Tibbs 9/13 amps 392 +& 323 pmps 374 why back up?

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tibbs5

tibbs5

Member Since 2014
Hi folks in LL
i have some questions for you knowledgeable folks please.
I have not changed shot times yet and i know i have to get on those pm mid cycle tests. Time change will def help with that.

Tomorrow i will be able to get some mid cycle tests in the pm cycle and based on those nadirs, then an increase for monday? we'll see what the pm numbers say. i just wonder why he immediately had a BG reduction from the new food from 9/6 to 9/9 and now he's back in pink. Wish i understood this. That's why I was holding off on the increase because i thought coming off the high carb food would drop him significantly and it did right away but.... sadly he does not want to stay in the lower numbers. I need to understand why that is. Can anyone possibly explain this or is it just a case of ECID ? He had such a great drop into blue when i changed his food and some yellows but now he is back in the pinks and i guess the food is not going to do much more for him so i know i have to increase. just trying to understand the science of what is going on in his body. Thanks so much for all your help. So appreciate it.
Nadine

This is my link to relaxed too.

viewtopic.php?f=32&t=125265
 
I suspect there are a couple of possibilities.

There isn't a consistent trend to lower numbers from 9/6 to 9/9. There may have been a low and a bounce but Tibbs isn't spending a good deal of time under 300. Thus, what you're seeing is his usual range.

You've been dosing 1.5u since 8/31.What you are likely seeing is glucose toxicity. While that term sounds dreadful, what it means is that Tibbs' system regards this BG range as his new "normal." The reason that the TR Protocol has you evaluate a dose after 3 days/6 cycles is to try to prevent this from happening.

I would also encourage you to follow the protocol and not increase by fattening the dose. Dose changes by less than 0.25u are really meant to be used when you are trying to zero in on a good dose. Right now,, if this were my cat, my goal would be to get the numbers in the low blues or greens.
 
Nadine - I think it's time for an increase now. You said you can get some PM cycle tests, Increasing the morning before then would be good timing. Your SS shows you went up a fat unit yesterday, but we've found that going up a full .25U is better. Save the fat or skinny changes for when you are trying to fine tune a green nadir. Until then, stick to .25 or .5U changes. I don't know if you've read the note on Glucose Toxicity, but the longer a cat stays in higher numbers, the more work it takes to get them into the good healing range.

And sometimes cats just have to go up in dose in order to go down. A couple of weeks ago Neko went off her food (very unusual) and she went from predominately blue to pinks. She's back eating again, I have no idea why she was off. But as soon as her numbers went higher I raised the dose to get her back in blue/green again. She gets used to pink way too easily.

If you are hoping to get Tibbs into remission, it's important to get him into healing green numbers as soon as you safely can after diagnosis. The Tight Regulation protocol we use here is based on that goal. Even if you aren't interested in remission but rather getting him well regulated (a good option), then getting him into good numbers sooner is better for his health.

ETA: I see Sienne just said the same thing in less words. :roll:
 
oh ok. i see. that's makes sense. Thank you so much. So i will just do the increases then. Do you think I can still overcome the glucose toxicity now that i have not been doing the dosing increases?
Thank you Sienne .that definitely helps me to understand what is going on.
Nadine
 
Thanks Wendy. the more i can read the better. So do i do anything differently now that he has the glucose toxicity?
 
i agree with Sienne. I suspect that to get him out of these pink numbers, you're going to want to be increasing every 6 or so cycles, based upon what nadirs you've gotten in those 6 cycles, to get on top of his numbers. Sometimes people get the idea that all cats only need small doses, like 0.5u-1.5u, but the truth is that a cat needs as much as it needs. Some cats simply need more than others.

When punkin got the acro diagnosis, i was lamenting about how high his dose was going. It's kinda embarrassing to have your cat need more insulin than everyone else's cat. That sounds dumb as i say it, but that's how i felt. Someone said to me that the important numbers are his blood sugar, not his dose. That stuck with me. The goal is to get Tibbs first into a range that protects his kidneys. For most cats that's spending most of their time under 250, and 200 is even better. The next goal is to get him tightly regulated - which means that you're protecting his entire body from the damage that high blood sugar causes. That means keeping his blood sugar in normal numbers, 50-120.

I'd go up immediately to 1.75u if i were you. I am a little doubtful that will be enough, because you had him at 2.0u before and although he wasn't there very long, 4 cycles can be enough to get an idea of what it might do and it didn't get him into good numbers by the time you decreased his dose. I wouldn't hold any dose more than 10 cycles unless you had consistent nadirs under 100.

In any case, it's pretty clear he needs more insulin, nadine. I'd be more afraid of the damage of high blood sugar than of having him get into low numbers. As you go up in dose and his blood sugar goes down, you'll learn that you can control his blood sugar and steer him safely with small amounts of carbs.

I don't think the food is playing much of a role in what i can see. I'd focus on his insulin dose.

Here is a post that has a complete description of Glucose Toxicity.
 
My only concern with increasing according to the protocol is that you have to follow the protocol -- and that means getting at least one spot check during the PM cycle. The TR Protocol is aggressive but safe providing you're able to test. I don't want to needlessly put Tibbs at risk if you can't get any PM cycle tests.
 
Thanks so much Julie
When i ran home for his noon shot, i did increase to 1.75. Thanks for telling me what is going on. I understand it much better and i will def
read the post on glucose toxicity. I guess i was just hoping the food change would do it but as you said, i have to get his pancreas to heal first.
Thank you so much for your help.
Nadine
 
yes ok i understand Sienne. Right now i have his shots at noon and midnight due to work time constraints. I am trying to move them to 7am and 7pm so that will make it way easier to get the pm readings. Also because of work time constraints, how much time play do i have in the 12 /12 cycle? i mean if i am off by
10 min/ 20 min/30 min 45 etc is that ok? What number of minutes of missing the exact shot time would make it dangerous? For example. If i have to be at work earlier one day (which happens often) can i shoot at 6:45. Is there an amount of minutes late or early that would be dangerous?
Thanks so much.
 
You can move shot times 15 minutes each shot cycle or 1/2 hour once a day. So if you are 1/2 hours late back from work or have to shoot 1/2 hour early one day, that should still be OK. Some cats are more sensitive than others to moving shot schedules. I move Neko's shot schedule fairly often to accommodate a couple of night meetings I have and it doesn't bother her too much. Shooting too early can act like a bit of an increase while shooting too late can be like a bit of a decrease. Here is Marje's post on Getting Back on Schedule.
 
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