[UPDATE: I think we're ok] Skipper's new higher dose may be too much. AM+5 = 94 AM+6 = 75 AM+6.5 = 75 AM+7 = 113 Skipper typically nadirs later in the day around +8. He's never been this low so I'm concerned. [UPDATE: I fed Skipper his regular low-carb food @+6.5. I"ll test in another 30 minutes. TEST = 113] Should I feed him his regular low-carb dinner now? I have higher-carb food standing by.
With SLGS yes he did earn a reduction of 0.25U. it was a bounce breaking cycle, which can often drop them a little lower than a dose would usually take them. So don't be disheartened if the reduction doesn't "stick" and you have to go back up in a few days. But better safe than sorry! Good catch on these numbers. As for the lows, general guidance is: - Above 60, feed 1-2 tsp low carb - In the 50s, give 1-2 tsp medium carb food, test again in 20-30 mins. Rinse and repeat til in the 60s. - In the 40s, give 1-2 tsp high carb and karo/honey. Test again in 15. Rinse and repeat until in the 50s or higher, and follow steps for those BG ranges above. The karo/honey gives a quick boost out of low numbers, and the high carb helps sustain it. Now, a giant BUT - if you're seeing really big drops and/or you have some time to go to nadir, feed more, and possibly higher carbs than normal. Conveniently, my spreadsheet the last few days shows what I mean by this. I had to throw rules to the wind and go guns blazing (granted, he has IAA and acro and one or both of them are doing something right now so we're flying down the dose ladder). If you're ever worried about a drop or low numbers, I'd post on the main forum. A lot more eyes. Maybe not as many ProZinc users, but enough people to help you feed and get him back to safety.
Thank you so much for the advice and general guidance for feeding his numbers. I've taken notes and added them to my spreadsheet. I fed too much at AM+6.5. His numbers are soaring now... he's already in the reds at AM+10 = 426! This is a major bounce, right? What a crazy day.
It's still progress! Greens are good, so are blues. As for feeding, he would have bounced anyway so no harm no foul, plus now you know how he reacts. You can see he got a big boost from the food, normally we want them to "surf" or stay somewhat flat in those good numbers as long as possible (it's a little harder with in and out insulins like ProZinc, but usually doable once you get to a good dose). We call them "healing greens" because that's where the beta cells in the pancreas can start to heal.
How interesting about the beta cells in the pancreas. I didn't realize that Skipper reacted to food so much! I guess the reaction coupled with the bounce makes it look twice as bad... but as you mentioned, it's good to now know. Thanks again for your guidance.
From 75 to 532 within 6 hours. This big of a swing surely is hard on him. He was ravenous at shot time.
A normal cycle shouldn't be more than 50% at nadir. 50% is about the maximum you want to see your cat's BG drop. A larger drop (close to or more than that 50%) usually leads to a higher bounce. Are you feeding anything earlier in the cycle other than the PS meal? So glad you got those bit earlier tests yesterday. Don't get too hung up thinking his typical nadir is later in the day all the time. Nadirs can and do move around, more so for Skipper since he hasn't really settled in yet. And, I gotta say, I'm very impressed how you handled YOUR FIRST GREEN!!!! YAY!!! Most of us would've panicked, reached for the high carb (and probably the syrup too) and overfed big time. You did great!
I have been feeding a portion of his meal around +9, but I'd never seen it affect him that much. Yesterday was a crazy numbers day, and I don't know what it was all about... and we were doing so well. LOL, yes, I was a little worried about those first greens! But I had just received my new shipment of lancets and test strips, so I had plenty on hand, I was home to test, and I had plenty of carb food on hand, so I thought I'd just wait and see before going into a full panic! Thankfully everything worked out just fine!
I should have worded this better, I do see on your spreadsheet that you feed a fair amount around +9. Are you feeding anything earlier in the cycle before the mid point of the cycle? Does he graze his PS meal? The reason I'm asking, we usually recommend feeding the majority of food/mini meals early in the cycle before nadir. We want to balance the food intake with when there is insulin available to process that food. It's usually better to not feed too much after the nadir, or mid-point of the insulin cycle (unless you need to because of low numbers). A snack size portion might be a better option around +9, with the main meal at PS and a mini meal sometime before +6. Food after about +6 can influence the BG numbers more because the insulin is used up by about the mid-point of the 12 hour cycle. So there isn't enough insulin left in the bloodstream to counterbalance the food intake and usually leads to the BG going up too far. Feeding earlier in the cycle can also help prevent some of those hard, fast drops. It may take a bit of experimenting with timing of your feedings and/or snacks to see what works best for Skipper.
Thank you so much for talking to me about meals because I didn't understand this topic. One issue that I'm up against is the dinner meal. I have several cats and dinnertime is about 5:30-6pm and everybody gets excited, of course. Currently, Skipper is getting his shot at 9:45am/pm, so I really need to get it back to 7am/7pm, and then maybe the dinnertime can be at 7pm. I'll re-read your message and try to work on feeding Skipper before his nadir.
There are so many added challenges having a diabetic kitty in a multi cat household. I agree, this later feeding doesn't appear to be really spiking his BG during his 'better' cycles, the ones where he's not headed to the start of a bounce. The rise the other day from green was largely bounce influenced. I find it amazing what their little bodies can do to protect themselves from perceived danger. I'm thinking about having a bit more food on board earlier in the cycle when the insulin starts working may help soften the drops and that may help reduce some of the bouncing.
When I get back to earlier shots (7am/pm) I can feed him at 7 and 10. I've always wondered if it's ok to feed immediately before bedtime. If I eat before bedtime, I wake up hungry. Are cats like this, too?
