? AMPS 124, +12.5 117 - ate after +12.5- +1 75 , +1.5 68 , +2 70 +3.25 54 +4 90, +5 68, +6 135

Hi, first I want to say I do not know how to easily or quickly find threads I’ve posted before so I’m Sorry I don’t have one to link but I do update my SS - so if someone can look and see what they think I should do- have I collected enough data? @Bron and Sheba (GA) @Sienne and Gabby (GA) @Marje and Gracie (to help pull responses faster)
Thanks!

she had a slightly closed eye and it’s tearing up- could be allergies - has happened before to her, also has history of URI

 

@Noah & me (GA)

 

@Camille and Cyclone

 

Sorry, not much medical help. I used Caninsulin and did my own spreadsheets in Excel, a habit I got into before I came here. When we've had as many as nine cats here there was always someone with a runny eye. If it persists or the eye closes completely get it checked out, it could be any number of things.
You can see your own threads and your replies to anyone by clicking your own name in the top right, then clicking "My content". You can do the same with any other member by checking their profile, it's not snooping. If it saves time you can tag multiple members in the same post.

 

Ya, she’s had the runny eye before. I know when I first adopted her they said she had URI (this was 2009)

 

Have you got some MC food you can give her now and then test in 30min?just a teaspoon or two, you need to keep her hungry in case you need to f to d some more.


How is her appetite?

 

I have some cheap gravy lovers food I keep on hand in case I need it- I’ve never given it to her though. She just ate an hour ago- I feed her vital essentials frozen raw. Shes cat napping at the moment. Should I give her some of the high carb food or wait to see if it keeps dropping?

 

see my post above,

if you dont have mc then give a teaspoon of gravy squuezed from the gravy lovers.

 

With Mimi droppping at +1 when we would expect to see a food bump because usually the shot will not have onset, this looks like it is going to be quite an active cycle, and you will need to monitor her carefully in this early part of the cycle.
Are you going to be home?

 

Are you OK, I've jsut seen the 911?? What has happened?

 

What is mc??? I just gave her a teaspoon of the food

 

Just tested 30 minutes after +1 and it dropped to 68, so fed teaspoon of fancy feast gravy lovers

 

OK I have to go take my dogs out for 30min before it get's dark. Can you please respond ASAP so I know everything is manageable before I go out.

MC is medium carb
HC high carb
LC low carb
What food did you give her? was it the gravy lovers? (gravy lovers is high carb)

So you need to
Test every 30min. monitoring the BG.
If she is dropping feed HC gravy.
If she is green more than 75 or blue then give her a teaspoon of her normal LC.

Can you tell me how her appetite is please? I don't know Mimi well enough to know if she is a good eater usually.

 

I didn’t know I had to keep mc in stock.. what’s a good brand for that? I only was told to have HC


I just retested at it was 68, so I fed her HC

 

She’s a good eater and she ran to the sound of the can and ate up the teaspoon of HC food

 

I have to write really quick, we have an installer coming over - you can also use karo or honey mixed in with her wet food - not sure how much (edited: just a drop or so). That can bring her numbers up quickly, but it wears off rather quickly too so you have to keep checking. The reason for giving just a bit of food at a time is that she doesn't get full, and you can keep getting her to eat to steer her numbers back up.

Hugs to you and Mimi

 

That's good she has dropped a bit but not much.
Did you feed at +1? what did you feed if you did?
or just at +1.5?

Excellent, check in another 30min. If she's still dropping a teaspoon of HC gravy. If she is coming up then just a teaspoon of her normal food.

 

Noo that is too much, it can make them sick. just a drop mixed in with a teaspoon of LC food.

 

No I just fed her at +1.5

 

Can make it MC? What brand should I have for medium carb.

 

Good to know.
Well done.
I'm quickly going to take the dogs out and I will be back for your next test.

 

Ok, she just went and hid because The other cat Batman and her started fighting

 

I don't kknow I use different brands I am in europe, FF do one that is MC, but not sure which it is, don't worry about that now. lets concentrate on the matter at hand and deal with that once the excitement has passed.

 

Thanks, I edited my post too.

 

Just tested again- 70 - so we are at +2

 

Side note- I really don’t like the new Relion meters.. they require too much blood. The alphatrak and the freestyle took barely anything to activate.. I still have the freestyle and tested today after a couple of tests and I’ve noticed it reads lower- like 10-15 points lower. I also read that’s possible with the freestyle. As far as following TR- and going by the numbers there- which meter would I follow say I switched back to Freestyle (so it’s less blood, less pricks, less stress for me and Mimi)

 

just fed a piece of cooked chicken breast I had for myself - plain nothing on it. I don’t want her to spike too much considering I gave her that HC food

actually just let her lick some of the FF HC - and almost inhaled it.. but realistically just ate a few little pieces because I took it away before she inhaled it- she’s like “what the hell is this junk food??”.

 

Just pick one and stick with it.
If you prefer the freestyle meter (with freestyle strips) that's fine. Just make the switch and you would use those numbers. The biggest difference with the freestyle is at higher numbers.
(note I would not use ATmeter with freestyle strips)

OK great number at +2.

Let's just check at +2.5
We are still early in the cycle, so want to make sure we don't get any drama from mimi.

 

What do you mean at higher numbers- what does the freestyle read at those? But when I’m following the TR protocol on how to proceed based on the numbers- which is closer to the one used for those numbers- does that make sense?

 

Mimi is currently cleaning her brother after only just 30 minutes ago they wanted to kill each other

 

don't get hung up on this.
The freestyle is a good meter, if you like the ease of use.
The numbers for TR are still the same below 50 you reduce. It's the same whichever meter you use.

I mean that at at higher numbers the freestyle has a bigger difference between some other meters ( I don't know about the relion specifically)
Again it doesn't matter what the difference is at higher numbers, high is high. With the dosing methods you are just looking at trends in the numbers with the human meters really, so it's important to just stick to one meter.

 

+3.5 53

 

Deep breaths,

 

Just fed her a tsp and a half of FF HC and a small piece of her raw- and shes slopping it all up. She’s acting like she’s never eaten before.
You know come to think of it-
In the night she was crying a lot before her auto feeder went off- and when it did she was ravished then too. Wonder if it means she’s been dropping low and I need to lower her to 1.25

 

Buddy goes through phases of acting like he is starving, then some days I have to fight to get him to eat.

 

Which meter are you using now?
Did you stick with the same one or have you swapped to the freestyle?

Also I think you are at +2.5?? or +3 going of the timings of the posts

 

No I’m still on Relion. If I switched to freestyle I would change it in my SS

 

Just checking.
Check him again 30min from the last test/food and post the results.

 

Sorry you’re right just updated SS +3.2 is 53

 

I’m having trouble with the jargon. Is how do the “point, number” work like what is 3 hours and 15 minutes

 

Up Mimi! You can add a little of the gravy to her regular food. The reasoning is the HC gravy wears off fast and her regular food will carry her a bit longer.

For MC, Pick up some of Fancy Feast ROASTED , they are MC.

 

15 minutes (one quarter of an hour) +0.25
30 minutes (half and hour ) +0.50
45minutes ( three quarters of an hour) +0.75

 

ok so, just feed her the gravy out the can with her raw next time she's low or feed her the food in the can as is.

 

Add a little of the gravy to her regular food. You don’t want to give a lot of the gravy as it can fill them up and you might need her to eat some more through this cycle. Adding it to her raw food will help hold her up longer.

 

Ok... so when would I feed her the meat that’s in the gravy, never- just scoop the gravy out- or. I’m still confused, maybe I’m overthinking it

 

Hopefully this explains it

If you add a little gravy to her raw, it will up the carbs a bit for that snack, but the carb content of that snack in itself will probably be more in the MC range. Adding HC to LC 'dilutes' the carb content of the meal/snack as a whole.

So if she has dropped below 50,I would squeeze gravy out of the FF gravy lovers, lets say 1tsp, and 1 tsp of the meat out of the gravy lovers and give that to her, that way you are keeping the carb content up.
ETA but keeping the volume of the meal down so you don't overfill her

 

I think it explains it.

Just got 90

 

Have you got a +3.5 yet?

 

Cross posted
Ok a teaspoon of her normal LC now and then test in one hour.

 

I have a question about testing her ear.. Ive seen how to do it and where to, but as Im pricking her over and over, trying to do different spots, but some I know work better than others, I notice she's getting scars where Im poking her. is that what Im feeling?

 

Do you treat the spot after you have poked? If you are not doing so it's important not to leave this out as you can get some scaring. I tried to swap ears.

To treat after the poke.
I would use a cotton pad I had a cold wet pad, that I would hold firmly over the poked spot applying firm gentle pressure and count slowly to 10 (if George let me there).

This will minimise scaring. George has no scars, and I tested tonnnnnnnnes,

 

+5 is 68 is it because its close to nadir?

 

I try and hold pressure, but I guess I could clean it out a little with something wet. I have these saline wipes, but I just ran out.

 

what percentage of carbs in a food is considered LC, MC, or HC.. so I know when I check it out on my own

 

well ok.. I fed Mimi some of that canned CD diet I had "gifted" to me after her Cystotomy figuring it was MC, but I just looked it up and its fricken 30 percent carbs, and the gravy lovers is 15... WTF IS WRONG WITH THIS COMPANY.. and their one for GLUCOSUPPORT is 15 %, so thats just like the stupid GRAVY LOVERS.

 

It's not about cleaning it it's more about it being cool to reduce inflammation.

Interesting question.
Nadir so far was that 54, nadir is the point at which the BG is lowest. We won't know till the cycle is over.
+5 is approaching midcycle, so we should be entering a point where insulin action is greatest, and from now on the amount of insulin action should slowly start to decrease.

Because +5/+6 is when we have peak insulin, in a typical, lantus cycle we would expect the nadir to coincide with that. But until a cat is well regulated we don't always get this, other factors affect when they may nadir, not just the insulin.
So this morning Mimi nadired early, because she was just clearing a bounce as you shot, when they drop like that they often nadir early, that's why we suggest the +1 (which you did and you continued monitoring closely and caught that 54)

Last nights cycle she probably nadired late, maybe even after the amps.

oops. Well save it if she ever gets into very deep water, I used 28% for george when he dropped into the 30's.

When did you give her it? was it just now?
Don't worry about it, at least it's canned it'll be out of her system soon enough consider it a food experiment. Note when you gave it (and any other food) on the SS, it will be interesting to see how it all affects Mimi.

I was just writing to say, give her some regular food sorry, not typing fast enough.

 

LC below 10 %
MC 10 to 15%
HC over 15%

FWIW I had to use over 20% to get Georges numbers to move when he was diving(I used 28% or he would not budge especially if he was dropping early in the cycle), he wasn't very carb sensitive, so it's important to learn what works for your cat as much as what is 'classed' as LC/MC/HC
That's why I would encourage everyone to take meticulous notes and keep that on the SS, somewhere everyone can see, so folk can use that info to help you more efficiently, but where you can at a glance see what worked and what didn't work for your cat.
I used to keep a note book and write down everything I did when I was steering an episode of lower than usual numbers, then I would transfer that info onto the SS, just so I wouldn't miss anything out in the excitement.

 

well almost everything Hills makes is 20% and above, so....oh- their Glucosupport is 15%..

 

+6 is 135

 

When did you give that 30%?

 

at +4.5 so that might be why her +5 spiked

 

is 30% too high you think? Or should I grab a few cans of Hills brand because they have such high carb content

 

OK you may have stalled the cycle with that.
Grab a +6.5 to make sure she is still up, after 2hrs the carbs (she probably will be/but you never know with cats)
If you managed to stall the cycle you may find she is fairly high at PMPS, a high PMPS could be a bounce but it could equally be a shortened duration from to many carbs.
You will not know which it is.
If its a bounce she will stay high in the pm cycle.
If its shortened duration what you will see is she will start to come down significantly tonight once she onsets. So even if she is high I would advise you at least get a before bed test to see which it is.

I used 28% so very similar, I found it useful when George was dropping steeply.

 

I didn’t want to get in the midst of Gill helping you but want to be sure your first question of the day is answered.

To get the link to any condos you have previously done, click on your user ID in the upper right hand corner and then click on “your content” in the right column. It will list all of the condos you’ve posted or the ones you’ve posted on. Find the one you want, open it, copy the browser address, and then paste it in your current condo.

 

When using LC food and adding HC gravy, it’s really important to look at three things:

• How carb sensitive is the cat?
  
• What is the BG and where is it in the cycle
• Is the cat flat or dropping in consideration of the above.

If you get a 53 early in the cycle and it was a big drop from the previous test, it might be necessary to alternate HC food with HC gravy to slow the drop down.

If the 53 is +4 or after and is flat, a couple of large tsp of LC alone might do the trick. Or in a cat that is not very carb sensitive, a drop of gravy added to that might help.

This is where knowing your cat comes in.

• What is kitty’s onset, nadir, and duration?
• How carb sensitive is kitty and how responsive if numbers are dropping fast or if they are flat?
• Where in the cycle does that lower number come in in relation to onset, nadir, and duration?

As in many things with FD, there is no one size fits all. Rosa is likely still gathering data on Mimi’s responses so it’s really important to write down when she was fed, how much, what % carbs, so that info can be used the next time around.

It’s always been my thought that one should use the lowest carbs that gets the job done. That might mean 10% on a regular basis for some cats. For others, it might be 3%. For some with fast dropping numbers early in the cycle might be 20%. It is correct to alternate gravy with food when working lower numbers to be sure kitty doesn’t get too full early in the cycle.

 

just did her at +8.. her ears are thickening by the site I prick so I wanted to give them a rest for a second. now its high- 354.

Should i keep her at 1.5 seeing she had such a drop with it today? or lower it to 1.25

 

when you say "onsets" do you mean at the +6 mark or earlier. "high PMPS could be a bounce but it could equally be a shortened duration from to many carbs" what does that mean?

 

Have you read through this post? It explains onset, nadir, and duration. Since it varies by cat, it’s something to important for each caregiver to know about their cat. After you read it, if you have questions, please tag me and I’ll be happy to explain what you don’t understand.

On the latter comment about PMPS being higher, if you feed a lot of HC food and/or gravy and karo during the cycle, it slams the breaks on the action of the insulin so the duration can be less than 12 hours. If it’s less, then numbers shoot up quickly at the end of the cycle because there isn’t enough insulin action to carry over until the next shot. After a low cycle, a higher preshot can also mean a bounce is starting. Sometimes it’s both. If it is solely duration, the BG comes back down once the next shot onsets.

 

it seems like something I should easily understand but for some reason I am a little confused. So lets say Mimi for example.
Based on her numbers, she was low AMPS, which could mean because I didn't get any findings during the night, could mean this dose is getting too high for her? The last few days she's had a lot of blue and yellow, which some green, so does that mean her dose is regulating her or eventually going to be too high according to the TR protocol?

today she dropped consistently at +1 and +2 and then at +3 when it dropped to 50 something I gave there the HC 15 % FF which spiked her a little bit but then dropped again at +5. I figured it was getting close to the nadir so I didn't want to spike her with HC again, so I found a can of the CD diet from Hills they gave her after her surgery, figuring it has to be lower than 15% carbs, and I couldn't find it on Dr. Piersons food chart. But then after finding out it has 30%??? so the +6 mark I got 135- i think thats why she spiked. not we are at +8-9 and her BS has spiked even more to 354.

what do you think is happening in her little body based on those numbers?

Also, can someone confirm I am right about the carb percentage in the CD diet- I went to their website and it said 30% carbs- but maybe the chart Dr P made is a different calculation?

 

I probably did read through it, but forgot. I think I need to actually learn what diabetes is- I know what everyone says it is- but I should find a youtube video explaining it in detail so some of this makes more sense.

 

It looks to me like she started a bounce the night of 11/4 and she bounced all day yesterday. The yellow at PMPS last night might have been the high before the break or she could have gone a bit higher or stayed in flat yellow before clearing the bounce today.

By AMPS today, she was definitely clearing the bounce and bounce clearing cycles are always very active ones. She had a very characteristic bounce-clearing cycle.

At this point, her dose is not too high. She’s just doing the typical bouncing we see until the liver gets used to seeing normal numbers.

From Dr. Lisa’s charts, it looks like tense different c/d formulas ranging in 23-28% of calories from carbs on an as Fed basis. You might want to read this post I did that explains where all the numbers come from on a website or can and how they differ from what the actual %calories from carbs is.

It’s also been my experience that vets ae not typically aware of the %calories from carbs in cat food. Meaning that I wouldn’t have taken for granted that by giving her c/d, that it would be under 15% calories from carbs.

 

oh so the percentage of carbs might not be 30% based on how Dr. Lisa listed it carbs to calories?


ok, what is a bounce? Also what do you mean the high before the break.
"she could have gone a bit higher or stayed in flat yellow before clearing the bounce today."- explain this to me like I am 5... lol

 

so what do I do while I am at work tomorrow and can't test her like I did today. should i assume shell drop and leave her higher carb meals to snack on? what would have happened today if I didn't feed her some HC food, would she have dropped to hypo?

 

+10 is 504

 

You asked what a bounce is? You're seeing a bounce!

 

well yea that makes sense, but why do you think she went so low in the first place?

 

Because the insulin is doing it's job!!

 

also, what bounce was she speaking of starting 11/4- the PMPS number?

 

do you think it was doing too good of a job? shouldn't it have been higher than the 80s towards the +12 mark?

should i have shot her 1.5? it dropped her a lot..

 

what do those jumps do to her little body though- does it put stress on it? are these bounces part of her getting used to the medicine? is this all common in the process of her getting regulated? Im just thinking what if I had to work today and couldn't do tests every 30 minutes, and feed her high carb.. I have been home all day monitoring her, which is fine because she's my baby, but what if I couldn't?

Im trying to see based on her numbers why she could have dipped so much, unless thats just part of the process, or should I reduce the shot next time.

 

does this jump mean the insulin isn't working anymore and its time to shoot her sooner than later? Or can I get back to shooting her at 9:25 , like today I did 9:50

 

is her being above 500 going to put her back at risk for DKA?

 

You should be giving shots as close to 12 hours apart as possible. Not shooting on schedule has an impact on the depot.

A bounce is the result of either low numbers, a cat dropping into numbers that may be in a lower range than what's she's used to, or a fast drop. The kitty's liver and pancreas release a stored form of glucose along with counter-regulatory hormones and it can take up to 6 cycles for a bounce to clear. This is what causes the numbers to spike upward. A bounce is fundamentally a protective mechanism. Your kitty's system interprets the lower numbers as "dangerous" which is why the big jump to high numbers happens. This is a normal response -- it's annoying but normal. A bounce does not mean that the insulin stopped working.

High numbers do not by themselves cause DKA. DKA is the result of an infection/inflammation + not enough insulin + not enough calories. FWIW, numbers can be pretty much anywhere and ketones can develop.

Rosa -- you've got to take a few deep breaths and not keep scaring the cr*p out of yourself! If there were something truly amiss, there are enough people here with experience that we would let you know. This place is is where we put the welfare of the cats first.

 

I just found the explanation of "bouncing" so I guess what @Marje and Gracie was saying is i can predict a bounce based on how her numbers looked in the days previous? My question is if she's AMPS lower than 150, do I have enough data to shoot her, or do I need to call out of work to monitor, or should I just give her some extra carbs in her food to be on the safe side.

Today was hard to get a response from anyone for a long time, so I didn't know what to do. Was shooting her the right thing to do, and just counteract the dips with HC food?

 

also, are bounces preventable?

 

HI! So a cat that has had a history of runny eyes from kittenhood which waxes and wanes is usually virally based. The shelters usually use the catch all phrase URI. However, with a true URI, the discharge is usually green or yellow indicative of an infection whereas a virus has a clear discharge which sometimes can take on a brownish color as well. Check the whites of her eyes and make sure they are not blood shot as this does not occur with a viral infection. Sometimes a course of Azithromycin can help expedite the runny eyes and or nose. Hope this helps! Hope she feels better soon!

 

Dr. Lisa’s charts are accurate unless the companies have changed their food composition.

The high before the break is when a kitty bounces, it looks like the bounce will clear by lower numbers (usually blue) being seen, and then a rise in the BG before the bounce clears.

If the +2 before you leave is the same as or less than the AMPS, I would leave food out. I don’t know if she would have dropped to dangerously low numbers today if you hadn’t been there.

The 304 at +10.5 in the PM cycle is indicative of a bounce starting.

Bouncing is normal. All cats do it until they don’t. The liver of some cats adjust fairly quickly and they don’t bounce long but many cats bounce and then go to normal numbers then bounce, etc. Again, bounce clearing cycles are very active cycles managing numbers can drop lower. We don’t change doses based on bouncing alone. Remember we base dosing primarily on the nadirs. If you need to leave for work and it appears a dose is clearing, you can “carb her up” and leave carbs out.

DKA is not caused solely by bounces but by not enough insulin + infection + not enough food/hydration. I’ve seen cats in pretty well regulated numbers get DKA so the infection, inappetance, and dehydration are also part of it. Keep checking ketones; if she shows less appetite, then it’s critical that you make sure you know what her ketones are.

Yes...with a post DKA cat, as long as it’s safe to shoot, you should not skip shots.

Bounces are not preventable.