? BG trending up, tripping, plantigrade stance

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Butterscotch's Pawrents

Butterscotch's Pawrents

Member Since 2019
Over the past week, we've seen Butterscotch's BGs trend upwards after some nice time spent in the blue and yellow numbers. We've also witnessed a lot of slipping and tripping over the past several days on the hardwood floor, with each day worse than the one before. Today, she slipped and fell onto her rear while on the hardwood floor and tripped on the carpeted floor knocking into her water bowl, and is now walking with her hocks very close to the ground (this is new as of a maybe 2 days). Although it seems that neuropathy is mostly symmetrical, it does seem that her left hock is mostly the one touching the ground and she looks like she is limping. She noticeably lost significant muscle mass particularly in her hind legs at the time of her diagnosis and her rear legs feel kind of creaky/clicky? when you handle them and she likely has arthritis.

If anyone could review our spreadsheet, we are wondering if her BG trend looks normal. Is it normal for them to get so many blue/yellow numbers and then without any notable change suddenly start seeing all yellow and now pink?

Since she was in mostly the blue/yellow range recently, does it seem unusual that her rear leg instability/presumed neuropathy to progressively worsen? I know it takes time for neuropathy to improve, but she didn't even really show signs of any significant neuropathy upon diagnosis or even for the first couple of weeks there after.

We're wondering if anybody has time to review Butterscotch's spreadsheet and/or to offer any advice or feedback.
 
I think she needs more insulin but since you're doing SLGS, you can't go up just yet. Is there a reason you aren't doing Tight Regulation? That would allow you to increase as often as every 3 days if you're not getting the numbers you want.

As for the left leg, I wonder if when she "slipped", she might have pulled a muscle so it's more tender?
 
Thanks for the suggestions. We had actually just been discussing potentially going to TR. I guess we had originally chosen to go with SLGS because we were a little nervous about adjusting insulin so aggressively when we first started. What are the pros and cons of TR vs SLGS, and what are reasons to/not to switch?

Great thought on the pulled muscle/injury. We're going to continue to keep an eye on her.
 
Sheba had neuropathy and used to slip and slide on the floorboards. Sometimes she looked as if her legs were going to give way as she lurched to one side. Other times she wasn't too bad. She lost a lot of muscle mass but she regained it all eventually and her neuropathy resolved completely as well.

I agree with Chris about a dose increase.
The "fat" and "skinnny" doses are usually kept for tweaking the dose when you are really close to the best dose for Regulation.

The two main differences between the TR and the SLGS are with TR you can increase every 3 days if indicated and 7 days for SLGS, and the number for a decrease is 50 for TR and it is 90 for SLGS.
Also you need to be feeding a completely wet diet to do TR

I think a pro for TR is that you don't have to wait for a week to do an increase which, if your cat is languishing in high numbers, is a real plus. The longer a cat stays on high numbers the greater the risk of some insulin resistance

They are both good methods. You need to choose the one that will suit you and your cat best.
You have tried SLGS and you can see there are some drawbacks for you.
Things to consider include how often you can test ....and you look as if you can test fairly frequently and do you have to leave Buttescotch for long periods of time. Is she a good eater?

I can't think of any reason for you not to swap......if you find it is not for you, you can always change back to SLGS.
 
As discussed on your other post, you could also start some B12 (Zobaline or similar) to help with the neuropathy.
 
Bron and Sheba (GA) said:
Sheba had neuropathy and used to slip and slide on the floorboards. Sometimes she looked as if her legs were going to give way as she lurched to one side. Other times she wasn't too bad. She lost a lot of muscle mass but she regained it all eventually and her neuropathy resolved completely as well.

I agree with Chris about a dose increase.
The "fat" and "skinnny" doses are usually kept for tweaking the dose when you are really close to the best dose for Regulation.

The two main differences between the TR and the SLGS are with TR you can increase every 3 days if indicated and 7 days for SLGS, and the number for a decrease is 50 for TR and it is 90 for SLGS.
Also you need to be feeding a completely wet diet to do TR

I think a pro for TR is that you don't have to wait for a week to do an increase which, if your cat is languishing in high numbers, is a real plus. The longer a cat stays on high numbers the greater the risk of some insulin resistance

They are both good methods. You need to choose the one that will suit you and your cat best.
You have tried SLGS and you can see there are some drawbacks for you.
Things to consider include how often you can test ....and you look as if you can test fairly frequently and do you have to leave Buttescotch for long periods of time. Is she a good eater?

I can't think of any reason for you not to swap......if you find it is not for you, you can always change back to SLGS.
Click to expand...

Chris & China (GA) said:
I think she needs more insulin but since you're doing SLGS, you can't go up just yet. Is there a reason you aren't doing Tight Regulation? That would allow you to increase as often as every 3 days if you're not getting the numbers you want.

As for the left leg, I wonder if when she "slipped", she might have pulled a muscle so it's more tender?
Click to expand...

We are doing a full curve today and are switching to TR tonight.

We do have to leave Butterscotch alone twice a week for about 10 hr. I guess I'm concerned about limited testing on those 2 days. We can check the AMPS and PMPS of course and could do a +2 and/or +4 during the PM cycle on those 2 days. The other 5 days a week we can be home and test whenever. Do you think that is ok while on TR?

What is the minimum amount of testing one must typically do per day on TR?
 
Typically testing before shots and at least one other time during the cycle is usual. But if you have to work, then you test either before you leave or when you get home and then at night. What you are plannning to do is fine.
I'm sure you will be fine. You will get a pretty good idea on the 5 days what to expect and if you have any concerns about leaving Butterscotch, then post and ask for advice.
Lots of people work and do TR but I do understand your concerns.
Looking forward to seeing Butterscotch's SS inthe coming weeks.
 
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