When to Feed When NOT to Feed-SETTLED GETTING A AUTO FEEDER

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Edye, Jul 12, 2019.

  1. Edye

    Edye Member

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    Jul 1, 2019
    I am noticing Orson can not eat his full meal in one sitting. So he eats what he wants and in a few hours I offer him the rest. I recently started putting out frozen wet before I go to work. Since I don’t know when it gets finished-I don’t know if it could be effecting PMPS number.
    Q #1. Is it ok to leave this food out?

    Dinner same thing-he doesn’t eat it all so I test him around +5 and give him the rest of his dinner. His +5 last night was 103 and +9 was 200.
    Q#2. By giving him the balance of his dinner at 10:30pm (+5) am I not getting true BG numbers because the food is effecting it?
    I am just so confused on when to feed and when not too. I have heard conflicting information. Some don’t feed between meals and others leave food out???
    Thank you


    https://docs.google.com/spreadsheets/d/1qFlH54Dd-JFmTThyIb7JwFzaog2BvV2_mrCNjwytifk/edit?usp=sharing
     
  2. Julie and Honey

    Julie and Honey Well-Known Member

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    Dec 22, 2018
    They usually say to get accurate AMPS and PMPS should have not eaten for 2 hours prior to blood test. During the time in between the shots, it is my understanding does not have to be that much time before a spot check, so okay to eat in between. That being said, I like to have a little bit of a wait before a mid cycle as well, like a +6 to see how low kitty is going without food influence.
     
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  3. Julie and Honey

    Julie and Honey Well-Known Member

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    Dec 22, 2018
    You might consider an auto feeder during day so you know what time he actually ate before PMPS. They have some that have an ice pack under to keep wet food fresh if left out until the timer goes off.
     
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  4. Figaro's Liz

    Figaro's Liz Member

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    Jun 18, 2019
    I see you are feeding all wet food, but which brand and variety of wet food? The carbohydrate content of wet foods can vary widely and they can have widely different effects on BG levels.

    Also, I am not able to view Orson's spreadsheet because it requires permission to access it. Have you followed the "publish to web" instructions for sharing your spreadsheet so any member can access it quickly and easily? Here is the link to the instructions: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
     
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  5. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Neither do I @Edye

    @Figaro's Liz but i just clicked to open Figaro's SS and got the same thing again - requests to be sign in w/ Google Acct to view.
    Is it a glitch in the system, or is it our devices malfunction? :confused:
     
  6. Figaro's Liz

    Figaro's Liz Member

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    Jun 18, 2019
    Hmm... strange. I just republished mine and re-copied the link into my signature.. not sure what happened there :/ Hopefully it hasn't been like that the whole time :facepalm:
     
  7. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    you are good now I just checked
     
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  8. Figaro's Liz

    Figaro's Liz Member

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    Thank you!!

    Edye, you may try to re-publish your spreadsheet if you had already done so before.

    I can also say that many diabetic cats are grazers and eat multiple small meals or nibble on their food throughout the day, and this is okay. I have not read anywhere about taking food away during the cycle EXCEPT 2 hours before pre-shot test time.

    I can't speak to how exactly the food will affect his numbers but someone more experienced on the board may have thoughts based on they type of food you give.
     
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  9. Edye

    Edye Member

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  10. Edye

    Edye Member

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    Thank you-so you are saying after a meal you wait 6 hours??
     
  11. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    An auto-feeder would be a great asset to you......the PetSafe 5 has 5 compartments so you could program it to give him several snacks during the day and then rotate to an empty compartment at +10....that way you'd know he didn't get any food for the 2 hours immediately before Pre-shot tests.
     
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  12. Margie and Jackson

    Margie and Jackson Member

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    Apr 26, 2019
    Ok, so if the cat is free feeding most of the time, isn’t their bg always food influenced? Wouldn’t you make decisions based on actual bg, not just bg during times when food is withheld? Maybe there are different rules for cats who can eat most of the day?

    I just failed to withdraw food prior to my pm shot, since I forgot to close the bathroom door, but I only learned of the fast 2 hours rule a few days ago...:rolleyes:
     
  13. Julie and Honey

    Julie and Honey Well-Known Member

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    Dec 22, 2018
    No, no. Sorry maybe my wording was not the best there.

    AMPS- preferably 2 hour fast

    +6 - preferably 2 hour or close (optional, but more accurate to get nadir) that is of course if your kitty nadirs at this time, most do but not all.

    PMPS- preferably 2 hour fast

    They only recommend am and pm shots 2 hour fast, but I also like it for mid day because you are likely to get the lowest number of the day and it will read higher if having recently eaten. Not a huge deal, but if I am going to get a nice blue or green, I don’t want to miss it because of food:joyful:
     
  14. Julie and Honey

    Julie and Honey Well-Known Member

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    Dec 22, 2018
    If free feeding, then yes it would be. Low carb is not going to raise it dramatically like high carb would, but low carb and even zero carb will raise it some, to where your reading will be off some. It is really just most important at shot times to make sure safe to shoot because the food will wear off before insulin will, so if you shoot and the number was inflated by food, it is possible they might have been too low to shoot, but recent food made the number higher. Make sense?

    Not an exact science because sometimes shot times can change due to life happening, etc. just good general guidelines..
     
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  15. Edye

    Edye Member

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    Jul 1, 2019
    I think I got it-you treat the +6 hour like you would AMPS and PMPS-so by +4 you would pull food? Did I get it correctly hahahaha
     
  16. Edye

    Edye Member

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    Jul 1, 2019
    How quickly does food influence wear off?
     
  17. Edye

    Edye Member

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    Jul 1, 2019
    I just looked this up-do you use this model?
     
  18. Julie and Honey

    Julie and Honey Well-Known Member

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    Yes:)
     
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  19. Julie and Honey

    Julie and Honey Well-Known Member

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    About 2 hours, see a pattern, ;)
     
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  20. Julie and Honey

    Julie and Honey Well-Known Member

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    Dec 22, 2018
    There is also a cat mate c300 with 3 compartments. The 5 gives you more compartments, but they are smaller, some cats don’t like to put their head in a small spot. Just would recommend the digital models, either 3 or 5, not manual, because some reviews have said the manual ones are not as reliable to open when they are supposed to.

    Also they are counting one spot as uncovered, so the “3” is one open, 2 closed and the “5” is one open, 4 closed...
     
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  21. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    @Edye
    @Figaro's Liz
    @Margie and Jackson

    Oh dear. I'm not sure where to start...
    with due respect to @Julie and Honey ... please discard the advice Julie has offered about feeding times (when to withhold, when to feed, and when to test).
    • Withholding food 2 hours prior to giving insulin is a suggestion made to newbies until they learn the effects of food on their kitty's blood glucose levels. Once you know how much of a food spike your cat gets from food fed at shot time it's no longer necessary to withhold food 2 hours prior to the shot. You'll dose accordingly. Typically, this will take around a month or two of collecting data (those 'forgotten' spot checks... the +1s and +2s will show you what kind of food spike your kitty gets off a typical meal at shot time).
    • You do not want to withhold food at any other time (especially mid-cycle) just to get a BG number that is not influenced by food. Feed normally and get those spot checks mid-cycle! You want to collect data that combines the effects of food and insulin to use to make dosing decisions. Here's what happens if you withhold insulin mid-cycle in an effort to get a so-called 'true' number:
      • You'll end up basing your dosing decisions on a lower number than kitty would have if you didn't withhold food.
      • That will lead to taking reductions based on 'false' or 'untrue' numbers... 'untrue' in the sense that they're not the normal numbers you'd see if kitty had been eating normally.
      • That will lead to a vicious cycle of reductions taken and kitty not holding that reduction... which means you'll only have to take the dose up once again.
      • Bottom line, kitty quickly becomes under dose. We don't want kitty to be under dose. All that will produce is a kitty remaining in high numbers too much of the time. The idea is to get the BG numbers down for several reasons:
        • We don't want glucose toxicity to set in.
        • We want to keep kitty below renal threshold (below about 200 - 225 mg/dL on a pet-specific meter) to avoid the start (or worsening) of kidney damage.
        • We want kitty's blood glucose levels to be as close to 'normal' as possible.
    Sorry to have to jump in here, but it's so important to recognize the effects of the combination of insulin and food when attempting to regulate kitty... and use the knowledge to your advantage. It's why we do spot checks... why we collect data. Not correcting the info given will end up spreading and creating problems.

    Questions? I'll be back later today to answer any questions you may have in case someone else doesn't come by sooner.
     
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  22. Margie and Jackson

    Margie and Jackson Member

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    I’m so happy to see I don’t need to withhold food! Also, don’t feel bad, Julie, I’ve seen the advice about not feeding many times.

    Thanks for the info.
     
  23. Julie and Honey

    Julie and Honey Well-Known Member

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    Dec 22, 2018
    Would have been nice to know this several months ago. I was only going by what I have been told.
     
  24. Figaro's Liz

    Figaro's Liz Member

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    Jun 18, 2019
    Thank you Jill for your input here. I certainly didn't know the answers to Edye's question being a newbie myself.

    I have been thinking that rather than withholding food, consistent feeding and dosing (as much as it can be consistent! Oh cats) would give us the best data? That said, Figaro always finishes his food well before 2 hours PS, so this hasn't been an issue for us in particular.

    When Figaro was diagnosed the vet said he should be eating 2x day without grazing, luckily I didn't buy that. I understand 2-meals-per-day is part of the "traditional" approach to managing FD, ie, feed and insulin together, but that such guidelines are really more based on quicker insulins, not long-acting ones such as lantus (? I may well be mistaken). Anyway, my point is, many CGs of newly diagnosed cats may be getting a lot of mixed messages about when (and of course what) to feed, and it is difficult to figure out what is best.
     
  25. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    @Edye
    thanks for making the SS accessible!
    I could not open it yesterday.

    How's Orson doing?
    Did we help you with foods at all?
    Please keep asking questions - as you can see many people responded and are willing to help Orson if you need us.
     
  26. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    Yes....before the longer lasting insulins came out (or when someone is using one of the harsh insulins like Vetsulin, Humulin, Novolin), it was important that the cat get a substantial meal before the shot because those harsher insulins hit "hard and fast" so it was important that the cat eat good so there'd be carbs on board when the insulin "kicked in".

    With the more gentle insulins, it's not that important that they eat any particular amount...just that they be willing to eat (not refusing food due to illness or something). Since they "kick in" gently and usually not for 2-3 hours after the shot, you have that extra time to let a grazing kitty eat their meals.
     
  27. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Adding to the discussion....Even on Lantus/Levemir, some cats do better if they get the majority of their food before nadir....so that as the insulin is starting to wear off, you're not adding carbs. A snack of pure protein is fine, but feeding cat foods after nadir can act like "slamming the brakes" on any remaining action of the insulin.

    Some cats can eat all the way up to +10 without problems.

    It's a "know thy cat" thing
     
  28. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Julie, I don't know about others, but I did bring the subject up of the effects of the combination of food/insulin up in the following threads:
    I backed off because you weren't very receptive at the time. If someone wants my opinion, fine. If they don't, that's fine, too. I don't like to force my opinion/an issue upon anyone.

    That said, I have been trying to figure out Honey's spreadsheet all along. Today, it became clear how withholding food prior to getting that mid-cycle spot check would give you a lower BG number than if you were feeding normally. In more than one case, that lower number had you take a reduction... setting up a vicious circle of premature reductions followed by the necessity to take the dose up once again.

    Let's just be glad we got this figured out and go on from here! :)

    For continuity's sake, I will post this in your current thread: 7/13 Honey AMPS 355, +5 297.
     
  29. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    How much of a food spike does Jackson get after a meal at shot time (if any)? Using the data you've collected, I can't tell.

    If you don't know the answer, you'll want to continue withholding food 2 hours prior to shot time until you figure it out. Hint: The combination of +1s and +2s taken in random cycles will give you the answer.
     
  30. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    And some cats can be free-fed throughout the entire cycle. It's definitely a "know thy cat" type of thing.
     
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  31. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Another important point worth mentioning:
    In the case of a kitty throwing ketones, in DKA, or simply a cat who is malnourished and/or grossly underweight... FEED THEM. Withholding food 2 hours prior to being given a shot takes a backseat to giving kitty the nourishment necessary to get better.
     
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  32. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Absolutely.
    For every 'rule' or guideline there is an exception. Learning/knowing the exceptions and when they should be applied is more difficult than learning the rules or guidelines themselves.
     
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  33. Edye

    Edye Member

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    Jul 1, 2019
    Orson is doing great today-getting back to his old habits and even taking care of his girlfriend-grooming her and letting her sleep with him again.
    :)
     
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  34. Edye

    Edye Member

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    Jul 1, 2019
    What is DKA
     
  35. Edye

    Edye Member

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    Jul 1, 2019
    Orson is huge so the 3 compartment may be better. I will research that one today.
    Thank you for the suggestions-I really appreciate it.
    Also If I miss a response-it's because I am having difficulty following the threads on the post. I'm not used to a MB format yet.
     
  36. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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  37. Edye

    Edye Member

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    i swear I answered this-FF and FK pates
     
  38. Figaro's Liz

    Figaro's Liz Member

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    Yes you did after I posted that. It might be a good idea to add this info to your signature!
     
  39. Edye

    Edye Member

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    Jul 1, 2019
    Thank you for the great answers and explanation of why.
    I am going to get an auto pet food dispenser. Now just to find the right now!!!
     
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  40. Julie and Honey

    Julie and Honey Well-Known Member

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    Dec 22, 2018
    You had mentioned keeping track of food amounts and when she eats, which I have posted on my refrigerator daily if anyone ever were to ask, no way to put all that on a spreadsheet. You never said not to withhold food 2 hours prior to preshots, which is all I have ever seen elsewhere on the board from many different people. I would say 90% of tests I have taken over the last 7 months (not just preshots) are all based on 2 or more hours without food.
     
  41. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Yes, it can be put on a spreadsheet. Many of us have adopted a system for noting that on kitty's ss using an asterisk... similar to what you can see on Alex's spreadsheet.

    From the first link above:
    "About fasting... I noticed you're noting 'fasting' times for Honey. Rather than fasting times, you want to focus on and record when (what +hour) she eats and about how much she eats. Pretty soon, it'll become apparent how food fed will affect her cycle. I kept track of when and how much food was fed each day by dividing Alex's food up into "x" amounts. I'd place an asterisk (*) for each small amount/mini meal eaten in the corresponding cell on her spreadsheet. Eventually, I was able to learn how food affected her at any given time in the cycle.

    Check her spreadsheets for examples of what I'm talking about. Some people will make notes in the Remarks section on the ss, but if you note the feeding in the cell you'll immediately have a visual. I found it helped immensely, but to each his/her own. :D"


    That's just one example. Please review/study the links I posted for related information.
    Correct. An idea born as a suggestion quickly becomes an ironclad rule as more members simply mimic what they heard without knowing why. Unfortunately, it's human nature. It's a problem all over the board and it encompasses more than one subject. I'm not playing a blame game.

    ETA: The suggestion to withhold food prior to shots is for newbies until they learn what kind of food spike their kitty experiences from a meal fed at shot time. If a caregiver doesn't get those +1s and +2s to show them what kind of spike their kitty gets from that meal at shot time... it applies to them, too.

    From the Tight Regulation: Becoming Data Ready to Shoot / Handle Lower Pre-shot Numbers sticky:
    "Why the +1s and +2s? Let’s say you have a lower than usual preshot. If you have collected the data to know what usually happens after you shoot and how long it usually takes for the insulin to start having an effect (onset), you may see that shooting low is actually very safe for your cat. If your cat typically rises through +1 and +2 before the insulin starts to work between +2 and +3, then you can feel comfortable knowing that your cat will actually be much higher before the insulin starts to work. If your cat typically has little to no food spike or an early onset, then you may need to be more conservative with low preshots. You are not shooting the number your cat is at now – you are shooting the number your cat will be at when the insulin kicks in. You need to know what that number will be. You are then using the lag time (aka overlap and carryover) to your advantage. It is important to note that while Levemir may typically have a later onset than Lantus or Basaglar, that is not true for every cat. Know thy cat."


    xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx


    ----------> The area of concern is and was not withholding food prior to shots. The concern lies in withholding food prior to getting that mid-cycle spot check. That's where your focus should be. You were looking for a lower number than you would have seen had Honey been eating throughout the cycle by withholding food prior to doing that mid-cycle spot check. All that did was set you up for premature reductions followed by the need to increase the dose. Look at Honey's spreadsheet. Do you see the pattern?

    If you're willing to break the pattern (stop withholding food mid-cycle), you may see different results. If you don't see positive results, the next step is to use food to manipulate the curve, but I'm putting the cart before the horse. One change at a time...
     
    Last edited: Jul 13, 2019 at 3:41 PM
    Reason for edit: to clarify
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