? 20.04 Chico 108@AMPS

Discussion in 'Lantus / Levemir / Biosimilars' started by Marina & Chico, Apr 20, 2021.

  1. Marina & Chico

    Marina & Chico Well-Known Member

    Joined:
    Jan 31, 2021
    Chico is settling in his new dose 0.5 and he is doing it pretty well :)

    What i would like to address is his huge swings in the beginning of the cycle. At around +1 he dips, by +2 he settles in and then he starts increasing again. We want to try to flatten the beginning of the cycle and hope it will tackle his high PS values. Yesterday PM cycle the difference between PS and +1 was was 25, which is relatively high, only that means we would have to intervene with honey when he was 90, which felt counterintuitive. We are wondering if we should give some honey at +1 when for example the difference between PS and +1 is higher than 30. Does anybody else have any other idea of how to flatten his curve?

    Thank you all for the input, it is as always greatly appreciated :bighug:

    Previous day thread
     
  2. Hercule's mum

    Hercule's mum Well-Known Member

    Joined:
    Jul 27, 2020
    I have seen @Mariette combating a rise at AMPS with a snack at +9 I believe? I can't remeber exactly the reasoning, but perhaps something about avoiding a glucogen dump at the end of the cycle?
    @Marje and Gracie was advising her on it, so she can explain.

    He is still looking great!
     
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  3. Marina & Chico

    Marina & Chico Well-Known Member

    Joined:
    Jan 31, 2021
    thank you for the idea and for the tag. I think i saw a discussion like this sometime as well, i forgot about it though. I hope Marje will give some her opinion if we should try this with Chico as well

    Today he again surprised me with the dip at +2, i was certain it made no sense to test 1.5 considering he was 104 at +1, he clearly proved us wrong again :rolleyes:
     
  4. Katherine&Ruby

    Katherine&Ruby Well-Known Member

    Joined:
    Oct 8, 2020
    Hi Marina, a few months ago Ruby was also prone to deep dives early in her cycle and she was also not very carb sensitive. It took a lot to bring her up. So I was always armed with two different carb percentage foods: one food that had 7-8% carbs and one that had less than 4%. I would feed her the 7-8% at preshot and if she was lower at +2, feed her again the 7-8%. I would reserve the lower carb food for snacks later in the cycle so as to not go against the waning action of the insulin.

    Some kitties can benefit from a small snack at +8 or +9, especially in the PM cycle as it kicks the pancreas into action to produce more insulin to cover the food to combat "dawn phenomenon," which pushes the AMPS higher into the blues. Mostly though it's not advised except for very low dose kitties who might be on their way to you-know-what. :) I never found the late cycle snack to be helpful except on low doses because if the kitty's AMPS wants to come down, it should do so on the action of the insulin and his own body, not food. Ruby's AMPS numbers have come down without the snack, though I did start giving it again to her yesterday as an experiment to prevent scarfing and barfing first thing in the morning, thankfully without any adverse or dramatic effect on her numbers.

    I'm sure Marje will weigh in an explain this all so much better than I can.
     
  5. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

    Joined:
    Jun 4, 2020
    Hi Marina. I don't have any experience with this since Darcy is so high dose and usually rises after his pre-shot meal (not so much as he used to though as now he doesn't seem to get much of a food bump). I was really interested in the reasoning of giving the snack at +9 though.

    I'm just stopping by to say hello to you and Chico and hoping he surfs safely today. :)
     
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  6. Summer and Susie (GA)

    Summer and Susie (GA) Well-Known Member

    Joined:
    Dec 20, 2020
    I would like to understand this too. Susie almost always has high AMPS and PMPS.
     
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  7. Marina & Chico

    Marina & Chico Well-Known Member

    Joined:
    Jan 31, 2021
    Did it help to flatten the curve with the higher carb food? we are considering to give him honey (which is his higher carb) at +2, it is an idea to try higher carbs at preshot. Doing both seems so counterintuitive but i hope that by flattening the beginning he would stop bouncing so high toward PS.

    From what you described the +9 snack is useful for kitties which are more advanced in the FD process but we will wait to see if @Marje and Gracie will share her opinion on this as well.

    thank you Kathrine for your input :bighug:
     
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  8. Marina & Chico

    Marina & Chico Well-Known Member

    Joined:
    Jan 31, 2021
    Thank you Suzanne for stopping by, i check on Darcy’s progress every day and i am very excited for all the progress you are making with him. No matter how anxious all the changes might feel, you must feel so much relief to see results after all your monumental work :cat::bighug:
     
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  9. Katherine&Ruby

    Katherine&Ruby Well-Known Member

    Joined:
    Oct 8, 2020
    Yes, feeding something higher carb does seem counterintuitive but I think you're not only trying to work against the steep drop caused by the shot but also any overlap from the shot from the night before (Lantus can stay in effect for more than 12 hours). To be honest I'm not sure the strategy worked for Ruby as she did what she wanted to do anyway, but that is how I tried to steer her numbers. I never used honey except early on when I got very nervous seeing a lime green numbers. I found some very high carb food (~30%) that I used, but Ruby's tummy is not as sensitive as little Chico's. The best strategy might be to keep giving him as much insulin as he needs and being patient with it. You're still relatively new at the FD dance. :)
     
  10. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    @PerfumedCatMom
    @Summer and Susie
    @Suzanne & Darcy
    @Hercule's mum

    I’m posting this in yesterday’s condo as I don’t see one for today yet and we are headed out for the day but I wanted to respond.

    Feeding a +9 snack to bring down the PSs will only potentially help those cats on a very, very low dose (think 1 drop), who are about to go into remission. These kitties already have a working pancreas.

    The AMPS is usually the last BG to come down and, if the pancreas is working pretty much on its own with just a tiny bit of insulin support, feeding three hours prior to the PS will cause the pancreas to release its own insulin and bring the PS down. It’s the same reason why, during an OTJ trial, we instruct the CG that if the PS is blue, feed and retest in three hours. We would expect the pancreas to do its job, release insulin, and within three hours, drop the BG into normal range. This is how the pancreas works in any nondiabetic mammal.

    If your kitty is on more than that little drop of insulin, feeding a +9 meal will likely cause the BG to rise as it will stop the action and duration of the insulin in many cases.

    Please let me know if any of you have questions. Good discussion!!!! :):)
     
  11. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    You don’t want to do this :) That’s not how we flatten the curve.

    The best way to flatten the curve is manage it with food. Please take a look at this condo and post 15 where Jill explains how to flatten the curve with food.
    You can put any questions you have on the condo you create for 4/21. We will be back later this evening (we are working a COVID vaccine POD during the days) and I’ll be happy to respond.

    Have a great day!!
     
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  12. Summer and Susie (GA)

    Summer and Susie (GA) Well-Known Member

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    Dec 20, 2020
    Thanks, Marje.
     
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  13. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    You’re welcome!
     

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