Fast transition to wet...New plan & General this is where we are at. Suggestions Welcome.

While transitioning Griffin to wet food slowly over two or three weeks I ran out of dry food half way through. I couldn't get to my Vet yesterday to pick up a small bag and the 5 Vets I went to in the "city" near us didn't have any in stock.

So yesterday morning (7am) was Griffin's last meal with quibble, hope you enjoyed it buddy. He is loving the wet food, as I only gave it in the past twice a year as a treat.

Since last night was his first cycle on all wet I monitored him closely. We spent four hours bellow 11 (200) and his numbers started to come up after his small snack at +8 (3am).

This morning his AMPS was 21.8 (392).

The original plan was to be home all day so I didn't panic when we ran out, however yesterday I found out I will no longer be home. I should be home for dinner around +10.

Since I will not be home for most of today, I dropped his dose to 1u so he doesn't go too low. He will have snack at +3 and a smaller snack at +8.

No specific question - Looking for anything thoughts, observers or knowledge because you are not new to this, may see something I do not or to let me know if I am completely mucking this up.

Thanks

PS Food schedule is at the top of world tab in SS - he is getting 234g of wet (Friskies). He is 10 lbs (gained 1 lbs since Oct 7) Not sure is that is enough food for him. We are aiming for him to be 12 lbs (ideal weight).

 

Good call on reducing his dose, it doesn't matter if his numbers go higher until you have assessed the response to the new feeding regime which will take a few days. It is easier to put the dose up later on than deal with a hypo. Shame you can't be around today but we do have lives to live as well. Can you get additional tests in after his PM dose to see how he is responding? It is possible the dose may need to come down further so please do let us know what his numbers do today and what his PMPS is.

ETA, he is getting a good weight gain so far so keep monitoring his weight.

 

It was surprise birthday present (a few days early) with tickets to an event today. Anything else and I would have canceled.

I can do testing again tonight from AM + 10 on. I just set an alarm for the overnight testing like last night. Wondering if it should be every hour or every two hours?

 

Every 2 unless you feel he is dropping faster than normal, or hourly if it makes you feel better, but we need to look at the PMPS first.

 

Annecdotal reports on this forum note drops of 100-200 mg/dL in glucose level and dose reductions by 1-2 units of insulin when changing from high carb food to low carb canned food. This may increase the risk of hypoglycemia - part of the reason to make such changes gradually - 20-25% different per day. The other reason to do so gradually is to avoid GI upsets (vomiting, diarrhea) and food refusals.

Since you've dropped the dose, that'll reduce chances of hypoglycemia happening. If you want to test in the middle of the night, when many cats go lower, set an alarm for a multiple of 45 minutes

 

Got home today at 430 (+9.5) his 3pm snack not eaten (he has a new auto feeder) don't think he knew he had food to eat till he got up on his post.
BG was 22.4

Will see what his BG is a PMPS but I anticipate it will continue to go up.

Wondering if I should do a 1u or 2u dose? PMPS is in two hours (7pm Ontario Canada time)

 

That number is consistent with previous days +10, I would err on the side of caution and go low on the dosing. I certainly wouldn't give 2 units.

 

@Alexi Thanks.

Just so I understand the decision process is that because for the last 10 days he has been around that number but with dry food the 2u wouldn't drop him as much?
Same number, wet food 2u could cause a lower drop.

No idea what I would do w/o this community.

 

You got it, lowering the % carbohydrate in the food means less of the final breakdown product from digestion of carbohydrate - glucose. Insulin is the hormone which enables glucose out of the blood and into the body's cells to be stored and used when needed. The greater the amount of insulin the greater the effect so too much insulin for the amount of carbohydrate fed means too little glucose in the blood and the result is a hypo. Which you really don't want. Especially not at night or when you are not around to intervene.

 

The BG numbers from last night are in. Missed one test, needed a few hours to function at work today.

My Plan go as follows:

If PS GB stay in the 20-27 range give 1u and do what testing is possible for the 5 days (Mon-Fri), allow Griffin to settle on the wet food and lower does. Plus he is still learning that food comes with out mom (auto feeder to provide consistency when I am not home).

Day 6 (Saturday) do a full curve on either AM or PM cycle to evaluate the effects of the changes.

Figure out next step and implement on day 7 (Sunday) when he can be monitored all day.

Suggestion or comments welcome by all.

@Alexi @MrWorfMen's Mom

 

It can take a few days for the effects of the dry food carbs to totally diminish so I think this is a good plan especially till Griffin gets used to the feeder. What you are seeing right now could be a bit of bouncing from the lower numbers the other night so holding at 1u for the moment to see the full effect of the food change is the best idea in my opinion. This is when the ability to make smaller dose adjustments of 0.25u comes into play so when you can test more, you'll be able to finesse his dose as need be.

Happy Birthday and I hope you enjoyed your surprise outing!

 

Thanks, I did enjoy my surprise very much.

It may be too early to be thinking of this but what is the ultimate goal to be shooting for - is it lowering the Pre-shot number (Griffin is usually in the red), is it getting the mid cycle (lowest point to be in the blue/dark green) is it stretching that low point out so it take up more of the cycle.

I am a bit nervous about the finessing part - figuring out what to do to manipulate his numbers when and where in cycle they need to change

 

Don't worry about the finessing. We can help you with that. Your goal is to get Griffin into decent numbers for as many hours per day as possible. So while it's nice to get those pre-shot numbers down, you want to slowly lower them so you can shoot twice per day without him going too low mid cycle. It can be a little bit of trial and error but with sliding scale dosing, you have a lot more control. One step at a time. Every cat is different so it's a matter of patience to understand how Griffin is reacting to his insulin and diet change right now. As he gets better regulated, and more used to lower numbers, his insulin needs may change. Don't worry. You've got this and have a much better handle on it than you think you do (stretching the low period out over more of the cycle is bang on). As Griffin's needs change, you have folks here to help you determine how to finesses his dose to keep him safe and as regulated as possible.

 

I agree! You've gotten up to speed with the finer points very quickly. It's great that you're thinking ahead but slow and steady wins the race with FD.

 

I like the plan. Often I see people being a little too impatient to get the numbers down, it takes time to see the full effect of the dose and food change, once you have the curve we will have a much better idea of how Griffin is handling the insulin and the dose tweak stage can begin. At this stage blue mid cycle numbers are good but don't worry if they are a little higher than that. It takes a long time to start seeing greens (at least for me) and fine dose adjustments are best. If things are taken slow and steady it helps Griffin to feel better as well.

 

28.5 tonight - not what I was expecting.....hmmmmm

 

It's one number, time to get the patience pants on!

 

I'm loaning you my patience pants!

 

When friends notice the changes, that's a good sign because they usually aren't tuned into our cats to that extent unless of course they are animal crazy people like us. My girl's been giving me a run for my money lately (she's a tough nut to crack due to her IAA) so my other pair of patience pants look like this.

JUST KIDDING!