01/16 MISSY AMPS 191 +6 122 PMPS 335 -ADVICE - Food Manipulation for more consistent numbers

Current dose is 0.75 units of lantus, TR. Fed low carb wet food 0-5% and sometimes a little dr elseys dry chicken for a treat.
I'm having a hard time keeping her numbers low becaue she often bounces when I get a normal or low number. So i'm now trying to manipulate her curve with food. I've read up on FDMB and some posts about it but im looking for any advice or tips that worked for others. I usually start feeding 0-1% after her insulin then feed hourly... around +3 or +4 i give 4%-5% food. After +6 she gets nothing except a 0-1% meal before her 2 hour pre shot fast.
She has dropped below 50 twice at 0.75 but im thinking of raising her dose slightly 0.85ish(using calipers) and using food to get better numbers more consistently or better preshot numbers.
Any advice or tips that can help would be appreciated.

Last thread Dec 24th

 

Hi Dana, I can't see your 2021 SS...is it there somewhere I'm overlooking?

 

Should be the last tabs

 

Found it! Sorry!

Could you please drag that tab over to the far left on your SS? Thank you

 

Bounces are very common...her numbers look good today. Feed LC to keep her surfing in those lower numbers...just a teaspoon or so will do the trick.

It's difficult to keep cats from bouncing as it's a normal response of their body to what they perceive as an emergency - just the liver releasing stored glycogens into the blood stream...it dissipates and the cycle begins again with help of insulin - lower numbers. Over time she'll get used to those lower numbers.

Have you posted here before? IF so, could you please copy and paste that last thread into your post? Also, could you please add the date/cat name/AMPS to your title? It'll help people as the day moves on to keep your condo organized.

Thank you!

 

Hi Dana, usually when we refer to manipulating the curve, it's to keep the cat from going too low for a few reasons, one of which is so that they don't earn reductions to quickly and have to go back up in dosing. Feeding any food will influence BG levels to go up, and it seems that what you are trying to do is avoid this. Your feeding schedule sounds pretty good, and you're dosing properly for TR, so I don't think you should change anything. It might just be that Missy's liver has to learn to be in lower numbers and eventually she will graduate from liver training school as Sue says.

 

Thank you. Fixed my title and added my last thread.
Do you think its ok to raise her dose a bit (to about 0.85 using calipers) to try to get better preshot numbers? This is her third time at 0.75 units.

 

I'm not a big fan of fat/skinny dosing...so I'd say since you're using TR and since you seem to test a lot - go for the next .25 increment up. Let's see if we can get some green mixed in with those lovely blues.

Your call though...do what you're comfortable with...you can also wait for another day or three - up to 10 cycles before you should increase on TR - entirely up to you and how much you are home and can test and help her surf safely.

 

Ok i'll try 1 unit again tonight or tomorrow, i'll decide once i see her preshot numbers. THANK YOU.

 

Dana --

If you are following TR, you need to evaluate the dose every 3 days. If the nadirs are not within normal range, you increase. If you're seeing mostly nadirs that are below 100, you hold the dose for 5 days. By holding the dose overly long, Missy's body starts to treat the higher numbers as her new "normal."

Since Missy is a longer term diabetic, her dose is reduced if she drops below 40. Alternatively, 3 drops into the 40 - 50 range in separate cycles.will also warrant a reduction.

I have a different spin on fat and skinny number versus what @Sue and Luci suggested. If you are getting consistently good (i.e., normal range numbers) and need to make finer adjustments to keep the dose in that range, making micro-adjustments may make sense. At this point, Missy isn't there yet. You have several runs of good numbers but Missy is still bouncing.

 

Im trying to do TR... but with these bounces i find it hard to up her dose as quickly as i should. It seems like she is bouncing every 3-4 days. The last few days i started to try to prevent a huge drop with food so it doesnt create another bounce. This is her 12th day at 0.75 and she has gone below 50 twice. Her pm shot is in 1.5 hours. If its above 180 i will probably raise her dose to 1 unit. Unless you suggest anotherwise....???

 

Dana, just to remind you, we don't determine the dose based on pre-shot numbers. It's determined by the lowest number of the cycle - so look at her nadir - the lowest number today - and ask yourself, should you raise or lower the dose based on the lowest number?

The only time you want to stop and re-evaluate the dose is when the pre-shot number is too low - then you want to stall, test again and see if she's rising or not - but that's a different matter than what you're trying to figure out now...

 

Yes, i guess i do need that reminder. I think im getting wrapped up in her preshot numbers because the up and down seems to make her feel so shitty. When the preshot is high, the drop is so big. I guess im looking at it as a whole. I feel like i have more control over her nadir with food then her preshot. But i guess looking at her nadir the last few days she is due for a dose increase.