Continuarion to borg the gorb

Good for you!! healthy indoor cats can live up to 20-25 years, Corky was diagnosed when he was 10 he will be 14 in July healthy as a log ! I’m more worried about him out living me! I’m 74 and also healthy as a log, but that worries me, George is in great hands stick around! It gets much much easier! You’ll be a pro in no time, if someone would’ve told me 4 years ago I would be helping other parents with FD I would’ve laughed, and here I am giving back what was so freely giving to me and Corky, LIFE!!
 
good morning! I went to sleep thinking of George, woke up the looking at his SS, did you test 2 hours after shot? is important, George will probably be Bouncing today with high and low numbers, but that is normal after no shot last nigh and a high BG this morning, hope you got a good rest last night, make sure you feed several small snacks or meals throughout the day.
 
CORKY said:
good morning! I went to sleep thinking of George, woke up the looking at his SS, did you test 2 hours after shot? is important, George will probably be Bouncing today with high and low numbers, but that is normal after no shot last nigh and a high BG this morning, hope you got a good rest last night, make sure you feed several small snacks or meals throughout the day.
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Ill check him when I get home, I had to go out and run errands after his shot unfortunately
 
CORKY said:
Now all your future posts will be on this thread. have you considered the CGM? for continuous BG readings. see link below

Getting Started With Continuous Glucose Monitors (CGMs) for Diabetic Cats
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I have considered it, my plan is to get one when I return to work. Im out of work due to an injury and I need to save money where I can hence why I went with the alphatrak instead of the continuous (I was going to be charged about 260 dollars for 2 of them as per my vet) so when I return to work in a month and have more money ill have the vet install one because I work in the pet store that the vet operates from
 
borg the gorb said:
I have considered it, my plan is to get one when I return to work. Im out of work due to an injury and I need to save money where I can hence why I went with the alphatrak instead of the continuous (I was going to be charged about 260 dollars for 2 of them as per my vet) so when I return to work in a month and have more money ill have the vet install one because I work in the pet store that the vet operates from
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That’s insane. You tell your vet to give a continuous prescription for the sensors and you can place that scrip at Walmart pharmacy. He’s charging commission and much more for the sensors. At Walmart the sensors are about $30.00 each is always good to have extra sensors in case they stop working, they do only last 14 days and you can replace it yourself is easy as pie, you program the sensor with an app on your phone or if you have an old phone you can use that it does not need to have service, the sensors are guaranteed by ABBOTT so if they stop working before the 14 days you call for replacement but you cannot say is for your cat! Also always keep the box of the sensor George will have one, because if you need to replace it they will request all the numbers on the box! And my gosh! The ALPHATRAK. Strips are $1.00?each get the ReliOn Premier (WALMART) I described at the beginning, you will still need to use it in case the sensor stops working , if the LIBRE gives you a low BG reading, you need to confirm manually and take the manual reading as value, this is one of its flaws and that the sensor may not reach the 14 days
 
CORKY said:
That’s insane. You tell your vet to give a continuous prescription for the sensors and you can place that scrip at Walmart pharmacy. He’s charging commission and much more for the sensors. At Walmart the sensors are about $30.00 each is always good to have extra sensors in case they stop working, they do only last 14 days and you can replace it yourself is easy as pie, you program the sensor with an app on your phone or if you have an old phone you can use that it does not need to have service, the sensors are guaranteed by ABBOTT so if they stop working before the 14 days you call for replacement but you cannot say is for your cat! Also always keep the box of the sensor George will have one, because if you need to replace it they will request all the numbers on the box! And my gosh! The ALPHATRAK. Strips are $1.00?each get the ReliOn Premier (WALMART) I described at the beginning, you will still need to use it in case the sensor stops working , if the LIBRE gives you a low BG reading, you need to confirm manually and take the manual reading as value, this is one of its flaws and that the sensor may not reach the 14 days
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Good to know. Thank you!
 
great, then test at 10:00M shoot with confidence, but test again two hours after shot, remember George is bouncing from not getting a shot last night, then test again two hours after that and bed time! Good job, I'll still be here if you need us!
 
CORKY said:
great, then test at 10:00M shoot with confidence, but test again two hours after shot, remember George is bouncing from not getting a shot last night, then test again two hours after that and bed time! Good job, I'll still be here if you need us!
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How long will the stabilisation phase (what im in with him right now, where im testing him constantly and adjusting his dosage) take? My husband is curious
 
borg the gorb said:
How long will the stabilisation phase (what im in with him right now, where im testing him constantly and adjusting his dosage) take? My husband is curious
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By next cycle ( tomorrow) then again, cats are unpredictable they love to keep us on our toes 😂he should start to stabilize the BG, then you can really start to see the effects of the insulin throughout the day from shot to shot
 
Zach, when you test before the shot, if the number is below 150, please check here on the forum before giving the shot. My guess is that he will be higher or at least right at 240, but we want to be sure he's not too low.

The stabilization phase is different for every cat. Take a look at Jude's spreadsheet--click 2024 at the bottom of the page, scroll down, and you'll see when he came out of remission. Then look at 2025, top of the page. I wasn't able to get his numbers down until 2025, around February/March. Also, regulation can depend on the type of dosing method you are following. Right now, you are following SLGS, which means that you will take dose reductions more frequently than if you were following TR (a more aggressive method of dosing). More frequent dose reductions can sometimes mean that it takes longer for the cat to get to regulation.
 
CORKY said:
By next cycle ( tomorrow) then again, cats are unpredictable they love to keep us on our toes 😂he should start to stabilize the BG, then you can really start to see the effects of the insulin throughout the day from shot to shot
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Mary & Jude said:
Zach, when you test before the shot, if the number is below 150, please check here on the forum before giving the shot. My guess is that he will be higher or at least right at 240, but we want to be sure he's not too low.

The stabilization phase is different for every cat. Take a look at Jude's spreadsheet--click 2024 at the bottom of the page, scroll down, and you'll see when he came out of remission. Then look at 2025, top of the page. I wasn't able to get his numbers down until 2025, around February/March. Also, regulation can depend on the type of dosing method you are following. Right now, you are following SLGS, which means that you will take dose reductions more frequently than if you were following TR (a more aggressive method of dosing). More frequent dose reductions can sometimes mean that it takes longer for the cat to get to regulation.
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So anything >150 is no insulin, got it. Thats good to know

It may be worth it to get the CGM then. I can test him with the alphatrak but he seems to get really distressed about it, and the less I stress him out the better
 
borg the gorb said:
So anything >150 is no insulin, got it. Thats good to know

It may be worth it to get the CGM then. I can test him with the alphatrak but he seems to get really distressed about it, and the less I stress him out the better
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No--for NOW, you want to post here if it's below 150. The "no insulin below 150" is a basic guideline for newly diagnosed kitties following SLGS (see below--I've posted an excerpt from the guideline sticky). Recall last night that Marje offered some guidelines for you in case George went below 150 at the preshot:

Here is what she said:
"Whether you shoot tonight depends on a few things but if he is below 150 and has never had any ketones, I wouldn’t advise you to shoot. What you can do is stall without feeding and see if the BG rises by testing every 30 minutes and as soon as it’s above 200, you can shoot 3u provided:
--it is not more than two hours past his normal shot time
--you have all the supplies you need (strips, HC food/gravy) to test him
--you can stay up as late as you need to test him
--someone on the board agrees to stay with you and help you. This is most likely the limiting factor."

I don't think it's going to be an issue in any event because he is currently at 240, and I suspect he will remain at that number or go higher by the time of his preshot. Let's see what happens.

Also, I'm copying the detailed information from the sticky on dosing methods which addresses how to handle a lower than normal preshot number under SLGS, which is found here: Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR). Over time, when you gather more data on George, you'll likely lower that "don't give insulin" advice from the suggested 150 mentioned here. Many folks following SLGS will shoot insulin when their kitty is below 150, but they have gathered enough data and are able to monitor, etc.:

"How to handle a lower than normal preshot number:

Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide."
 
Mary & Jude said:
No--for NOW, you want to post here if it's below 150. The "no insulin below 150" is a basic guideline for newly diagnosed kitties following SLGS (see below--I've posted an excerpt from the guideline sticky). Recall last night that Marje offered some guidelines for you in case George went below 150 at the preshot:

Here is what she said:
"Whether you shoot tonight depends on a few things but if he is below 150 and has never had any ketones, I wouldn’t advise you to shoot. What you can do is stall without feeding and see if the BG rises by testing every 30 minutes and as soon as it’s above 200, you can shoot 3u provided:
--it is not more than two hours past his normal shot time
--you have all the supplies you need (strips, HC food/gravy) to test him
--you can stay up as late as you need to test him
--someone on the board agrees to stay with you and help you. This is most likely the limiting factor."

I don't think it's going to be an issue in any event because he is currently at 240, and I suspect he will remain at that number or go higher by the time of his preshot. Let's see what happens.

Also, I'm copying the detailed information from the sticky on dosing methods which addresses how to handle a lower than normal preshot number under SLGS, which is found here: Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR). Over time, when you gather more data on George, you'll likely lower that "don't give insulin" advice from the suggested 150 mentioned here:

"How to handle a lower than normal preshot number:

Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide."
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Got it, thank you! Ill update you all in 30 minutes when I test
 
Mary & Jude said:
No--for NOW, you want to post here if it's below 150. The "no insulin below 150" is a basic guideline for newly diagnosed kitties following SLGS (see below--I've posted an excerpt from the guideline sticky). Recall last night that Marje offered some guidelines for you in case George went below 150 at the preshot:

Here is what she said:
"Whether you shoot tonight depends on a few things but if he is below 150 and has never had any ketones, I wouldn’t advise you to shoot. What you can do is stall without feeding and see if the BG rises by testing every 30 minutes and as soon as it’s above 200, you can shoot 3u provided:
--it is not more than two hours past his normal shot time
--you have all the supplies you need (strips, HC food/gravy) to test him
--you can stay up as late as you need to test him
--someone on the board agrees to stay with you and help you. This is most likely the limiting factor."

I don't think it's going to be an issue in any event because he is currently at 240, and I suspect he will remain at that number or go higher by the time of his preshot. Let's see what happens.

Also, I'm copying the detailed information from the sticky on dosing methods which addresses how to handle a lower than normal preshot number under SLGS, which is found here: Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR). Over time, when you gather more data on George, you'll likely lower that "don't give insulin" advice from the suggested 150 mentioned here. Many folks following SLGS will shoot insulin when their kitty is below 150, but they have gathered enough data and are able to monitor, etc.:

"How to handle a lower than normal preshot number:

Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide."
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Tested. 279
 
do you have the spreadsheet on GOOGLE DRIVE? that where it should be so you can post, and giving us access to read, just saw the spreadsheet, you posted the BG therefore you should be able to edit, good number to shoot and rest for the night, George's SS is the first thing I am going to see tomorrow at 10AM
 
borg the gorb said:
Tested. 279
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Good. You're going to give him one unit of insulin tonight. We try to get a test at +2 and, if possible, another test, perhaps before you go to bed, just to make sure George isn't dropping too low on the insulin. If he begins to drop too low, you'll want to post on the forum. Someone will likely guide you to give George some medium carb or high carb food which will boost his blood glucose numbers.

Again, as you're beginning this journey, check in if there are preshot numbers below 150.

And just so you know how the dosing method will work, here is how you will proceed under SLGS:

"Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change)."
 
Mary & Jude said:
Good. You're going to give him one unit of insulin tonight. We try to get a test at +2 and, if possible, another test, perhaps before you go to bed, just to make sure George isn't dropping too low on the insulin. If he begins to drop too low, you'll want to post on the forum. Someone will likely guide you to give George some medium carb or high carb food which will boost his blood glucose numbers.

Again, as you're beginning this journey, check in if there are preshot numbers below 150.

And just so you know how the dosing method will work, here is how you will proceed under SLGS:

"Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change)."
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I set a timer for 2 hours and ill test him then. Then ill wait another two hours and test again. So what youre saying is I should wait a week from today to do a glucose curve and hold the dose at 1 unit?
 
borg the gorb said:
Hes eating it right now. Im going to test him when he finishes
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Good plan to give him some HC. Try not to feed too much—only a tsp or so. You don’t want him to fill him up because you have a way to go in this cycle, and you might need to keep giving a little food to bump him up. Report back about an hour after feeding the HC. 78 is not too low, but he could drop lower, so you’ll need to monitor.

When they drop significantly from the preshot to +2, that usually can mean he might go lower in the cycle, and you’ll need to monitor.

You only gave him 1 unit, right?
 
And Zach, since he fell below 90, he’s earned a .25 unit dose reduction at his next shot. His new dose is now .75.
 
Mary & Jude said:
Good plan to give him some HC. Try not to feed too much—only a tsp or so. You don’t want him to fill him up because you have a way to go in this cycle, and you might need to keep giving a little food to bump him up. Report back about an hour after feeding the HC. 78 is not too low, but he could drop lower, so you’ll need to monitor.

When they drop significantly from the preshot to +2, that usually can mean he might go lower in the cycle, and you’ll need to monitor.

You only gave him 1 unit, right?
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Correct. Only one unit of medicine was administered. Im going to keep him in our bedroom for the next hour and test him again then because I just tested him after eating and there was no change, so im going to wait until hes digested it a bit more. Hes alert and awake, behaviour seems startled but otherwise normal but I know that cant really help all that much
Mary & Jude said:
And Zach, since he fell below 90, he’s earned a .25 unit dose reduction at his next shot. His new dose is now .75.
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Got it, so his dose is now only .75 of a unit
 
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