Well now that I have the bouncing stopped...Now what?

I'm planning on running a curve on Musette tomorrow to see where exactly this .25 is getting us, but from what I'm seeing from the spot checks that I have been able to get in one the last 3 days, she is staying high although we did get a toe into the blue today...barely but still it was there.

So my best guess is that I need to start rising her dose ever so slightly until her numbers start coming down. Since this whole microdosing is new to me any advice would be greatly appreciated.

Mel, Maxwell, Musette and The Fur Gang.

 

Best 2 things to do are read Sheila's explanation http://felinediabetes.com/FDMB/viewtopic.php?f=10&t=15637#p156967
and look at her pictures
http://felinediabetes.com/FDMB/viewtopic.php?f=10&t=34424#p360982

You might let her settle for another day before raising dose though. Oh, you said you are doing curve tomorrow. OK, make decision after that.

I hope Sheila will pop in, because I don't know that raising dose is the answer. She is nadir-ing very early in cycle for Lev and dropping pretty far early. Guess that's not a word. Anyway, that can be a sign of too much insulin as well, believe it or not. It may not throw them in to rebound, but when they don't hold after that drop like they should, I wonder.

Maybe she just needs a couple more days. I sometimes think the whole 3-5 days thing is malarky, but it's an ECID thing. We've seen that with some cats you can't rush things.

 

Well.... one question, did you change her diet when she came to you? As you know that makes a big difference in their insulin needs.

To be honest, I would not have caught that early "nadir". It isn't much of a nadir - just barely over 100s point drop today - less the other days. I'll be interested to see the curve. And I would be looking for continued settling on this dose. So far, each cycle seems to be better than the last by a little bit. I would maybe stick with this dose until things stop changing. It may take more than 5 days, but she just finished day 3 today, so you have a couple of days to go.

Then an increase can be considered. After you read the micro dosing stuff, let me know if you have questions.

 

Well now that you mention it, yes, I did change her diet when she came here...Don't know why I didn't think about that until talking to a friend last night. Probably because I'm so use to Maxwell and the civies. But Don had her on Fancy Feast which is around 3% carbs, when she got here I just went ahead and fed her the same Friskies as I do everyone else (around 5-7 %) carbs. Not much I can do at the moment to switch her back to the lower carbs, at least not until this Friday as the budget for critter food has already been spent for this week (with 12 cat, 1 large dog and a single income, we are on a tight budget). Now when I go to get food again this week while I will get the rest of crew their regular Friskies I'm seriously thinking of getting her some nice low carb Fancy Feast, since she perfers to eat by herself anyhow, and doesn't try to steal food out of the others dishes. (1 cat on FF I can do, 12 not so much). The biggest challenge is what I am limited to in this little one horse town, I pretty much have the choices of FF, Friskies, 9-lives, and Special Kitty, and even those are limited in flavors. FF I probably have the biggest choices in when it comes to flavors.

The thing I have noticed since day one with her, is even for Lantus she is dropping way early, when technically her new dose shouldn't even be kicking in yet. Lantus shouldn't even kick in until around +3-ish yet she will drop as much as 60 pts by +2 when she should be either the same or slightly higher (food spike). So I'm almost wondering if I take her carbs down to around 3% if she wouldn't go OTJ, or be pretty darn close to OTJ. Since she has such a extreme reaction to even the tiniest bit of insulin in her system.

That is one of the reasons I want to get a curve on her today, and see exactly what she is doing on that .25 hour by hour. She will be pissed at me for all the pokies but I need to be able to see what she is really doing. She is still peeing a lot but then again right now with our ungodly heat and humidity even the civies are drinking like fishes and peeing buckets, so I can't really say her drinking and peeing is greater than any of the civies. (today's forecast 102 with a heat index of 115). She is actually right now more active and happy than the civies...lol. So in the whole cat thing, she is doing better than my civies.

So I guess right now I'll get a curve on her today, so I can see what is really happening with her on .25, hold her until I can change her food to a lower carb one on Friday and then see where she goes from there. Because honestly those very early drops, early nadir and then rapid rise towards the end of her cycle still looks like too much insulin, but then again I don't want her to continue to stay in the higher numbers. Man, she is as complex to figure out as Maxwell was easy...lol

Mel, Maxwell, Musette & The Fur Gang.

 

Her cycle yesterday was incredibly steady, which is what you're looking for. I think trying a diet change to even lower carb is a good idea before raising dose. My only concern is if you have to put her back on other food for cost reasons, it might set her back. If she doesn't eat a lot you're lucky, I found FF too expensive for a 14 lb cat who can eat 5 cans of it a day!

 

Well she is only 6lbs and I don't think even if she gains some weight she is going to top out much higher than 8lbs at max, she is a little thin but not by much. So at most I would think perhaps maybe 2 cans of FF a day. She is only eating 1 (5.5oz) can of 9-lives at the moment and maintaining if not gaining slightly on that. Yeah Fancy Feast would be way out of the budget for all 12 cats but for her I could see it.

But I honestly don't know how much lower that 4% carbs I could go without feeding way too much fish. I mean after looking at Binky's list we are only talking about going from 4% carbs down to maybe 3% carbs for most of the non-fishy flavors, and I have a hard time believeing that she is that carb sensitive, where that minor of a reduction in carbs would do her a whole lot of good. I mean even if I look at putting her on a raw diet like Feline Pride I'm still looking at 4% carbs for chicken, and 3% for Turkey. So as long as she likes and will eat 9-Lives Chicken Dinner at 4% carbs why not stick to that and just adjust her insulin accordingly? Maybe switch it up for her with some Turkey and Giblets for a change of pace every now and then. Because I don't want her eating a lot of fish, because first off it isn't good for her, secondly she doesn't like it all that well, and third I run the risk of my fish-boy (whose allergic to it) of getting into it.

I mean I love my cats, but I also can't see driving myself crazy over trying to balance everyone's tastes, carb content, and what is readily available....Everyone likes Turkey and Giblets and Chicken Dinner....One can't have beef and one can't have fish (except in small doses) so that pretty much takes us back to 3-4% carbs anyhow. Now Maxwell does like his Friskies Mixed Grill at 8% carbs but it doesn't effect his OTJ status at all. So as long as they all like the food, stay off the dry and gravy laden stuff, might as well stick with what works for everyone and adjust her insulin. Unless someone can see a reason not to? Those nice stable numbers yesterday was from having her on the 4% 9-lives Chicken Dinner. I mean short of ordering EVO 95% Chicken & Turkey online for her (and is that really worth it for 1 cat?) there isn't much better I can do with what I have to work with locally.

The other thing is she is already on such a tiny dose, if I can just adjust it to get her numbers down for a month or two, I would almost bet she would end up OTJ and if that were to be the case then I'm going to want her on a diet that is sustainable locally.

So far is my reasoning sound?

Mel, Maxwell, Musette & The Fur Gang

 

Right now I wouldn't worry about lowering her carbs from where they are. There have been so many changes in the past few weeks it's hard to sort things out if you keep making changes to her routine. Better to make one change at a time - and concentrate on getting the dose right for now.