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I am not sure where the concern is....he is holding steady, not really going up and in healing numbers.

The insulin doesn't guarantee that the blood levels will go down, you just have to hope they don't go up a lot.

Remember this is a marathon not a sprint. Don't get discouraged and think the protocol isn't working because one cycle doesn't go the way you think it should. You have to string all the cycles together to see what is going on.
 
Sandman said:
I really DID give some insulin this morning?!
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As was stated this is a marathon not a sprint.

My Tuxie has had similar readings some days where he should be going down but stays the same (which your readings are given the error factor) I would rather have numbers staying in a decent range, rather than the extreme bounces that my guy does. If a kitty can hold a number then it is a matter of wait and see if they will come down. After a few days then a dose increase could be considered depending on what the more experienced posters have to say. Hang in there...I would "kill" to have a spreadsheet like Mr Sluggo has for my Tuxie. :)
 
Looks like a nice cycle after all. :D Neko ranged all of 6 points last night. Some cycles are just like that. And remember meter variance can make small changes.
 
Since Lantus is a depot-style insulin and dosing decisions are primarily based on the nadir rather than preshot values, bouncing back and forth between two different doses like that may very well result in even wonkier numbers - not that Mr Sluggo's numbers are wonky to begin with. I would really try to stick with shooting the same dose both morning and evening, rather than toggling back and forth between two different doses.
 
I agree. As frustrating as it is, I think you need to work the protocol the way it is designed to work for at least a couple months before making changes and straying from it. Mr. Sluggo really can't show you what he can do with the protocol without a decent amount of time on it.

He did not become diabetic overnight and regulation and remission don't happen overnight either.

Even thougb you don't seem to think he is doing well, he is doing exceptionally well...

I guess my question to you would be what are your expectations for using this protocol? How quickly are you expecting it to work and what are ypu considering the protocol working? From where I am looking, it is working just fine.....

Patience has been the hardest part for me and there have been so many times I questioned everything....however, I stayed the course, worked the protocol and look at Skooter now....more importantly....look at how long it took us to get to this point.....we had gains, we had set backs. ..ups and downs but bottom line the protocol works when you give it the chance to work....
 
You run the risk of ketone development. Too many and you could wind up with diabetic ketoacidosis. Also, weight loss can provoke hepatic lipidosis, which can be fatal, too.
 
OK. Just making sure. Pick up either urine ketone test strips (KetoDiaStix or KetoStix or generic) or get a blood ketone meter - the Precision Xtra has had some decent reviews.
 
Post-sleep urine may be more concentrated and likely to show them if present.
Also check his breath, as 2 of 3 ketone types have a detectable odor (fruity or vinegary).
Monitor dehydration (see my signature link Secondary Monitoring Tools for details).
 
You absolutely want to go slow on the weight loss. If a cat loses weight too quickly the liver can literally clog up with fat. That's the Feline Hepatic Lipidosis that BJM mentioned. Stick with 1% of body weight per month - a cat with FHL is a cat that is seriously ill. We've seen it here and you don't want to risk it.

As far as the dose goes - think of every dose change as rocking the boat on a lake. In order to know what the dose can do, we let the dose settle - that essentially gives us a flat lake to look at. You're not the first person that has wanted to give a different dose am and pm - it has the effect of rocking the boat all the time. It can make it difficult to figure out what the dose is doing. You're better off splitting the difference and keeping the dose identical as much as possible, between both am/pm shots.
 
Sandman said:
I am disappointed both in the fact he's still on insulin after two months (though we're only a couple weeks into lantus) and particularly disappointed he keeps on popping a bit above the TR range (50-120 basis human meter). When first diagnosed, I did manage to get him off insulin in a month with prozinc, no less.
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I'm sure others have told you that treating FD is a marathon, not a sprint. Two months is not much time at all (it took Trixie over 3 years and about with pancreatitis to go into remission), and many cats just plain are insulin-dependent. Remission is the icing on the cake, but it doesn't always happen. Try to focus on the good here: You are lucky...Sluggo is very well-regulated, not bouncy at all, fairly predictable, and all that means he is healthy and doing very, very well. Hopefully he will go into remission, but if he doesn't, he is still in an extremely good position. There are many folks here who would give their right arm to be in your shoes.

Please go slowly with the weight loss. FHL can pop up very quickly...IMO, it is just not worth the risk, given how positive everything else is with Sluggo.
 
DKA = ketoacidosis, which is not what you are looking for in Atkins. And cats seem a bit more likely to do DKA, as opposed to just ketosis. The body's pH lowers and rapid respiration (a clue to monitor) may ensue in an attempt to compensate for the lowered/acidic pH.
 
As others are noting, giving different AM and PM doses is unlikely to get you the results you are anticipating.

More to the point, a dose of 1.75u has resulted in a nadir of 58. Given where this dose is taking Sluggo's BG, I'm not sure that raising the dose is wise. Remember, you are basing the dose on the nadir, not on the pre-shot number.

I'd also remind you that Sluggo is leading in this dance. You're following. This is not a process that can be forced.
 
Sandman, your desire to push Mr. Sluggo's healing process along scares me, quite honestly. To intentionally push him into a weight loss situation that induces ketones is dangerous. We see ketones here - anything more than a trace can accelerate into a crisis in the matter of one day, hours even.

Don't try to be more aggressive than is necessary. His situation has been developing for YEARS. He's not going to heal in a month or two. Attempting to push him into remission again, to try to make him lose weight too quickly - all of that adds up to stress on Mr. Sluggo's body that probably doesn't need to happen.

What he needs is to merrily spend as much time as possible in normal numbers - not hypo numbers, just the normal range. If he needs to lose weight, it needs to be slow.

You're experienced at anesthesiology. We're experienced at diabetic cats. We're not experts, but we're experienced. You've got a chorus of experienced people telling you that you need to relax and let Mr. Sluggo's body do its thing in his own time. If you had someone who had just read up some information on anesthesiology who wanted to ignore your experieced advice because of something they'd read, wouldn't you be alarmed? Saying the same things we're saying to you?

Sometimes the wisest you can be is to know what you don't know and to be willing to learn from those who know more than you. I'm just being honest with you before Mr. Sluggo is harmed.
 
You might also want to consider that dropping back food too much could potentially cause his numbers to drop rapidly in a cycle. Food is needed to work with the insulin. Without it, numbers can tank quickly.

While we normally don't see the kind of dives from numbers below 100 that we see from numbers above 200 or more, I have had Gracie drop from 90s to 30s in an hour. That can set off a big bounce even in a cat that might not have been bouncing.
 
You can delete all the comments you want. However, they can be restored at any time. They aren't "gone". As long as your posts remain within the confines of the terms of service of the board, the " KGB moderators " have no reason to act. Any actions by the mods are your fault. Not theirs.
 
Restore what you want. Delete what you want. You can't restore a post I don't put here.

Deletions are my fault says the moderator?

Well, consider the source.
 
Yes. If I delete something you say, it will be because you said something you should not have said. So your fault, and my job. If you delete something you said, it will because you were smart enough to realize you shouldn't have said it. Or because you want to hide what you said before anyone else reads it.
I've been doing this sort of stuff since you were in diapers, dude. You're no different than thousands of other people who never learned how to play well with others.

ETA - and for the record, I have never deleted, edited, or restored a single word you have posted. I just take offense with your referring to the mods as "KGB moderators" without having any clue who we are or what our jobs entail. I'm pretty sure all of us have more important things to do in life than playing "day care worker" for people like yourself.
 
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