7/22 kit +8.5 56,+9.25 48,+10 64,+11 62,+11.5 78,PMPS 70,82,+1 159,+2 191,+3 206,+10.25 240

yesterday
https://www.felinediabetes.com/FDMB...-241-2-5-270-5-5-260-pmps-251-2-5-214.232531/

day 46 in kit's switch to lantus/relion from prozinc/alphatrak2
day 2 of her decrease to 5.5U
day 27 of TR


based on how she reacted to carbs the other day, i went straight to

0.4oz HC 28%. which she ate willingly.


have a great day everybody,
^jw

 

HC did good.
gave 0.25oz LC and will test again in 30m

 

I hope Kit keeps surfing safely today.

 

now dropping again.
deciding what to do about food ....

 

after BG @ 3.75
@4 gave 0.25oz HC 28% ate willingly.



joji is going to swing by soon to take-over from our side

 

@4.5 still dropping.
gave 0.25oz HC 28% ate willingly.
because we know she's a late cycle slider and we're not even half way thru the AM ...

 

You're doing great. Really on top of things with the carbs. Hopefully it will give her a nice buffer for nadir.
I'll be around but, you know exactly what to do!!

 

I would have fed mc. after the last test. Let’s see how it goes. She’s breaking bounces early. She may just need a reduction but time will tell.

 

you have no idea how calming it is to see you liking along the posts.

joji is going to take over shortly. i don't think she's done one of these yet so you being here is an extra comfort.
i'm writing her a little note below on "thoughts for the plan"
please chime in if you have inputs.


for joji
testing again 30 min after last food prop which means test at 11:59am eastern (+5)
if flat, do nothing and test again in 30min
if dropping, consider by how much when deciding what kind of food to give next. probably HC or possibly LC. either way. just a small amount like 0.25oz so she doesn't get too full.

keep the post title and the spreadsheet up-to-date to make it easy for others to watch.

briere is watching us, so she may chime in with thoughts too.

 

ha, i could hear you saying that in my head. but i was going off our data from the other day when MC was not doing a thing.

also, joji is going to take over for me starting in like 10min.
please see post 9 above.

 

I think your plan is good. It's hard to tell if Kit's going to nadir late, as she likes to do or at a normal +6. Testing gives you the data to see the big pic because cycles aren't predictable everytime. The only thing I might do a lil diff is the frequency of testing. I would let the #s dictate. If she's flat...back off on testing(maybe every hour)....feed as normal letting the #s dictate what type carb content. If she's seriously dropping...continue food propping and testing until you get into better #s(normal protocol). But, it really depends on how Kit's handling all the pokes and if you want the data. I like data. In the height of Moey's lantus journey, I was curving everyday.
So, basically let the #s dictate...you know
@tiffmaxee what do you think? You after all have the most experience here

 

She dropped from 122 to 109 after the HC so what do you think? More food or hold off? Test in 30 or an hour? joji (new to this!)

 

Goodness Kit you don't make this easy. If she's dropping with 28%, makes you wonder how low she would have gone w/o it. She's not in any danger with the #s. If you want to keep her #s where there at, continue with a little food propping and test in 30 just to see. The 28% doesn't seem to have a huge effect on her so I suppose use that. If you see a big increase in #s after feeding the 28% I'd switch to the MC. @tiffmaxee thoughts?
If she's still dropping beyond +6 we'll know she's gonna nadir laterand may need to be steered more.

 

I’d see what she does without food but test in 30. My thinking is if you have to prop up with hc then perhaps she’s getting too much insulin. I saved hc for when Max was nearing the sharks.

 

We do want those #s down more. It's just a matter of if Kit's gonna stop dropping after +6 and if she's going to drop w/o food(and by how much). She's not very carb sensitive and likes to nose dive. Just have to be on top of the drop. And predicting those drops is never 100%. You can try not feeding too as tiffmaxee suggested. She's not in danger. You can see if she's angling for another reduction as tiffmaxee mentioned above. I was just thinking this last night. If Kit's not responding to 28% well and you're having to keep her afloat with mc/hc, than she may be getting too much insulin.

 

@tiffmaxee you have the lead. I'll be a backup just in case. I'll still be here though

 

Ok. I’ll tag you if I need to leave.

 

When it’s hard to bring them back up with hc that’s what it usually means. Whenever Max wasn’t ready for a reduction he came up quickly. Granted he was carb sensitive but when he was getting too much insulin I’d have to guide him for hours and he even would drop into the 20’s and 30’s.

 

another 30 minutes down, re-tested and she dropped to 91 without food joji

 

Time for a little lc.

 

0.25oz LC?

 

Yes. Keep her hungry.

 

@+6.25 67 30 mins after .25 LC feed more? Joji

 

Just saw last test. Give a little mc and test in 30.

 

BTW if we need to give her hc because she drops under 50 it can be a teaspoon or two of food with lots of gravy or gravy with Karo if you are worried she won’t continue to be hungry. Notice if she’s looking for food or asking for it as she drops.

 

If she’s surfing., you can give a teaspoon or two of lc and test in 30. You ok? She’s doing great Looking for next test. Flat us good.

 

Nice # Kit. come on and stay on that wave....surf it!

 

Doing okay. Not as fast or facile with all of this as is jw but I'm catching on. You're all amazing! Just gave her LC and she licked it up. yumyum joji

 

You're doing wonderful Joji. You'll be an old pro at this in no time. ***fist pump***

 

studying ; )

 

You getting ready to test to see if she wants that reduction as in no food if still surfing?

 

64 flat @+ 7.5 she's hanging ten claws on her surfboard in the lagoon joji

 

title is getting long. here's the day so far
2/22 kit AMPS 213, +2.5 126,+3 162,+3.75 139,+4.5 122, +5 109 @+5.5 91 @+6.25 67 @+7 66 +7.5 64

And now @+8 she's 60 joji

 

Let’s see if she surfs without food. What do you think? It’s late in the cycle. If she goes under 50 she earns a reduction.

 

Hoping for a reduction. Then we'll probably have to stall and maybe reduce insulin tonight similar to 2 days ago, yes? joji

 

@+ 8.5 56 joji

 

Getting close. She’s toying with us.

 

Next time she drops early I think you should avoid the hc and maybe even feed normally and see what happens. I’m thinking she’s needing less insulin but if you prop her up with hc she doesn’t have the opportunity to show you. See what others say about that.

 

Like her favorite mouse toy!

When we test again in about 19 min it will be at about +9.5 (bc the AMPS was a bit late as we're still coming back from the previous stall)
Thinking that if that is <50
what would you recommend for food?

 

I see a Marje is on line. @Marje and Gracie What are your thoughts? A
So looking forward to tonight what do you think?

 

yeah, agree. it's jw popping in for a sec. when i did that i didnt know if joji would be able to come by to handle the day and i knew i couldnt. so bad care giver on my part

 

Not bad care. Don't throw yourself under the bus. You were doing what you thought was best at the time. It's all a learning experience. You learn something from this and apply it to the next situation.

 

Not bad care giving at all. In this case I think we need to see if she needs less and that’s the only way. You kept her safe and in nice healing numbers.

 

@+ 9.25 48

Feed something?
If yes, what do you recommend?

 

A tsp or two of HC now that she's dropped under 50. Here's @tiffmaxee 's recommendation from above:

She's earned her reduction!

 

Time for hc. Reduction earned for real !

 

thinking 0.4 oz?

and then we need to start thinking about a possible good value if we do BCS.

maybe 5/2 = 2.5U ?

 

She’s clearing a bounce and that’s why the numbers keep dropping. It doesn’t necessarily mean she wants a reduction and even with the BCS two nights ago, a 6u depot is going to affect several cycles after a reduction.

What we want to avoid is her continuing to drop after +10 as a kitty would normally do when they are clearing a bounce. She needs to be up. Also, normally, this late in the cycle, you would feed LC to keep from putting the brakes on duration.

But sometimes the “normals” go out the window with bounce clearing cycles. I’d suggest a nice helping of higher MC (more if she’s not carb sensitive) and retest 30 mins after. It’s possible that she’s going to just flirt with the 40s all the way to shot time.

If at +10, she’s still in the 40s, you’ll want to give her 20 mins to see if she starts to head up on her own. If she doesn’t, then you want to stick with small amounts of LC. That might enable you to still shoot without having to stall if she gets above 50.

ETA: I’d give her the reduction tonight. I found with Gracie that doing something similar on a bounce clearing cycle didn’t mean she needed a reduction but I had gobs off data. We aren’t sure yet with Kit.

 

I’m glad to see you. She has late nadirs. What dose would you suggest for tonight and morning? Would you avoid another reduction since this was influenced by the higher dose? I’m learning too as I never dealt with high dosing.

 

eta: MC doesn't seem to touch her based on recent past.

seems like this HC doesn't have gravy
0.5 oz plus small amt karo. ate willingly
test again in 30min

 

@Marje and Gracie down to 5 units?

 

also, thinking about how much she's likely to eat in the PM cycle given all the snacks today.
last time we did this dinner was a distant interest.

 

Next time you go food shopping get some fancy feast gravy lovers. I used to drain the gravy and feed mostly gravy. That’s where the most carbs are. I hope Marje comes back. I was thinking the same as you. How long did it take her to get hungry last time?

I also bought Soulistic Triple Harmony. It was one of Max’s faves before diabetes. Petco seems it. Very high carb. It’s chicken, tuna, and salmon if my memory is right and lots of gravy. It comes in pouches and sold at Petco.

 

She has late nadirs because she’s clearing bounces. Gracie did the same and it’s why I switched her to Levemir.

I’m around so let’s see how she does with the food before we worry about a dose. I’ll BBS.

 

Thanks. I was worried you might not be around. Lev’something for Joji to consider although she recently switched to Lantus.

 

it was an effort to get her to eat main meal that night. 7/20
we gave her the LC 6% portion first and only after that was eaten did we give her the tiki (0 carb) portion
and then she ate about half a normal mini which is full mini = 0.5oz ff 6% and 0.5oz tiki
she lost complete interest in all of it around PM+3.25 according to my notes.

 

thank you.

 

I just looked at your ss and she didn’t need to eat after 3.5 so that’s good.

 

right. bc we shot 3.0U

 

64 at basically +10

 

read and understood.

what do you think about the desire to eat after a day long treat fest?
on 7/20 we shot BCS of 3U in the face of that reduction bc she was not her usual happy to eat self.

thanks so much for your guidance.

 

Recall that a large depot will affect the cycle even if you shoot a BCS so most of that cycle would have looked at exactly as it did as also indicated by her AMPS the next day...the BCS didn’t change what her cycle would have looked like anyway due to the depot.

Excellent. I would test no later than +11.5 so you don’t get any surprises but it’s fine if you want to test at +11. Just post and I’ll help you with a dose.

We definitely want to be sure kitties are eating when we give insulin. In similar situations, I’ve tested, fed to be sure she was going to eat, and then shot. But, I once had a very, very wise person here tell me, for a caregiver (CG) who has some data (which you all do), that stalling, skipping, and shooting BCS doses is more for the CG than the cat especially when you have such a large depot. Sure, there are some instances where it’s just better to take one of those routes as long as you don’t get a false sense of security (which you did not the other night).

Make sense?

 

62 at one hour before the typical BG time for PMPS
remember there's a 15min differential in there bc we are still walking back from the stall the other night, so this isn't exactly +11, but you get the idea

will test again in 30min (t-22min)

yes. makes sense.
and i think we have read the writings of the very, very wise one.
we really do want to shoot the 5U.
we see how much better kit is doing now that she's getting into these numbers. so yeah, it's for her not for us (CG's)
thanks for your support.

of course, just for the record, our lowest shot so far is like 91 ... so if we don't get much higher by pre-shot we will be in new territory for us.
shoot low to stay low.

 

and kit food fact while we're waiting for the next bg ....
looks like she has a bit of a sweet tooth, that karo went down without a hitch.
hmmmmm...

 

Come on Kit, up just a tiny bit.

I never had a problem adding a drop of syrup as a topper to food.

 

@+11.5 78 @Wendy&Neko I think Kit heard you! joji

 

I’d suggest shooting the 5u dose. You can feed her first if you want to be sure she eats. You can give her MC if you want to bump her BG up a bit but be aware the other side to that is she might start a bounce; we don’t know.

You can go with LC because she’s on the way up and test at +1 to see if she has a food spike.

 

For her meals, we usually do a mix of zero carb Tiki and 6% LC Fancy Feast so we were actually thinking of just doing the LC FF tonight, skipping the Tiki. joji

 

IMHO, mixing foods isn’t the best option, typically....not just in this situation. Most diabetic cats actually do better with foods in the 6-10% carb range.

With that in mind, your suggestion is a good one. You might want to consider using the FF going forward without the Tiki which are usually pretty low in % carbs.

 

PMPS is 70 @Marje and Gracie

stall or no?

 

@Wendy&Neko @tiffmaxee ?

 

ok. we did a half stall of 10min and we're at 82.
feeding all LC dinner now.
and plan to shoot the 5U
if she's eating willingly.

 

shot

 

Sorry....when I said shoot 5u above, I meant on time but I didn’t add that part. My bad.

 

Good job! Woohoo

 

np, so many little details.
turns out we only shot about 7mins later than our normal time.

eta: come to think of it. i think it was implied in the part about what's at the convenience of the CG. xo

 

I’m guessing you already had a +1 and a +2 planned.

 

Over the years, I’ve seen members with data, want to stall because the BG was in the 60s or 70s but then what happened was the BG just kept dropping and the lower it dropped, the more they were afraid to shoot.

But once a member knows how the kitty responds to food and understands onset, nadir, and duration, shooting on time allows the CG to immediately feed so the drop stops and the BG goes up. Kit has been pretty flat since +11.5 so that’s good but, hopefully, this explanation will help you see what happens if you stall.

Now, obviously, if the BG is below 50, you definitely need to stall and see if the numbers come up. If, after stalling 20 mins, it doesn’t, it’s time for a small amount of LC and as soon as the BG heads up above 50, shoot the rise.

I’d suggest a +1 and +2 and then go from there.

 

thanks for the explainer on the consequences of stalling.

tonight, it was probably our "knee jerk" reaction from the "early days" when PS were higher, but still felt low .... if that makes sense... and the guidance in those cases is to stall and ask for help.

and yes we will test +1, +2 and go from there.

in other fun food facts: kit ate that all LC meal like we'd never fed her before

thanks again for your support.

 

Good girl, Kit! You’re welcome

 

159 @PM+1

 

@JOJI and Kit
Hi there just noticed your date in your thread it says 2/22 instead of 7/22
Only wanted to make your aware of it

 

thanks. that poor title has taken a real beating today. should be back to the present now jw

I don't want to re-live Spring 2020 thank you. joji

 

You are welcome, I see you have been very busy today with Kit
They really do take us on some ride don't they.
Wishing you all the best with Kit

 

second that ^jw

 

PM+2 191 pokey break for the night or one more?

 

I’d get one more.

 

lol. i knew you'd say that.
i'm gonna start writing them down and putting in a sealed envelope with a timestamp so you don't think i'm making it up.
t-25 until +3

 

sorry her action kept marje from getting back to you sooner. looks like you're ok now tho.

 

At least I’m predictable, lol.

 

it means your lessons are getting into my head.
you want the +3 bc onset.

 

Pretty soon you won’t need any help. I find the +3 a good indicator. Plus I’m super cautious with someone else’s cat since I can’t see what’s going on.

 

Nighty night! Good call on the +3. AM of the 20th, the +2 was misleading.

 

that's very generous of you. i think it's gonna be longer rather than sooner.

fair.
so she's 206 @+3 and she ate half of a mini meal @+2

thoughts?

 

yeah, that day we did a straight +2, but i think her onset is more like +2.5 (when we mostly get that first one after breakfast).

 

Oh Liz don't be silly, your situation was more urgent than Tyler.
Going to increase his dose tomorrow morning, keeping my fingers crossed after the depot fills again after 6 cycles he starts to show me greens again like he did in the past.
I hope you get a good sleep tonight both you and Kit

 

if you insist.

thanks to everybody for today's guidance and support.
oh.and. we've lowered our lowest shot number by a bit.
tired, but happy.

 

Great job shooting! And you learned a lot today. Sleep tight!