2018.04.13 | Emmett | AMPS • 320 | +6 • 320 | PMPS • 299 | +3 • 250 | +5 • 198

[Rob W. & Emmett]

Previous (April 12)

Hey all, so bg is a little elevated, can't say I'm surprised. But Red & Rover, and Bobbie, I didn't see your dose advice post until this morning. That said, after brushing 40 last night with 41, (and knowing I read that in the protocol) I opted to reduce by 0.25 units because I know that if I didn't intervene he most definitely would have gone below 40. Bobbie, I think you agree with the reduction? You think it's a good call?

No problem Bobbie, for not being online, we can't be everywhere all the time. That's why I poke so many, I just hope someone is online

Which brings me to my question. Isn't the object of this is to get him to a dose where I don't need to supply him with high carb food or corn syrup. I don't think I should be at a dose where I need to do that every day and night, right?

Since I've gone and done it anyway, how long should I be hold this 3.5 to see if it works? 2-3 cycles? Anyway, touchy night, but Emmett hasn't seen those numbers before, he actually seemed pretty happy and relaxed in that range. A bit hungry around 41, but once he got up around 50 he was fine. It's hard to tell, because well, Emmett is a cat, and Emmett always want food if he sees it.

Curve probably will be out of whack but I've never had a successful Friday curve day, I'm tempted just to check for the hell of it. Haha. Emmett seems to like his pokes...I think he thinks I'm massaging his ears or something.

R

@Wendy&Neko
@Stacy & Asia
@Bobbie And Bubba
@carfurby
@Sienne and Gabby (GA)
@Tracey&Jones
@Christie & Maverick
@Mandy & Rex
@Red & Rover (GA)


R

 

[Rob W. & Emmett]

I would say you're right.

+2 • 20.9

 

[Gill & George]

Hello I've not visited before,
been away from the board for a few months. However I've looked at your ss and the last couple of days posts/

Which brings me to my question. Isn't the object of this is to get him to a dose where I don't need to supply him with high carb food or corn syrup. I don't think I should be at a dose where I need to do that every day and night, right?

I've always thought that the object of TR is to proactively (some would say aggressively) get our kitties into those healthy healing green numbers and keep them there as long as possible, it is this tight regulation of BG numbers that gives our kitties the best chance of regulation and if we are lucky remission.

I'm not sure how the feedings transpired last night, I can't seem to find info on the ss , but two things I think you can take away from last night are

• shooting a falling number
• +1 lower or the same as PS

Yesterday morning he started in pink, and was blue at +11, green by +10. You shot when the bounce was clearing, that is, more often than not a heads up for an active cycle, they can gather quite some momentum when they are clearing a bounce and you shoot. It's still OK to shoot, but you need to be cognizant of the fact that you are shooting a falling number. So you get a +1, (which you did/ great start), that +1 was the same as PS, now in normal circumstances we would expect to see a food bump at +1, if that is absent then you need to continue watching closely, and, with the benefit of hindsight, perhaps give a snack, the shot has not onset yet, so when it does (often somewhere between +2 to +3) that number is going to drop further. If you can stay ahead of the insulin give a snack early in the cycle, the carbs will be there ready for when the shot onsets, and it may allow kitty to surf in the greens, and not drop too low, which could trigger another bounce.
Last night I would have probably given a snack at +1 (possibly some higher LC/ or MC, dependent on carb sensitivity) and then I would have gotten a test at +2, depending on numbers another snack to aid surfing. By intervening with food early on, you can avoid the low drops that trigger bounces and force you to feed high carb.




That said with a drop into the 40's and given that he is newly diagnosed, I agree with Bobbie recommendation and with your reduction this morning, that is indeed as per the TR protocol.

 

[Rob W. & Emmett]

Hello I've not visited before,
been away from the board for a few months. However I've looked at your ss and the last couple of days posts/


I've always thought that the object of TR is to proactively (some would say aggressively) get our kitties into those healthy healing green numbers and keep them there as long as possible, it is this tight regulation of BG numbers that gives our kitties the best chance of regulation and if we are lucky remission.

I'm not sure...

Hey Gill, thanks for the detailed response and looking at Emmett's SS. Always happy to see new onlookers

For my spreadsheet I have all my food comments as "google sheet comments", so if you hover over the cells last night you can see what I fed. I fed a bit of medium-carb food (Wellness Chicken & Salmon Morsels in gravy) and I also experimented with some Raw Beef (Healthy Paws Food -- not sure if it's in the USA) with some FortiFlora. I know it's not high carb but wanted to see if it did anything...surprisingly his levels did rise up slowly...not sure if it was just coincidence.

So how long would I hold this 3.5 units if I don't see 50-80 bg levels? ie. how many cycles before I think about going back to 3.75 units?



R

 

[Gill & George]

so if you hover over the cells last night you can see what I fed

Got it!! I didn't see that.

Did you really feed 2 tablespoons of MC when he dropped into the lime green? That's quite a lot, we usually give just a couple of teaspoons at a time until they come out into safer territory. It's a balance, too much HC early on can result in higher numbers at the end of the cycle. Also you don't want to over feed them either.

Some Cats are more sensitive than others to carbs, for instance George isn't carb sensitive, so a drop like that early in the cycle would have had me reaching for 28% carb. Anything less would have seen him in the 30's or 20's, I was able to figure it out by making notes of carb content and what I fed when in the cycle. Though the learning process did see George feasting on HC for hours because I waited too long to intervene, or not intervening with enough carbs.

So how long would I hold this 3.5 units if I don't see 50-80 bg levels? ie. how many cycles before I think about going back to 3.75 units?

No straight answer for this one, for the first few cycles (two or three) we would expect the depot of the larger dose to still be having an effect, so you may well see some lower numbers then. He takes 3-4 cycles to clear his bounces, he has just started one now, so I would wait at least 4 cycles before calling a failed reduction. See if where his nadir's land when the bounce clears.

 

[carfurby (GA)]

Emmett definitely earned the reduction last night. I'm glad you got him to finally oome up and surf.

 

[Tracey&Jones (GA)]

Hope Emmett clears this bounce quickly and you can see where this new dose takes him!

 

[Bobbie And Bubba]

Hi Rob, yep no surprise with a higher number today after those lows last night. Since he is in bounce mode right now, you'll need to let the bounce clear and that could take up to 3 days. But, where it gets tricky when you have a reduction and a bounce going on is to discern is kitty still bouncing? or is this a failed reduction? That took me a while to wrap my head around. When they are bouncing, the numbers will bobble around a bit up and down as an example: a yellow number then a blue number, then another yellow number , then back to a blue ......... When it is a failed reduction the numbers will start to climb upwards .

The new depot of 3.5 needs about 4 cycles to get stable. So, I wouldn't bother doing a curve today because of that and because of bouncing. Just some spot checks today for data and safety.

 

[Rob W. & Emmett]

Ah, thanks Bobbie and Red. Will see how we are Sunday morning. Perhaps do a curve on Saturday, depending on the values I get at +2 on Saturday.

Red, yes, I think it was 1-1.5 tbsp. I'd never had Emmett in that range before, but ya, I realize it was prolly too much carby food at once after everyone chimed in with 1-2 tsp. But that said, it didn't rise him dramatically at first but you're saying may be the reason for the 320 this morning?

The food is rather "chunky" too, so maybe 1 tbsp...


R

 

[Gill & George]

But that said, it didn't rise him dramatically at first but you're saying may be the reason for the 320 this morning?

It's possible, though I think he is most likely bouncing.

We try not to fill them up, just in case they have prolonged low numbers and we need to keep steering them. If you give them two tablespoons of HC that may spike the numbers up, but once they wear off they may come back down again and you want to be sure that you he will eat more if you need him to.

 

[Sienne and Gabby (GA)]

The drop into the 40s gets Emmett a reduction! There is one "trick" to consider. When a bounce occurs in the cycle immediately following the drop into reduction-worthy numbers, you have 2 options. You can reduce the dose that next cycle (i.e., Emmett dropped into the 40s during the PM cycle on 4/12 so you can/did reduce this morning). Alternatively, when there's a big bounce, you can hold your previous dose, the 3.75u, for one last cycle to try to help offset the effect of the bounce and reduce the dose the subsequent cycle.

 

[Rob W. & Emmett]

The drop into the 40s gets Emmett a reduction! There is one "trick" to consider. When a bounce occurs in the cycle immediately following the drop into reduction-worthy numbers, you have 2 options. You can reduce the dose that next cycle (i.e., Emmett dropped into the 40s during the PM cycle on 4/12 so you can/did reduce this morning). Alternatively, when there's a big bounce, you can hold your previous dose, the 3.75u, for one last cycle to try to help offset the effect of the bounce and reduce the dose the subsequent cycle.

Ooooh, very good idea, I didn't consider that option. Perhaps for the next time!


R