Good morning wonderful people! We are once again coming here for help managing our newly diabetic cat. Balvin was diagnosed on 4/23/24 when he went into the ER on DKA. We made it out of there but we are still learning a lot about diabetes and the management at home. We have been relying heavily on CGMs. We place a new one every 14 days. Recently we started getting more comfortable with the SLGS method and we made the first dose adjustment on 5/18/24. We noticed Balvin loves to get in the blues at night but usually stays high during the day. We started feeding him 4 times a day but had to go down to 3 times a day because of work schedule. We feed at 0600-1800-2100 before bed. We have noticed lately what appears to be a "bouncing" pattern (feel free to peek at the spreadsheet) and we are not sure how to handle this. Do we increase the dose with the bounce? We might have made the mistake to freak out and increase the dose, just to see a drop and then bounce back up. Wondering also if those days he stays high is due to a fur shot? We have shaved the area to make the shots more confident for us. We love to see the greens and blues come around but they usually come at a cost Please help us navigate this bouncy-boy's patterns as you might understand this better.
Welcome to the club! Everyone here hates that old trampoline! It’s part of the his body getting used to lower numbers he’s not used to. With slgs you don’t adjust the dose based on bouncing but rather the low point (nadir) that he gets each cycle. Also unless he gets below 90, you hold each dose for 7 days to allow the depot to fill. The sticky’s at the top of the forum are full of information that help to reread occasionally. Hang in there it just takes time and patience!
Thank you for the support @Deb and Tiger. Often when we see values below 65 we test with AlphaTrak to verify if it’s a true low. He’s never been symptomatic with any of his lows (lowest seen on CGM is 53) and they usually don’t last or CGM corrects after 5-10min. Do we still take the 90 from CGM even if the AlphaTrak says otherwise to justify a decrease in the dose?
I’m not familiar with the Alpha Trak as I’m still fairly new but I will tag someone who can help. @Wendy&Neko @Diane Tyler's Mom
I'm not familiar with the Alpha Trak either ,sorry, most all of us use a human meter Until Wendy see's this I can tag @Bandit's Mom @Bron and Sheba (GA) The easy-to-use ReliOn Premier Test Strips require no coding and just a small 0.5 microliter blood sample. With just a five-second test time, these test strips ... Relion Premier Classic Meter at Walmart for 9 dollars https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103 The tests strips are 17.88 for 100 https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197 At least if you need more test strips you can run into Walmart and pick them up or if you're running low you can just order them from Walmart
We are in month 6 and Karamelle still bounces. Its truly frustrating to see good numbers and then they disappear and are replaced with high ones. But like others said it takes time and LOTS of patience. My patient pants are worn thin for sure. Hang in there.
Did you test with the AT to double check the 89? If the AT was higher I would use that and not reduce, especially with DKA in the history. If the AT is under 90 always reduce.
What Elise said above. Double check the lows with the AT and reduce if below 90. If you are at a dose that is getting you nadirs in the 90-149 range on the AT, you stay with that dose until either he goes lower, or nadirs drift upwards. Pretty much all newly diagnosed cats bounce, and even some not so new still do it. I was thrilled when after a year Neko stopped bouncing above 400. Ignore the bounces when you are considering dosing questions. I don't know where 600, 1800 and 2100 are in relation to shot times. We talk in terms of + hours here. I'm guessing you mean he gets no extra food during the day? More smaller meals are easier on a potentially healing pancreas. You might want to invest in an automated feeder to help spread out his food and keep him safe during the day. The Catmate and Petsafe 5 compartment feeders are popular ones.
Are you still testing for ketones in the urine? With a recent diagnosis of DKA I would advice you still do especially with those higher BGs still around. Also are you feeding lots of food and giving snacks?
We are testing often for ketones and they are trace at most. We have been increasing the amount of food and added a snack at +3 (PM) before bed. We are considering an auto-feeder but want to make sure it’s safe and keeps the temperature at the correct number. @Bron and Sheba (GA) about my question above, when trying to decide on a dose change, sometimes the FreeStyle Libre reads much lower than the AlphaTrak (cat calibrated glucometer). We double check those lows (50s, 60s) with the glucometer but they’re barely ever below 90. At that point we do not reduce dose if the glucometer is still above 90?
Wait for the glucometer to register under 90 before reducing. With recent DKA, you don't want to reduce the insulin dose unless he really earns it. The Catmate autofeeder has a space under the rotating tray to put a small gel pack, which you can buy as an option. For the Petsafe, I just used a small soft gel pack folded to fit. Or you can add an ice cube to the food, which will keep it cool until it melts and adds water, which is a good thing for a diabetic.
some info on auto feeders always add a little water to the wet food Here is an auto feeder that hold 5 slots and comes with 2 ice packs for wet food https://www.amazon.com/Cat-Mate-C500-Digital-Automatic/dp/B01AUYLVU8/ref=sr_1_6?gclid=EAIaIQobChMIuM_y2p79_AIVDvrICh1_xAy6EAAYASAAEgJBDfD_BwE&hvadid=178540036693&hvdev=t&hvlocphy=9003521&hvnetw=g&hvqmt=e&hvrand=6990619631848479728&hvtargid=kwd-12652445711&hydadcr=10635_9894649&keywords=petsafe 5-meal automatic pet feeder&qid=1675560889&sr=8-6 Extra ice packs so you can keep them in the freezer ready to go https://www.amazon.com/Cat-Mate-Rep...5c-bd5c-e23f6094563c&pd_rd_i=B091HTXNHR&psc=1 This one has 3 slots with one ice pack https://www.amazon.com/Cat-Mate-Automatic-Feeder-Digital/dp/B01MXDFB28 Extra ice pack https://www.amazon.com/Mate-Replace...cb-974a-deec2fb8a80c&pd_rd_i=B07KFP7PRG&psc=1 You can even order the stainless steel inserts for the 5 slot if you don't like your kitty eating out of plastic, from what I have heard plastic could cause acne on some cats https://www.amazon.com/Cat-Mate-Sta...36-830d-6cc20f385409&pd_rd_i=B0B3MS1MWR&psc=1
