I gave her 3U AM shot and she got 56 +4. I gave some kibble Royal canin Diabete and plain yogurt with 2~3 drops of honey... It's first time that Misso got that number... I'll check her BG in 10mn. What should I do next ? @FrostD
Thanks for reply! Ok, I'll do dit. And I have checked after 17 mn, it was 76. If it goes down again, I'll give some more food. One more question: Should I reduce her dose for next shot? If so, could I modify her dose like this ? : 3U -> 2.8U Thanks again!
It depends which dosing method you would like to follow. It looks like that 56 was probably nadir; following the more aggressive methods no reduction. Following the more conservative method, yes it would be a reduction since she went below 90.
Hello Melissa ! Ok. I follow the modified method PZI. So, no dose reduction. By the way, I just checked and it was 505 (@+10). Could this rebound be because of the honey and kibble she ate when it was 56? She ate them immediately after seeing 56. I was so shocked when I saw this number and all I could think of was to make this number bigger. Do you think it was better not to give honey to this number? And would it be enough with wet food? One more question again (sorry) : I gave the PM Shot 2 hours early due to her BG being too high. Could I change the shot times like that from time to time? Thanks again <3
The bounce is a combination of a really fast drop, plus the dry food. It's best to use wet high carb food, but if dry is all you have in an emergency by all means use it! I'd have also fed high carb at that point because it was quite a drop. The forum recommendation is to always shoot 12 hours apart. When shooting early a lot of factors come into play - insulin duration, BG, BG rising or not, diet, bouncing, etc. In this case I would not have recommended to shoot early, but I don't think it did any harm. The problem is that we don't know when the dry food will start to wear off, and when they break bounces they tend to go lower and dive faster again...and you get stuck in a vicious cycle. I'm going to watch the next few shots. If she keeps diving early like that, we'll need to tweak what you feed at shot time and in those first few hours. The hope is to slow the drop to prevent a bounce. She had been doing ok up until now, hopefully it's just a fluke.
Does kibble last longer than wet high carb food? Could you tell me more about why it's better to use the wet high carb food for the drop? After her PM shot yesterday, she only had yellow numbers until midnight. After that, I couldn't check. And then there was a bounce this morning. 434. Maybe there would be a drop that I didn't catch overnight or not. Thanks, I hope so too... I'm looking at her BG now, but according to my data, I feel it's going to be all flat with yellow today. I heard about glucotoxicity in cats. When Misso has a flat curve with only yellow numbers during the day after a big bounce, could it be because of glucotoxicity? Or is it just a cycle influenced by the bounce? I have also heard that if the cat often has yellow flat curves and sometimes a rough drop, that it might be because of inflammation. Is this true?
Could you explain more about this method? I would like to know how to slow the drop with food. Because there were the same yoyo with drops and bounces when she was on caninsulin. Misso only eats wet low carb food, 280g per day. And I feed like this for each cycle: AM/PMshot=100g +2=20g +4=20g (dehydrated chicken treats in between) Thanks again
Re: kibble - yes, there's two issues with using kibble in hypo situation. 1) it takes longer to affect BG. Honey usually boosts BG within about 10 minutes, wet food within about 20-30 minutes, but kibble is unpredictable and could take an hour or more. 2) it takes longer to wear off. The effects of wet food usually wear off within about 2 hours, but kibble once again is unpredictable - it can last hours. So once youre past that hypo situation, the high carbs are still sticking around and boosting BG even more (which we usually don't want). The flat yellow last night and today mean a few things: 1) the normal dose was not enough to cut through such a big bounce 2) her body is still bouncing, so this mornings shot also was not enough to cut through that. I'm guessing she may clear it tomorrow, based on how tonight's numbers look. Remember that bounces are unpredictable, which is why we always say still shoot your normal dose. They may clear it the next cycle, or it may take up to 3 days. Trying to override a bounce usually makes things worse - you end up with a serious hypo because you gave too much insulin and the bounce broke, and then you get another bounce from that. I have not heard of the inflammation thing, no. I see the flat yellows after a bounce quite a lot, it tends to affect all cats. But I'm very curious if you have a link or something for me to read about it? In order to slow the drops, you need to first find when her onset is (when the insulin starts to lower BG). It looks to me that it's by +1 on ProZinc - not quite enough data because of the bouncing, but that's what it looks like. And this is where a lot of trial and error comes in - Since her onset is so early, I'd probably feed medium carb (around 10-12% carbs) with the shot. Start with that for about a week and see how she does. You have to give it a week because you have to "filter out the bounces" - meaning,.you have to give it enough time to see how it works when she isn't bouncing. If it slows the early drop down, great! But then more than likely you'll probably have to give medium carb again around +2, and you may have to feed equal amounts (instead of the 100g/20g/20g) Now the trouble with that is ideally you don't want to feed the medium carb while she's bouncing - take last night, this morning, and tonight for example. Feeding the medium carb is only.going to raise BG more, and we don't want that. But again, it's unpredictable. I'm usually pretty good at spotting the patterns and when the bounce will.break,.so I'm hoping after a few more weeks I'll be able to pinpoint her trends.
Thank you for your detailed reply, Melissa. I think Misso finally came out of her bounces on September 30 evening. As of last Friday night, her BG is much better. In the meantime, I've been keeping her 3U dose. And it took 4 cycles to break the bounce. Walking on the red and yellow numbers, I tested the distribution of meals: If I give most of the portion of a cycle with shot and +1, there is food spike at +2. If I distribute the portion in three times with more balance (shot=50g, +2=50g, +4=30g), it seems to me that it softens the curve. So I would keep on with the second way. As I don't have medium carb at the moment, I am giving Granatapet Symponie chicken which has 9% carb (DM%). I don't know if it's because of the insulin or the Granatapet symphonie but she doesn't have a harsh drop these days. I will be watching the next few days as I keep on this food. And actually it's hard to find a food that has the carb between 10 and 12% here where I live. So I have a question: If this food work is in order not to lower the drop too much, do you think we could test a wet food or kibble with 10~ 15% carb? For example, Royal canin diabetic pouch (14%) or Purina proplan vet DM kibble (14%)? I gave her the RC diabetic pouch before, and it seems to me that it was not very different the result to the comparison of other lower carb wet foods (<9%) that I tried. Despite this, I stopped the Royal Canine because of the starch and the cost. But if it can work to delay the drop, I may try again. Also, I would like to know if you have heard of any members here who have tried and/or succeeded in regulating their cat with vet diabetic food (wet and dry)? The description of this kind of food always says that it is clinically proven to regulate blood sugar levels, but I would like to hear your opinion on this first because you and the members here have real experiences. For the inflammation I told you about, I read that through a comment from someone in a French diabetic forum (I go there for local info, food, vet, etc. because I live in France). I can't find the comment anymore but I think he meant the case of pencreatitis or hepatitis.
As for food, I would use whatever works for Misso and your wallet! I'm glad it seems to be helping. I would not use the kibble because of the issues I mentioned earlier, it tends to complicate things. Truthfully I have no idea how they can claim these things, and I know at least in the US they've been sued and had to change labels and claims, etc. Technically you can regulate a cat on almost any food, as long as you're consistent with when/how much you give. It just takes higher doses of insulin the more carbs there are. Remember that regulation is defined as BG between 100-300 with no/minimal clinical signs. But above that is well regulated (100-200/250), and beyond that is tightly regulated (60-120). Regulation itself is fairly easy; well or tightly regulated is not. We have cats that for medical reasons must be on kibble, and in those cases we just have to keep raising the dose. But if you see those spreadsheets, you can see the BG is still much harder to control (lots of BG swings, leas predictability).
As for inflammation - it does typically raise BG, but it's different in every cat. If.your cat is well regulated, then yes he might end up flat yellow because of it. If tightly regulated, probably end up blue/yellow. Hard to say!
