? Zeke - 8/23 - AMPS 338, +2 314, +6 288, PMPS 206, +2 91, +3 57, +3.5 53, +4 59, +4.5 79, +5 103

Yesterday's Condo

His numbers are back to staying high yellows and pinks. Thinking tomorrow if today stays this way, upping his dose to a fat 2.5u. Maybe that will be where he needs to sit at.

Would tomorrow be fine to up his dose to fat 2.5u, or wait til the day after?

 

I'd give him a few days. They can wobble around a bit and find that doing "f" and "s" is best reserved for when you're trying to tweak the dose. See what others have to say.

 

What I am looking at though is that he has already been on this dose and we are starting to see the same numbers he had before. Since the 2.75 was too much, that is why I was thinking the fat dose instead. Would give an in between.

 

Zeke gained some weight this week. He sat at 12.6 for 2 weeks, this week he is at 13.2.

 

The pinks and yellows you are seeing now seem to be a bounce triggered by that 98 just 3 cycles ago.
The depot of the 2.75u was probably in play when you got that 98.

If he hadn't gotten down to that 98, I would say yes take him back up if you don't see green by end of today, but I'm a bit hesitant to recommend that with that 98 there just 3 cycles ago, I might wait a couple more cycles to see what he did when the bounce cleared, before calling a failed reduction.

I do agree with Karen, fattening/skinnying the dose is usually used when you are honing in to a good dose, I don't think Zeke is there yet. When you do take him up, if it were me I'd probably go back up to 2.75u, I know he got down to 33, but I looked back at the condo for that day and one thing that stood out was that you waited for him to drop below 50 before steering with food.
Given that on that day he dropped to 69 @+2 from an amps of 122 that was a sign that he meant business for that cycle.
From the new to the group sticky:
Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

Feeding some LC/ or MC at that point might well have helped him surf along in greens and not drop quite as hard as he did, or maybe you'll find that he needs MC or more, keeping notes on your ss and experimenting with the fuds can help you manage the curve with food, the goal being to get him to spend more time in greens, this with a little luck and a fair wind may help mitigate his bounces, it certainly made a difference for George, once I got the hang of managing his BG he flattened out.

Managing the curve with food can help flatten the curve, and allow kitty to see more green. When I adopted this approach I changed Georges feeding schedule, from 4 meals a day to 8 a day, I split his food so he got 1/4 of his allotted food for the day at amps and 1/4 at PMPS then he got 1/12 at +2; 1/12 at +4; and 1/12 at +6 (in am and pm cycle), I used that as a starting point, then as I gathered data and learned his cycles, I let the numbers guide me.

Here are a couple of post that talk about managing the curve with food and bouncing, I found them very useful when we were starting out.


Scroll down to post 13 and the discussion on managing the curve with food starts there
Tashie managing curve with food
http://www.felinediabetes.com/FDMB/threads/8-10-tashie-pmps-high-questions.101989/

Jetta and bouncing
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=55306

 

He was eating at that time, we free feed LC. I only mention food when feeding other then his normal food. He was actually eating pretty steadily on his LC and after we started doing the HC he would go eat some of his LC every time after he finished the HC.

 

Are you saying to start feeding MC instead of LC? Wouldn't that cause him to end up needing more insulin?

 

good to know.

Given that he was eating LC and that didn't stop him from dropping, next time you see a drop like that you might want to offer some MC at that point. I'm not suggesting that you swap to MC, just that you can use it to help steer his numbers.

If you were feeding it all the time then yes, but if you are using it to steer, what it can do is allow you to safely hold on to a dose for a little longer, and that can help with the bouncing and the yoyo ing with the dose. The aim is to get them into green and have them stay there as long and as regularly as possible, the dose is one side of the equation, the food is the other, it can be used to effectively flatten them out. It may result in a little more insulin for a while, but if this allows him to spend more time in the healing greens, it is the path that usually leads to a well regulated cat, earning and holding reductions.

 

Ok, I think I got what your saying now. So basically, like we give the HC when he drops below 50, keep the MC on hand for when he has a significant drop from PS to +2 to help keep him from dropping below 50 to begin with. What is a good MC range? We do the fancy feast gravy lovers for the HC. His LC is friskies pate's which are at 4-5%.

 

Yes, but keep in mind that depending on the cat you might even need to go for HC, a drop like that with George required a couple of teaspoons of 25% carb, any lower and he would dive, but he's not overly carb sensitive.

You'd be looking at something in the region of 15%, I'm in europe and don't use the same fuds, but I think that FF do some, is there a variety called grilled something or other???
I'll tag @Bobbie And Bubba hopefully she'll be able to help with that.

 

Ok, I thought that was considered HC and is what I am feeding for HC now. I swear every time I think I am getting things figured out, I get confused all over again lol.

 

11-15% MC

above 15% HC

Try not to get hung up on the numbers, it's more important what works for your cat (ECID). Some cats BG will zoom right up with 15%, and won't usually need anything higher, others are less sensitive.
George was one of those, I had to use 28% to bring him up especially if he dropped below 50 early on in the cycle, 18-20% just wouldn't do it for him if the drop was early in the cycle, however if he dropped below 50 in the latter part of his cycle (say at +8 or there abouts) I could get away with a 20% snack to steer him.
That's why it's important to keep notes so you can look back, it really helps you figure them out.

 

Hey Meridith. the medium carb food I used was the Fancy Feast Roasted. They are around 12 - 13 % You can check Dr. Lisa's new chart for the count for each flavor. When I was giving Bubba canned, I was using the FF Classics for my low carb, the FF Roasted for my medium carbs and the FF Gravy Lovers for HC.

 

Was getting time to restock my HC anyways. I have 3 can's left, 2 are 15% and the other is %20. So I have a combo of them and didn't even realize it.

That is what I have been grabbing for HC, but sounds like it can actually fall more to MC instead unless I just get the Beef Feast flavor.

I will be printing out the list for carbs again so I am getting within the carb range I am needing. I would like a more of a middle ground for the MC then what I currently have.

 

His PMPS is 206 so we might get some blues tonight.

 

Getting some action tonight! @Gill & George

+2 91. A good drop from his ps. Have given a spoonful of 15% MC and will test again in 1 hour.

He ate good at meal time and is still eating well on his LC. Can tell when he is in these lower numbers because he gets very playful!

 

looks like the bounce in over

 

Good job on the MC - I hope it slows him down a bit. As it is, that was a pretty good drop to +2. Surf's up Zeke.

 

Yep, that it is lol

When his ps was that much lower then the way his numbers had been lately, figured something was coming. Good thing I was talking with @Gill & George earlier on this so understand the food part on controlling when the numbers are dropping like that so maybe we can keep him from going below 50 this time round.

 

+3 57. Gave him a good spoonful of HC to help stop the drop since MC didn't really slow him down. Testing again in 30 minutes

 

+3.5 53

Looks like we have finally slowed the drop. Gave him another spoon of HC. Testing again in 30 minutes.

 

+4 59

Gave him a spoon of MC this time and will test again at +4.5.

 

+4.5 79

We are raising back up so definitely away from 50 now. Testing again at +5 to see how he is going then probably going to test at +6 for the next test. No MC or HC this time.

 

Great job!

 

Thank you.

 

Morning!

Looks like the threat of a dosecrease worked a treat.
Good job.

 

Thanks!

Yep, I really wasn't expecting these numbers at all tonight. At least it will be bed time soon for me then my daughter can finish monitoring for a couple more hours once we know he isn't going to drop back down again.

 

+5 103

Yep, he is rising enough and close enough to nadir that I don't have to worry about him nose diving so I am off to bed. My daughter is going to do a +6 and +7 just to make sure he stays going the way he needs. Looks like we will definitely be staying at this dose for a few more days lol.

 

As you last fed higher carb at +4, if he is still up by +6 your daughter could call it a night.

 

She is my night owl and prefers to be up later. She is home schooled so we just do our schedules so it works with her being up later and it let's us get more testing done then we other wise would be able to.

 

+6 151

Will see at his +7 if the rise will slow some since it will then be a bit since his last HC.

 

Keep it blue please Zeke, no need to go flying to the moon!

 

He is going for the moon again. +7 271.