Nico’s New Thread - 1.21: AMPS 397, +3 361, +7 290

Emily Tuomey

Emily Tuomey

Active Member
Continued thread for Nico from https://www.felinediabetes.com/FDMB/threads/nico-link-to-new-thread.241044/#post-2718250

AMPS, 211.
+6, 555.
+9, 536.
PMPS, 512.
@Deb & Wink @Shelley & Jess @JanetNJ

pillow fort day! :)
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Mr. Bouncy just gave me a black number :oops: +6, 555. Do you ever just get used to the constant rollercoaster of numbers?? I feel like I’m anxious about it all the time. Every other aspect of life I’m super patient, I swear!
(To be fair I did see this one coming, more or less. This one is definitely in his eyes and behavior today.)

Does look a bit like his bounce from 1.4.21-1.5.21...
 
Hi, I’m new, but is the Clean Protein (Dr Elseys ) the dry? I am getting suspicious that it’s not low carb like the rep said. I’ve had trouble regulating my Boots and wonder how much the amount / treats I give her of dry Clean protein affects her.
 
Which flavor of the Dr Elsey's? The dry kind, the chicken flavor is lower carb, but the salmon flavor is too high for a diabetic cat. Keep that for you hypo toolkit.
 
Right. I use the dry chicken but the rep just told me last week by email that their calorie count is incorrect as printed/ displayed so I worry they have other values incorrect also. I asked because she LOVES it like kitty crack. And I’ve had a hard time regulating her even though she only gets a small amount.
 
Deb & Wink said:
Nico is not your typical diabetic case. Difficult to regulate and a "superball" too.
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I don’t know that there is much more in my/our control. It’s definitely taxing on both of us with so much bouncing and large swings— I literally never know what is coming next, sometimes only an hour or two apart. Which means I also can’t really be away from him for more than a couple hours either. He does have a strong tendency for higher numbers rather than low though. From your standpoint it seems like we are making okay progress, right? The vet doesn’t want another curve until April..
 
Make a note on your spreadsheet about what/when/how much you fed last night when trying to slow that fast drop - that way you can look back and see how it worked if you need to take control and steer an over active cycle again.

It's a bit of trial and error to see what works to ease him down and keep him surfing in good numbers and may help Nico not bounce so high.

I'm going to copy and paste an excerpt from Debs' +2 write up that says it best.

Cats tend to bounce high if the drop is 50% or more from pre-shot to nadir.

So you steer those mid-cycles with food, to slow down the steep drop and stop the bounces from being too high.

The steeper the drop, the higher the bounce.

It's a balancing act.
 
Thanks Shelley, for helping Em last night. I had forgotten I had made that writeup about the +2 a shared google doc. It's a good one to bookmark.

I know that some people don't think that dry food/treats take longer to get digested and into the bloodstream, and have an impact on the BG levels. But I do. I like to use the dried bean analogy.

Throw some dried beans and water into a cooking pot, turn on the heat, and it takes a while to cook them (the slow method). Soak overnight (or heat and pre-soak) them first, and they cook faster (medium length method) . Put the beans in a pressure cooker and the cooking time is cut in half (fast method).

Same idea with dry vs wet food. Dry food has to get wet first, interact with the stomach acids, before it starts to get broken down in the digestive system and from there get into the bloodstream.

Canned (or raw) food is already wet, usually in smaller pieces already, so the stomach acids can start to break up the smaller pieces faster, so the glucose can get into the bloodstream faster.

Gravy type higher carb food, squeezed out of the can into a dish, is the fast "pressure cooker" type method.
Medium carb food is like the medium length cooking method.
Low carb food or dry food is like the slow cooking method.

If a human diabetic needed to raise their BG quicker, they'd drink some high carb OJ. They wouldn't eat a few pieces of dried fruit and wait for those to get broken down and into their system.

Same idea with our cats.
 
Deb & Wink said:
Thanks Shelley, for helping Em last night. I had forgotten I had made that writeup about the +2 a shared google doc. It's a good one to bookmark.

I know that some people don't think that dry food/treats take longer to get digested and into the bloodstream, and have an impact on the BG levels. But I do. I like to use the dried bean analogy.

Throw some dried beans and water into a cooking pot, turn on the heat, and it takes a while to cook them (the slow method). Soak overnight (or heat and pre-soak) them first, and they cook faster (medium length method) . Put the beans in a pressure cooker and the cooking time is cut in half (fast method).

Same idea with dry vs wet food. Dry food has to get wet first, interact with the stomach acids, before it starts to get broken down in the digestive system and from there get into the bloodstream.

Canned (or raw) food is already wet, usually in smaller pieces already, so the stomach acids can start to break up the smaller pieces faster, so the glucose can get into the bloodstream faster.

Gravy type higher carb food, squeezed out of the can into a dish, is the fast "pressure cooker" type method.
Medium carb food is like the medium length cooking method.
Low carb food or dry food is like the slow cooking method.

If a human diabetic needed to raise their BG quicker, they'd drink some high carb OJ. They wouldn't eat a few pieces of dried fruit and wait for those to get broken down and into their system.

Same idea with our cats.
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Shelley & Jess said:
Make a note on your spreadsheet about what/when/how much you fed last night when trying to slow that fast drop - that way you can look back and see how it worked if you need to take control and steer an over active cycle again.

It's a bit of trial and error to see what works to ease him down and keep him surfing in good numbers and may help Nico not bounce so high.

I'm going to copy and paste an excerpt from Debs' +2 write up that says it best.

Cats tend to bounce high if the drop is 50% or more from pre-shot to nadir.

So you steer those mid-cycles with food, to slow down the steep drop and stop the bounces from being too high.

The steeper the drop, the higher the bounce.

It's a balancing act.
Click to expand...
These are both FANTASTIC, thank you!! And, I’m so grateful to each of you for pitching in to help Nico. :cat: I do have wet food (gravy) and syrup for potential hypos in our kit too. So my next question is how should I (or would y’all) determine whether to use high carb versus medium carb, and faster acting versus slow? Again, he has a tendency for high numbers, but just so I’m prepared when/if those low numbers happen, or like last night have to slow a drop? I’m just hoping I can feed on time tonight— he’s been stalking me for the last hour lol, one more to go!— I’ll be back in about 45-50 mins!
 
Emily Tuomey said:
PMPS, 431. Ughhhhhh :confused: I don’t like it. :( What am I doing wrong....??!
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Nothing. You are still learning what works for Nico and Nico is still adjusting to new numbers.

Deb & Wink said:
I know that some people don't think that dry food/treats take longer to get digested and into the bloodstream, and have an impact on the BG levels. But I do. I like to use the dried bean analogy.
Click to expand...
I've read conflicting information from senior members about this. I like your analogy, makes sense to me. Thanks for sharing your thoughts on this. (Another one to bookmark!)

General observation, one thing that does seem to hold true is that dry food/treats stick around longer in the system, keeping numbers higher longer than than wet food and the effect may linger through to the following cycle(s).

Emily Tuomey said:
So my next question is how should I (or would y’all) determine whether to use high carb versus medium carb, and faster acting versus slow?
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ECID, every cat is different - this is where you need to find out what works best for Nico. Even though Nico grazes does he seem to eat more LC at certain times during the day? Does it seem you're putting more food out at around the same time every day? Maybe keep an eye on it, note his eating pattern, see if coincides with a rise in the BG or appears to slow downward momentum. When they graze sometimes it's difficult to see the true impact LC has on the BG.

This thread https://www.felinediabetes.com/FDMB/threads/do-daas-pz-dosing-thread6.229373/#post-2606373
Scroll to Post #15 by Marje and Gracie talks about "feeding the curve" and how to prevent kitty from dropping too fast and/or too low.
It's a long read and not all information in this post applies to you and Nico, but it's a good read with good information and may give you some ideas where to start.
Halfway down this post Marje has a section "There are important things to consider when you are determining whether to feed lc, mc, hc:"

Please note, for anyone reading, hypo numbers need to be handled different than discussed in the above thread. The How to treat HYPOS guideline for feeding and testing should always be followed when treating for low blood sugar.
 
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@Deb & Wink @Shelley & Jess @JanetNJ “SUPERBALL” IS AT IT AGAIN!!! +7, 51. :nailbiting: Good night(!), this kid keeps me on my toes..! Here I was thinking “eh, he doesn’t need more than one mid-cycle test today, then SURPRISE— 51. “Well, crap.” So much for that theory. Should I try to get him up a little??? He’s eating Purebites chicken/duck liver at the moment, but obviously no carbs in that. I could put the sweet potato back into it so he has those carbs at least? I’ll keep you posted!

And thank you @Shelley & Jess for this— Great information to read over and save!
Shelley & Jess said:
Nothing. You are still learning what works for Nico and Nico is still adjusting to new numbers.


I've read conflicting information from senior members about this. I like your analogy, makes sense to me. Thanks for sharing your thoughts on this. (Another one to bookmark!)

General observation, one thing that does seem to hold true is that dry food/treats stick around longer in the system, keeping numbers higher longer than than wet food and the effect may linger through to the following cycle(s).


ECID, every cat is different - this is where you need to find out what works best for Nico. Even though Nico grazes does he seem to eat more LC at certain times during the day? Does it seem you're putting more food out at around the same time every day? Maybe keep an eye on it, note his eating pattern, see if coincides with a rise in the BG or appears to slow downward momentum. When they graze sometimes it's difficult to see the true impact LC has on the BG.

This thread https://www.felinediabetes.com/FDMB/threads/do-daas-pz-dosing-thread6.229373/#post-2606373
Scroll to Post #15 by Marje and Gracie talks about "feeding the curve" and how to prevent kitty from dropping too fast and/or too low.
It's a long read and not all information in this post applies to you and Nico, but it's a good read with good information and may give you some ideas where to start.
Halfway down this post Marje has a section "There are important things to consider when you are determining whether to feed lc, mc, hc:"

Please note, for anyone reading, hypo numbers need to be handled different than discussed in the above thread. The How to treat HYPOS guideline for feeding and testing should always be followed when treating for low blood sugar.
Click to expand...
 
Emily Tuomey said:
@Deb & Wink @Shelley & Jess @JanetNJ “SUPERBALL” IS AT IT AGAIN!!! +7, 51. :nailbiting: Good night(!), this kid keeps me on my toes..! Here I was thinking “eh, he doesn’t need more than one mid-cycle test today, then SURPRISE— 51. “Well, crap.” So much for that theory. Should I try to get him up a little??? He’s eating Purebites chicken/duck liver at the moment, but obviously no carbs in that. I could put the sweet potato back into it so he has those carbs at least? I’ll keep you posted!

And thank you @Shelley & Jess for this— Great information to read over and save!
Click to expand...
Give him a little of his regular food to just steer him a bit.
 
When you are guiding the BG numbers, aka "feeding the curve", you would usually start off with the lowest carb food, then increase to the MC, then increase to the HC if needed. Small amounts, so your cat doesn't get too full to eat if the BG numbers still need to be brought up a bit.

Marje gives a much better explanation of how to "feed the curve" than I ever could. So that thread from Goose about his cat Do Daa is a good one to read and bookmark.

Nico was so close to earning a reduction with that 51 today, you could consider reducing the dose to 1.75U at PMPS 1/15/21. But he doesn't seem to hold reductions well, so you might want to keep him at the higher 2U dose. Hard to say without seeing the PMPS test.

Your call Em.
 
Deb & Wink said:
Nico was so close to earning a reduction with that 51 today, you could consider reducing the dose to 1.75U at PMPS 1/15/21. But he doesn't seem to hold reductions well, so you might want to keep him at the higher 2U dose. Hard to say without seeing the PMPS test.

Your call Em.
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I’ll for sure be back with a PMPS, but I wholeheartedly agree with you about Nico not handling dose reductions well, and I was planning on asking to keep him at 2.0u if he’s above like 120 or so; if at all safe, of course. I can test overnight (TGIF) if need be. I just hate to set him back again when we were just getting back on track. I’ll let you know. I’m actually gonna test him here in a few minutes (+9) to see what direction we are headed. I’ll post that momentarily too.
 
+9 154. Which is HIGHLY food/treat influenced. I pulled his food up now instead of in an hour so I can get as accurate a reading as possible for PMPS. But, it looks like we should be in good shape for 2.0u if he stays where he’s at!
 
This is making me CRAZY. PMPS, 373. W-T-F?!!!! I’m so confused by his body, I really am. I’ve removed all suspected, tangible reasons for such a rollercoaster of numbers, so I know it’s just his body and the insulin. But now I’m like “well I’m gonna have to test every couple hours during the day, and especially overnight because these greens/lime greens pop out of [seemingly] nowhere. And he doesn’t really exhibit any symptoms one way or the other, so I can’t rely on that. Suggestions please?! @Deb & Wink @Shelley & Jess @JanetNJ
 
@Deb & Wink @Shelley & Jess @JanetNJ we are having a very rough day. Very rough. I think we need to consider bumping him back up to 2.25u, I really do. We have a lot of black and red creeping back in, and he is visibly miserable today. Roll that idea around for a bit and let me know your expert thoughts. It’s just really hard to see him unwell, I guess. I know I should just practice patience with it, but I wish we could go back to when his numbers were doing so much better at the start of the holidays. I just feel like we are taking major steps backwards right now, and that is a difficult pill to swallow.

AMPS, 430.
+4, 596.
+8, 490.
PMPS, 423.
+5, 263.
 
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@Deb & Wink @Shelley & Jess @JanetNJ permission to go to 2.25u next cycle? I can’t handle the unending reds/blacks happening here.. it’s not seeming like a bounce (because then he’d have to actually clear that at some point, right?) anymore. And, he was doing really well at 2.25u! Then we had two dose reductions in a row and he just can’t seem to recover, especially with that token dose on 1.11. We’ve been at 2.0u for twelve cycles now— pretty please!! :rolleyes:

AMPS: 411
+6: 367
PMPS: 420
+4: 397

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Emily Tuomey said:
@Deb & Wink @Shelley & Jess @JanetNJ permission to go to 2.25u next cycle? I can’t handle the unending reds/blacks happening here.. it’s not seeming like a bounce (because then he’d have to actually clear that at some point, right?) anymore. And, he was doing really well at 2.25u! Then we had two dose reductions in a row and he just can’t seem to recover, especially with that token dose on 1.11. We’ve been at 2.0u for twelve cycles now— pretty please!! :rolleyes:

AMPS: 411
+6: 367
PMPS: 420
+4: TBA

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Go ahead just keep a close eye out esp if the preshot is under 300.
 
Em, bounces can last anywhere from 3 to 6 cycles. You got blues in a couple of cycles after that 01/11 token dose and he absolutely cleared the bounce in the 7th cycle later with that green 51.

Please be careful and monitor closely.

Did you get a chance to read the thread about 'feeding the curve' I linked above?

Marje said this in Post #15 of the linked thread:
For anyone reading this who then thinks, “well, if I just give my cat more insulin, the bouncing will stop”. No it won’t and it’s not safe to just increase the dose to stop bouncing. It’s the process of managing the curve with food specific to your cat that keeps it safe to increase the dose.
 
Shelley & Jess said:
Em, bounces can last anywhere from 3 to 6 cycles. You got blues in a couple of cycles after that 01/11 token dose and he absolutely cleared the bounce in the 7th cycle later with that green 51.

Please be careful and monitor closely.

Did you get a chance to read the thread about 'feeding the curve' I linked above?

Marje said this in Post #15 of the linked thread:
For anyone reading this who then thinks, “well, if I just give my cat more insulin, the bouncing will stop”. No it won’t and it’s not safe to just increase the dose to stop bouncing. It’s the process of managing the curve with food specific to your cat that keeps it safe to increase the dose.
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^^thats a lot. And really overwhelming. I’m not feeling great about any of this today— please forgive me for not being very receptive or communicative. Today is not gonna be my day. :(

AMPS, 526
+4, 370
+8, 309
PMPS, 223

@Deb & Wink @Shelley & Jess @JanetNJ some updated numbers.
 
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FYI, for future reference. You never have to get our "permission" to change the dose.

You are there, and know a whole lot more about how Nico is doing than we ever will.

Yes, increase the dose back to 2.25U for Nico.

Sending some long distance, virtual hugs your way. :bighug::bighug::bighug:
Hope today gets better for you.
 
Deb & Wink said:
FYI, for future reference. You never have to get our "permission" to change the dose.

You are there, and know a whole lot more about how Nico is doing than we ever will.

Yes, increase the dose back to 2.25U for Nico.

Sending some long distance, virtual hugs your way. :bighug::bighug::bighug:
Hope today gets better for you.
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Thank you. I did get to sneak away for a quick trip to Trader Joe’s and a massage therapy appointment, so that helped somewhat. There’s a lotttttt more to the story than just Nico (things that are also out of my control, so my perfectionism/controlling tendencies are going absolutely crazy, and nearing impossible to sit with), so I’m sorry if it sounds like I’m getting grumpy with anyone; it isn’t intentional. I greatly appreciate all of you, and I’ll probably always ask for permission because you guys know best. I’m a newbie. But, I’ll always weigh it with Nico and my gut instincts as well. One step at a time. It’s a marathon, not a sprint, right? <sigh>
 
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