Luke AMPS 172, +2 68, +3 53/49, +4 53

Kristen ardito

Kristen ardito

Member Since 2023
Hi Everyone,

I haven't posted in a looonnng time. The good news is, that's because I've learned how to mostly manage Luke's diabetes using the guides and advice I've gotten on these forums.

About 1.5 months ago, I started him with a new vet and this vet was fairly knowledgeable
about Feline diabetes (at least she said she would always go with Lantus and not Vestulin). There was one topic that she diverged however - and that was on how to get him into remission.

Her advice was because he was so bouncy (she kept using the Somogyi effect word), that I wasn't doing him any favors by continuing to increase and decrease his dose so frequently. I was following Tight Regulation from about May - Beg of Nov. She said that if he goes below 90 mg that I need to reduce, and if he ever goes below 50 mg that I need to skip the next dose.

She said that the reason to skip was because his body is trying to produce insulin on it's own and by my continuing to give him doses, it never learns how to make it and increases the odds that he will be on insulin forever. She said she's gotten many cats into remission and it's critical to understand that cats that go that low are trying to tell us something.

I was curious if this is true, what you all think and how to proceed given that this morning he had 53 (Freestyle Libre) and 49 with Freestyle Lite.


Previous thread: https://felinediabetes.com/FDMB/threads/luke-8-28-amps-hi-1-hi-3-361-6-374.280945/#post-3098520
 
Kristen ardito said:
Hi Everyone,

I haven't posted in a looonnng time. The good news is, that's because I've learned how to mostly manage Luke's diabetes using the guides and advice I've gotten on these forums.

About 1.5 months ago, I started him with a new vet and this vet was fairly knowledgeable
about Feline diabetes (at least she said she would always go with Lantus and not Vestulin). There was one topic that she diverged however - and that was on how to get him into remission.

Her advice was because he was so bouncy (she kept using the Somogyi effect word), that I wasn't doing him any favors by continuing to increase and decrease his dose so frequently. I was following Tight Regulation from about May - Beg of Nov. She said that if he goes below 90 mg that I need to reduce, and if he ever goes below 50 mg that I need to skip the next dose.

She said that the reason to skip was because his body is trying to produce insulin on it's own and by my continuing to give him doses, it never learns how to make it and increases the odds that he will be on insulin forever. She said she's gotten many cats into remission and it's critical to understand that cats that go that low are trying to tell us something.

I was curious if this is true, what you all think and how to proceed given that this morning he had 53 (Freestyle Libre) and 49 with Freestyle Lite.


Previous thread: https://felinediabetes.com/FDMB/threads/luke-8-28-amps-hi-1-hi-3-361-6-374.280945/#post-3098520
Click to expand...
Tagging experienced members for you to answer your question and take a look at your SS
@Wendy&Neko
@Suzanne & Darcy
@tiffmaxee
 
Lots of healing time today and I’m glad you checked with an ear prick. Take the reduction. My cat was bouncy and it took about 9 months to start to get him tightly controlled. He never became diet controlled likely due to chronic pancreatitis.
Are you giving a snack at +1? A big drop at onset often will cause a bounce. What’s your feeding schedule?
 
Thanks for the link. I'll take a look at this.

For about 6 months, I was feeding him pre AM shot, then a can about 3 hours later, and a half can (250 ml - small can of FF) about 3 hours later, then Pre PM shot.

Then, after advice from my vet, I switched to feeding him only twice a day. He was getting a lot of diarrhea and it seemed to get better when I switched to twice a day. The thinking was that his body was chronically digesting food and never getting the chance to settle. Since he has a history of IBD, as a kitten, I thought that sounded like sound advice.

I did that for about 2 months but he was STARVING. Like all the time.

So now, I give him a half of a snack at about +3. Maybe I should move that closer to +1 or +2?

Will take the reduction. And thanks for clarifying. I thought it sounded suspicious that I would skip a dose given that after a day of lows, he usually bounces and I didn't want to take a chance of the bounces being catastrophic by skipping a dose.
 
Like Elise said, Somogyi doesn't exist in cats monitored on long lasting insulin. There can be issues if people start on too high a dose, increase by too large amounts and don't test. But you've got a Libre on and are doing small changes.

I like her suggestion about feeding at +1. Luke does seem to drop really early in the cycle and a few extra carbs then might slow down those drops. Some IBD cats do better with smaller more frequent meals. I like the idea of feeding at preshot, +1 and +2.

Remission rates for people following TR, as those documented by the people who wrote the TR protocol, tend to be higher than average. Looks like your vet is following a modified SLGS? The TR goal is to get a cat used to numbers in the 50-100 range, as that's when they'll stop bouncing as much. For my cat Neko, who was really bouncy to start, I found getting to a dose where her nadirs were in the 70's or lower helped her get flatter cycles. The switch to Levemir also helped.
 
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