SLGS Attempt to regulate is proving challenging

[simonsugar]

Hi all, this is my first post here, but I have been tracking my sugar cat's numbers for almost a year, please see spreadsheet: Simon's SS

I am having a really hard time. EVERY time I try to bump him up above 2.5 as per SLGS guidelines, we have a horrible time and I get super frustrated and feel like I've failed my sweet sugar cat, Simon. He is incredibly tolerant, and I want to help stabilize him so he feels better. I home test using his back paws, he hates the ear pricks. The vet doesn't really want me messing with dose (she wants him on 3 IU), aside from "no insulin if <200" which would have sent him into even more bounce cycles. I will do whatever is best for Simon, my whole life revolves around his shot routine and testing, but right now, I feel like I am not doing a good enough job taking care of him.

Please look at the SS and let me know if you see what I am missing?? He is VERY picky and gets low carb wet food (refuses FF and Friskies pate) 4-5x/day. If I miss his midnight snack or he won't eat, he WILL be low for AMPS. I work at 530AM so it is very challenging when he decides not to eat when I wake up at midnight to feed him. He won't eat from an autofeeder unless I am sitting with him (defeats that whole purpose). His brother will scarf and barf if I just leave a bowl of food out. Right now, his choice food is Kirkland wet food pate, and Petco Wholehearted Chicken Flakes. I will top with Dr. Elsey's Chicken dry food as a tempter. The dry does nothing to his BG as I have tried to give it to him to bring him up from a mid-low when I need to leave and then I retest in 20-60 minutes and BG has not changed by more than 5-10. He was on Prozinc previously and we could not get him regulated, so I asked to switch to Lantus. Please, help me help him so I don't lose my mind in the process.

 

[Wendy&Neko]

Hello and welcome. There are a few other things besides the signature that can be really helpful for us to see in order to help you better. Details are in this post, specifically the part about the signature. New? How You Can Help Us Help You!

I see that he's been on Lantus about 6 months now? How are Simon's clinical signs? Is he peeing normal amounts, grooming, playing, etc? Cats are more than their numbers and how they are acting is a useful indicator.

With the numbers you caught in the 40's (good catch!) 3.0 units is too high a dose for him with SLGS. Lantus is a depot style insulin. The larger depot can influence 4-6 cycles after a reduction, hence the low numbers you also saw yesterday. With SLGS, it doesn't impact what you do about the dose, the 0.25 unit reduction what you needed to do. I'm curious what 1.5 units will do for him for the next few days.

There are a couple suggestions I can make. I'm glad to see that you are not following directions to not shoot under 200. Though you do seem to be shooting lower doses if under 150. People following SLGS, with the data to do so, can shoot the full dose as low as 90, provided you are around to monitor that cycle. We determine how to change dose based on how low the dose takes the cat, not the preshot values. Lantus does a great job at keeping cycles flat if you shoot lower numbers. Over time, and when you can monitor try shooting more and more of the full dose when under 150. Every time you skip or reduce the dose, it impacts the depot meaning a few cycles of higher numbers.

My second suggestion is to try to get more night time tests after PMPS, especially since you can't get the daytime data due to work. Many cats go lower at night. If you can get a +2 or +3 or whatever just before bedtime is, we can get an idea whether he's dropping lower at night. It's possible you've been missing some previous reduction values.