8/11 TASHIE amps=Hi/+6=593!!!***Can we talk CARBS***

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Re: 8/11 TASHIE amps=Hi ***Can we talk CARBS***

Okay, I know my signature line is a mess - working on it :?

So, I need to talk CARBS here and also make sure we are on the same page.

I have been feeding Tashie %5 and UNDER. Now, a thought that came across this morning is that when she is running HIGH, feed her the LOWEST of carbs - for example, this morning she was HIGH so I fed her FF Salmon which is only 1% ....... thinking if I can do this "through the bounce" it might help? Trying to keep it at 2% or so.
On the days she is maybe 350 or so at PS, give her 5% Carbs
On the days she is UNDER 300 at PS give her higher, start with %5 and then +2 go to maybe 8, 9%?

Now, I need to know what is considered "medium carb" ........ since I am keeping her to 5% and below, would 10% be considered medium in this circumstance? Or, is it better to go to 12%?

Yes, I have ALL the food lists - but can anyone suggest a BEEF/ TURKEY/non fish PATE type food that fits the bill? I have spent a small fortune on food that I have thrown away (can you relate!) and they do not like "shredded" or "lots of chunks" ......the PATE type food seems to be the winner.

It never ends...........thank you for your perseverance with me!
 
Re: 8/11 TASHIE amps=Hi ***Can we talk CARBS***

I'm copying Jill's post from last night to make discussion a little easier:

Jill & Alex said:
hi bern. i've been using a method i dubbed "using food to manipulate the curve" to help control alex's curves for years. i've taught the method to sienne, marje, and scores of others. i don't necessarily consider it an advanced technique. however, a caregiver better pay close attention when using food to manipulate a curve or it can become risky business.

here are the basics:

what is meant by using food to manipulate the curve?
simply put, it's a method of feeding used to prevent kitty from dropping too fast and/or too low.
the amount of food usually fed to the cat is broken down into several mini-meals fed throughout the course of the day with the intention of flattening out the curve. lc is normally fed to all numbers except possibly in the case of a significant or fast drop or fed to a drop below 50.

the only time you might want to feed a little higher carb food at shot time is to bump the numbers up so the insulin is starting from a higher number when onset occurs if you're running out the door and will be unable to monitor.

if you're around to monitor, there's no reason to bump the numbers up at shot time. the beauty of lantus and levemir is being able to shoot low to stay low. shooting low is how you obtain the low flat curve with lantus and levemir.

whether you'd want to feed lc, mc, or hc to slow a drop depends on two things:
1. the carb sensitivity or lack of of your particular cat.
2. the point you're at in the cycle. a drop early in the cycle *may* require big guns. a drop at nadir (unless nadir is less than 40) or late in the cycle usually only requires lc to bump the numbers up. however, if you have a carb sensitive kitty, you may not have to use anything except lc to bump up the numbers. "KNOW THY CAT".

why would you want to manipulate the curve with food?
--- bouncers: kitties who drop low and then bounce to the moon benefit from food manipulation. using food to manipulate the curve will tend to flatten out the curve. flattening out the curve helps to prevent huge bounces.
--- carb sensitive kitties: kitties who experience large food spikes when consuming even lc benefit from manipulating the curve with food. strategically spacing out meal times will help flatten out the curve.

why do i want to use food to flatten out the curve ?
--- flattening out the curve allows you to get as much insulin into the cat as safely possible without having kitty bottom out on you.
--- flattening out the curve *usually* allows you to hang onto a dose longer
--- flattening out the curve allows you to shoot higher doses of insulin than you would have been able to otherwise.

why would i want to get as much insulin as possible into the cat?
lantus and levemir are known to have a harder time bringing down higher numbers. more insulin helps bring down the higher numbers in a bouncer's cycle. more insulin will help counteract the spikes in a food spiker. using food to manipulate the curve will flatten out the curve and help keep your kitty safe.


when using food to manipulate the curve, i generally recommend starting with dividing up the normal amount of food your kitty should be eating into 8 mini-meals to be fed at preshot, +1, +2, and +3 of each cycle. however, that recommendation is strictly a starting point. a plan customized for YOUR cat is YOUR goal. frequent testing and learning how YOUR cat responds not only to food, but to the insulin itself will help you tweak the plan.

a quote that goes along with this subject from Libby/Lucy found in one of Mocha's condos:

"carb manipulation is more about learning what your cat's response is to varying amounts of carbs at different times during the cycle, and using that information to your advantage. Learn how many points bump she gets from LC, MC, and HC, both early in the cycle and later in the cycle. Use that information to guide her cycles the way you want them to go. Mocha's AM and PM cycles are very different, so the best feeding times for her might not be the same in each cycle. Take the amount you would feed her over the 12 hour period, divide it into 3-4 meals, and experiment with when to feed them. Whatever changes you make, write them in your spreadsheet and hold it for at least 3-4 days to see if it is changing anything. Mocha drops later at night than she does during the day, so your food schedule might need to be different at night.

Many cats benefit from front-loading the cycle with food. That means feeding at PS, +1, +2, +3 (when the insulin is kicking in) and then NOT feeding after +6 (because for a carb sensitive cat, you would be adding food at the same time the insulin is wearing off, driving the numbers higher). The +9 snack is helpful for some cats when they are trying to go OTJ, because it can stimulate their pancreas. That is more useful if the cat is generally flat, but spikes up just before PS. I wouldn't worry about that yet, until you get to a lower dose."

experimenting is how YOU learn how YOUR cat responds not only to food, but to the insulin itself. no one feeding plan will affect two different cats in the exact same ways. experimenting, testing, recording your observations... these are the things which will help YOU with YOUR kitty because like you'll often hear around here...ECID. :mrgreen:



just a few thoughts...
Click to expand...
 
Re: 8/11 TASHIE amps=Hi ***Can we talk CARBS***

Hi Bern and Tashie! That was helpful information! Looks like we got a lot of good info last night. I had really good stuff in my condo on bouncing. Unfortunately, since I don't feed wet food, not sure this would work for me. :?
 
Re: 8/11 TASHIE amps=Hi ***Can we talk CARBS***

BorisV said:
I have been feeding Tashie %5 and UNDER. Now, a thought that came across this morning is that when she is running HIGH, feed her the LOWEST of carbs - for example, this morning she was HIGH so I fed her FF Salmon which is only 1% ....... thinking if I can do this "through the bounce" it might help? Trying to keep it at 2% or so.
On the days she is maybe 350 or so at PS, give her 5% Carbs
On the days she is UNDER 300 at PS give her higher, start with %5 and then +2 go to maybe 8, 9%?
Click to expand...
My two cents: I've seen people try to do this, and in my mind it makes things more complicated than necessary. Usually it is easier and more effective to play with timing of the food rather than the carb % of the food. For some cats, those small differences in carb % might make a difference, for others it wouldn't.

Jill's strategy is one that has been used by a lot of people over the years, and would be worth trying. Tashie tends to drop early in the cycle, so spreading out her meals a little bit might help regulate that a bit. On Tashie's spreadsheet, on the days she has gone low she has already started dropping at around +1 or +1.5, and by +2 she has dropped a lot. So instead of feeding her whole meal at PS, maybe feed 1/4 of her meal at PS, then another 1/4 at +1, +2, and +3. The hope is that each of those mini-meals will help slow down the drops and flatten her out. You will probably have to tweak that schedule once you have gathered some data on how it works for Tashie, but it's a good starting point.

Of course, if you are testing before these mini meals, if she is dropping very fast then you might want to switch to a higher carb food.

Want to give it a try?

Now, I need to know what is considered "medium carb" ........ since I am keeping her to 5% and below, would 10% be considered medium in this circumstance? Or, is it better to go to 12%?
Click to expand...
I know this answer seems like a cop-out, but each cat is different. While you're doing the food experiment, try to get an idea of how much of a rise each carb % gives to Tashie. Some cats are very sensitive to carbs, others are not. Some cats seem to get a good bump just from walking near the food dish :lol: but others need a bunch of carbs to slow things down. Do you have a feel for how carb sensitive Tashie is?
 
Re: 8/11 TASHIE amps=Hi ***Can we talk CARBS***

what a great summary of carb manipulation! That should be a Lesson for Today. Maybe we could have one sticky w/ links to all of them?

Feeding lower carbs in the midst of a bounce doesn't really help, carb manipulation is used for dropping numbers. Been there, tried that, doesn't work. Bouncing comes from what the liver produces to counter low numbers or perceived low numbers. The bounce ends when the liver stops producing the counter-regulatory hormones and glucagon and they clear the system.

What works as LC or MC for your cat goes back to Know Thy Cat. Generally we consider LC under 10%, MC 10% to 15% and HC over 15%, pates are usually lower carb foods. Foods w/ gravy tend to be higher, the carbs are in the gravy. Keep in mind to that carb % we have are from a snapshot the company takes of the food, it can vary by batch. A percent or two difference in food usually isn't significant.

For example I usually feed Tess 1% to 4% food, to bump her up more 4% or 5% food usually works. If I really need to get her up 8% to11% really do the trick. I never need to resort to full HC food. Some cats eat 8% all the time and no big BG rise and need higher carb % to get them up. ECID

ETA You'll see that Tess get added meals at +3 and +6, we worked that out because she is on Lev, has a much later onset and very late nadir.
 
Re: 8/11 TASHIE amps=Hi ***Can we talk CARBS***

Bern:

Are you asking your questions in reference to Jill's post or are your questions separate from Jill's note?

If the latter, you're asking good questions. I'm not sure my spin on the answers will be satisfying. A lot depends on how carb sensitive Tashie is. This was one of the initial points in Jill's post. (It's also one of the reasons I consider the information she posted an "advanced" approach. You need the data to know how your cat responds to carbs.) For many cats, any change you make in food can take a cycle or two (or more) to exert an effect on numbers. I think we all have experience feeding higher carb food and know, for the most part, how our kitties react. Shifting from 5% to a lower carb food may not show any immediate effect. You may see an effect if you consistently were to feed 1% but that might take more than a couple of cycles to show any reliable difference.

FWIW, there are actually some cats that do better on higher carb food. It may be that you need to experiment. Like Libby suggested, you may want to alter the time(s) that your feeding and give this a week or two (or more) to see if the change is having the desired effect. If you look at Gabby's SS, you'll see I test early. In my signature line, you'll also see that I feed at pre-shot, +1, +2, +3, and +4. This is because Gabby has an early nadir and is prone to fast drops early in the cycle. It took a few weeks to see any change after I changed how I distributed her food.
 
Re: 8/11 TASHIE amps=Hi ***Can we talk CARBS***

Morning just stopping by to say hi, I hope you get this figured out :lol: good luck
 
Re: 8/11 TASHIE amps=Hi ***Can we talk CARBS***

Sienne,
Are you asking your questions in reference to Jill's post or are your questions separate from Jill's note?
Click to expand...

My questions are "separate" from Jill's note. I have sort of been feeding Tashie the way you feed Gabby - I feed right after shot - if she eats ALL, I will put a bit more down +1 1/2 or so - or, refresh what is left with home made chicken broth. I try my best to make sure she has food throughout the morning and just a little late afternoon. I do remove ALL food 2 hours prior to her insulin shot.

As far as "carb sensitive" - I THINK she is .... when I've panicked (for example, July 13th, I found her @33 +4) I was not doing T.R. at this time and my vet told me NOT to test but I had a feeling .....I started with Gravy and SHOULD have left that alone!!! I got her to 89 +6.5 and SHOULD HAVE LEFT IT BE!!! I then gave her a few DRY DM cookies (18%?) and she skyrocketed to 422 by +8 ...... DUMB! DUMB! DUMB!

Yet, on 7/26, using LOADS of gravy AND Karo, I fought a battle and @ +10 she dropped to 36. But maybe that was due to the much lower PS number? So, then, the "shooting low numbers" scares the daylights out of me.

And, on the BOUNCES ........Tashie went down to 56 yesterday - I ONLY fed LC ....then at PMPS she was HIGH - PMPS this morning she was HIGH and I just left in the middle of writing this to do a +6 and she is 593! She's barely moving today .... I get SO confused :? and so forlorn with this. I appreciate everyone's time and effort that you make with me - Just when I think we're getting there, we're not!
 
what I mean by "carb sensitive" is how much of an immediate bump up in numbers do you get from medium carb or high carb food? Like within 30-60 minutes after feeding. For example, Jill's Alex is very carb sensitive. Jill has said that if she needs to get Alex out of low numbers, she can get a 15 point rise from a piece of freeze dried chicken. On the other hand, for my KK, I can give him a whole can of high carb Fancy Feast and he might still be dropping. Often I have to give him another can after an hour. Those are both extreme examples, and most cats fall somewhere in between. Next time Tashie is in green, or even low blue, try feeding a couple tsp of her usual low carb food and test in 30 minutes. Write down how many points that raises her. Try the same with medium carb and with high carb. Do it several times to get an idea of what each type of food does for her. Then you'll know - "hey, she's at 50 and I want her to get to the 60s - I know how to do that!"

The big rises you are talking about - when she is green and ends up at 500 by PMPS - those are just bounces. Those are thanks to hormones and would happen no matter what you fed, or even if you didn't feed anything at all (but of course I'm not suggesting not to feed!). We can try to prevent or moderate the bounces by trying to prevent her from dropping so fast, but once she DOES drop fast or low then the bounce is going to happen. Tashie bounces higher than most, but they all bounce to some degree. They are very hard to look at when it's your own cat, but they are a normal part of the process and they do go away.
 
Libby did a great job explaining what I meant by "carb sensitive." I think her suggestion to do some assessing how Tashie responds to carbs is a wonderful idea.

FWIW, I don't feed Gabby the way I do because she's carb sensitive. Gabby is probable average in that regard. I use food to buffer her numbers and prevent her from dropping too fast or too far early in the cycle. I feed her the same way every day. The only difference is whether I need to add HC to her meals or fed more often if her numbers are dropping. If you take a look at Gabby's SS, you'll have a visual of what I'm talking about.

You may want to consider feeding Tashie more of her food earlier in the cycle. It looks like when her numbers are dropping, it's before +6. You can divide her food into 3 portions and feed at pre-shot, +1, and +2 or however you feel makes sense. Since there's less of an issue with Tashie's numbers dropping late in the cycle, you might want to not feed after nadir.
 
Thanks Libby & Sienne! I do "get" what you are both saying :-D ....But, with Tashie, I also have to factor in how fast she is dropping & how early she starts - when she dives down and I have an all day struggle to keep her safe with high carb, I obviously can't take any chances :smile:

Yesterday, and even the day before, were not the "usual" Tashie cycle - she actually "surfed" which is not her usual M.O. - I felt more comfortable to "test" her on Low Carb food, which I did and she was fine.

It all depends on the day! Wish they'd respond the same each time- yeah, I'm dreamin'!

I think what I will do is add a column on my SS to track EXACTLY when & what I'm feeding and see if I can see some trending - it's a bit difficult as she is "high" half the time :roll: Gurrr!

Thanks again for time and thoughts! MUCH appreciated!
 
yeah, the cycles when she is stuck in high numbers are not so relevant with regards to feeding. The cycles that are lower can give you a lot of information, though.

So, back to the idea of trying mini-meals to see if that will slow down her drops. What do you think, want to try it or wait?
 
Bern

Just thought I'd throw my two cents worth in this great discussion.

When Gracie was started on lantus, I also was feeding 1 or 2% carbs when she was low, and then something else if she was high green and something else if she was low green....it made Sienne's head spin :lol: :lol: :lol: She suggested I just pick a food to give her all the time and then use something higher carb (notice I didn't say HC...just higher carb) if she came down. :idea: :idea: Genius. So I started feeding her WN 4% and that's her basic diet all the time unless she drops fast or drops really low. Oh the simplicity and I love it. Ever grateful to Sienne for that.

And then Jill suggested feeding to manage the curve as she has suggested for you. I started with dividing Gracie's food into four equal portions. It was helping some but she was also an early diver. Another member (Beth) suggested I feed a majority of the food at AMPS and +1 and then a lesser amount at +2 and +3. It didn't happen overnight but that method really worked well for Gracie on lantus. She still dropped but she wasn't taking those huge nose dives. And for her, she will bounce higher from a dive then she will from low numbers, in general.

So that is just an example of what Libby, Jill, and Sienne are referring to with the ECID. You start somewhere, you make copious notes (which you can see on Gracie's lantus SS), you check the pattern; if it's not working, try something different. Simplify. Don't grab for 15% if 8% will get the job done.

eta: if you look back through your condos, I believe it was the Jun 8th condo that I discussed all of this....when to consider feeding what in the cycle, how to manage the curve with food, etc. You said you printed it out ;-) More detail here today which is superb!

Definitely a bookmark worthy condo!
 
Yes, Marje! You are right - we have discussed this before but wanted to "revisit" ...... as, my main question was "what IS medium carb food"? But, I guess since I have been feeding 5% & under, "my" medium carb could just be 8 or 9%. ???

Meaning - the "recommended" carbs are 8% or less, right? Since I am not feeding that high and just about 1/2 of that or so, 8% COULD be "my" medium carb food - where if I was feeding her at 8% carbs on a regular basis, my medium carb would be possibly 12 - 15% - right?

And, due to our prior discussions (((Which did not go remiss))) I have been "front loading" as you suggested some time ago. Keeping in mind that I do have somewhat of a problem eater but she is doing much better.

I have added a new column to my SS that will be strictly for a food log - as now, it's sort of "buried" in my "food & behavior" column. I will be diligent about trying to track her foods - it's tricky some days as having 2 cats, who is eating what?!!! Some days she head butts Boris right out of the way and eats his too! Guess I need a web cam for some of this! :roll:

Thanks for having the patience to go over this again with me - it cropped up yesterday when I, for the first time, just used LC to see if she would surf - felt that I had more TIME to do this as she wasn't dive bombing at a rate of 100+ an hour. When she goes fast & hard I have to pull out bigger guns!

Merci all!
 
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