4/21 - Miss Meows PMPS 291, + 2 222. I can go to sleep with no worries tonight!

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missMeows

missMeows

Member Since 2015
Good afternoon everyone,

Last nights thread, not sure if this is the type of post to continue linking threads but I did just in case :)

So I was informed last night that I should probably pick a protocol to follow for my kitty. From what it looks like, the SLGS is more like tiny increases/decreases once a week, and the TR protocol is more to change doses on the fly? I know that TR needs more BG monitoring. Here is what I believe I can have done consistently.

Me - AMPS
Fiancé - a mid day test around a +6 to a +8
Me - PMPS
Me - a +2, or more, after PMPS

Most weekends I'd be able to do a curve, but weekends like this upcoming one, probably not since we are taking her with us to the, future, in-laws and she'll probably have wacky readings there. Every once in a while I'll be able to switch my schedule around and do a +2 in the AM. Possibly once a week, the fiancé will be able to do more testing while I'm at work. She also eats just twice a day. Half a can morning and night. Would that mess things up too?

Are these amounts of testing good enough to do a TR protocol? What do you do about vacations while doing TR? We will be gone for 2 weeks in June and will probably have to hire someone to come to the house twice a day. IF we could find someone willing to test the amount we need to continue with TR, I'm sure we couldn't afford it. Can we switch between protocols as needed?

Thanks in advance for reading. I feel like if so many people can manage picking a protocol so easily I must be missing something. I've read over the stickies many times and I'm still just not sure what's best.

Cheers!
 
Many of the members who follow TR work and can't test during the day. They catch up on dat on the weekends.

Check at you vet to see if any of the techs do pet sitting. I know many will set a reduced dose for safety while they are gone. @Sienne and Gabby is a good example.
 
At the top of this forum is a Sticky Note on doing TR with a full time job. There may be some useful tips in there for you if you go that way. When people go on vacations, they usually suspend increases while they are gone. It all really depends on who you can find to care for Angel and if or how much they can test. Some people's kitties won't let anyone else test, even at preshot times. Some people get preshot and mid cycle tests from a sitter. The strategies might be different for those two scenarios, but generally involve a reduced dose while you are gone. Safety first!

The amounts of testing you say you can do are enough for TR. You can always switch if it doesn't work for you. Some people change their schedule and shoot earlier so they can always get a +2 in the AM as they go out the door. The +2 test is a good indicator of how the Lantus cycle might go. A number about the same as the preshot indicates a normal Lantus cycles. A lower +2 means an active cycle that either means more testing or leaving out higher carb food (daytime if away). A higher +2 test means a quiet cycle. Yesterday you asked:
he thing with my kitty... She is always hungry. Leaving a little food out means it will be gone the instant its on the floor! I pretty much just have to check on her. As for high carb food in an emergency... Does her old dry food count? Or does it have to be a high carb wet food?
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Many of us here use autofeeders, especially if our kitty is a hoover (like mine). I like the Petsafe 5 feeder. If you get a +2 in the morning and it's lower than the preshot number, then you can load up the autofeeder to provide meals closer to nadir time. You can also play with giving low, medium or high carb food in the feeder, depending on the numbers.

As for high carb food, we recommend high carb wet food. Dry food can take longer to take effect and can cause high numbers to last longer. There are a number of foods with gravy (like the Fancy Feast Gravy Lovers) with carbs in the gravy. You only have to give a tsp or two to boost the numbers. However, the gravy food contain wheat, which some kitties react to. Neko does a bit, so I switched to Merck Cowboy Cookout. It's not gravy, but carbs from potatoes boosts her numbers just as well as the gravy did.
 
Hi Gabrielle,

I'm the Mikey the early dropper's mom. You definitely are testing enough to do TR. Just remember that whichever protocol you choose, you're not going to be able to do it perfectly. I work full time, and every once in a while, there's a day when I can't test at all in the AM cycle other than AMPS. I leave a timed feeder out and don't sweat the occasional time I can't test. (Unless I'm concerned that he might go too low of course.) Also, your decision is not irrevocable. If you choose a protocol, then find it doesn't work for you, you can easily switch. Just be sure everyone knows you're switching, so their advice will be appropriate. Personally, if I switched protocols, I'd put it in the subject line of my condo for a couple of days, just to be sure.

As far as the vacation plans, no clue! :) I'll be watching to see what you discover.
 
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So what it seems like is, if I go TR, I need to watch her numbers for 6 cycles (3 days) and since I did a fur shot yesterday I start the timer with today. So Friday if she has been consistently over 200, I increase the dose by .25. If she has been under 200 (which she probably wont) I keep the dose for another 10 cycles?

@Wendy&Neko - Thanks for all that good info! For that pet feeder you suggested, I'm assuming we can use the wet food as well? Also, what would your opinion be on getting a +1 in the morning? Is that helpful at all or is really a +2 the way to go?

@Marycatmom - Seems to be the consensus so far is to find a vet tech and keep the dosage low :) Hopefully it's that easy! And thanks for the encouragement, it's nice to hear that I don't have to be perfect all the time... goodness knows I'm not ;)

Thanks everyone!
 
Yes you can put wet food in there as well. There is a small spot below the feeding tray for a ice pack - I think you can buy one that fits it. Another option is to add an ice cube which will melt and add water (always a good thing for diabetics). Not everyone can get a +2, some get whatever they can.

As for the dose, you are right that the counter started over last night, today is cycle 2. She did get blues last night on cycle one so that means holding the dose a little longer (8-10 cycles on TR, one week on SLGS) before evaluating what to do, unless she goes under 50 (on TR) or 90 (on SLGS).
 
Everyone works around whatever constraints they have. Some people have medical issues and can't test in the pm cycle. Some people work 12 hr days x 4 days a week. I think it's more of a motivation question to doing TR rather than "can I make it work in my life?" If you want to follow it, you certainly can. The thing I like most about it is that you can adjust the dose every 3 days if your cat is in high numbers. Holding for a week and looking at solid high numbers . . . that wouldn't be for me.

Timed feeders are one really helpful strategy no matter which dosing method you use. I thought the Petsafe 5 compartment feeder was worth its weight in gold. Some smart person had 2 of them so she could have the feeder open every hour if she wanted. Punkin always ate his +3 meal from the feeder, both am/pm and i added more times to feed him if I thought he needed more. He ate 1 can of FF at breakfast and 1/2 can at +3 always, plus more sometimes. He weighed about 13-14lbs. I never looked for an ice pack but i did add one ice cube to each of the food compartments.

In general, it's better to feed a diabetic cat more than twice a day. Feeding more often helps smooth out their blood sugar drops. Especially while their blood sugar is high, they aren't getting the nutrients from the food they do eat - it's floating about in their bloodstream in the form of the high glucose. Cats with high blood sugar are quite literally, starving.

Do you have the "Where Can I Find?" post bookmarked yet? On the second section there is at least one post about timed feeders with some suggestions from people on what works for them.
 
julie & punkin (ga) said:
In general, it's better to feed a diabetic cat more than twice a day. Feeding more often helps smooth out their blood sugar drops. Especially while their blood sugar is high, they aren't getting the nutrients from the food they do eat - it's floating about in their bloodstream in the form of the high glucose. Cats with high blood sugar are quite literally, starving.
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Hmm... I'm not sure how I would go about doing this. The vet said one 5.5 oz can split morning and night for her. I can't imagine feeding only 1/3 of a can at each mealtime and 1/3 in the afternoon. I'm hesitant to feed more since the vet said she is still overweight...

Oh and I missed that "where can i find" post! What a great idea. Thanks for linking it :)
 
If a cat goes into low numbers we feed them to bring up the blood sugar. If you're not home, the feeder is the next best thing for being a substitute for you. We used ours all the time even if we were home. It was just so convenient to be able to fix the food twice a day and let it open on time for Punkin.

If you're giving her 1/2 of a 5.5oz can with each shot, I'd just take that 1/2 can and put 2/3 of it down at shot time and the remaining part in an autofeeder for later, perhaps +3. A feeder is also great for nights when you're falling asleep and you need her to eat still.

That's not very much food overall - even if she's overweight, you want to keep track of her weight loss. It has to be very slow in a cat to avoid fatty liver. A cat that loses weight too quickly can actually have their liver clog up with fat - which is a crisis. If you don't have a scale at home, you might take her to the vet's once a week and just run in and weigh her on their scales.

missMeows said:
So what it seems like is, if I go TR, I need to watch her numbers for 6 cycles (3 days) and since I did a fur shot yesterday I start the timer with today. So Friday if she has been consistently over 200, I increase the dose by .25. If she has been under 200 (which she probably wont) I keep the dose for another 10 cycles?
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by the way, about her dose - once blues start showing up regularly, the Tight Reg guidelines suggest holding the dose for 8-10 cycles to see if the cat's going to settle into green numbers with a little bit of time. She's got quite a bit of blue tests, so when you go to evaluate her dose that should be considered. Most people ask for help when they think they should adjust the dose until they have the hang of what to look for. You're looking primarily at the low point (nadir) of the cycles rather than the high numbers.

Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
 
I think I see what you're saying. I was very nervous about giving her only 1 can a day (I was giving 1.5 cans a day). She has lost a little over 1 lb in 2 months, after I switched from dry food with grazing to only wet food measured out. Figured it was because of the new food, not the amount of food. Anyways, multiple vets at this practice have advised it, and I've read in some other threads here that people were only giving one 5.5 oz can a day. So I thought I was good. I better do some more research cause now I'm nervous again.

About the feeder, it makes sense to have something for her low point when I'm not home so I'll look into the timed feeder. I was under the impression, however, that giving more food not with insulin, would mess with her numbers. This is not the case then? Wouldn't her Nadir always spike at the time she gets her mid afternoon meal?
 
Ok I just looked up how many calories a cat needs to maintain their weight, 20 per pound. So if she is at 10.4 pounds, she needs about 208 calories to maintain that weight. Right now the can of food I'm giving her is 188 calories per can, so enough for a 9.4 pound cat to maintain her weight. If she is still over weight (which the vet says she is), I'd want to give her less then the 208 calories.

This is the link I used. It says that if your cat need to loose weight, to feed about 40 calories less
http://www.allfelinehospital.com/getting-your-cat-to-lose-weight.pml
 
You're not giving more food. You're just spreading the food out over several hours. Gabby gets 3/4 of a 3 oz can twice a day. I usually feed at pre-shot, +1, +2, and +3. However, in the morning, I'm out of the house by +3. So, she gets her +2 and +3 at the +2 time. The same is true if I'm going out for the evening -- I adjust the servings around when I'll be home. I don't feed more than her usual amount.

If you read Dr. Lisa's site on feline nutrition, she suggests that you base the amount of food on the calories, not the quantity. Some foods (e.g., Wellness) have a higher fat content and as a result, are higher in calories. Some of the other brands are much lower even though the quantity is the same. It's just like with people -- it's the calories that matter. And, just like with people, not every cat needs the same amount of calories to gain or lose weight. Things like activity and metabolism are also factors.

 
missMeows said:
I was under the impression, however, that giving more food not with insulin, would mess with her numbers. This is not the case then? Wouldn't her Nadir always spike at the time she gets her mid afternoon meal?
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you're sort of right, but not quite. The action of the insulin is strongest in the first half of the cycle with lantus. It hits its nadir, low point in the cycle, then begins to rise again until the next preshot time. Most people don't feed much after the nadir because it can act to put the brakes on the insulin's action. That can cause higher numbers at the next preshot.

But feeding in the first half of the cycle works great. I can't really tell much about miss Meows's patterns yet, but we'll be able to figure them out before long with a little more information. The cycle on 4/19 looks like it was a bounce-clearing cycle, and those override the normal cycle. Are you familiar with bouncing yet? Might be helpful to read that link.

The best site about cats and nutrition is http://www.catinfo.org/?link=felineobesity - I've linked to the page about obese cats. Dr. Lisa has some info on there about helping a cat lose weight safely. Start there and that will help you.
 
Ok, I think I'm starting to get it. So if I give her the food in thirds, would that work? It's so easy to shoot at night because I do it with dinner. If that goes away I'm not sure what I'd do :)

I started looking at the whole "bouncing" thing. I'll re-read and see if I can get a better understanding now that we've had these talks :)
 
And I was just thinking... If say I need to go to work and her numbers look like they will go real low. Would I then substitute her usual mid day meal with a high carb one then? Since her low carb meal might not bump her up enough?
 
yup - you've got it. You can have your typical plan A for what you put in the feeder on an ordinary day, but if she's lower than usual at preshot, you can adjust the times or the food to include some higher carb, or some feedings of low carb and some of high, whatever you predict might keep her safe.

There's so much to learn about cats and diabetes - i found that when I needed the information was when it made sense. Just reading stuff when it doesn't apply at the moment helps some, but it's not the same until you need it and can see what's being talked about.

By the way, I'm not sure if you have another post going for today or not - I haven't noticed - but you want to have just one per day, then you can edit your subject line to include things like this. That way all of your questions and discussions stay attached to little Miss Meows. :) When you're done with a particular topic, you can edit the subject line to go back to a "regular" one or put in a new question. People change the subject lines all day long, as needed.
 
Thank you for all your help and advice. Really its amazingly helpful. I've been worried I've been inundating everyone with too many questions but you've all been so nice and understanding. I've said it before... but I can't wait until I can return the favor :)

I started a thread last night and this was the new one for today. That's definatly good to know about the titles though, and a pretty resourceful way to keep this stuff organized. One more question about posting to this particular forum. Am I always supposed to start with the date and kitties numbers as a title, or did I do it ok for now with just a question?
 
I'd start all posts with 4/21 Miss Meows amps 382 ...............then add something like this after the test info: SLGS vs TR - how to decide? vacations?

It's not critical, but the reason we use this particular format (date/cat's name/ tests) is that experienced people can see at a glance from the main page what's going on with a kitty's blood sugar. Especially with new members, sometimes you don't even know something's going on but an experienced member may spot something significant in the tests and come post.

For example, if a cat on lantus has a significantly lower +2 when compared to the preshot, that's a red flag that the cat needs to have extra monitoring. Many people will scan the main page to watch and see if someone has questions or if there is something odd in the test data and then open the thread (condo) to pass on info to that person.

You can't ask too many questions for us. No worries about it. We've all been in your shoes and there is a lot to take in when you start. It's like a college crash course in Feline Diabetes 101!
 
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