3/29 Bambi AMPS 266, +3 140, +7 102, PMPS 269, +10 92, AMPS 115, +0.5 130, +1 126, +2 166

[Caglar and Bambi]

Previous post: https://www.felinediabetes.com/FDMB/threads/late-introduction-and-advice-needed.275665/#post-3059187

Hi, I lowered Bambi's dose by 0.25 down to 2u, 3 days ago as suggested by @Bron and Sheba (GA) since her BG was falling below 90 on a few occasions in those cycles suggesting a bounce, and it seems to be the case as her BG was less volatile mostly between the 100s to 280s range. Today she has an unusually low PS at 115, +0.5 130 just taken now. I guess it's great that she's stabilizing but I could not decide what to do. I haven't given her a shot yet, will continue testing every 0.5 - 1 hours.

Not sure whether I should skip the shot, give her a 1u token dose, or keep testing until over 200 and continue with 2u?

Also, I could not do as many mid-cycle tests as I wanted to but I've seen a 72 and 92 BG levels in the last few cycles. Is it early to drop the normal dose to 1.75, or is it too soon to decide? (Considering due to the last low PS levels)

 

[Caglar and Bambi]

Update: 126 @ +1

 

[Bandit's Mom]

Did you shoot? has she eaten? She is stable and slowly heading up. With SLGS you can shoot any number over 90 without stalling if you can monitor.

 

[Caglar and Bambi]

Did you shoot? has she eaten? She is stable and slowly heading up. With SLGS you can shoot any number over 90 without stalling if you can monitor.

I still haven't given the shot. 166 @ +2 right now. She has eaten, 2 hours before PS and at the time of PS. (2 hours and 4 hours ago) I planning to give either 1u or 1.75u.

 

[Caglar and Bambi]

With SLGS you can shoot any number over 90 without stalling if you can monitor.

Confused a bit since these are the directions in SLGS:

Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.

• Below 150 mg/dl (8.3 mmol/L), don't give insulin.
• Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
  • a.) give nothing
  • b.) give a token dose (10-25% of the usual dose)
  • c.) feed as usual, test in a couple of hours, and make a decision based on that value

 

[Bandit's Mom]

I still haven't given the shot. 166 @ +2 right now. She has eaten, 2 hours before PS and at the time of PS. (2 hours and 4 hours ago) I planning to give either 1u or 1.75u.

She is heading up and it's safe to give 1.75U. Since you are shooting 2 hours late, you will need to delay future shots accordingly. You can adjust by 30 mins per day.

Confused a bit since these are the directions in SLGS:

These are for caregivers whose cats are new to insulin and do not have any experience or data on their cats. With data and experience you want to shoot lower and lower preshots - especially if you can monitor. With SLGS, you can shoot any number over 90.

 

[Caglar and Bambi]

Ok makes sense, I just gave 1.75u now, and in combination with the 2-hour delay I guess that will be like giving 1.25-1.5u for this cycle. And yes, I will give the next shot 12 hours later.

These are for caregivers whose cats are new to insulin and do not have any experience or data on their cats. With data and experience you want to shoot lower and lower preshots - especially if you can monitor. With SLGS, you can shoot any number over 90.

I think I've never shot below 150 so I'm still a bit hesitant. I guess if numbers continue like this I can take a bit more risk and keep monitoring a bit more.

Thanks @Bandit's Mom

 

[Bandit's Mom]

Ok makes sense, I just gave 1.75u now, and in combination with the 2-hour delay I guess that will be like giving 1.25-1.5u for this cycle.

And you can possibly count on her bouncing

And yes, I will give the next shot 12 hours later.

You can give the next shot 11.5 hours from the time you shot tomorrow. You can make up 30 mins per day till you get back to your original shot time.

I think I've never shot below 150 so I'm still a bit hesitant. I guess if numbers continue like this I can take a bit more risk and keep monitoring a bit more.

Shooting lower numbers can be scary initially, but Lantus gives flatter cycles when you shoot low. Newly diagnosed cats see a lot of bouncing and diving initially, but as their bodies get used to lower numbers, cycles become flatter. Bambi has stopped bouncing to reds and pinks are also on their way out.

 

[Caglar and Bambi]

And you can possibly count on her bouncing

Indeed, I expect to see a 300s tomorrow but let's see The general picture seems to be getting better.

Shooting lower numbers can be scary initially, but Lantus gives flatter cycles when you shoot low. Newly diagnosed cats see a lot of bouncing and diving initially, but as their bodies get used to lower numbers, cycles become flatter. Bambi has stopped bouncing to reds and pinks are also on their way out.

Fingers crossed. I guess I should have lowered the dose to 1.75u yesterday when I saw the 72 nadir, probably would not have fallen so much today but I'm on it for next time.

 

[Bandit's Mom]

I guess I should have lowered the dose to 1.75u yesterday when I saw the 72 nadir, probably would not have fallen so much today but I'm on it for next time.

Actually considering how much you test, you could, at some point, think about a lower reduction point. That will enable you to hold a dose where she sees safe greens - the higher end of the normal range.

 

[Caglar and Bambi]

Actually considering how much you test, you could, at some point, think about a lower reduction point. That will enable you to hold a dose where she sees safe greens - the higher end of the normal range.

100 @ +2 and 72 @ +4.

Sure, I will continue testing and posting figures here to determine that. I guess we need a few cycles to see that.

Only after a month and a half am I just getting used to understanding the bounces. 2 weeks ago when I involuntarily had to drop the dose and it shot up to 400s I thought that the dose was not enough but now I understand it's the bounce that was caused by too much.

 

[Bandit's Mom]

Is she still on Pro Plan DM dry food?

 

[Caglar and Bambi]

Is she still on Pro Plan DM dry food?

Yes, I'm waiting for the right time to transition to low-carb wet food. I also posted some names on the previous thread but people must have missed it, planning to repost that for advice...

 

[Bandit's Mom]

I also posted some names on the previous thread but people must have missed it, planning to repost that for advice...

Here you go:
https://www.felinediabetes.com/FDMB/threads/late-introduction-and-advice-needed.275665/#post-3059082

Are the carbs you have calculated based on Typical Values and are they on a Dry Matter Basis? Or are they from the UK food list?

 

[Caglar and Bambi]

Here you go:
https://www.felinediabetes.com/FDMB/threads/late-introduction-and-advice-needed.275665/#post-3059082

Are the carbs you have calculated based on Typical Values and are they on a Dry Matter Basis? Or are they from the UK food list?

Yes, I took the figures on the guaranteed analysis on the packaging, calculated the carbs and converted them to dry matter basis. I wish I could use the UK list but I couldn't find a single one sold here (Or couldn't be sure they are the same product.) I spent a good few hours manually calculating them. :/

 

[Caglar and Bambi]

Yes, I took the figures on the guaranteed analysis on the packaging, calculated the carbs and converted them to dry matter basis. I wish I could use the UK list but I couldn't find a single one sold here (Or couldn't be sure they are the same product.) I spent a good few hours manually calculating them. :/

The ones I posted on the link are only the filtered ones below %10 carbs.

 

[Bandit's Mom]

Yes, I took the figures on the guaranteed analysis on the packaging, calculated the carbs and converted them to dry matter basis. I wish I could use the UK list but I couldn't find a single one sold here (Or couldn't be sure they are the same product.) I spent a good few hours manually calculating them. :/

OK. Some of the ones in your global list are on the UK food list - Sheba, Whiskas, Felix, Gourmet Perle

I would start slowly introducing wet food - does she eat wet food or is she a kibble addict?

 

[Caglar and Bambi]

OK. Some of the ones in your global list are on the UK food list - Sheba, Whiskas, Felix, Gourmet Perle

Yes, they're not exactly the same ones with the same values as the UK list but the brands are there. Those are the ones I feel are more trustworthy but at the same time, the general notion here is that for e.g. Whiskas is a junk food for cats. Even the low-carb ones make me think twice since I'm not used to considering market-shelf brands as 'healthy' compared to bigger brand dry foods that are not on the market shelves. Are they all pretty much the same? I'm more used to the Purina brand (Felix and Gourmet) from Proplan, and perhaps Sheba... Any recommendations? Maybe get different varieties and use a few together?

I would start slowly introducing wet food - does she eat wet food or is she a kibble addict?

Thankfully Bambi has a great big appetite and goes crazy for wet food. I've only been putting off in order to control her BG levels. Is it better to mix a little wet to the dry at every meal, or give for e.g. 1 meal as wet and 3-4 as dry when starting off?

 

[Bandit's Mom]

Yes, Whiskas in not a great brand. Sheba and Felix are definitely better. But low carb canned food beats high carb dry. And not just for diabetic cats.

I think you might want to give her a little bit of wet and dry with each meal initially. Generally food transitions are spread over a week-10 days to prevent any stomach upsets. Some cats get diarrhea from overnight changes in food, so it's recommended to gradually increase the proportion of the new food.

 

[Caglar and Bambi]

Ok, thanks for the clarification. I will pick up some soon and start slowly transitioning in a few days then.

I've got 2 other non-diabetic cats (Bambam and Yoda) so they will all start getting wet as well. Bambam is the kibble addict, he will be hard to convince but hopefully, I won't have to separate their foods once they're all used to wet food.