? Glen 06/01 PMPS 68?

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Islandmomma

Islandmomma

Member Since 2016
o_Ohttp://www.felinediabetes.com/FDMB/threads/glen-05-01-amps-122-pmps-184-2-103-3-81.170803/#post-1863127

We had overnight shenanigans again last night! Thinking I should take a break and not shoot.

Not sure what to do about this cat. I am going to work a bit later today but won't be able to monitor all day. Same for tonight - we have plans with friends.

In addition, I think Glen had carbs this AM:arghh:
My son brought me a bag of treats that was torn open savagely and said I won't be too happy! They live in a cupboard on the fridge. My littlest kitty got them and they were caught with their faces in them on the floor:D
 
Although, it's awfully quiet right now. If no one is able to offer advice, my super ultra cautious suggestion would be to skip if you can't monitor. Any reading you get now might or might not be carb influenced, and carbs wear off.
 
Red & Rover (GA) said:
Although, it's awfully quiet right now. If no one is able to offer advice, my super ultra cautious suggestion would be to skip if you can't monitor. Any reading you get now might or might not be carb influenced, and carbs wear off.
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Thanks I appreciate it. If anything he would be getting a 0.1u dose. He earned a reduction last night - again! Technically that would be a 0.25u reduction I think, which is nothing
 
It's not nothing considering how little a cat is. Micro doses help the pancreas along and makes for a better remission. How long before you have to go to work?
 
Red & Rover (GA) said:
It's not nothing considering how little a cat is. Micro doses help the pancreas along and makes for a better remission. How long before you have to go to work?
Click to expand...
No I know it's not nothing, but he would drop 0.25u. He was on a 0.25u dose so if I drop 0.25u it's zero (nothing).
 
A lower dose would mean measuring the 0.25u then squeezing out a drop. Practice allows for consistency. A magnifying glass helps.
I do apologize for not giving top of the line information. I'm not awake yet and my meds haven't kicked in.
 
Gill & George said:
How long can you monitor him for this morning?
At what time did he get I to the treats?
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I fell asleep from 1-7am so somewhere in there. I was supposed to work but I was so tired I couldn't go in.
So I'm home for the day. Taking Glen for his cartrophen in 6 hours and then I have an appointment in 8 hours. I will then be out for the evening.

I tested more than an hour ago and he's been fed breakfast.
 
Tammy:

I want to caution you about giving back-to-back reductions. Lantus is a depot-type of insulin. Because there is a depot (think of this like a storage tank), it can take a few cycles for the amount of insulin in the depot to catch up with a dose reduction. Let me outline what I'm seeing:
  • 12/30: dose is 1.5u and Glen drops into the 40s
  • 12/31: dose is decreased to 1.25u
  • 1/1: skipped shot at AMPS and dose reduced to 1.0u at PMPS despite no indication that numbers were below 90
  • 1/2: numbers drop below 90 during PM cycle
  • 1/3: dose reduced from 1.0 to 0.5u
  • 1/4: dose reduced to 0.25u after a drop into the 70s
  • 1/5: PM numbers fall below 90
There are a lot of back-to-back reductions (4 reductions in 7 days) and reductions that are more than 0.25u. I would be more comfortable with the frequency and size of the reductions if Glen's numbers were consistently in the low blues/greens. You are great at getting tests and monitoring Glen's numbers. It may be a better strategy to give him some LC food (or even a little HC) if you see his numbers are dropping like last night when he dropped from 184 to 103 by +2. Propping his numbers up with food will allow you to keep at a given dose so that the overall level of the numbers begins to come down since you're still seeing yellows and high blues. Ultimately, you want to try to keep Glen on insulin as long as possible so you're giving his pancreas plenty of time to heal. That way, you increase his chances of a very strong remission.

 
Sienne and Gabby (GA) said:
Tammy:

I want to caution you about giving back-to-back reductions. Lantus is a depot-type of insulin. Because there is a depot (think of this like a storage tank), it can take a few cycles for the amount of insulin in the depot to catch up with a dose reduction. Let me outline what I'm seeing:
  • 12/30: dose is 1.5u and Glen drops into the 40s
  • 12/31: dose is decreased to 1.25u
  • 1/1: skipped shot at AMPS and dose reduced to 1.0u at PMPS despite no indication that numbers were below 90
  • 1/2: numbers drop below 90 during PM cycle
  • 1/3: dose reduced from 1.0 to 0.5u
  • 1/4: dose reduced to 0.25u after a drop into the 70s
  • 1/5: PM numbers fall below 90
There are a lot of back-to-back reductions (4 reductions in 7 days) and reductions that are more than 0.25u. I would be more comfortable with the frequency and size of the reductions if Glen's numbers were consistently in the low blues/greens. You are great at getting tests and monitoring Glen's numbers. It may be a better strategy to give him some LC food (or even a little HC) if you see his numbers are dropping like last night when he dropped from 184 to 103 by +2. Propping his numbers up with food will allow you to keep at a given dose so that the overall level of the numbers begins to come down since you're still seeing yellows and high blues. Ultimately, you want to try to keep Glen on insulin as long as possible so you're giving his pancreas plenty of time to heal. That way, you increase his chances of a very strong remission.
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Thank you
Everything I have done has been based on advice given here. I don't know what to do!

I have been good at getting his tests in but it is costing me work time and my sleep. I am a breast cancer survivor and I am post chemo and radiation. I need something stable for him so that I can focus on getting myself better. That is why I have been posting here so I can get help and guidance.

So should I give the 0.1u? I am way past shot time. I can get a +2 this AM but not tonight seeing as it is already so late here. I need him on earlier shot times, which I can try and readjust over the weekend but I usually work at 0800 so have to test/feed/shoot earlier in the day.

Last night I did give him some LC food when his numbers were dropping, and he helped himself to HC food from the other cats dish. But in a week I have been up 3 nights with him into the wee hours monitoring. This is not sustainable for me. I am anxious and not feeling well because of it.
 
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I can shoot now and can get a +2 and I can shoot at the same time tonight but I can't get a +2 tonight.

Advice please!
 
With being so far past his shot time (2hrs) just be aware that you will only be able to get back on schedule by 30min total a day. So if your schedule is tight it may be best to skip.
He will be high by shot time but will recover.
 
Gill & George said:
With being so far past his shot time (2hrs) just be aware that you will only be able to get back on schedule by 30min total a day. So if your schedule is tight it may be best to skip.
He will be high by shot time but will recover.
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He will be high for sure because we are stopping in at the vet today.
I am just super tired and frustrated. I am out this evening so leaving my husband to give Glen his shot for the first time. He is reluctant to give him anything because it has been sleepless nights for me and he doesn't like seeing me this way. I can't even leave instructions for him because I don't know what to do or what to give him.
I have been cancelling my social plans with my friends (and missing work because of it) since Glen started on insulin so I could be home to monitor and haven't taken any time for myself. It's been work and test the cat for 2 weeks. Feeling very burnt out and not feeling any further ahead.
 
:bighug::bighug:
Don't worry about him being high tonight, just think of it as a fur shot.

When I stalled for 2 hours once with George it was a major pain in the butt getting back on schedule, and I wasn't working at the time.

So as long as he hasn't had DKA I think skipping altogether this morning and having a break is a good option.
 
Granted I can convince my husband to test Glen prior to shooting what parameter should I give him to shoot?
Glen doesn't seem to follow the rules...
 
With regards to @Sienne and Gabby (GA) post, I would tend to agree that he has come down the dosing scale awful quick and that his ss is not looking green enough for a cat that is ready to go OTJ.
I have looked back at some older threads and it seems like you transitioned him to a LC diet fairly recently, after starting insulin, and that may well have greatly influenced his slide down the dosing scale.
Given that although he was below 90 (the reduction point for slgs) but not massively so (he was still in a safe range) perhaps you could keep him on the 0.25u and try doing what Sienne suggested and seeing if you can steer his numbers with food, that way you may be able to hold on to the dose longer hopefully giving him the chance to lower his overall BG range.
Islandmomma said:
Granted I can convince my husband to test Glen prior to shooting what parameter should I give him to shoot?
Glen doesn't seem to follow the rules...
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Would DH be willing to monitor him this evening whilst you are out should he need to?
 
Gill & George said:
With regards to @Sienne and Gabby (GA) post, I would tend to agree that he has come down the dosing scale awful quick and that his ss is not looking green enough for a cat that is ready to go OTJ.
I have looked back at some older threads and it seems like you transitioned him to a LC diet fairly recently, after starting insulin, and that may well have greatly influenced his slide down the dosing scale.
Given that although he was below 90 (the reduction point for slgs) but not massively so (he was still in a safe range) perhaps you could keep him on the 0.25u and try doing what Sienne suggested and seeing if you can steer his numbers with food, that way you may be able to hold on to the dose longer hopefully giving him the chance to lower his overall BG range.

Would DH be willing to monitor him this evening whilst you are out should he need to?
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I doubt he will. He hasn't even tried testing him before. It's been me 100%.

I just don't have it in me to test him all night again. It sounds terrible but I can't. I am almost in tears I am so tired and don't know what to do.

I know I sound very negative nelly but I can't help it. Not to mention I've blew through another 50 strips and $50 in a week. I just can't keep it up.
 
:bighug::bighug::bighug::bighug::bighug:
Try and breath, we have all felt like this, sleep deprivation is awful, You need to look after yourself too.
Lets just see where he is at his usual PMPS before making any decisions.
I'll see if I can get some folk over and see if we can come up with a sensible strategy for tonight.

Can you tell me when he stopped all HC food? Just want to see how that pairs up with the numbers on the ss. (thanks)
 
Gill & George said:
:bighug::bighug::bighug::bighug::bighug:
Try and breath, we have all felt like this, sleep deprivation is awful, You need to look after yourself too.
Lets just see where he is at his usual PMPS before making any decisions.
I'll see if I can get some folk over and see if we can come up with a sensible strategy for tonight.

Can you tell me when he stopped all HC food? Just want to see how that pairs up with the numbers on the ss. (thanks)
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I won't be home for PMPS: he will have to get it, text me, so I can post for advice and then let him know what to give. I was hoping to draw his insulin up before I left (I know not ideal) but he has never used a syringe before either and I need to make sure he gets the right dose!

I am heading out the door today for an appointment I have at +8 (in 5 hours). I won't be home after that.

Glen stopped kibble even before starting insulin and hasn't been on it at all since. I think he is tired of the flavour so just quit straight up! He was getting some friskies with gravy (shredded and prime filets) and been having raw intermittently. I am trying to get him consistently on LC but he sometimes sneaks the other cats MC wet food.
 
I'm bleary eyed after staying up till 4:30 am with Uncle to keep him out of trouble as well last night.
Exhaustion, frustration and worry is a terrible combo. You have put so much commitment into Glen's treatment so far, I would hope some relief is just around the corner.
I hope Gill & co. can come up with a strategy to offer so you can get some relief from missing work and sleep.
 
My work schedule is Monday to Friday 0800-1600. I test/feed/shoot at 0700 & 1900ish. I am more flexible during the weekends. I sometimes work 12 hour shifts during the week to further complicate things.

During the week there is no one to take a +2 to +9/10 AMPS.

Because of my work & health needs I can take a +2 or +3 max PMPS but that is all I can really manage safely.

I know there are one-offs but I can't manage being up after PMPS to +5 or +6 3 times a week.

I also know that Glen's diabetes has no regard for my work schedule LOL
 
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Barbara & Uncle said:
I'm bleary eyed after staying up till 4:30 am with Uncle to keep him out of trouble as well last night.
Exhaustion, frustration and worry is a terrible combo. You have put so much commitment into Glen's treatment so far, I would hope some relief is just around the corner.
I hope Gill & co. can come up with a strategy to offer so you can get some relief from missing work and sleep.
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Oh no! Hoping you can get some rest today!
 
Islandmomma said:
+2 or +3 max PMPS but that is all I can really manage safely.
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Yes, and I see that the issue then is -what can you do if you find that Glen is dropping and needs to be monitored and steered with food again through the night.
It seems like following the SLGS method should theoretically keep Glen safe enough, and you sane enough even with your schedule. But with the way he's repsonding to the insulin seems he's needed much more monitoring. GRRRR
Islandmomma said:
Oh no! Hoping you can get some rest today!
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Thanks, I'll be okay. It's been a while since I've had to stay up through the night, and I had the bonus of seeing Uncle break through back into green, thus avoiding a dosecrease this a.m. so that's a bit of a pick-me-up if not only psychological! I gotta go to work after I get his +2 in.
 
Islandmomma said:
My work schedule is Monday to Friday 0800-1600. I test/feed/shoot at 0700 & 1900ish. I am more flexible during the weekends. I sometimes work 12 hour shifts during the week to further complicate things.

During the week there is no one to take a +2 to +9/10 AMPS.

Because of my work & health needs I can take a +2 or +3 max PMPS but that is all I can really manage safely.

I know there are one-offs but I can't manage being up after PMPS to +5 or +6 3 times a week.
Click to expand...

It helps to know that Tammy.
It is always harder in the beginning, once we get to know our kitties patterns it gets easier.
That is plenty of tests really.

Regarding tonight Tammy, are you out all night? Do you think you would be able to get a test in when you get back?
I know it's DH's first time, but do you think you could persuade him to get a +2 perhaps?

Just trying to figure out what the best thing to do would be.
 
Gill & George said:
It helps to know that Tammy.
It is always harder in the beginning, once we get to know our kitties patterns it gets easier.
That is plenty of tests really.

Regarding tonight Tammy, are you out all night? Do you think you would be able to get a test in when you get back?
I know it's DH's first time, but do you think you could persuade him to get a +2 perhaps?

Just trying to figure out what the best thing to do would be.
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I will be home for a +2 after PMPS. I can get hubby to shoot at 1930 and I can get the +2 @ 2130.
But I want to give Glen a safe dose because I need to sleep. I know it's not possible to know exactly how he will react but I can't pull an all nighter.
 
Tammy, how are you fixed this weekend for being able to monitor Glen? It's OK if you are busy, just trying to weigh up all the options.
 
Would a 6am/6pm schedule possibly work for you?
That would allow you to get a +3 before bed, and a +3 before you leave in the mornings.
If you are early to bed and early to rise sort of a person bring the TFS schedule forward by an hour might make sense.
 
Gill & George said:
Would a 6am/6pm schedule possibly work for you?
That would allow you to get a +3 before bed, and a +3 before you leave in the mornings.
If you are early to bed and early to rise sort of a person bring the TFS schedule forward by an hour might make sense.
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I could do 6:30 LOL

Either way I wouldn't get a +3 in the AM. I work at 08:00 so leave before that.
 
I have a suggestion to help streamline part of the process.

I don't have Shadow anymore , i have young cats now but I feed them from foods that are on the fdmb list.
I would suggest these.... for all of your kitties....
these are the cheapest ones I will let mine eat and I rotate them all among some expensive ones....
they seem to be the most palatable to cats that like gravy but aren't getting gravy.....

friskies chicken and liver pate
fancy feast chunky chicken ( green label) 5% carb
fancy feast flaked trout feast 7%
friskies supreme supper
friskies mixed grill

getting rid of gravy in the house will keep you from catching Glen eating the wrong foods....
of course, he wants what the others have.....
 
Islandmomma said:
I could do 6:30 LOL

Either way I wouldn't get a +3 in the AM. I work at 08:00 so leave before that.
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sorry misunderstood.

Guess it would give you time to get an out the door test at arround +1? If you take a look at the sticky on doing TR on a full time job, it explains how that might be useful to you (the info applies even though you are on SLGS, it will help you with dosing decisions)

I'll try and explain what we are thinking and why all the questions.

Over the years it has been found that a strong regulation is more likely if the kitties pancreas gets some continued insulin support. Take a look at Georges ss, he's been OTJ for 9 months now, if you look at the 2016 tab you'll see what his numbers looked like as he approached remission nearing april 2016, that's what you are aiming for in terms of numbers ( I tested frequently because I had the luxury of being at home and being able to, but it wasn't necessary, in fact if you look back the closer we got to remission the less I tested, because as we got to shooting those lower numbers his insulin curve became flatter that's the beauty of lantus it holds on to those lower ps numbers and gives you a flat curve that lantus is so famous for, and as a result I was more comfortable with his numbers.

George didn't get there quite as quickly as Glen has, it took him a good few months of lots of high numbers before we started to see nice numbers, that had the advantage of giving me time to get 'used' to FD. Glen has decided to do it a different way, which is harder on the bean, in the one sense, in that this is all still very new for you. But on the other hand it is a good sign that he is getting into good numbers so soon after starting insulin, it bodes well for Glen. We also know that the sooner you can achieve strong glycaemic control, the better the chance of remission, and it with this in mind that some of us have expressed the concern of taking reductions so quickly, sure they have for the most part been earned on SLGS, but it has also been our experience that racing down the dosing scalet can often lead to the numbers going pear shaped and kitty starting to go up the dosing scale and back to square one. In the same way as taking the dose up too quickly can result in us overshooting the goldilocks dose and ending up with a kitty that is overdosed, going down quickly, when the depot hasn't a chance to settle with frequent reductions can equally result in too small a dose and the resultant high numbers.

So holding on to the 0.25u for now, would be a slightly more 'aggressive' approach, and it might in the short term mean some closer monitoring, and clever use of autofeeder to supply snacks through the night and while you are at work, but ultimately I do think that it will be the quickest root to achieving regulation/remission. The way I saw it for George was short term pain for long term gain.
This doesn't mean that I expect you to be having to stay up for PJ parties nights on end, using the autofeeder to supply snacks of appropriate carb content through the cycles when you are not able to monitor can be used to effectively keep him safe and allow you to get rest and go to work.

If that approach is not something you are comfortable with then taking the reduction to the micro dose that was discussed last night 0.1u, is another option, but you should be aware that because of the speed that Glen has arrived at this dose, that once the depot settles altogether you may very well see numbers rise, and when that happens often times kitty ends up on a higher dose than the one they originally started to see a break through in. So you could find yourself back at square one.

Everyone's personal situation is different, so that's where you need to decide what is going to work best for Glen, you and DH. (getting DH on board for monitoring, so you could hare that responsibility if and when you had to might be worth exploring)


It might be an idea to get a test in before you leave for the vet that way you will know what the non stress influenced BG is.

As for tonight, if he is over 200 I think you should consider shooting something.

How do you feel about all that? I know it's a lot to take in.
 
I don't have enough experience to help with the dosing but I do understand it can be reall hard some times, I have a full time job and by full time down here really means more than 8 hrs plus traffic going to work and back ( that adds sometimes more than one hour going and one hour getting back ) and even though I said I was going to follow SLGS protocol, well kitties have other plans, and I have ended having to monitor him more closely.

I just want to say hang in there, try and test him as much as you can, that sometimes means just before shooting and just enough tests to keep him safe maybe a +2 in the night or one as soon as you wake up and leve the testing every two hours or more just for the times when you see him going down or when you are at home.

Yes I have had to skip shoots sometimes and that does not help his numbers but it would have been too risky for him if I shooted since there would not be any one to monitor him and I had work, its not easy, and he is still not regulated but his condition has improved a lot I can see him playing and going around the house in good spirits so I think that is what counts and is worthed.
 
Gill & George said:
sorry misunderstood.

Guess it would give you time to get an out the door test at arround +1? If you take a look at the sticky on doing TR on a full time job, it explains how that might be useful to you (the info applies even though you are on SLGS, it will help you with dosing decisions)

I'll try and explain what we are thinking and why all the questions.

Over the years it has been found that a strong regulation is more likely if the kitties pancreas gets some continued insulin support. Take a look at Georges ss, he's been OTJ for 9 months now, if you look at the 2016 tab you'll see what his numbers looked like as he approached remission nearing april 2016, that's what you are aiming for in terms of numbers ( I tested frequently because I had the luxury of being at home and being able to, but it wasn't necessary, in fact if you look back the closer we got to remission the less I tested, because as we got to shooting those lower numbers his insulin curve became flatter that's the beauty of lantus it holds on to those lower ps numbers and gives you a flat curve that lantus is so famous for, and as a result I was more comfortable with his numbers.

George didn't get there quite as quickly as Glen has, it took him a good few months of lots of high numbers before we started to see nice numbers, that had the advantage of giving me time to get 'used' to FD. Glen has decided to do it a different way, which is harder on the bean, in the one sense, in that this is all still very new for you. But on the other hand it is a good sign that he is getting into good numbers so soon after starting insulin, it bodes well for Glen. We also know that the sooner you can achieve strong glycaemic control, the better the chance of remission, and it with this in mind that some of us have expressed the concern of taking reductions so quickly, sure they have for the most part been earned on SLGS, but it has also been our experience that racing down the dosing scalet can often lead to the numbers going pear shaped and kitty starting to go up the dosing scale and back to square one. In the same way as taking the dose up too quickly can result in us overshooting the goldilocks dose and ending up with a kitty that is overdosed, going down quickly, when the depot hasn't a chance to settle with frequent reductions can equally result in too small a dose and the resultant high numbers.

So holding on to the 0.25u for now, would be a slightly more 'aggressive' approach, and it might in the short term mean some closer monitoring, and clever use of autofeeder to supply snacks through the night and while you are at work, but ultimately I do think that it will be the quickest root to achieving regulation/remission. The way I saw it for George was short term pain for long term gain.
This doesn't mean that I expect you to be having to stay up for PJ parties nights on end, using the autofeeder to supply snacks of appropriate carb content through the cycles when you are not able to monitor can be used to effectively keep him safe and allow you to get rest and go to work.

If that approach is not something you are comfortable with then taking the reduction to the micro dose that was discussed last night 0.1u, is another option, but you should be aware that because of the speed that Glen has arrived at this dose, that once the depot settles altogether you may very well see numbers rise, and when that happens often times kitty ends up on a higher dose than the one they originally started to see a break through in. So you could find yourself back at square one.

Everyone's personal situation is different, so that's where you need to decide what is going to work best for Glen, you and DH. (getting DH on board for monitoring, so you could hare that responsibility if and when you had to might be worth exploring)


It might be an idea to get a test in before you leave for the vet that way you will know what the non stress influenced BG is.

As for tonight, if he is over 200 I think you should consider shooting something.

How do you feel about all that? I know it's a lot to take in.
Click to expand...

I will shoot tonight and I am comfortable with the 0.25u. I will get a +2 and if he is dropping quickly will give him some snacks. But he did seem to bounce up quite quickly and didn't get into dangerous numbers, just dropped too quickly for my liking.

So my plan is this: I will test Glen before the vet our appointment is in an hour. I am anticipating a highish number. I will get my hubby to shoot the 0.25u and will get a +2 when I get home. Depending on that number - if numbers like last night will give some snacks and leave it at that.
 
Islandmomma said:
I will shoot tonight and I am comfortable with the 0.25u. I will get a +2 and if he is dropping quickly will give him some snacks. But he did seem to bounce up quite quickly and didn't get into dangerous numbers, just dropped too quickly for my liking.

So my plan is this: I will test Glen before the vet our appointment is in an hour. I am anticipating a highish number. I will get my hubby to shoot the 0.25u and will get a +2 when I get home. Depending on that number - if numbers like last night will give some snacks and leave it at that.
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Will dh test before shooting? I would not recommend shooting blind.

Just seen he is 119. @+6
WT*
 
I would need Pre-draw as well. I am literally taking Glen to the vet, dropping him at home and back out the door to head downtown for my appointment.
 
With that 119 at +6 I would not shoot blind, not even the reduced dose.

You could always test and shoot when you get back, though that would see you off schedule for the weekend, but maybe you could make the time up? If you decide on that option, remember no food for 2 hours before.
 
Ok. New plan.

I am going to get hubby to feed at 1800 and leave out until 1900. I will test when I get home around 21:00. If above 200 I will give 0.25u. If not - hold?
 
Getting close to bedtime for me, so I'm of to feed my hungry snugglemonster, then catching some zzz'

Sending vetty vines for Glen.:bighug::bighug::bighug:
 
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