6/23 Biscuits' amps 126 +1.5 115 +3 54 +3.5 62 +4 72 +5 59 +6 64 +7 77 +10 174 pmps 218 +2 171

Yesterday

WHAT A Day!

 

Looking good. Nice start Biscuits, just take it nice and easy now.

 

54 now, any advice?!

 

54 now..any advice??

 

I would feed him a little medium carb just to try to get him up a little and test again in 30 minutes. How long do you have before taking a +4?

 

30 min . I just tested 3.5
Which foods are medium carb? all I know is low and high

 

Just seen on his SS that he is coming up a bit, did you feed him or is he doing this on his own?

 

Usually something in the 9-10% carb range. If you don't have any I would mix like low carb and high carb together 2:1. High carb alone may just push his BG a bit too much, but I'm by no means an expert on this. I've had some low numbers with Jerry but he's never been a High dose cat like Biscuits so that is an unknown for me.

 

Are there any brands that are medium carb?
I fed him a little hc

 

There are a few on Dr. Piersen's food list. Have a look I think anything in the 9-10% carb range is considered MC. It may be an idea for you to have a few of these in house now that Biscuits is starting to like the lower numbers. They are good to have if you want to steer the curve but that is for another day... good that you gave him a little HC then. You will however need to stay on top of it now as the HC can wear off quite quickly.

 

Don't forget to BREATHE... you know what you need to do.

 

Thanks!!! And I'm breathing

 

Nice rise.

 

Hi Molley... biscuit is looking great!!!
I’m going to tag Sue @Sue and Luci is a pro on the different medium and high carb foods .
thanks sue

 

Thanks

 

Medium carb is 11-15% carb. 8-10% is still low carb, but the high end of LC. Here is the dictionary of slang that contains the definitions. http://www.felinediabetes.com/FDMB/threads/lantus-basaglar-levemir-isg-slang-dictionary.1903/.

Nice surf today. I do agree that if you don’t already, it’s time to get in some high carb foods. Get something over 20% and one in the 15-19% range. Cats differ in how carb sensitive they are, and it has nothing to do with size of dose. Neko was usually good with 16-17% but if she was in the 30’s I would break out over 20% and some syrup (karo). Other cats need over 20%. You have to learn what works for Biscuits. Take good notes on how much and what percent when you gave today. I put it in the spreadsheet notes so I could see what effect certain foods had before. That’s how I learned what worked for Neko.

I would suggest trying the higher carb wet foods first. With larger depots you err on the side of caution. And typically we don’t give high carb foods until they are under 50. Neko would cruise along the low 50’s for hours with nothing but testing treats in her.

 

I'm glad you came on. I wanted to know should I have given the 25 of Lantus this morning with that lower amps ? the mornings are kind of scary for me because he's been lower and there's no one available for me to ask questions to and I need to know what is too low. Usually it's + 5 by the time someone comes on to ask.
are you telling me to give him high carb food now or just have it available for when he gets low?
I don't see on the can where the percentage of carbs is listed, do I get that information somewhere else?
I have Fancy feast gravy and friskies with gravy for the high carb. He get friskies pate and fancy feast classic pate normally.

 

Your other post today. One per day please so we can keep it all together, http://www.felinediabetes.com/FDMB/threads/biscuits-54.216009/ @Crista & Ming @Idjit's mom @Olive & Paula @Marje and Gracie continuing on this post and please let the other one drop down by not responding.

When you need fresh eyes on you, add the ? to the current post of the day and change the subject line to include something like “54 please help”.

OK, enough of that, only to the questions.

Size of dose has nothing to how low you shoot. I have seen someone on 60 units (that is not a typo!) shoot green. Because she knew her cat and knew it was safe to do so. It helped that she was on Levemir and preshot tends to be closer to nadir on Lev. I have also seen a kitty on 25 units Lantus shot a 52. ECID and it was safe in that cat’s case.

@Idjit's mom quoted from the Sticky Note on how to handle low numbers, I recommend you print that off. As well as the one on handling lower preshots. Never know when you will see lower numbers. My luck, once it was during a power outage so I had my paper copy.

Don’t feed high carb now, unless he goes below 50. After nadir, the insulin should be wearing off and you don’t need as higher carb to counter the insulin. It’s fine to give a tsp or two of low carb food if he is hungry. It can help encourage a surf. As for percentage carbs, Start first with the food list here and look up what you are feeding. https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

 

One other thing, what we dose is determined mostly be the nadirs, not the preshots. 54 is getting close to the reduction point of 50. If you have some days or nights ahead where you can’t monitor, feel free to raise the nadirs a bit by taking a little off the dose. Maybe down to 24.5 units? Or 24, depending on ability to monitor. Note, this suggestion is for Sandy and Biscuits only. With acros our goal is a dose with mostly under renal threshold. Reductions do not mean the pancreas is healing, but rather that the acro tumour is pulsing and the insulin dose doesn’t match it, so you have to adjust the dose.

One other tip on large doses and reductions, you are dealing with a large depot than most here. Again depending on your ability to monitor and whether Biscuits will bounce, you may choose to take a one time reduced dose after a reduction is earned. That reduced dose could be half or two thirds of the normal dose. The cycle after that you would go back to the new dose. Note, the first time Neko started earning reductions, I could guarantee she would bounce, so I didn’t do the one time reduced dose thing until much later.

 

I give the 25 units when he's green. He drops fast in the mornings.
Tomorrow I can't test between +2 and +4.5 and I have 2 other morning appointments this week that I can't change. I won't be able to test every hour.
I'm not clear on when he nadirs. Can't seem to get it.
I made the second post today hoping someone would be on to help. Sorry! I was getting anxious.

 

I missed the second post because I just saw the first one. It was only when someone tagged me there that I saw the second post.

To determine nadirs, you have to look at cycles without R, and those where he is not breaking a bounce, which can make nadirs later. Note that nadirs can move around, so you are looking at “typical” nadir times. It seems to be around +4 or +5 with Biscuits.

Look at 6/21, he dropped fast with a high start, though you also gave R. Often kitties drop much slower and flatter when they start with lower preshots. Today he dropped a total of 72 points starting at 126. Two days ago he dropped 261 points, starting at 343. Lantus (and Levemir) are great at keeping lower numbers low and flat. I much preferred shooting low, the following cycle was a lot more predictable. However, this is something you have to gather data on, today was a great example.

Tomorrow, can you leave food out based on the +2 number?

As for today, his last couple tests are rising. As long as you haven’t given any HC in the last couple hours, he is rising on his own. You can take a couple hour break to the next test.

 

I don't know what you mean by tomorrow can I leave food out based on the +2 number

 

If the +2 number is quite a bit lower than the AMPS, it could signal an active cycle. And if that happens, you can leave higher carb food out for him to eat and keep himself safe while you are gone. Do you have an automatic feeder?

 

No I don't have one. My husband will be home. He doesn't test but he'll feed!

 

Even better, a manual feeder!