Charlie 10/12 - Time for an increase

Karen & Charlie

Karen & Charlie

Member Since 2020
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It's been 2 weeks since Charlie's last increase. I'd like confirmation for a .25 increase in the AM (10/12).

Also, if someone has the time to explain it, I'd like to understand what's been going on with him the last 2 weeks. Reading about TR, it's made clear that consistent dosing is shown to work best and that you must know how your cat reacts to Lantus. Right now, I'm not understanding the data.
  • On 10/1 when he saw his first blues and then bounced it was explained why and I also was just reading Tilly's info to confirm what I was told. But, he seemed to not recover for longer than a few cycles.
  • On 10/4 he had a PM fur shot. Was that why it took 2 days to come back down?
  • Since 10/9 he is bouncing every day? How does that stop? If more insulin is going to bring his BG down even further, isn't that just more bouncing?
I chose TR, but I don't really know why, except that I read that the longer a cat has high BG, the less his chance is for remission and TR was faster. Everything I've read about TR explains how it's done. What I haven't seen explained, though, is what is the difference between TR and SLGS--e.g., is it only all about timing?

Thanks for helping me understand.
 
Hi!

I’m not able to give dosing advice, but wondered if you had given insulin on the pm cycle on 10/9, 10/10 and 10/11? It’s not on the SS.

Looks like you are going between periods of nice numbers and bounces. Though, doesn’t look like it takes too long to break them, which is good. Here is a good post on why that happens, and the answer on how to stop them, is time...and patience. :)

https://felinediabetes.com/FDMB/thr...1-1-295-2-281-8-346-increased-tonight.234063/
 
You are holding doses far longer than TR suggests you do. Doses with green nadirs can be held 10 cycles. If you do a fur shot or skip a shot, it does start the cycle count over, but you could have increased back on October 2nd.
Karen & Charlie said:
  • On 10/1 when he saw his first blues and then bounced it was explained why and I also was just reading Tilly's info to confirm what I was told. But, he seemed to not recover for longer than a few cycles.
  • On 10/4 he had a PM fur shot. Was that why it took 2 days to come back down?
  • Since 10/9 he is bouncing every day? How does that stop? If more insulin is going to bring his BG down even further, isn't that just more bouncing?
Click to expand...
Cats take up to six cycles to resolve a bounce. The bounce in Charlie's case was due to the blues he saw on the first - the first time in a while he's seem blues, so his body is used to higher numbers and "bounced" or dumped sugars to bring his numbers up to where he's used to. Count forward 6 cycles from those blues, and he might have broken the bounce that night, were it not for the fur shot. Side note - they always happen at the worst of times! :banghead: A fur shot depletes the depot, so you have to wait for the depot to build back up again. In the mean time, numbers can be higher. We don't really know for sure, as there were no night time tests the night of the 5th and 6th. He could have had nice numbers again and bounced again, but we don't know without data. The good news now is that he's seeing some green, and clearing bounces faster now.

Stopping bounces is really up to Charlie's body. Bounces will reduce or clear faster once his body starts getting used to normal BG numbers again. That means getting to a dose where he spends more time in safe green.
 
Wendy&Neko said:
You are holding doses far longer than TR suggests you do.
The good news now is that he's seeing some green, and clearing bounces faster now.
Click to expand...
Thanks for the explainer. I'm increasing to 2.25 when I shoot at 7AM Pacific (20 minutes).

Wendy&Neko said:
We don't really know for sure, as there were no night time tests the night of the 5th and 6th. He could have had nice numbers again and bounced again, but we don't know without data.
Click to expand...
I'm going to post separately inquiring about experience overnight testing, but I wonder if you've heard anecdotal experiences from your interactions with fur parents about this: I have a very stressful job and just can't function well without adequate sleep. I realize overnight testing is part of the job, but how do others handle it? And *how much* testing is necessary and in what conditions? For example, you mentioned my lack of overnight testing in relation to there now being insufficient data to determine if he's bouncing overnight--I would infer from that that I would need to overnight test every night so that there's adequate decision making data available. That may not be possible. I'm disheartened to realize I may not be in a position to continue this journey with Charlie.

Thank you for your candor.
 
You don't necessarily need to get up in the middle of the night all the time. If you can get a +2 or +3 before you go to bed, it can tell you a lot about how that cycle will go. If you see a big from from PMPS to that before bed test, then you know you need to test again, or leave a food out to keep him safer.

I don't see a post for today. But I do see that 53. Give him a couple tsps of low carb food, and test again in 30 minutes. We'd like him to level out there and not go any lower.
 
Wendy&Neko said:
I don't see a post for today. But I do see that 53. Give him a couple tsps of low carb food, and test again in 30 minutes. We'd like him to level out there and not go any lower.
Click to expand...
I posted right before I went to bed last night so it feels like it's a today post. I changed the title date, in case that's an acceptable option. If not, I'll move over to a new post.

He's a grazer so ate right after the +4 52. Tested now at 68.
 
No worries, stick with this post for now. Looks like Charlie is surfing those healing greens now. :D Glad he knew to get a snack to keep himself in good numbers.
 
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