Rennie ProZinc -- One more step to recovery -- 2 units

Most cats don’t do well on giving different doses for a.m. and p.m. There are a few exceptions that I have seen, but since one cycle affects the next, it generally doesn’t work and causes erratic BG.

If you would like to stay with SLGS then you should take the dose reduction that she has earned by reducing to 1.75 units at her very next shot. She already earned the reduction by dropping below 90 (on more than one occasion.)

The target nadirs for SLGS are between 90 and 150. That’s not horrible, but if your goal is to keep Rennie spending more of her time in the normal healthy BG numbers then you would be better off following MPM. There is nothing wrong with following SLGS, but it is unlikely to help your Rennie into remission or close to those normal BG numbers of 50-120 which are much healthier for her kidneys and other organs. That is the only reason I suggested you take a look at the Modified ProZinc Method. We would not be too aggressive with Rennie’s dosing, but we would have more flexibility to increase doses more quickly if needed.

La and Rennie said:
What is the harm of staying with SLGS for Rennie? Have her stay on 2 units for a few more days. Then, I think she'll need 2.25 units. Stay with that for 10 days and see where she is at.

And, can I give her 1 dosage for the day, and a slightly lesser amount for her nighttime?
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Rennie would not stay at 2 units per SLGS. She would be dropped back to 1.75 units if following SLGS. And we do not hold doses for ten days but for 7 days, and then we evaluate the nadirs to see if we should hold a little longer or increase. Reductions are to be taken as soon as Rennie’s BG drops below 90 (we don’t wait for seven days and then reduce, in other words.)

If she eats only LC wet then I just recommended the MPM to help Rennie maintain better BG numbers and possibly even go into remission.

I hope this clarifies a few things. Ask any questions you have! Questions are good. 😊
 
Looking at her spreadsheet— Rennie is making real progress and is staying in blue numbers for longer periods of time. She would not be doing this well if you were following SLGS because you would have decreased her dose to 1.75 units. That is my point.

She’s been on the 2 units long enough for us to see what is happening and how it’s affecting her BG. She is ready for 2.25 units, especially if you are feeding a spoonful or two of food around +2 and +4.
 
Suzanne & Darcy said:
Looking at her spreadsheet— Rennie is making real progress and is staying in blue numbers for longer periods of time. She would not be doing this well if you were following SLGS because you would have decreased her dose to 1.75 units. That is my point.

She’s been on the 2 units long enough for us to see what is happening and how it’s affecting her BG. She is ready for 2.25 units, especially if you are feeding a spoonful or two of food around +2 and +4.
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I just started Rennie on 1/2 can snack at 11 am. To let her system adjust to that, I will wait and then take her to 2.25 units.

Thank you for your response, Suzanne. Please keep in mind that if I were not in the midst of caretaking a 95 year old family member in hospice care that I'd be able to cope with a potential new method. I am barely hanging in there. I also am recovering from weeks of illness myself.

Rennie needs to stablize and have her system start to take over as much as possible which I am finally seeing hints of this in her. If needed, I can do the modified method later. One thing I also need to see in Rennie stabilizing is the duration of her insulin.

I did see Rennie with changes in her insulin dosages depending on her prior numbers in May. It was like riding aa wild horse that needed taming. It was while I took her from 5 units down to 0.5 units with transitioning her from prescription/dry (higher carbs) to FF wet (nearly zero carbs). I did this without anyone's guidance, and kept adapting to Rennie's prior #s and as I changed her food gradually.

What I learned was those lower desired #s in May were not stable which is why the gradual SLGS and lowering her stable bg line gradually downward is important.

I now go to sleep at night and not worry her numbers will not drop into hypo range. Her system automatically takes her bg up on her own!!
 
OK, you are free to do that… and I do think that she will do better on the 2.25 unit dose. But you need to change your signature and remove from both your spreadsheet and your signature the dosing method of SLGS because you are not following SLGS because you did not take the reduction that was earned when she dropped below 90. The reason this is important and why we ask people her on the FDMB to do this is because it confuses other people who are following SLGS when a reduction is not taken when a reduction has been earned— or when the dose is increased when it should not be increased. Please write “Custom Dosing. Do not copy dosing” on your spreadsheet and please write Custom on your spreadsheet where it currently says GS. Another thing is that there are a lot of people who join the Board who read other people’s posts and look at their spreadsheets and they do not ask questions or start their own threads to get help and get the correct information given to them —and they don’t understand why people are dosing the way they are dosing. More in a minute… I just needed to take care of that housekeeping matter first.
 
I could actually tell from your spreadsheet numbers alone that you had added in a snack because her numbers have been better. The snack however, does not need to be a full half can —if it’s a 3 ounce can of say fancy feast or whatever you’re feeding her, a fourth of a can would be plenty to give her at +2 and again at +4 or thereabouts. Just stop feeding after nadir. This will become even more important as you go along in her journey and she starts getting into better blood glucose numbers. You are doing a beautiful and very attentive job of taking care of Rennie. I can see how much she means to you. ❤️ And you certainly are stretched thin, I know. Believe me, I know what it’s like.

Sometimes I see a pretty substantial jump in her numbers after nadir so just be sure to feed as low carb as you can and try not to feed after nadir.
 
La and Rennie said:
Please keep in mind that if I were not in the midst of caretaking a 95 year old family member in hospice care that I'd be able to cope with a potential new method. I am barely hanging in there. I also am recovering from weeks of illness myself.
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I am so sorry you have been ill, and caring for a family member who is dying is extremely difficult. We went through that with my mother. I am amazed at how well you have coped so far. Hang in there. I can see how, at this stage in your life you perhaps should take it easy with Rennie’s dosing. My job here with regard to recommendations is to is to make sure she stays safe while evaluating her numbers and other information that you provide about her overall condition. I will recommend what I think will work well for her, but you have to provide the context. For some people that is work schedules, for some people that is family situations (like yours.) Thank you for reminding me about what is going on. Again, she is doing so much better and I am very pleased. Look back to the beginning of her journey. What a difference!

I understand it can seem stressful to try a new dosing method, but the only real difference at this point is that we would not take reductions at 89 and we can (but do not have to) increase the dose without holding it for 7 days.
 
La and Rennie said:
I just started Rennie on 1/2 can snack at 11 am
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11 a.m. doesn’t mean anything to me. I am on Eastern time.

What is her shot time and how many hours after her shot time is 11 a.m. ? Since we are frequently on different time zones from those we are helping we use the +hours on the spreadsheet to communicate.
 
La and Rennie said:
One thing I also need to see in Rennie stabilizing is the duration of her insulin.

I did see Rennie with changes in her insulin dosages depending on her prior numbers in May. It was like riding aa wild horse that needed taming. It was while I took her from 5 units down to 0.5 units with transitioning her from prescription/dry (higher carbs) to FF wet (nearly zero carbs). I did this without anyone's guidance, and kept adapting to Rennie's prior #s and as I changed her food gradually.
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You definitely will see huge reductions in BG as well as insulin needs when transitioning to low carb food (as you already saw!) I don’t have data from May on Rennie, but I am astounded that she would have been on 5 units at all. That is a dose that should have been worked up to very gradually with small changes and strict BG monitoring. Wow. But, see how you helped her with the food transition and monitoring her so closely. Again, well done! You have helped your sweetie tremendously.

Remember, if you are still using the Libre to track her BG, you will need to be able to use a handheld glucometer and get an ear prick and test the low numbers with a drop of blood from her ear or a paw pad although that is less common. Otherwise, you will be making dosing decisions based on what are most likely falsely-low numbers. I want to show you a couple of spreadsheets as a matter of fact, so you can see what I’m talking about.
 
Having said all that, I am completely familiar with being overwhelmed with life. In the last several months, I have been at the vet an average of 3 to 4 days a week. I have sick cats, sick foster cats, sick feral cats with bite wounds that I have taken to the emergency room and recuperated for several weeks in my home. TNR of feral cats…. Feral cats run over by cars, dead kittens, abandoned kittens born paralyzed (last Thursday)….. Rescues that have to have eyes removed and I now have to find a home for him and others.

I am currently in a pretty trying situation with one of my beloved girl kitties. I will be taking her back to University of Georgia on Tuesday if all goes as planned, She is practically a full-time job in and of herself. If it weren’t for my daughter, who also helps me, I don’t know how I would manage very well. Some days I don’t.

I know that none of this really compares to your situation with your sick family member, because I know what that is like as well — and I am so sorry that you’re going through that, but I’m so glad that you are the kind of person who is caring for a terminally ill family member. It takes a special kind of person with a great deal of love and fortitude to do that.
 
Oh, you asked— or mentioned— about Rennie’s duration of her insulin. She’s already getting better duration as her dose is approaching a more optimal dose for her current needs. It takes time and management of the dose as well as not feeding after nadir if you can manage it. Another thing that helps with duration is learning to shoot lower AMPS and PMPS numbers. This takes time and guidance and careful monitoring but is definitely possible.
 
Take a look at the difference in Libre numbers and handheld glucometers for Buster’s spreadsheet. I have circled some places where the Libre is giving low numbers that are not actually low. Buster’s caregiver checked these low numbers with her meter.

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See how in the higher numbers the Libre is closer to the handheld glucometer. In the lower numbers they are not close. Libre says Lo (scary) and AT meter says 86 or 77 or 93.

However when the Libre says 181 the meter says 191 (so much closer.)
 
Thank you beyond words, Suzanne. I will read and reply as I can. Right now, I have very low energy and low concentration due to this post viral fatigue condition. No one to help me.

Your kindness, patience, and expertise is deeply appreciated. Rennie will be fine with 2 units, then 2.25 units. I need to sleep now.

I added a bar on my SS so it gives the "11:00 AM" time above the +4, and "7:00 AM EST" so it would known I'm on the east coast.

Yes, I deeply love my Rennie.
 
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