Full Curve Testing

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Marty, Mar 17, 2018.

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  1. Marty

    Marty Member

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    Looking for advice on testing. We've gotten 3 readings so far but now we'd like to get a full curve. Our cat is still on prescription dry food. Should we wait until he is switched to a wet food diet before getting a full curve or is it beneficial to go ahead and do it? Not really sure what we should do to at this point. Thanks
     
  2. Kris & Teasel

    Kris & Teasel Well-Known Member

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    A switch to low carb wet food can cause a significant drop in BG numbers and a lowering of the insulin dose. The reason for a curve is to see the response to a given dose. I'd wait until the switch to low carb wet food is accomplished.

    You'll have to monitor BG carefully throughout the food switch because the dose you're giving when dry food is what he's eating might well be too high once he's on wet food.
     
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  3. Marty

    Marty Member

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    Thanks. So should we switch to low carb wet food soon? I thought we would need more testing on the dry food first. I just don't know how to gauge how much insulin he would need at this point
     
  4. Kris & Teasel

    Kris & Teasel Well-Known Member

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    What dose is he on right now? Following the recommended testing routine daily will allow you to see his response to the food change.
     
  5. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    The sooner you switch to low carb wet food, the better it'll be for Joey.

    Feeding high carb food while giving insulin is like continuing to pour gasoline on a fire that you're trying to put out.....you can do it, but it'll require a lot more water (insulin) than it would if you just stopped pouring gas on it (extra carbs)

    As long as you're able to home test, you'll be able to know what's going on inside Joey's body and will be able to keep him safe.
     
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  6. Marty

    Marty Member

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    He is on 2 units of Lantus twice daily
     
  7. Marty

    Marty Member

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    I guess I'm confused how the insulin injections should occur after the switch. Let's say we give him wet food in the morning. We would test him beforehand, but how would we know if he needs insulin or not? Haven't found a lot of info on that.
     
  8. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    At first, we say if they're under 200, don't shoot, don't feed and post for help.

    Test again in 20-30 minutes to see if the number goes up without any food....if it does, then it's usually a good sign that it's going to be OK to shoot, but in that time, hopefully someone with experience will be around to help you make a final decision. With ProZinc, sometimes you might be advised to shoot the full scheduled dose, or you might be advised to shoot a smaller dose....depends on the data

    As you learn more about Joey and how he responds to food and insulin, you'll gradually learn to shoot lower than 200, but first you have to collect some data by testing as frequently as you can.

    We like to see at least 4 tests per day......the 2 "Pre-shot" tests and one test somewhere mid-cycle on the AM cycle and a "before bed" test on the PM cycle.

    It will be really helpful if you'll start using our spreadsheet. We're very data driven here and people will want to see what's been going on before giving you too much in the way of advice.

    Here are Instructions on getting the FDMB spreadsheet
     
  9. Marty

    Marty Member

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    Sounds good. We'll do four tests tomorrow and upload a spreadsheet. We'll keep giving him the dry food for tomorrow. I'm nervous to switch at this point
     
  10. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Just do it slowly....replace 25% of the dry with wet, then 50/50, then 75/25 until you're totally on low carb wet food only.

    It's not only safer (while you're gathering data) but going slowly will reduce the chance of upset tummies and diarrhea
     
  11. Marty

    Marty Member

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    What about altering insulin during that time? If we reduce the carb intake by even a little, wouldn't we want to reduce the insulin as well? Is it just a guess at the beginning?
     
  12. Kris & Teasel

    Kris & Teasel Well-Known Member

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    As Chris said, the key to doing this safely is testing, first of all, and then setting up the spreadsheet to track your numbers. We look at the spreadsheet to see what's happening before giving advice. You can't just alter the insulin without knowing its effect as the food change happens.
     
  13. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    That's why testing is so important.....yes, we could reduce the amount of insulin, but it would be a total guess as to how much and if we guess "too low", it could cause Joey to be in higher numbers longer than necessary.

    The better choice is to test often enough as you reduce the carbs to know what's happening. If he drops too low, we know it's necessary to reduce the dose.

    The reason we test is to know what's going on inside their bodies. As long as you can test, you'll be able to keep him safe and know when it's time to decrease (or increase) the dose.

    Of course it's also important to have a "hypo kit" ready in case you need it. Several cans of high carb food like Fancy Feast Gravy Lovers, a bottle of Karo/honey/syrup and an extra package of test strips.

    Between home testing and having your "hypo kit" ready, YOU are in control of Joey's blood glucose
     
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  14. Marty

    Marty Member

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    I'll add my spreadsheet today. Hopefully that can help us figure out what's going on with him. We've gotten 2 samples so far today. Hoping to get a few more
     
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  15. Marty

    Marty Member

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    OK, I'm going to be asking a LOT of questions in the upcoming weeks. We're getting better at home testing so that is positive. I have a container of honey near him in case of trouble when we start the switch, but I'm nervous if something happens when I'm away for work for around 10 hours a day. I'm thinking maybe Thursday I'll adjust the food amount to 75% dry/ 25% wet, and maybe I can take those days off to make sure I'm around if anything bad happens. Plus that gives a few extra days of testing and getting a better picture of his BG levels and reaction to the Lantus. Thanks to you and Kris for the advice. Every time we have a success in the process it feels a little less stressful.
     
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  16. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, it is a process. You'll get there! :)
     
  17. Marty

    Marty Member

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    @Kris & Teasel @Chris & China I've added the testing we've done so far. Not sure if it's enough to draw any conclusions at this point, but I'm glad to have it started at least
     
  18. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Hurray for data! He's running high on this dose but you're undertaking a food switch. Don't change dose right now. Make sure you get a pre shot test AM and PM every day (no food at least 2 hours before) to check that the planned dose is safe. You need non food influenced BGs to know that. Get at least 1 other test in the +4 to +7 range daily or at least a before bed test if you're away all day.
     
  19. Marty

    Marty Member

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    I haven't switched the food yet. He's still at 1/2 cup twice a day of the Feline W/D Chicken dry prescription food right now. Or did you mean I'm about to begin to switch the food so don't change the insulin dose just yet?
     
  20. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, leave the dose as is for now and through the food switch but keep up the testing to monitor as you introduce the new food over several days.
     
  21. Marty

    Marty Member

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    I've added a few more tests to the spreadsheet. Does it seem like we could start switching from dry to wet food tomorrow? Going 75% dry/25% wet and staying at the same insulin dose of 2 units of Lantus.

    Unfortunately I won't be home tomorrow to monitor him, but the kids are home on spring break so they can pop in to make sure he's OK.
     
  22. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I think he'll be OK. He'll still have a fair bit of dry so I doubt that he'll have a BG nose dive.
     
  23. Marty

    Marty Member

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    Alrighty. Is there a place on the spreadsheet to indicate a diet change is taking place?
     
  24. Kris & Teasel

    Kris & Teasel Well-Known Member

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    You can go to the right side of the spreadsheet and make notes there to track the change. You can also use the "insert" function at the top left of the SS under its title to insert a row above tomorrow's date. You can merge cells in that row and put in a title about the food switch beginning. The merge cells icon is in the SS tool bar.
     
  25. Marty

    Marty Member

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    Thanks. I used your tips.

    So the proposed diet change is from 1/2 cup of the dry food every 12 hours to 3/8 cup (3/4 of the normal dose) and 1/5 can of Friskies Classic Pates. Since he is a long boy who currently is underweight at 9.2 lbs, I figure that he should be getting around a can and a half a day, which would put him at 270 calories or so. I'm hoping I've done the math right, basing that it's about 20 calories per pound. I haven't checked the dry food bag to see what the calorie count is, but I might do that for his dinner feeding.
     
  26. Kris & Teasel

    Kris & Teasel Well-Known Member

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    If your diabetic kitty is underweight you can feed more wet (once you've switched) if he's hungry. You can split it into several small meals. It's helpful to weigh him every couple of weeks either on a digital baby scale or on your own scale while you hold him and then subtract your weight.

    Your spreadsheet looks great - very clear. :)
     
  27. Marty

    Marty Member

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    About how long is recommended to keep the 75% dry food/25% wet food diet before switching to half and half?
     
  28. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I think 2 days should be enough. If you see signs of GI upset back off on the rate of switching and let his tummy adjust.
     
  29. Marty

    Marty Member

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    OK, we'll keep our eyes open for that. And keep the insulin dose the same at 2 units of Lantus?
     
  30. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes but make sure you monitor BG. A +2 test daytime or evening is a good sign if action awaits. If it's significantly lower be prepared to test hourly for a bit.
     
  31. Marty

    Marty Member

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    What would be considered significantly lower? Like 400 to 200?
     
  32. Kris & Teasel

    Kris & Teasel Well-Known Member

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    100+ points for the BG level he's at right now.
     
  33. Marty

    Marty Member

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    OK, think we'll wait until the weekend to make a change so we can test more frequently.
     
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  34. Marty

    Marty Member

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    Today we're doing an AMPS, +2, +4 and possibly a +6 test to get an idea how he's reacting to 2 units of Lantus at 75% dry food / 25% wet food. Tomorrow we'll make the switch to 50% dry / 50% wet and keep insulin at 2 units. We'll keep our eyes open for a steep drop at +2 .

    My question is, am I looking for a steep drop relative to the AMPS (today went from 435 to 402), or relative to the +2 shot today? Also, if there is a steep drop, does any corrective action need to be taken or just keep monitoring BG levels throughout the day?
     
  35. Kris & Teasel

    Kris & Teasel Well-Known Member

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    You're looking for a steep drop between PS and +2. If you get a steep drop give a teaspoon or two of the food mix and test again at +3. The purpose of this is to try to control the drop so it doesn't get too low. Repeat the small snack at +3 if there's another significant drop. If not, just test again hourly up to about +6.
     
  36. Marty

    Marty Member

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    He went from PS of 527 to +2 of 445. A drop of 82. Does that qualify as needing to give him a small snack to help control the drop?
     
  37. Marty

    Marty Member

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    All right, we're done testing until his evening shot. He sure did a lot of zigzagging. Not sure if that's related to bouncing or not.
     
  38. Sean & Rufus

    Sean & Rufus Well-Known Member

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    No, you want them to drop. A steep drop would be numbers under 100.
     
  39. Marty

    Marty Member

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    Sounds good. Unless anything seems out of the ordinary I assume we'll keep him on this diet for at least until next weekend.
     
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  40. Marty

    Marty Member

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    Since his PM shot he's been
    PMPS - 448
    +1 - 366
    +2 - 331
    + 3 - 282
    + 4 - 218

    We've been giving him dry food after each test just to try to stabilize the drops a little but doesn't seem to be slowing them down much. While we're happy to see lower numbers, not sure if they should be this low this fast. Any thoughts?
     
  41. Sean & Rufus

    Sean & Rufus Well-Known Member

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    That dry food is going to keep him propped up, carbs stay in system longer. See how his numbers are better when fed less dry food overall? These numbers are going in the right direction. I wouldn't give him dry food after tests. If he gets under 100 you would give high carb wet food.
     
  42. Marty

    Marty Member

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    Right now we're transitioning him from dry food to wet food so we're slowly changing the percentage he's getting. Today was the first day of 50/50 mix. I'll have to pick up some higher carb wet food to help for the drops. I'm worried about tomorrow when I'm not able to test him during work. Hopefully I'm just overreacting.
     
  43. Sean & Rufus

    Sean & Rufus Well-Known Member

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    How often do you feed him? Once he gets regulated his numbers will be flatter, but in the meantime if he gets too low, you could try smaller meals more often.
     
  44. Marty

    Marty Member

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    Twice a day right now. 7 AM and 7 PM. We could do more meals on the weekends but the week days are pretty busy. I might look into an automatic feeders to see if those might help. I think I'm most worried about not knowing if/when we should cut the dose of insulin.
     
  45. Sean & Rufus

    Sean & Rufus Well-Known Member

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    It is scary when the numbers drop.
    I was going to suggest a timed feeder. I think they are about 150, so not cheap. Insulin reductions are earned when they get below 90. I know how scary it is when they start to drop, but his numbers are still plenty high. Maybe tomorrow feed 60/40 so he stays a little higher if you're worried.
     
  46. Marty

    Marty Member

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    Good to know, thanks. Sounds like we're on the right track and I just need to take a deep breath. I appreciate the advice and will keep testing and making notes.
     
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  47. Kris & Teasel

    Kris & Teasel Well-Known Member

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    It looks like to 50/50 food mixture is having an effect on overall BG levels. Good sign! :)
     
  48. Marty

    Marty Member

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    Yes! I got pretty nervous last night as the numbers were plummeting but I think that's because we hadn't seen any yellow numbers yet :). I decided to work from home today to get a couple tests in just to be safe. Very afraid of a hypo even though it seems we're not that close to one yet.
     
  49. Kris & Teasel

    Kris & Teasel Well-Known Member

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    If you have hypo supplies (lots of test strips, something sugary like honey, Karo or maple syrup, and some high carb wet food with gravy) and you post here when you see lower than usual BG numbers, you can manage that situation. The reason for the testing routine we recommend is to help avoid that but cats can be unpredictable.

    You can be more strategic in your testing if you want to reduce the number of pokes. I'd suggest a +2 whenever you can. If that's a bit higher or similar to the PS you likely won't have an exciting cycle. You could test again at +6 or +7 or wait until next PS. If it's a lot lower (50-100+ points) be prepared to test hourly after that.

    Your best resource for all things Lantus is the Lantus forum. It's big, busy and looks scary at first but there are many experts there to guide you, including through any lows that might pop up.
     
  50. Marty

    Marty Member

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    Thanks. I'll start posting his numbers there as well. I need to pick up some high carb wet food it sounds like
     
  51. Kris & Teasel

    Kris & Teasel Well-Known Member

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    It's good to have a few cans of that. The gravy is the part you'll most likely use. In a pinch you can add a little syrup to the low carb food. What I do when my kitty is too low is put 6 or 7 Temptations treats on a few teaspoons of his low carb wet food. He has sometimes turned up his nose at sweetened food but never the Temptations on top. The gravy from high carb foods doesn't agree with him.
     
  52. Marty

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    I have a three day weekend starting tomorrow and wanted to get your advice on making another food switch to less dry food. Does it seem like we have enough numbers to proceed with caution? Having more days to test him makes me feel more comfortable.
     
  53. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Can I ask why you gave a high carb wet snack twice yesterday? If you are going to be home, I'd take him completely take him off the dry food. That way you'll be home to test.
     
  54. Marty

    Marty Member

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    Kris had advised to give him a little carb boost if his numbers were dropping quickly. I think it's to help teach him to drop more gradually as opposed to gigantic drops.
     
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  55. Sean & Rufus

    Sean & Rufus Well-Known Member

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    Hmm. OK. Trying not to come off rude, or step on Kris' toes, but I'd only give high carb if they get below 50 or maybe 100 in your case since you are new. The goal is to get him to go lower. You want him to be between 50 and 120 on a human meter. Bouncing is inevetible as they get into lower numbers, but you want them in lower numbers, just to be above 50. If you take a test and they dropped a lot (but still above 100), take a test in another 20 mins. If at that time he drops below 100 then you can intervene. But the goal is to let him get used to lower numbers and you want him in lower numbers. Giving him high carb food is not at all helping him get used to lower numbers.
     
  56. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I might not have been clear. o_O In post #35 above I was referring to controlling the drop with small snacks of the regular food if the +2 showed a significant drop. Later on in another post (#49) I was referring to using high carb food to deal with very low numbers (50 and lower). I apologize if I said it in too general a way or caused confusion. This is why a peer reviewed forum is so good. :)
     
  57. Marty

    Marty Member

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    No worries! I'll keep my eyes open for low numbers. Guess we'll do a complete switch away from dry food this weekend. I'm nervous but hoping it goes well.
     
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  58. Marty

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    And just to be crystal clear, we are NOT reducing the insulin dose despite going 100% free of dry food, correct?
     
  59. Kris & Teasel

    Kris & Teasel Well-Known Member

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    That's correct. Two reasons:
    1. his numbers are still quite high so there's a lot of room to drop
    2. you'll be able to test beginning at +2 on the first day of zero dry food to monitor. That test is pretty good indicator of the cycle ahead.
     
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  60. Marty

    Marty Member

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    Thanks!
     
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