? 2/10 - Wally - AMPS:113 +1:138 +2:125 +3:97 +4:57 +4.5: 51 +5: 68 +6:60 +6.5:63 +7:63 +7.5:64

Prev condo
http://www.felinediabetes.com/FDMB/...0-4-5-83-5-70-5-5-65-6-65-6-5-62-7-65.210557/

We are on the green again close to 50.

At +4 he still have some more morning food left.
In addition I gave him a teaspoon of 5% LC and will monitor again at +4.5

 

@Wendy&Neko @Bear & Lora @Mandy & Rex @MrWorfMen's Mom @Bobbie And Bubba

 

51@+4.5

I gave him 1 teaspoon of 15% MC
I will measure again in 30 minutes

 

Beautiful numbers

 

68 @ +5

He has learned to stop before 50 (cheating... he ate 15% MC food)

 

Hi Stefano, I would test again in 30 to make sure he doesn't drop again. It is close to mid cycle so perhaps he will surf into the PMPS. A tsp of LC food would help at next text if he starts to drop again.

 

i'm going to test now +6

It feels like I'm trying to save him from hypo after every test

I wonder how I will manage tomorrow if I'm at work...

 

+6: 60
He still has some of his regular LC left from this morning breakfast
I gave him a teaspoon of 5% LC to help him go up a bit

I need an opinion on prevision of tomorrow working day
I do have the sensation he is trying to go below 50 BG, and I'm the one stopping him to reach that value

 

Do you have access to an automatic feeder Stefano?

If you leave food down does he eat it all at once? or does he graze?
Have you noticed if he is dropping or getting into those lower green numbers does he look for food? Is he more hungry?

He is getting some great cycles on this dose.

 

I do have a timed feeder with 2 serving and I could used it tomorrow.... my worry is that this dose bring him on a good zone but he needs continuous supervision

I noticed that he is requiring less food these days since he's on the green zone

He has left uneaten almost 1/4 of his morning amount of food

Right now he's calm and sleeping in the bed... I'm the one bothering him from time to time for the tests

 

63 @+7

He is stuck there or my meter is broken

 

That's something I noticed with George too.
When he get's closer to 50 does he get hungrier? George for example will not be hungry when he is in flat green but if he is in mid blue and drops into green he comes and stares at me and follows me about, I usually test when he does this behaviour and usually he's either dropped down into green, or he has bounced and is on the way up. But when he is just in flat greens he is not hungry, I have to remind him to come for his snacks.

I see that sometimes you pop back from work and get a test, do you usually know when you can do this?? Or do you not know in advance.

An option would be to leave MC in his timed feeder, and leave more food than you would normally so that he can go back and snack on it, if you think he will eat.

It looks like you usually leave just one feed of 30g at +6 when you are out at work.

I'd probably leave a timed feed at around onset and then another around nadir
Which looking at the numbers on his ss looks to be at around +2-+3, if he has an extra bit of food in as the insulin starts to kick in it may help to keep him a little flatter, and help him not to dip so low.
As you have 2 meals in your timed feeder, I would also leave another meal at +5 to +6, to tide him over through the peak action of insulin and his nadir.

If you have some food on board just before he onsets and just as he is reaching his nadir, it will flatten the numbers out. It might be an idea to stick to this feeding schedule at the weekend, making your decision when you get the PS as to what food he is going to have, supplying his snacks at say +2 and +5 and not feeding anything else, unless he falls below 50, in effect simulating the working week.
By monitoring the numbers at the weekend and keeping the timed feeds the same as during the week, it will allow you to learn what will keep him safe during the week when you are not there.

Does that make sense.

That still leaves you in a bit of a nervous situation going forward this week. I am hesitant to suggest taking him back down to 8.00 because he is doing great on this dose and seemingly making progress with the numbers which is the goal for regulation.

But I totally understand your apprehension for the working week as the depot continues to fill. It would be nice if he were green but was giving you a better margin.

I've sent a message out to Marje and Wendy, I hope that they will pop round later.

 

Thank you Gill, I will do as you suggested.

Just measured +7.5 and his BG is 64... flat green. Good.... not hungry. He has food in his feeder but he's not eating it

 

Im also anxious for this evening shot.... isnt he too low for another 8.5 shot?

 

The cycle isn't over, he hasn't earned a reduction yet, but if he doesn't drop below 50 the 8.5u looks like a good dose to me.

My only concern is you leaving for work tomorrow.
Taking a reduction when it's not earned usually results in the numbers creeping up, and reduction failing.
I know it's nerve racking

 

Good surf going on! The more time he can hang in green numbers, moves him closer to regulation and less bouncing. This does look like a nice dose for him for achieving that goal and I also understand your concern during the work day. Gill gave you some great advice with the feeder and timing of meals and also using MC food if necessary.

Hopefully, tomorrow if there is any worry about his AMPS number, you will be able to come home during lunch break to check on him.

He is making some great progress.

 

It looks to me like you're doing a balancing act. You're feeding the curve which is helping to keep Wally in safe numbers. However, the trade off may be that he's missing a dose reduction when you bump up his numbers with high carb food. The dilemma is that with a cat with a history of DKA, you do want to attempt to give as much insulin as possible. However, there's a point where your kitty may need a dose reduction. I would try to use low carb food as much as you can. In some cases, if you keep bumping up the numbers with high carb, your kitty gets your attention by really dropping into low numbers.

Are you able to buy Ketostix (these are strips you put in the urine stream to test for ketones) in Italy? Alternatively, there are meters that test for blood ketones. I think if you knew that Wally wasn't having problems with ketones, it might make dosing decisions a bit less complicated.

 

Wally is looking great so far. Gill had some good advice and I agree with it. Keep posting when you grab tests.

 

My concern also was that a reduction was being prevented, but with DKA not to long ago ( Nov) it makes it a bit more complicated with allowing a reduction. And with working and Wally flirting with a reduction...it does make it more complicated.

Checking for ketones and knowing they are not present is a really good idea. That will make the decision to let him earn a reduction an easier decision.

 

Thank you Sienne, you have cited my own dilemma.... he is clearly sliding down below 50 but I’m holding his little paw and bring him up on safe zone using various carb % corrections.

I am almost sure that whitaut these steering manouvers he would have fallen below numbers.

It seems to me that TR protocol doesnt say much about this topic .... I understand thst these are the best numbers, but its realistically impossibile to manage them on working days\

Update: +10: 95

 

I will measure ketones these evening, last recent measurement showed zero Ketones

 

PMPS: 129.... good number, we have safe margin for 8.5u

 

Nice PMPS, his numbers are on the rise. Hope he has a good cycle.

Try feeding his regular LC at +2 for snack, then again at +5, like you might do in the morning with his timed feed.

Just his regular LC tonight, unless he drop below 50.

49=HC
50=LC

If he got to 51, as an example, feed LC if he is due a meal, then check in 30min.

If he is not due a meal, perhaps don't feed wait 10-15min and recheck. You'll need to judge how fast he's dropping, to decide if it's safe to wait without feeding.
Does that make sense?

I'm hoping this will give you a better grasp of how hmis BG might respond to his normal food at his normal times making dosing easier during the week.

 

Thank you Gill, very usuful!