? 5/7/17 Sprocket,AMPS/299 +2.75/223,+4.5/247,+7.25/254,PMPS/149 +1.25/89, +2.2/77, +3.25/85,+5.2/131

http://www.felinediabetes.com/FDMB/...278-4-75-252-why-no-drop.177506/#post-1957397

@Wendy&Neko .....have you seen the ss with last week with new dose....bad.
Thats why i m worried about going up. Thibking he will drop hard once he gets more insulin.


This am 299. Looking n acting good. Ate 2oz 3 carb. Left .75 from 3am 0carb meal.
Has .5 of 3carb meal too. With probiotics too.

 

Hi Darnell, Sprocket has room to go lower and there doesn't seem to be any real dives on the SS that should worry you. When you see that he is starting to drop fast and early, you can give some LC food to help slow down the cycle and keep him flatter.

Glad that he is eating for you and is doing well.

 

Think positive. We increase in little tiny increments. Hopefully a 0.25 dose increase will just bring his overall range of numbers down a bit into more blues and a sprinkling of high greens. That should be your goal for now. Good luck with the dosecrease when you decide to do it.

 

Firstly I want to say that you do a great job of monitoring Sprocket, when I look at his ss, I'm not seeing any worrying 'holes' in the data that leave me wondering what Sprocket has been up to.

The range you have been getting on the current dose still leaves you with a lot of margin for improvement, he's seen nothing lower than a 180 for the last week, and if anything his numbers may be trending up slightly, you don't want to hold on to a dose for too long as that can be counterproductive.
Along with the others I think there is certainly room to take the dose up by 0.25u, we'll be there for you when you decide to take the plunge, I know the thought of him dropping gives you a lot of anxiety

 

???'s

I am feeding him about every 3 hours currently. Is that stopping the insulin from working?

I had thought that since he was in upper 100s with 3.5 that he would go to lower 100s with the increase to 3.75u. That has not happened. He is better than he was months ago but because he was dka and ketone prone this is why the 200s are not low enough. Is that correct??


With going up to 4u that should put him down more. Correct?

When I get the dose that puts him down to lower 100s then what happens?
Will he stay there?
Or will he start going back down?
Or does that happen once his organs heal more at the 100s & his organs start making its own insulin again??

How does the next step work??

@Wendy&Neko
@Meya14
@Jill & Alex (GA)
@Gill & George
@Dyana
@Bobbie And Bubba

 

I have a question to ask about Darnell's feeding schedule for Sprocket and how/if it will effect the Lantus 'drop' 'working the lantus' 'the bg'.
If he feeds at AMPS (6am).
Then leaves food out to eat (6-9 am).
Eats again at 9:15 am.
Eats between 11 am to 12pm.

How does the lantus drop ? Doesn't this just keep the numbers up ? Does it make sense moving forward at the increase of 4 units that there is more time in between the feedings so the Lantus can drop the bg and let it do its work. Or no... this doesn't matter at all that he has 10 feedings a day ?
Does it make more sense to put down 4 ounces at 6 am and his next feeding would be at 12 pm to allow the Lantus to drop and work. Or to feed him throughout the 6 hours to 12 pm ?

I just question amount of feedings..

I agree an increase is needed but doesn't amount of food, carbs in total for the day, frequency of feeding, calories count too. Shouldn't we be focusing on reducing the amount of feedings to 8 feedings or 6 ? Or no .. just feed all day and continue to increase.

That's all...

 

Because Sprocket is ketone prone, it was suggested to get as much food into him as possible at the time to combat the ketones from developing into DKA again.
If he is gaining too much weight, a small reduction in calories would be okay.
As far as timing of he food, every cat is different (ECID). She is feeding a low carb food, so the Lantus should work to lower the blood sugar even if he has frequent meals.

Cats insulin needs can change while you're doing this dance. He is better than he was when he had all those pinks. Pancreas healing if it happens, will do so when it doesn't have to work as hard, while the added Lantus insulin helps him to stay in normal numbers (50 to 120).

You can stay there for a while until you are more comfortable with those numbers, and then try for more greens. I know it's hard and scary, but the more often he gets to the lower numbers the more comfortable you will feel with it.

 

Sometimes when you get close to the right dosing, you'll actually see the blood sugars become very even "flat" before they actually get into the good range with the next dose increases. "Flat" blood sugar curves without a lot of bouncing and closer to the normal range, indicate that his body is also trying to regulate and keep homeostasis rather than going high-low and all over the place. -This is a great thing!- I expect with your next few dose increases you will see the flatness continue, but the numbers will start to be flat in the blue or even dark green range.

The flat numbers also protect him from the hypos - as his body is regulating better and less swings in numbers.

Once you can hold him in the dark green range and have flat blood sugars for a few weeks or sometimes even shorter, its possible that his pancreas can heal some and you might even have to reduce doses once he is making his own insulin.

Cats insulin needs can change for a lot of every-day reasons too, food, activity level, hot or cold weather, mood, etc. It's not always worth worrying about. Hormones are funny that way. It's best to gauge food intake on weights rather than blood sugars especially when DKA prone. It's possible that reducing food without considering weight can lead to lower sugars, but the low sugars can be due to starvation - which is bad news.

 

@Meya14
@Gill & George @Jill & Alex (GA) @Dyana @Bobbie And Bubba

Please tag anyone else cause I WILL NOT BE GOING UP ON DOSE AGAIN WITHOUT DISCUSSION. THANKS

Ok...if this doesnt say the # of carbs makes a difference.....then I dont know!!!!

2pm in afternoon. +7 25 he is at 254.
He eats 2oz of 1 carb food
6pm he is 149!!!! Pmps!!!!

I gave 4carb 2oz plus 3carb .75oz.
I hope its enough to hold him up now.
I am worried!!
Just shoot 3.75 on 149!!!

 

Yup, shoot the 3.75. I still think that you are OK for the dose increase, however, you should try to schedule the increases during times when you have a lot of time to monitor, and when it will be the least stress for you (like on a weekend or days you have off). Remember, lantus really doesn't kick in for hours later, so the preshot number don't always indicate what will happen later especially depending on what he eats. Hoping for a nice flat blue curve tonight. Once my kitty started getting into flat numbers, I'd regularly shoot his dose on anything higher than 60 and his numbers would pretty much stay around 60-70 all day. It takes some time to feel safe when you get into the lower numbers.

 

But if you compare it to, say 4/29 and 4/30 then it doesn't. On 4/29, you started him on 4%. He got into blue numbers. You then gave him 3%...and he went up to yellow numbers. Then overnight on 4/29, he got 7% food, followed by 4% at AMPS...and still got back into blue numbers. Or 5/3, when his meals during the daytime cycle were all 1% and 2%, but you had a PMPS of over 300. Leaving aside that I still don't think there is the guaranteed difference in the carb percentages that you think there is based on Dr. Pierson's list, the evidence just isn't there unless you look at only one or two numbers in isolation. Today, he got 1% and 3%..so actually slightly MORE carbs (in theory) than on 5/3 but with a lower PMPS as a result. Yes, he has a lower PMPS tonight - but he might have had that anyway. You are, of course, free to keep trying different carb percentages, but I think you need to look at the numbers overall rather than just one unusual number in the overall pattern.

 

He dropped at +1.25 to 89!!!

 

You've got this. A little bit of low carb food - see if he can surf. Cats can very easily surf the entire cycle - their bodies do learn to recognize the normal numbers and they'll hang out there happily all day - preshot to preshot.

 

Well i am pointing out that after the carbs of 7% that night his numbers went higher like it accumulated then raised him instead of raising him right away.

 

Uhm...that's not how it works at all. The reason we test at +2 is because that's about when you'd expect to see the maximum food spike from food. After that, it starts to digest and is gone relatively quickly (a matter of hours). Anything you're seeing the best part of a day later isn't the result of a 7% carb food. The carbs don't accumulate. That's why, when we give a higher carb food for a genuinely low number, we have to keep testing AFTER we stop giving the food - it really is gone that fast.

 

Before the insulin has kicked in though!!

 

He still has depot action from the previous shots as he's been at this dose for a few days now. He only needs low carb food at the moment.

 

So maybe wait another day or two before the increase to see where he's at.

My experience with my cat and food is that once he got into better numbers and no bouncing, the higher carb food tended to just raise his BS evenly over like 12-24 hours. He never really got "food spikes" close to the time of feeding, even if he ate straight dry food (he'd sneak into the other cat's food sometimes).

 

I was told by i dont remember that the food lasts longer thats why it keeps bg up after a few hrs. And gravy is fast acting to raise for now till food kicks in.

 

Yeah, but you wouldn't see a definite spike of close to 100 points almost 24 hours AFTER the higher carb food and after the numbers during the previous part of the cycle hadn't been any different from the slightly higher carb food. That's the issue I'm having with the claim that the 7% somehow 'accumulates' and causes higher numbers...but only almost a day later.

 

I feel the total amount of carbs a day makes a difference and influences numbers. Yes, I understand when someone says 4 and 3 carbs makes no difference. But, when Sprocket has many feedings throughout the day those 1 and 2 carb differences can add up some days to a total of + 20 carbs. I told Darnell just try it today you have nothing to loose before starting 4 units. Meaning go back to 0, 1, 2, 3 (max) and it's an extremely low pmps as well as a nice drop at amps to +2. I agree she needs more days to have enough evidence to say if the total number of carbs made a difference or not but I am convinced it's not coincidence.

The bottom line is ..it's very important as far as I am concerned that you pick a feeding schedule which includes similar (carbs, calories, frequency of feeding, and amount).

 

I dont mean 100pts higher. I am talking it makes a difference little at a time but when he is lower it only takes a little to cause hypo possibly.

 

The carbs are a percentage. You can average them, but you don't add them to each other.

 

But when the little you're talking about is 20-30 points on a reading of 200+, then the difference isn't even relevant to anything. It can be completely explained by meter variance. And your spreadsheet just doesn't back up what you're saying unless you pick one or two numbers out of the whole thing. I could equally make the argument (and prove it based on numbers on specific days) that he actually does better numbers-wise on slightly higher carb food.

 

But 20-30pts will make a difference when he is 149

 

I was about to ask the same thing...how the '20' came about. Because unless he's getting incredibly high carb food at some point, there's no way there can be a 20% difference. If all the food is between 0% and 4% carbs, then the most difference there can be is +/-4.

 

Except that it won't BE 20-30 points when he's at 149. It'll be maybe 10-15. And if he's at 80, it'll be maybe 5-10 points.

 

This is looking like a nice cycle! I've been off line most of the day and just got the tag. If you haven't all ready you can give some LC food to keep him surfing. I would test again at +3 and give a bit more LC food. Save the HC if he goes under 50 .

 

Sometimes, I feel like when he got into the dry food it would be even raised for longer than 24 hours, the lantus would take a few cycles to beat his numbers back into the range they were in prior. I would not see a spike that far later, but 100pts up from previous days numbers and a flat curve at higher number definately would happen. Granted, this was mostly when he got into the dry food (probably more than 20% carbs).

The other thing that happened with my cat is that if I accidentally fed food with fish in it, even very low car foods, his blood sugar curve would also rise for a day or two, sometimes more than 150pts. I suppose he may have a sensitivity to this and higher numbers may have been due to inflammation.

I think that the more consistency overall in feeding (brands, amounts, times) helps regulation, but knowing how to "steer the curve" for your kitty is also an art in itself. Sometimes things can be a little random and patterns aren't really patterns. It's hard to figure out.

 

I've heard up to 3 days for dry food for some cats, so that doesn't sound all that unlikely.

The days I'm looking at on Sprocket's ss, for reference, are 4/29 and 4/30. He got 7% food at 3 am on 4/30, yet still showed a fairly nice drop after his AM shot that day. That's why I don't think the 7% influenced anything beyond potentially his AMPS although even that wasn't out of range for him based on the days around it (when he'd had lower carb food). I'm not buying the claim that the 288 that evening (which again, isn't out of range for his PMPS numbers) or the 302 the next morning (which again is a little higher, but not ridiculously so...and he's had AMPS numbers around that level after food with 4% or less carbs too) are caused by feeding 7% food instead of 4% for one meal the day before. Especially not when the reason being given is some kind of 'accumulation' of that extra 3% of carbs in his system that did nothing to his numbers until that point.

 

When our sugar cats get into higher carb contraband , the carbs can take up to 72 hours to clear according to what Jill posted on my thread when I thought Bubba had gotten into food garbage ( baked ziti) unless I misunderstood. This was when he was OTJ not sure if that's the difference or not.

 

In my experience only, remission is a factor. The time Rosa was at a boarding vet and they gave her DM dry food (don't get me started), it took a week for her numbers to come back down. She was in remission at that point. I just think that you would see the food start to have an effect much faster than 24 or more hours later.

 

Yes , I agree on that point , it would be immediate.

 

I agree that the difference from 3-4% and 7% probably isn't doing much to the numbers any more than the hundred other immeasurable variables during the day. The variance even from can to can or brand to brand might even fall outside of that range depending on the manufacturer and how they test and report the carbs. Hence, consistency in feeding I think is more important, as it eliminates food as a variable cause you are feeding the same brand, same amount, same time. Sometimes, the body just does weird things too for no reason, so taking one day's or even 3 days numbers and trying to find patterns can be the wrong approach. Better to look at the bigger picture pattern - at this point it seems with the current feeding and insulin dose, he's right at the edge of where he needs to be and number are looking pretty good.

Also glucose toxicity can really be the "pattern wrecker" for many cats.

 

So much this! We're battling this with Roxi constantly. She'll do well for a bit, maybe even earn a reduction...then back up she goes and stays there. We tested for acro and IAA too - both completely normal. I'm sure we'll break the toxicity at some point, but it makes her really, really unpredictable.

 

Have you gotten another test? With that fast drop I would be testing fairly frequently.

Food experiments don't see results immediately. Sometimes you need a week or two before you can see the results. There are too many other things at play day to day in blood sugar numbers (bounces, breaking bounces, glucose toxicity, absorption rate, amount of exercise, sometime scary.....), so you need several days of data to figure out what you are seeing.

 

Ok. Yes @Wendy&Neko . I did. Added above. Sorry for delay.

+2.2/77, +3.25/85
Fed (8:07pm,1.5oz of 7 carb)(9:05pm,.25 of 7 carb+ 2tsp 13carb gravy with food pieces)(1030p,1.5oz of 7carb)

When i switched to 3.75u. I also started feeding a 4 carb at every amps and pmps meal for days. Doesnt that count??
He stayed up and was kinda flat. But today I did 3carb at amps then did ocarb and 1 carb rest and look where we are now?
I dont think that is just a coincedence.
Thats what i am talking about.

 

Those were some really nice numbers you got last night.

 

Those were some scary hard numbers though. I had to keep feeding alot to keep those numbers.
I hope he is ok.
I worry now. It was an odd time for a drop.

And I continue my discusion today on the food. If he is ok feeling then its the food difference.

 

Some cats are really carb sensitive.

 

Ya issue is its is the carb cumulative? Cause it didnt go low till afternoon.
I dont want another repeat of last night. I have barely slept still but i have a burial this morning so staying awake right now.
I have been writing all food on ss and I will fill it in for past weeks to see if patterns show up.

 

I wonder if what you saw yesterday with him dropping into pmps, was him clearing a bounce, he saw blue a few cycles earlier??? It seems odd but who knows.

I don't understand what you are getting when you ask, are the carbs being cumulative?

This is a great idea.