? 11/02 Millie AMPS 266/+2 259/+4 215/+6 178/+8 198/+10 210/PMPS 148+.5 202/+1 209/2.25/+2 139/+4 95

H

Heidi n' Millie and...

Member Since 2022
Yesterday: 11/01/2022 Millie/AMPS 229/2.25U/+2 199/+5 185/+8 206/+10 222/PMPS 218/+2 217/+4 232 | Feline Diabetes Message Board - FDMB

AMPS was high...266, especially considering that she didn't eat her last PM snack. We were down to her last 10 units of glargine, so I tossed and opened a new one, just in case the last one had lost effectiveness. We shall see since the new dose doesn't seem to have made a lot of difference. No low number to bounce to. Ugh. Then again, she's only been on the new dose since Monday night and this is obviously not finely tuned science, because it involves cats.
 
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When is her last pm snack? How much YA is she eating? Any possibility of ditching it? Why do you think mirtazapine is needed?
 
Her last PM snack is 3hrs 20 minutes before her AMPS, 1 hr 20 minutes before the timed feeder moves to an empty slot. Because of the way that the feeder timer works, she gets her first PM snack 4.5 hours after her PM meal/shot. Then, 2 more at 2-hour intervals. Her daytime snacks are spread out more because of the way the timer works, every 2.5 hours, starting 3 hours after her AM meal/shot. She gets less than a teaspoon(I just went and counted, about 16 pieces) of YA for her middle snack, along with freeze dried raw meat treat of the day...we rotate between chicken, chicken liver, rabbit, salmon and duck. Her other two snacks are 1/2 container watered down Sheba pate, with a little bit of freeze dried to entice her. She now gets 2 pieces of YA kibble when she gets tested. I do the YA because I know that she will eat it...everything else is kind of a crap shoot, depending on the day, whether the moon and stars are in alignment, who knows what else. She gets excited about her two pieces of YA, at testing. I could cut that down to 1. She was so finicky, when we started this, that I have just tried to get her diet/appetite consistent. Since I work long days and am gone from home all day on Friday/Saturday/Sunday, and timing requires that I only have 1 hour between her dose and leaving (and it can't go earlier because of what time I get home on Friday and have to leave on Saturday morning), I watch her like a hawk for signs that she is going off her feed. If she sniffs and walks away, I'll do mirtazapine. It happens maybe once every week to 10 days. She was 3 pounds below her normal weight when diagnosed, and we did a couple of months of Vetsulin, before the new vet in the practice took over her case, that I wanted to get her back to her normal weight and eating consistently, to compensate for my almost total absence for 3 days/week. My compulsive testing is probably latent OCD taking over and I might have been a statistician in another lifetime. The interaction between food intake, numbers and insulin doses fascinates me. The one time that I gave her the wrong feeder and she didn't get a snack all night, her AMPS was way low compared to normal...85. There, way more than you asked for.
 
Do you know why she sometimes doesn’t want to eat? Pancreatitis? Feeding after nadir can cut duration of lantus. Does she need that late snack? We usually don’t suggest it until very close to remission and getting a dose of 0.10 or sometimes .25 unless there’s a medical reason to feed then.
When Max became diabetic my first post started with something like don’t shoot me because I will not be testing at home. I became a testaholic so I get why you test a lot.
 
When you say late snack, are you referring to the entire PM snack or the last of the 3. I just keep reading that it's better to have many smaller meals than 2 big ones, like many vets counsel. I was just trying to keep her consistent through the day. Food is taken away 2 hours before AMPS and PMPS. I just read about pancreatitis in a Cornell paper. Her funky appetite doesn't seem to be due to that nor does she vomit, except for a very occasional hairball. It's not like she quits eating...she will always eat YA. It's like the flavor of the day thing. She also has consistent bowel movements...number, texture, size, etc... urine output is also consistent. She lost weight in the beginning and I got really hypersensitive to her eating habits and trying to keep her consistent. She has gained back all of her weight, plus a little. Her dandruff is gone, her coat is shiny and she has become perfectly happy to be the only cat in the room, who directs my every movement and has me at her beckoned call. In the beginning, I thought I would have to put her down because I have several others and I was at wit's end about sequestering her, feeding, testing, etc... Knowing that I couldn't live with myself, I decided I needed to go big or go home. So, now I'm hypersensitive and, obviously, more than a little compulsive. I could cut back on the size of snacks and just split a Sheba in thirds, with some freeze dried protein. Sometimes I think her nadir is at the end of the cycle, then it will change and be +5 or 6. It's all still a mystery to me. I can adjust however anyone who knows more than me thinks I need to....that's pretty much everyone. Also...I feed a packet of Tiki Cat broths with her Fancy Feast, for her meals, because she likes it better that way. They all have guar gum and xantham gum but, from everything I've read, they have 0 net carbs.
 
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It is true that several small meals are better than just a couple of big ones. I would just try to make the last one around +6 unless dropping too low and see what that does for duration. Max had chronic pancreatitis for a few years before becoming diabetic. He became picky about food and then almost stoped eating. People said he must be nauseous but he was not vomiting so I figured that wasn't it. His main symptom was inappetence. Since Millie is eating just keep an eye out for this. She should not need an appetite stimulant. You don't want to stimulate the appetite of a nauseous cat because that is how food aversions develop.

How is her weight now?
 
Well, I just weighed her and she actually could stand a little reduction. She is at 12.6 lbs. That is 1.2 higher than what was her normal. She was down to 8+ when diagnosed and came back up to 10 pretty quickly. I'm like an Italian mother, pushing food, I guess. I will adjust the timing of snacks and cut back on the amount. Also, phase out YA, except for one piece of kibble at shot time. Obviously she is utilizing all of her glucose. I am so afraid of hypo. The first post I read when I came on here was the gal who misunderstood her vet's instruction and, for her first shot, did 5 units instead of .5. I followed the post as it was ongoing and it put the fear in me.
 
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I understand. My vet had me coming to his office twice a week to check nadir. When we saw a 60 at +7 he had me stop insulin. Big mistake. After a couple weeks off we resumed as Max was not in remission and I started testing at home after he handed me the needle in his office to test.
If she will only eat YA when she’s low and you aren’t there you might not want to stop feeding her a small amount of it. With your schedule you need to follow SLGS so I would keep the YA in your arsenal.
 
Hmmm...she only licked her +8 treat (going to change up treat timing tomorrow)...doesn't seem fond of duck liver. PMPS 148,40+ points below usual. According to the SLGS protocol, I have 3 options. The last time this happened at an AMPS, I waited, tested, shot, then spent the next 4 days walking back the time. I was actually going to walk the time forward an hour and a half because I will be working and hour and a half later on Friday night. I will test in 30 minutes. I meant to withhold her food until then but while I went to the kitchen to grab my phone, the stinker jumped up on the high shelf and got some of her food. She must be hungry after no 3rd snack. If I should do something else, please let me know.
@tiffmaxee
 
Her BG will be food influenced now so kind of defeats the purpose of stalling. Did she eat much?
 
I was trying a new additive to FF, she smelled it, found it, really likes it and was wolfing it. Ate the liquid off the top, then some of the food. Probably 10 to 20% of meal. She was at 202@+.5, 209@+1. I went ahead and fed and gave her shot. I will test her at +2 and +4. Tonight, I will adjust snack times. Hope that's okay. Glad I have to do SLGS, I'd be a mess at TR.
 
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