe still. We shot 1.25 though I think 1.50 would have prob been fine. But I should have never increased to 1.75 when I did. I should have known too - he has never made it past 1.50 - always gets a lime number and earns a decrease. In fact looking back he never even made it to 1.50 this year at all! I'm sure I missed some chances and messed up a few decreases due to fear but he is a very sensitive cat. The only thing he ate last night was his regular food - and maybe only 2/3 of a meal - and a finger of whipped cream. no gravy.
 
I wasn't sure either. I expected a bigger bounce, but when he came up 243 (4 hours after 188) I decided to play it safe still. We shot 1.25 though I think 1.50 would have prob been fine. But I should have never increased to 1.75 when I did. I should have known too - he has never made it past 1.50 - always gets a lime number and earns a decrease. In fact looking back he never even made it to 1.50 this year at all! I'm sure I missed some chances and messed up a few decreases due to fear but he is a very sensitive cat. The only thing he ate last night was his regular food - and maybe only 2/3 of a meal - and a finger of whipped cream. no gravy.
So one of the things I've been suggesting a lot lately to people who are at the lower dosages and/or have a sensitive cat and finding themselves in this situation is to maybe try a 1/8u increase/decrease. If 1.25 is too little, and 1.5 is too much, 1.375 might be the answer. Might be getting a little too nitpicky but I figure it's something to consider.
 
I've thought about it but I feel like its hard enough to measure 1.25 when the syringes can sometimes be so inconsistent. I guess I could try calipers but that sounds just as difficult with small doses.

How was Sebastian last night?
 
Yeah I've never tried them so don't really know.

Sebastian has been great. He's gotten his energy back finally, been eating consistently and a normal amount, and is putting up some pretty good numbers.
that's great! he's had FD for a long time, huh? I can't imagine what that would be like. I guess we're lucky Tigger was already very old when diagnosed. And I felt like it was the worse thing in the world for him, but we got good at taking care of him real fast. It's not that hard you just gotta plan your entire life around his sched lol.

Then the CKD happened and I realized FD was easy compared to that. We know Tigger's remaining time is relatively short, vet has said anywhere from 4 months to 3 years - theres no way of telling. But I mean, there is a chance he is 17 years old. That would be the prognosis regardless of CKD! All I want is to make sure he is happy and thriving. I don't think he'd be very happy to change to the Rx food with 20 carbs. The time it would take for us to figure out how high to increase his dose would be all the time he has left. And being the picky eater we know he is there was no chance he'd take to it anyway - believe me we've tried.

So now, we wait, watch, test, get him to eat whatever food we can (within reason & that keeps the phos under 200 atleast), and love on him every minute we can. I've actually never seen him happier or snugglier - esp as we've finally let him into the bedroom this year - something he's wanted for 15 years!

Anyway thanks for listening to me and checking in, it's been a long 24 hours!
 
I had a cat with CKD, Diabetes (acromegaly), heart disease and lymphoma. Yes managing multiple conditions is hard.:bighug: My goal was to help Neko's kidneys by keeping her under renal threshold as much as possible. Those solid blue cycles are perfect for that. And my cat was happier too. Let Tigger be your guide.

The 1.5 unit depot is influencing the last couple cycles. It can influence 4-6 cycles after a reduction. I think 1.25 units will cause his numbers to drift up again.
 
I had a cat with CKD, Diabetes (acromegaly), heart disease and lymphoma. Yes managing multiple conditions is hard.:bighug: My goal was to help Neko's kidneys by keeping her under renal threshold as much as possible. Those solid blue cycles are perfect for that. And my cat was happier too. Let Tigger be your guide.

The 1.5 unit depot is influencing the last couple cycles. It can influence 4-6 cycles after a reduction. I think 1.25 units will cause his numbers to drift up again.
at this point i'm just going to go back to slgs. we can continue increasing on friday evenings and getting 5 - 7 straight cycles of testing day and night. its the best i can do
 
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