05/11 Bambi AMPS 298, +2 162, +5 53, +6 86, +8 140, PMPS 225

Previous thread

Evening everyone. All seems normal, just want to ask one thing, Bambi fell to 53 today and it's likely she may fall below 50 in the upcoming days. Since she's already down to the minimum 0.1u dose so what happens after this?

I'd like to think she's close to OTJ but she did rise all the way up to 300s a couple of times in the past week or so, so not sure if this is normal?

 

Another bounce :/ I also have another question. I just took another reading 3 times at +3.5 - The first reading did not collect enough blood (The meter has a safety line and it did not fill it) and my experience is that typically when this happens the BG would always be lower. However, on this occasion, it read 354. I then took 2 more readings with plenty of blood and they were 269 and 262. I normally take the highest value when I do multiple readings, but this reading confused me. Is this because the meter can make false readings sometimes or am I missing something?

 

Meters are allowed to vary by 20%. So the last two are within that. The first reading was an error probably due to not enough blood as you thought.

 

She’s not ready for an otj trial. She needs to have all but a rare reading under 100 and nadirs 50-80.

Here’s a link that explains what you are asking.
https://www.felinediabetes.com/FDMB...ng-reductions-and-starting-otj-trials.150160/

Are you feeding the curve? Ate you feeding very low carbs only? If so she might need slightly higher carbs, closer to 9%, to prevent a drop under 50 and perhaps even up her dose to get her surfing green.

There is a dose lower than .10. It’s a drop dose. I’d try and prevent her going under 50 if possible.

 

Thanks for the explanation @tiffmaxee. Yes, I wasn't expecting an OTJ trial either but couldn't find the way to go after a 0.1u dose.

I'm trying to feed the curve but I'm partially able to do that, impossible to do it regularly, but I will try on a case-by-case basis. (Example - I fed the 4% carbs liquid snack below at AMPS +4 the other day when she was hungry)

Right now I'm sticking to a strict feeding schedule:

1 pouch AMPS
1 pouch AMPS +5 (5 hours after previous feeding)
1 pouch PMPS (7 hours after previous feeding)
(Felix 85g Sensations - Jellies - Beef/ Felix 85g Sensations - Jellies - Chicken) - 8g carbs

The wet foof low-carbs (tools) I can afford and could find are:

Felix (Sensations Beef/Chicken) - 8% carbs
Sheba (Tuna/Turkey) - 3.33% carbs
Whiskas (Pure delight Beef/Chicken) - 3.53% / 4.37%
Liquid snack (Wanpy) - 4% carbs

Any suggestions welcome, I found the snack just a few days ago so I may be able to feed that occasionally from now on but I can't do it regularly at fixed times. I read the feeding the curve post @Bandit's Mom shared previously and in a nutshell what I understand is if I see the regular falling pattern in her data, I can feed a snack to bump her up a bit, for e.g. in Bambi's case when she is on a steady fall and she hits 60-80s to keep her falling to below 50, and secondly avoid giving food or snacks when she starts rising and or after her expected nadir time.

 

Waiting until +5 is the problem.Even waiting until +3. A decrease was needed onBy then it’s too late and his bg goes too low if it’s going to be an active cycle. Better to feed a little less at amps and give a snack at +2 and if the bg has dropped then give a snack at +4. Just a couple teaspoons is enough.

 

Here’s another sticky to read.
https://www.felinediabetes.com/FDMB/threads/8-10-tashie-pmps-high-questions.101989/#post-1087990

 

Very sorry for the late reply @tiffmaxee, it's been a very busy week overall, and I could just get around to writing back :/

I understand what you're saying but here is my problem - If I give less food at AMPS, and snacks in between, I cannot feed her all the nutrition she needs to get. The wet food recommends 3 - 3 1/2 pouches a day for her size and I'm giving her the minimum 3 + reserve for snacks if needed. Her weight looks to be pretty ideal right now so I think the amount is ideal. I give her this 3 times a day and if I change the hours then I have to feed her after the nadir which will be worse. Also, I live alone and there's no one who can pitch in regularly, so I can't sustainably give her smaller 5-6 meals each day regularly.

However, I'm trying to do all I can to feed the curve - I tried to take a reading each hour yesterday when I was available. She seems to be responding well to this schedule. I fed her a full pouch at AMPS, she went really steadily from 106 - 153 at +4, and then dropped slightly to 128 at +5. I then fed her at +5 like usual and it started rising to 160 1 hour later and although a gap inbetween she rises up to a point pretty fast and flatens out again. Today coincidentally was an exceptional day where her AMPS was a record-breaking low at 71. Therefore I fed her first at her usual AMPS shot time but gave her shot an hour late. Since she was floating low and I had to leave the house, I also gave her meal half an hour early which combined with the late shot was at +3.5. Her numbers look to be holding better compared to feeding at AMPS then at +5.

What do you think about changing her eating schedule to 1 hour before AMPS (Instead of right at AMPS) and then to +3 instead of +5? Am I taking the right approach? Also I could not understand why she dropped so low overall today except that her dosing is pretty difficult right now so I might have given her a bit more than 0.1u due to the syringe.

Sorry if my post is a bit long and hope I could clearly explain myself. Thanks.

 

I would try and feed before need and not feed an hour before insulin when it’s losing potency. I live alone as well and had no help so I understand that. Can you get an auto feeder? I would feed at preshot and then a small snack at +2. If she’s not hungry at +2 feed a little less at preshot. You need to slow her down and prevent drops under 50 because she needs long stretches of green. By +3 if she’s going to go lower it’s been too late to prevent her going too low. You might also consider slightly higher carb food so you can give her more insulin.

Measuring small amounts can be challenging especially since the lines on the syringes are not always accurate. I had to increase and decrease in 1/8 increments so I used digital calipers. I will post a link so you can see if you might want to try them.

Long lists are just fine as are lots of questions. That’s how we help each other here.

https://www.felinediabetes.com/FDMB/threads/dosing-with-calipers-updated-w-videos.79851/#post-862835

Also please start a new condo. We ask for a new one each day you post.

 

Life was really easy before FD with my dry food auto feeder. I could not find a suitable one for wet food and I have 3 cats, I doubt it would work in my case. One of my cats doesn't eat wet food properly so I have to give them a mix, the other eats any remainder and I have to put Bambi in a room so that she doesn't eat the other's mixed food. I'm searching for a freeze-dried low-carb food but couldn't find a suitable one yet.

She is always hungry. I'm pretty sure she will eat her normal pouch at AMPS and another whole pouch at +2 if I give it to her. However, after that she will get really hungry until PMPS and will be really cranky. Also if I don't feed the other two at the same time, they will also get grouchy. I would then need to feed them at different times and will need to feed minimum 4-5 times a day at regular intervals which will not be possible. I will try that in the next few days but right now I'm a bit pessimistic about how that will work.

I'm confused about this, wouldn't that lower her chances for remission? Is steadiness of BG the key here, the flatter her BG, the higher the chance? Interesting. She's on 8% right now, for e.g 10%? I was also thinking of lowering further, there's a 4% carb Whiskas which I can find. I tried to avoid Whiskas as a brand but if it increases the chances of remission I could give it a try...

Thanks, I will look into this, seems it could be very handy.

Yeah sorry, I usually do, I meant to reply to your comment sooner so continued on this one. Next time I'll post a fresh one.