? Regarding SLGS protocol for a newbie

[Kelly and Buddy]

Two questions for the experts out there. After reading all the information, I feel like this protocol might be better for Buddy so I can get an idea of how his body is handling the insulin. I do have two questions:

1) As a teacher, I work long hours during the school year so free feeding isn't really an option (because Buddy will eat anything you put in front of him). The protocol says it's better for cats that are free feeders but does that mean I can't get it to work with 4 - 5 meals a day?

2) I am a bit confused about when to start treatment for hypo. In some places, I read that numbers above 50 are okay but on the hypo protocol page, it says to begin treating for hypoglycemia if you get a number between 40 - 60, even if they show no symptoms. At what point do you recommend I pull out the Karo for a cat with no symptoms?

Thanks!

 

[Wendy&Neko]

Hello and welcome. First off, SLGS is a dosing method developed here over time. It is not a formal protocol. Only Tight Regulation is a protocol based on published research. Using SLGS for dosing is fine, itpfnthat's what suits you best.

As for your first question, many here use autofeeders to space out feedings. I too had a Hoover cat, I liked the Petsafe 5 feeder.

Here we feed high carb food if the numbers go below 50, if you are using a human meter, below 68 if using a pet meter. Karo with or without food is an alternative to high carb food.

 

[JoyBee&Ravan]

Hi Kelly
My Kitty Ravan dropped to 39 & another time to 35. He showed no symptoms either time. I gave him High Carb food (the gravy from Fancy Feast Gravy Lovers both times )
& checked every 15 to 30 mins for several hours to make sure he didn't drop again .
Some kitties just do that,don't show signs that they are in danger. So Yes you do need to pull out the Hypo food!

You can look at his SS (spreadsheet) to see how the Bg came up.Hope this info helps?

 

[Sienne and Gabby (GA)]

I'm going to add a bit more information to Wendy's post.

Normal blood glucose range is 50 - 120. When numbers drop below 50, you don't have much of a margin for safety. (That said, with long term diabetic cats and when following Tight Regulation, numbers have to drop below 50 for a dose reduction.) As a result, if numbers are dropping below 50, we steer the numbers back up with food. The carb content of the food may vary as some cats are more sensitive to carbs than others or when in the cycle the numbers are dropping may influence how you steer the numbers. For example, I would be more likely to intervene with high carb food early in the cycle when there's more insulin available to effect BG numbers versus late in the cycle when the insulin is wearing off. In the latter case, I might try either low carb food or not be as aggressive with the amount of HC food.

Ultimately, you don't want your cat to be sitting in the 40s for an overly long period of time. I tend to look at low numbers and earning a dose reduction as not being unlike dipping your toe in cold water -- dip your toe in, take it out, warm up. In other words, if you test and numbers are low, give some (high carb) food, wait 15 - 30 min depending on your experience and how low the numbers were, and retest to make sure your kitty is back in safe numbers.

If you look at Gabby's spreadsheet, I would document when I was giving her HC food in the comments section. See if that helps you get a feel for what I did. I have a lot of data so don't get overwhelmed. I was following TR so it may not all directly apply to your situation.

I also agree with Wendy about using a timed feeder.

 

[Kelly and Buddy]

Hi Ladies,

I am literally in tears as I type this. Buddy was a number that I am comfortable with this morning and I was hoping today would be a day I could get him back on track. I took my dogs for a walk and came back to find Buddy eating another sick cat's prescription GI food. I am so frustrated. I know his numbers will skyrocket and, based on his own GI issues, diarrhea will probably follow. I have 7 cats. 5 are on a regular diet, one is on the GI diet, and then there's Buddy. Trying to keep 3 different feeding locations and schedules (not to mention keeping dogs away) has been a nightmare. I was hoping today might be a turning point, but alas, another step backwards.

On top of all this, I am suddenly having such a hard time getting blood. I use a warmed rice back and follow all the tips. Thankfully, he stays still and is patient but it takes several pokes each time and his poor ears look terrible. I know his #s will go high today so I think I will just give him a break on testing until this evening, unless you all advise otherwise. Unless he is really high, I may reduce him to .5 so that I don't have to worry about him all night. I really just need one night of decent sleep. I am sleep deprived, tired and emotional (which is SO not me).

I go back to work tomorrow and am so worried about Buddy because he will be alone for at least 9 hours. That's why I was asking about the Go Slow method. I thought by backing him down to .5 units twice a day he would be safe from going low and I could monitor for the week to see how his body responds to the insulin and trying to get him on a feeding schedule that is doable with my job. Then, maybe I could do a curve next weekend, when I can be home all day to do a glucose curve.

Thoughts? Suggestions? I'll take any you have. I'm feeling pretty hopeless right now.

 

[Sienne and Gabby (GA)]

One suggestion that was made to me when Gabby was first diagnosed was to feed my other cat the same food I was feeding Gabby. Frankly, low carb, canned food is good for your other cats! Cats don't need all of the gluten, veggies, fruit, etc. that's in some foods. Cats are obligate carnivores and all they really need is a good quality protein and the vitamins and minerals (e.g., taurine) that's in their food. Being able to feed Gabby and Gizmo the same food made life MUCH simpler. The other options for preventing Buddy from eating anyone else's food is expensive -- a radio frequency feeder. They aren't cheap!

It's not unusual to struggle for a bit with getting blood in the beginning. It takes a while for the capillary bed in the ears to build up. One temporary option is to get a larger gauge lancet. For example, a 28 gauge lancet is thicker than a 30 gauge and it will make it easier to get blood when you poke. Alternatively, if you poke as close to where you made your initial stab, it may help with getting blood.

Reducing the dose if you are exhausted is fine. You can't take care of Buddy if you're operating on fumes. In fact, if you were thinking of reducing his dose to 0.5u so you don't worry as much, it's not a bad idea to do that tonight. Dropping the dose will also give you some data on how Buddy does at the smaller dose.

 

[Kelly and Buddy]

S

One suggestion that was made to me when Gabby was first diagnosed was to feed my other cat the same food I was feeding Gabby. Frankly, low carb, canned food is good for your other cats! Cats don't need all of the gluten, veggies, fruit, etc. that's in some foods. Cats are obligate carnivores and all they really need is a good quality protein and the vitamins and minerals (e.g., taurine) that's in their food. Being able to feed Gabby and Gizmo the same food made life MUCH simpler. The other options for preventing Buddy from eating anyone else's food is expensive -- a radio frequency feeder. They aren't cheap!

It's not unusual to struggle for a bit with getting blood in the beginning. It takes a while for the capillary bed in the ears to build up. One temporary option is to get a larger gauge lancet. For example, a 28 gauge lancet is thicker than a 30 gauge and it will make it easier to get blood when you poke. Alternatively, if you poke as close to where you made your initial stab, it may help with getting blood.

Reducing the dose if you are exhausted is fine. You can't take care of Buddy if you're operating on fumes. In fact, if you were thinking of reducing his dose to 0.5u so you don't worry as much, it's not a bad idea to do that tonight. Dropping the dose will also give you some data on how Buddy does at the smaller dose.

Sienne,

I looked at Gabby's SS. WOW!! I don't know how you can do all those overnight tests for so many consecutive nights. I can barely function now and I've only been getting up during the night for a week! I don't need a lot of sleep but I need a 5 hour chunk. Once I'm up (especially after endless attempts to get blood), I have a really hard time going back to sleep and it definitely takes a toll on my body and brain.

I thought about feeding all the cats the same but, right now, it's a monetary issue. On top of everything else, I am in the process of a divorce (which is a big financial blow) and I am also in grad school so money is tight. Also, I don't know if I should change the diet for the cat that is on the special GI food.

As for the lancet, I am using the 30 gauge. At the beginning, I used the 28 and it was so easy. Now, I can never get blood with the 28 and even the 30 is a struggle. The only way I can typically get blood is when I go through the ear completely, which I hate doing. It's gotten worse for me, not better.

I am definitely dropping to a .5 dose. My vet probably won't like it but I don't really see an alternative. Hopefully, I can get Buddy and I both back on track this week and then get some good data (and blood curves) next weekend.

Thanks again. I'm sure this isn't the last time you'll hear from me!

 

[Kelly and Buddy]

Hello and welcome. First off, SLGS is a dosing method developed here over time. It is not a formal protocol. Only Tight Regulation is a protocol based on published research. Using SLGS for dosing is fine, itpfnthat's what suits you best.

As for your first question, many here use autofeeders to space out feedings. I too had a Hoover cat, I liked the Petsafe 5 feeder.

Here we feed high carb food if the numbers go below 50, if you are using a human meter, below 68 if using a pet meter. Karo with or without food is an alternative to high carb food.

I have looked at the timed feeders but they don't get great reviews. My biggest concern is it not opening and him not getting food and going low when I am away. Have you heard of this happening and/or what happens if it does? Technology is a great thing but, when it doesn't work in a case like this, it can be costly.

 

[Wendy&Neko]

A lot of people here use the Petsafe 5. Another alternative is to feeeze cubes of cat food and leave them out to thaw for later. It's less precise on the timing, but you will have food for later.

 

[Kelly and Buddy]

A lot of people here use the Petsafe 5. Another alternative is to feeeze cubes of cat food and leave them out to thaw for later. It's less precise on the timing, but you will have food for later.

I thought about the food freezing but he is SO food driven, I think he would gnaw away at the frozen cubes, LOL. Seriously, he trolls for a crumb on the floor, any dish left in the sink or any food bowl in the house. He acts like he is starving ALL THE TIME despite 13 ounces of food each day, which seems like a lot for an 8.5 pound cat.

I just ordered the Pet Safe 5. Thanks for the suggestion.

 

[Sienne and Gabby (GA)]

The info that's not on the sheet is that my shot time was 5:00 for a couple of years. I ended up moving the time earlier once I changed jobs. I also had a fair amount of flexibility with my hours at work when I was in Chicago. When Gabby was first diagnosed, I was up late. It took a while to figure out that she had an early nadir and could dive into low numbers early in the cycle. It got a lot easier once I understood how she was responding to Lantus and once I moved her shot time earlier. I was also pretty good about about getting a test in if I woke up during the night -- I could fall back asleep pretty easily.

I didn't have luck with the PetSafe 5 -- others here swear by it. I used the 2 compartment feeder. It's much lower tech and I never had a problem.

I would do a price comparison with Friskies vs whatever else it is you're feeding. Actually, even Wellness in the 12 oz cans if you're feeding a herd of cats works out to be relatively inexpensive. Admittedly, I don't know if you're feeding the other cats dry food and if so, what the comparison would be.

FWIW, Gabby was very food motivated. She would lick "catsicles" from the second they were in her bowl. She didn't wait for them to defrost.

What's your other cat's GI issue? There are plenty of cats here with GI problems and maybe we can offer some thoughts. I wasn't thinking about changing the food for your cat with GI issues as much as the other kitties.

 

[Ana & Frosty (GA)]

My cat eats twice a day and he is on the SLGS method. Haven’t had any issues. I am out of the house for 12 hours each day so we can’t do TR. I tried automatic feeders, and he managed to break into ALL of them. Also, Frosty tends to break into contraband every now and again. It happens to the best of us. I know how frustrating it is, especially in the beginning, and yes he will go high but he will come down. You will eventually develop a routine that will work. But mistakes still happen, pets will occasionally eat the wrong food. Don’t be so hard on yourself, you’re doing the best you can.

 

[Kelly and Buddy]

I looked at the 2 compartment feeder also. Neither had good reviews so I took my chance on the 5 compartment. The 2 compartment was out of stock on every site that I browsed.

All of my other cats are on dry. I know it's not ideal but I end up taking in every misfit stray that shows up so I have to watch the spending. (I AM the crazy cat lady). After this whole experience and seeing how drastically changing to canned food lowered Buddy's BG, I have been contemplating trying to switch my other cats to at least half canned. Just need to do the math and see if it is financially feasible at this point. Currently, I have a room downstairs where I feed the five healthy cats and then Buddy and my other G.I. cat have their own separate rooms for feeding.

The other cat with a G.I. issue was not really diagnosed. She got very constipated and they had a hard time getting her to pass a stool. She was at the vet clinic for several days and then came home and was still sick for several days but seems to be doing well now. That all happened while still trying to get Buddy regulated. It's crazy around here at times.

I was able to find some .5 unit u100 syringes tonight but I think I will skip tonight since he has dropped so much the previous nights and I have to get some sleep since tomorrow is my first day back to work in 6 weeks! It will be long day. Surprisingly, even after eating the high carb food this afternoon, his BG reading at 7:45 p.m. was only at 189. I would love to see it lower but expected a much higher reading after his sneaky HC binge. LOL.

I'm a bit anxious about drawing from the pen with a syringe. Pulling up just a .5 unit is SO small. Are there any tips I need to know for drawing from a pen? I saw the diagram but didn't see any other suggestions. I know I read somewhere never to shoot any insulin back into the pen but, other than that, is there anything else I should know?

Again, thanks for your support. I could not do this without this group; I hope I can return the favor to someone else in the future - once I figure out what the heck I'm doing.

 

[Kelly and Buddy]

My cat eats twice a day and he is on the SLGS method. Haven’t had any issues. I am out of the house for 12 hours each day so we can’t do TR. I tried automatic feeders, and he managed to break into ALL of them. Also, Frosty tends to break into contraband every now and again. It happens to the best of us. I know how frustrating it is, especially in the beginning, and yes he will go high but he will come down. You will eventually develop a routine that will work. But mistakes still happen, pets will occasionally eat the wrong food. Don’t be so hard on yourself, you’re doing the best you can.

Ana, your post sounds encouraging. Does your cat not drive you crazy in between feedings? I am curious how much you feed at each feeding and if your cat nibbles throughout the day or inhales it like Buddy. I think I could leave the entire 13 oz can down and he would eat it in one sitting.

Have you been able to get his numbers down by only feeding twice a day?

 

[Ana & Frosty (GA)]

Ana, your post sounds encouraging. Does your cat not drive you crazy in between feedings? I am curious how much you feed at each feeding and if your cat nibbles throughout the day or inhales it like Buddy. I think I could leave the entire 13 oz can down and he would eat it in one sitting.

Have you been able to get his numbers down by only feeding twice a day?

Frosty is a gobbler. He has another metabolic disease called Cushing’s, so he is extra hungry and crazy with food. Since he is a big long boy and 14 lb, I feed him 2 cans of FF twice a day. (He’s had issues with vomiting lately but it’s not food related. In case you come across my posts about that).

Due to his illness, it doesn’t matter how often or how much I feed him, he is constantly begging and trying to steal food. He has to be fed separately from other pets and doors have to be closed and we have to watch everyone. If the other pets don’t finish or don’t eat, their food has to be put away before I let him out. We try not to keep him locked into one room while we are out of the house all day, but sometimes it’s necessary. It doesn’t happen often.

Yes, his numbers have been improving with just 2 feeds, as you can see. Don’t be alarmed by the period of really high numbers if you look at my SS- like I said, we just diagnosed him with Cushing’s, which is why he has the diabetes. Once he started on treatment for it, his diabetes became better controlled.

The whole thing is an overwhelming struggle. We also have 4 pets and although i live with my bf, he works more than I do and also goes to school at night. So I’m the one who takes care of the animals. You just kind of figure out a routine as you go.

 

[Kelly and Buddy]

Frosty is a gobbler. He has another metabolic disease called Cushing’s, so he is extra hungry and crazy with food. Since he is a big long boy and 14 lb, I feed him 2 cans of FF twice a day. (He’s had issues with vomiting lately but it’s not food related. In case you come across my posts about that).

Due to his illness, it doesn’t matter how often or how much I feed him, he is constantly begging and trying to steal food. He has to be fed separately from other pets and doors have to be closed and we have to watch everyone. If the other pets don’t finish or don’t eat, their food has to be put away before I let him out. We try not to keep him locked into one room while we are out of the house all day, but sometimes it’s necessary. It doesn’t happen often.

Yes, his numbers have been improving with just 2 feeds, as you can see. Don’t be alarmed by the period of really high numbers if you look at my SS- like I said, we just diagnosed him with Cushing’s, which is why he has the diabetes. Once he started on treatment for it, his diabetes became better controlled.

The whole thing is an overwhelming struggle. We also have 4 pets and although i live with my bf, he works more than I do and also goes to school at night. So I’m the one who takes care of the animals. You just kind of figure out a routine as you go.

Aaahh, I know Cushing's well. I had a Chow that had it and he was a food shark too. Twice he got down a bag of cat food and consumed the whole bag. Fortunately, he did not have diabetes on top of the Cushing's.

So, you are only feeding a 14 pound cat 2 cans of FF. I assume you mean the small 3 oz cans (as I've never seen any larger ones). I'm feeding Buddy (who is down to about 8.5 pounds buy should be about 13 pounds) 1 large, 13 oz can, of Friskies. Something doesn't add up there. I've asked my vet if his food should be cut back and she doesn't seem concerned but, according to directions, the recommended food serving is only 3/4 oz - 1 oz per pound which definitely does NOT add up to 13 oz. With all that said, I can not imagine him only eating 2 small cans a day. I think he would chew his leg off. But I do wonder if I cut his food intake how his BG would be affected. It's all so intermingled and complicated.

 

[Ana & Frosty (GA)]

Aaahh, I know Cushing's well. I had a Chow that had it and he was a food shark too. Twice he got down a bag of cat food and consumed the whole bag. Fortunately, he did not have diabetes on top of the Cushing's.

So, you are only feeding a 14 pound cat 2 cans of FF. I assume you mean the small 3 oz cans (as I've never seen any larger ones). I'm feeding Buddy (who is down to about 8.5 pounds buy should be about 13 pounds) 1 large, 13 oz can, of Friskies. Something doesn't add up there. I've asked my vet if his food should be cut back and she doesn't seem concerned but, according to directions, the recommended food serving is only 3/4 oz - 1 oz per pound which definitely does NOT add up to 13 oz. With all that said, I can not imagine him only eating 2 small cans a day. I think he would chew his leg off. But I do wonder if I cut his food intake how his BG would be affected. It's all so intermingled and complicated.

2 small cans of fancy feast twice a day. So he gets 4 cans per day.

 

[Kelly and Buddy]

That makes more sense; I misread our original post. I'm thinking about switching to 4 cans of FF Turkey and Giblets pate because they are less than 1/2 the carbs of what I feed now. Will wait to I get him back on track with insulin before I make dietary changes.

I'll stop with questions for now but I'm sure I'll have more in the coming days.