Not regulated- two meals a day or many?

[Deena and Malby]

Hello,
Deena and Malachi here
Malachi is still not regulated and his numbers seem to be higher even though I recently did a dose increase.

Do most people suggest feeding two times a day when a cat is not regulated or several? I originally read that having smaller meals would be less work on his pancreas so I started giving him:
1.5 cans Breakfast
.5 can mid-day lunch
1.5cans dinner
.5 can before bed.
His numbers are ALWAYS high though and I'm starting to re-think the mid-day snack snack as it just shoots his numbers back up but MORE importantly, he is always hungry so he STRESSES about getting that lunch snack and won't calm down until he gets it. I'm thinking 4-5hrs of his pacing and stressing aren't helping his numbers.
Has anyone dealt with a high-stress cat and can that also affect his numbers?
Just don't know what to do to get his numbers down.
Any feeding suggestions or stress reducer advice would be appreciated.
He was double dosed a few weeks back (some of you might have helped me through this-6 units total!) and he never went below mid-200's! I'm starting to think he's a high dose cat? His numbers are just so high and I don't know how to proceed...
Thanks in advance! Loosing hope.

Deena and Malachai

 

[Marvin's Mom - Nat]

Hi Deena, my Kitty is a high dose cat, was diagnosed with Acromegaly a month ago when I reached 6U, I got him tested for IAA and 1GF-1. Mind you he had most of all the symptoms of an Acrocat. Before I got to the 6U, it was hard as I had to be patient. Like you I didn't test much until recently. I had to bribe mine with treats to be able to test regularly. It is great that you are home testing, however you may want to test more often as it will be hard for the experience folks to help if they can't see a pattern in his BG, especially if he is a high dose kitty. It's probably too soon to tell. Mine seemed flat in the pinks all the time an didn't vary much. Some kittys stay flat until the get to the right dose for them from what I have heard and seen. Also testing only mid cycle for me would not have helped, as his nadir is late most times and at the moment it's all over as he is now reacting to the insulin.

Since he get stressed very easly slowly but steadily try and test him more often. Give him his favorite treat each time, and in between when not testing bring him to the spot you test him, play with his ears, give him treats a few times a day. That helped me, teach him that tests are ok. Now he is a cat so he stills give me a hard time especially the last few weeks, as I have had to test him a lot more as his numbers have been low.

It took me a while to get used to it myself to test more often, and I still have a hard time doing a proper curve, I just do my best to test more. Some days I do great, other days not so much. At the moment I have not choice as it's for his safety.

I hope others will provide you some more information. As for feeding more often, I have heard that multiple small meals helps a lot, I am still at just two, but think I will have no choice but to change that up, due to his low numbers soon. The last few days I have given him a third feeding overnight before I go to bed.

 

[tiffmaxee]

I fed small meals up to nadir and unless Max was low didn't feed after that. It looks like you aren't doing a pmps test. There's a chance of a late nadir and bounce. See what others say.

 

[Chris/China (GA)/Garfield]

I know testing him is a challenge, but without tests before each shot as well as the mid-cycle and "before bed" tests, it's impossible to know what's really going on. We really need to see at least 4 tests per day....the two Pre-shot tests and one test sometime between each shot

As for the food, since he's still acting hungry, he may need more food! How is his weight? If he's underweight or normal, I'd try feeding him more frequently....maybe every 3-4 hours (except the 2 hours immediately before shot times)

Most cats do better with small, frequent meals, so I think the answer may be feeding him more if he's still that hungry. Until he's better regulated, his body isn't able to use all the food he's eating, so he'll need more.

Think of it like this....insulin is a "key"....and on every cell in the body there's a "lock"....without the right amount of "keys", the "locks" can't open to let the nutrition into the cells, so they're starving

 

[Deena and Malby]

Hi Deena, my Kitty is a high dose cat, was diagnosed with Acromegaly a month ago when I reached 6U, I got him tested for IAA and 1GF-1. Mind you he had most of all the symptoms of an Acrocat. Before I got to the 6U, it was hard as I had to be patient. Like you I didn't test much until recently. I had to bribe mine with treats to be able to test regularly. It is great that you are home testing, however you may want to test more often as it will be hard for the experience folks to help if they can't see a pattern in his BG, especially if he is a high dose kitty. It's probably too soon to tell. Mine seemed flat in the pinks all the time an didn't vary much. Some kittys stay flat until the get to the right dose for them from what I have heard and seen. Also testing only mid cycle for me would not have helped, as his nadir is late most times and at the moment it's all over as he is now reacting to the insulin.

Since he get stressed very easly slowly but steadily try and test him more often. Give him his favorite treat each time, and in between when not testing bring him to the spot you test him, play with his ears, give him treats a few times a day. That helped me, teach him that tests are ok. Now he is a cat so he stills give me a hard time especially the last few weeks, as I have had to test him a lot more as his numbers have been low.

It took me a while to get used to it myself to test more often, and I still have a hard time doing a proper curve, I just do my best to test more. Some days I do great, other days not so much. At the moment I have not choice as it's for his safety.

I hope others will provide you some more information. As for feeding more often, I have heard that multiple small meals helps a lot, I am still at just two, but think I will have no choice but to change that up, due to his low numbers soon. The last few days I have given him a third feeding overnight before I go to bed.

Hi Nat,
His cycle actually seems pretty predictable. High it the AM, insulin starts kicking in at +3, then his numbers fall a bit and stay steady and are back up usually by +12. Even though I don't have many +12 shots, if you look at his spreadsheet that seems to be the pattern. Seems that feeding many meals seems to be the consensus.
He's pretty good at letting me test him although I usually have to smear a small amount of his wet food on a plate to keep him steady for 5 seconds while I prick his ear.
In regards to stress, I was referring to the fact that he's always looking forward to his next meal (+4) and won't calm down again until he gets it. I was just thinking him stressing for more food wasn't helping his numbers...
Thanks for your input. I'll have my vet run those test

 

[Sienne and Gabby (GA)]

I want to echo Chris' concern. At some point, you're going to reach a dose where Malachi's numbers are going to improve. If you're not routinely getting pre-shot tests, it's always possible that you're shooting a number whereby it's unsafe to give insulin.

As for feeding, I would not feed past nadir. As the insulin starts to wear off, if you're giving your kitty food, it's only going to help to cause the numbers to rise. You may want to thing about giving that additional meal before your cat's nadir.

 

[Deena and Malby]

Hi Chris,
He's at 12lbs and looks pretty good. Could maybe use another 1/2lb but this cat has always been obsessed with food since he was a kitten. I could feed him 8 cans a day and he would probably still ask for more.
Do you think I should be giving him more than 4cans if his weight looks good? Again, I usually feed breakfast, a +4, dinner and then bed-time.

One of my concerns with the small meals is his stress. Originally I was feeding him 2 times a day but heard small meals were better.
Once he got in a routine of knowing he was getting lunch, he started screaming for that meal. Same with the post bedtime snack.
It's like he won't calm down until he gets that meal and I'm assuming the stress isn't helping.

He's VERY hard to pre-test. He's PSYCHO for food and SO hungry it's nearly impossible to keep him still. I tried 3 times this morning with no luck. Just to squirmy.
While I know pre-test are extremely important. He does seem pretty predictable with his numbers.
If you look at his chart again, he's almost always high in the AM, starts falling at +3, stays steady throughout the day and is back up by +12.
I've been basing my dose increases off of this. I'm hoping I didn't pass a good dose but I can't seem to get a Nadir below 220 so I'm assuming he's needing an increase.
Recently I was trying to test in the AM hrs to see if he's dropping overnight but he's been in the 300's.
Thoughts? Thanks!!!!

 

[Deena and Malby]

I want to echo Chris' concern. At some point, you're going to reach a dose where Malachi's numbers are going to improve. If you're not routinely getting pre-shot tests, it's always possible that you're shooting a number whereby it's unsafe to give insulin.

As for feeding, I would not feed past nadir. As the insulin starts to wear off, if you're giving your kitty food, it's only going to help to cause the numbers to rise. You may want to thing about giving that additional meal before your cat's nadir.

Hi Sienna,
Yes, it is definitely a concern of mine. He's getting breakfast, a +4 lunch (maybe I should change that to +3???) but then he doesn't get fed again until dinner time. Trying to keep his numbers low when they actually are!

 

[Deena and Malby]

I know testing him is a challenge, but without tests before each shot as well as the mid-cycle and "before bed" tests, it's impossible to know what's really going on. We really need to see at least 4 tests per day....the two Pre-shot tests and one test sometime between each shot

As for the food, since he's still acting hungry, he may need more food! How is his weight? If he's underweight or normal, I'd try feeding him more frequently....maybe every 3-4 hours (except the 2 hours immediately before shot times)

Most cats do better with small, frequent meals, so I think the answer may be feeding him more if he's still that hungry. Until he's better regulated, his body isn't able to use all the food he's eating, so he'll need more.

Think of it like this....insulin is a "key"....and on every cell in the body there's a "lock"....without the right amount of "keys", the "locks" can't open to let the nutrition into the cells, so they're starving

Hi Chris,
He's at 12lbs and looks pretty good. Could maybe use another 1/2lb but this cat has always been obsessed with food since he was a kitten. I could feed him 8 cans a day and he would probably still ask for more.
Do you think I should be giving him more than 4cans if his weight looks good? Again, I usually feed breakfast, a +4, dinner and then bed-time.

One of my concerns with the small meals is his stress. Originally I was feeding him 2 times a day but heard small meals were better.
Once he got in a routine of knowing he was getting lunch, he started screaming for that meal. Same with the post bedtime snack.
It's like he won't calm down until he gets that meal and I'm assuming the stress isn't helping.

He's VERY hard to pre-test. He's PSYCHO for food and SO hungry it's nearly impossible to keep him still. I tried 3 times this morning with no luck. Just to squirmy.
While I know pre-test are extremely important. He does seem pretty predictable with his numbers.
If you look at his chart again, he's almost always high in the AM, starts falling at +3, stays steady throughout the day and is back up by +12.
I've been basing my dose increases off of this. I'm hoping I didn't pass a good dose but I can't seem to get a Nadir below 220 so I'm assuming he's needing an increase.
Recently I was trying to test in the AM hrs to see if he's dropping overnight but he's been in the 300's.
Thoughts? Thanks!!!!

 

[Sienne and Gabby (GA)]

Is it possible to give him a treat before testing and would that make him less of a psycho-kitty?

I can't really tell if Malachi's nadirs are typically early without the pre-shot number. If the cycle is usually flat, I wouldn't worry about providing several small meals, especially if he's really food motivated. An automatic feeder may simplify your life and make for a happier cat -- it may also make him less crazed at pre-shot time. My cat had an early nadir. As a result, I was feeding her at pre-shot, +1 and +2. It all depends on what the cycle looks like.

 

[Marvin's Mom - Nat]

I'll have my vet run those test

Hi Deena,

When and if you get those test done (it maybe a bit early for those as your kitty is still in normal range of insulin units), mind you if you look at Marvin's SS it is similar except for the black early on. Check what the symptoms are for acro cats, Mine had the heart murmur, his facial features also had changed slightly, his paws where sightly bigger, his teeth also showed under bite, he didn't have the weight gain yet, and he was as 6U and was rather flat in his BG most times, variance tended to higher numbers. If you haven't researched Acromegaly yet, I will provide a link. If you are like me, It scared the hell out of me, however Marvin is doing fantastic and will tell you why shortly. Here is a link http://vetbook.org/wiki/cat/index.php?title=Acromegaly

Now, if you look at Marvin history and my postings, you will see I went through major ups and downs. My visit with the internist did not go well, My Vet (I so miss my vet) and the people here were my saving grace. Without their support, Marvin wouldn't be here anymore and that was just about a month ago. I decided to try a trail drug for his acromegaly and my vet was more than willing to try that out, started the experimental drug two weeks ago. Take a look at his SS for the last two weeks.

If your gut is really telling you that he is a probably a high dose kitty, you can get him tested or wait till he is trending to about 5U to 6U for the 1GF-1 test & IAA. You may have to push your vet for it. Not sure if testing too soon would affect the test results or not. BTW there are also fantastic members here with experience with High dose kitties. They have been my support, and Marvin's cheer leading team through out this diabetes journey. I do hope that seeing how well my kitty is doing will provide encouragement if you do have a high dose kitty.

 

[Deena and Malby]

Hi Deena,

When and if you get those test done (it maybe a bit early for those as your kitty is still in normal range of insulin units), mind you if you look at Marvin's SS it is similar except for the black early on. Check what the symptoms are for acro cats, Mine had the heart murmur, his facial features also had changed slightly, his paws where sightly bigger, his teeth also showed under bite, he didn't have the weight gain yet, and he was as 6U and was rather flat in his BG most times, variance tended to higher numbers. If you haven't researched Acromegaly yet, I will provide a link. If you are like me, It scared the hell out of me, however Marvin is doing fantastic and will tell you why shortly. Here is a link http://vetbook.org/wiki/cat/index.php?title=Acromegaly

Now, if you look at Marvin history and my postings, you will see I went through major ups and downs. My visit with the internist did not go well, My Vet (I so miss my vet) and the people here were my saving grace. Without their support, Marvin wouldn't be here anymore and that was just about a month ago. I decided to try a trail drug for his acromegaly and my vet was more than willing to try that out, started the experimental drug two weeks ago. Take a look at his SS for the last two weeks.

If your gut is really telling you that he is a probably a high dose kitty, you can get him tested or wait till he is trending to about 5U to 6U for the 1GF-1 test & IAA. You may have to push your vet for it. Not sure if testing too soon would affect the test results or not. BTW there are also fantastic members here with experience with High dose kitties. They have been my support, and Marvin's cheer leading team through out this diabetes journey. I do hope that seeing how well my kitty is doing will provide encouragement if you do have a high dose kitty.

Hi Nat,
I actually did research it yesterday. He doesn't have larger paws and I haven't noticed and change in his bite (no underbite) or facial changes. It is something to keep in mind though if we get up there in the dosing units! The more knowledge I have of what COULD be going on the better thanks for your input so glad your kitty is in green numbers now. I would just like to see my first blue!!!

 

[Marvin's Mom - Nat]

Hi Nat,
I actually did research it yesterday. He doesn't have larger paws and I haven't noticed and change in his bite (no underbite) or facial changes. It is something to keep in mind though if we get up there in the dosing units! The more knowledge I have of what COULD be going on the better thanks for your input so glad your kitty is in green numbers now. I would just like to see my first blue!!!

I know how you feel, hang in there, it will happen

 

[Deena and Malby]

Is it possible to give him a treat before testing and would that make him less of a psycho-kitty?

I can't really tell if Malachi's nadirs are typically early without the pre-shot number. If the cycle is usually flat, I wouldn't worry about providing several small meals, especially if he's really food motivated. An automatic feeder may simplify your life and make for a happier cat -- it may also make him less crazed at pre-shot time. My cat had an early nadir. As a result, I was feeding her at pre-shot, +1 and +2. It all depends on what the cycle looks like.

Hi Sienne,
Treats don't help with pre-shots. Here's a typical pre-shot morning:
He's screaming bloody-murder (mind you he's a Bengal cat) and frantic. I can usually test him pretty quickly so I'm not worried about the food changing his numbers if I can get a reading on the first try.
I usually put about 1 teaspoon of food diluted with water in a bowl and go to his testing area. He licked it so quickly he was done before I could get the blood on the test strip. I ran to get more food, this time 2 tablespoons diluted with more water to give myself more time. Same thing happened. He scarfed it up, was shaking his head and was just too frantic. I tried 3 pricks with no luck. I don't ever want his "test snacks" to skew his numbers so after several tries and several tablespoons of food I gave up.

How long after I feed him until you think his numbers go up and aren't a valid pre-test number? He's usually somewhat calm after a large meal.

I have tried an automatic feeder already. I used to feed my animals out of them but his brother has different food (CRF cat) so they need different food. PLUS Malachai is so crazy for food, he'll just eat all of his and then head over to eat the other cats food. That's how he got so fat before becoming diabetic (again, food obsessed).
So I tried the wet food in the timed feeder. It's one of those heavy duty ones but still not heavy-duty enough for my cat. The food in the feeder made him even more stressed. He would just work on getting it open for hours dragging in across the room and/or would just lay by it for hours until it opened. I've even come home to the feeder flipped upside down from him trying to get in it.

Even though I've only done a dozen or so of pre-shots, he always seems to be in the red or black.
Again, when I look at his chart, he does seem to have a consistent pattern of numbers....he's always high in the mornings and then also at +12. He also seems to Nadir around +5 +6. The numbers seem pretty consistent to me with a normal "cycle." I just can't seem to get his numbers lower.
I know only a dozen of pre-shot numbers aren't a lot but it's just so difficult to test him in the mornings. Again, I've been trying to gadge his dose increases from the information I have which is high numbers in the AM, Nadir +6, and high numbers in the PM.
Thoughts? Thanks again for your input.
Would definitely like to know how long you think I could test him after his breakfast before the numbers aren't valid anymore for a pre-test number.

 

[Marvin's Mom - Nat]

He's screaming bloody-murder (mind you he's a Bengal cat) and frantic.

That may explain alot they are so beautiful, but a handful from what I hear. Wonder if there is an imote for :tiger: lol

 

[Wendy&Neko]

I actually did research it yesterday. He doesn't have larger paws and I haven't noticed and change in his bite (no underbite) or facial changes.

Neko had no visible symptoms of acromegaly when she was diagnosed. Only 35% of kitties do show clinical symptoms on diagnosis. Her main symptom, besides her dose, was her crazy hunger. I found that feeding her mini meals through out the day in an autofeeder moved her attention from nagging me, to hanging around the autofeeder. I used the Petsafe 5. It made life much easier for me.

A recent study by the Royal Veterinary College showe that 1 in 4 diabetic cats has acromegaly. Their doses ranged from 1 to 35 units with an average of 7 units. There are lower dose acros. If it is a concern for you, get the blood tests done.

As for suggestions on dose, Chris made some great suggestions. Get a test before every shot and one other sometime during each cycle. Without that data, we can't tell if your kitty is underdosed or overdosed and bouncing. Both scenarios are possible with the data you do have.

 

[Adrian and Chino]

I have tried an automatic feeder already. I used to feed my animals out of them but his brother has different food (CRF cat) so they need different food. PLUS Malachai is so crazy for food, he'll just eat all of his and then head over to eat the other cats food. That's how he got so fat before becoming diabetic (again, food obsessed).
So I tried the wet food in the timed feeder. It's one of those heavy duty ones but still not heavy-duty enough for my cat. The food in the feeder made him even more stressed. He would just work on getting it open for hours dragging in across the room and/or would just lay by it for hours until it opened. I've even come home to the feeder flipped upside down from him trying to get in it.

It's not easy with a cat like that... I have an acro whose world revolves around food and sometimes I have to leave the apartment in the 2 hours before his PM dose/meal or go into the bedroom and close the door, since he'll leap from the couch and run into the kitchen every time I twitch, thinking I'm getting up to feed him. He also vomits stomach acid sometimes 2-3 hours before feeding time since he's already anticipating it.

Before the diabetes and the switch to wet food, I had an automated feeder that opened when the tag on his collar got close enough to it, and it only allowed him to eat for 2.5 minutes in a 6-hour period (though any unused time rolled over to the next period). This kept him from eating the other cat's food, but he managed to outsmart the machine. It kept showing that he was eating less than 50% of his allowed amount, and I stressed over this for weeks, I couldn't figure out why he was having trouble getting it to open, until I stood outside the kitchen one day and watched his reflection in the oven door - he was taking a giant mouthful when the doors opened, then backing up and dropping it on the floor. The machine only detected the few seconds it took to do this, so he was taking out and eating as much as he could!

I only feed or give him a treat after I test, but he purrs now whenever I test his BG because he knows he's either getting food or a treat when I'm done.

 

[Deena and Malby]

It's not easy with a cat like that... I have an acro whose world revolves around food and sometimes I have to leave the apartment in the 2 hours before his PM dose/meal or go into the bedroom and close the door, since he'll leap from the couch and run into the kitchen every time I twitch, thinking I'm getting up to feed him. He also vomits stomach acid sometimes 2-3 hours before feeding time since he's already anticipating it.

Before the diabetes and the switch to wet food, I had an automated feeder that opened when the tag on his collar got close enough to it, and it only allowed him to eat for 2.5 minutes in a 6-hour period (though any unused time rolled over to the next period). This kept him from eating the other cat's food, but he managed to outsmart the machine. It kept showing that he was eating less than 50% of his allowed amount, and I stressed over this for weeks, I couldn't figure out why he was having trouble getting it to open, until I stood outside the kitchen one day and watched his reflection in the oven door - he was taking a giant mouthful when the doors opened, then backing up and dropping it on the floor. The machine only detected the few seconds it took to do this, so he was taking out and eating as much as he could!

I only feed or give him a treat after I test, but he purrs now whenever I test his BG because he knows he's either getting food or a treat when I'm done.

Hi Chino,
OMG this is exactly like Malachai! If I even move on the couch or walk near the kitchen, he goes nuts...even if he's "sleeping," and see's movement he'll run to the kitchen. I usually try and leave my house for a few hours before as he just harasses me and it literally is giving me anxiety too.
Malby also purrs as well in his testing area. He doesn't mind it at all. It's just hard to do in the AM when he's so frantic.
While I would like to do the machine and it probably would take his attention off of me. He's just distructive with it. I also use the petsafe.

 

[Deena and Malby]

Neko had no visible symptoms of acromegaly when she was diagnosed. Only 35% of kitties do show clinical symptoms on diagnosis. Her main symptom, besides her dose, was her crazy hunger. I found that feeding her mini meals through out the day in an autofeeder moved her attention from nagging me, to hanging around the autofeeder. I used the Petsafe 5. It made life much easier for me.

A recent study by the Royal Veterinary College showe that 1 in 4 diabetic cats has acromegaly. Their doses ranged from 1 to 35 units with an average of 7 units. There are lower dose acros. If it is a concern for you, get the blood tests done.

As for suggestions on dose, Chris made some great suggestions. Get a test before every shot and one other sometime during each cycle. Without that data, we can't tell if your kitty is underdosed or overdosed and bouncing. Both scenarios are possible with the data you do have.

I will try my best to start getting these numbers to see if he is underdoses or bouncing. I'll follow up in a bit to get some opinions. In the meantime, I'm using the SLGS method and he's up for an increase. Was going to do my best to get a curve done tomorrow.
Should I hold the 3.5 until I can get some more pre-shot numbers and advice on how to proceed or move to 3.75 and start trying to get more pre-shots???
How important are the curves anyway? When Malby was first diagnosed, I remember reading someone's advice that testing on a regular basis was more beneficial at looking at the "big picture" of what was going on as a cats numbers (or a curve) can vary each day due to different factors.
I agreed with that as some days I'll test at +5 and he can be at 270 and then another day he'll be at 415!

 

[Deena and Malby]

Neko had no visible symptoms of acromegaly when she was diagnosed. Only 35% of kitties do show clinical symptoms on diagnosis. Her main symptom, besides her dose, was her crazy hunger. I found that feeding her mini meals through out the day in an autofeeder moved her attention from nagging me, to hanging around the autofeeder. I used the Petsafe 5. It made life much easier for me.

A recent study by the Royal Veterinary College showe that 1 in 4 diabetic cats has acromegaly. Their doses ranged from 1 to 35 units with an average of 7 units. There are lower dose acros. If it is a concern for you, get the blood tests done.

As for suggestions on dose, Chris made some great suggestions. Get a test before every shot and one other sometime during each cycle. Without that data, we can't tell if your kitty is underdosed or overdosed and bouncing. Both scenarios are possible with the data you do have.

Hi wendy,
Also, I'm thinking he's a high dose kitty as a few weeks ago he was double dosed at 6units and never went hypo. The amazing folks here talked me through it....I monitored him hourly and did give him some high carb food but he never went below 240 I think!

 

[Wendy&Neko]

Should I hold the 3.5 until I can get some more pre-shot numbers and advice on how to proceed or move to 3.75 and start trying to get more pre-shots???

Yes. Curves/mid cycle spot checks and preshots are essential. We need to know how low this dose is taking a kitty before knowing if it's safe to increase.

Don't let the accidental 6U overdose fool you into thinking he's high dose. I've seen a few (and too many) overdoses and commonly the kitty's self defense mechanisms come to play.

 

[Deena and Malby]

Yes. Curves/mid cycle spot checks and preshots are essential. We need to know how low this dose is taking a kitty before knowing if it's safe to increase.

Don't let the accidental 6U overdose fool you into thinking he's high dose. I've seen a few (and too many) overdoses and commonly the kitty's self defense mechanisms come to play.

Hi Wendy,
Okay thanks. I know there's a science to this and the veterans know best. It's just that in the past seven months of testing, I've never seen him below 249. The vet started him on 1unit even though with his weight, he could have been started at 2.5 they said.
I know the goal is to find out how low each dose takes him, but I've gone from 1 unit to 3.5 and I have never seen a number even close to blue
I can only assume that he needs more? I'm constantly second-guessing myself like if I'm holding the dose for too long or too short. I recently started trying to follow the SLGS method which says I should be holding each dose for 5 days (10 cycles) even though my vet thinks I should be holding each dose for several weeks. I just never know what the right advice/route is. I just can't imagine I skipped the right dose since I've never caught him in the blue or green?
All I know is that he lays on the floor all day looking sad, or begs for food. It just breaks my heart and I feel like I'm doing everything wrong.

 

[Marvin's Mom - Nat]

I would suggest, try for a couple weeks the suggestion on testing pre-shot and a couple in-between, and if possible one curve on your day off. create a daily post and update with your data. Experienced members will guide you through. It is possible that she is just flat, which simply means you would be increasing every 5 days and monitoring, until you see some active cycles. Once the two weeks are up, see how you feel about how it's going.

Feel free to vent, I've posted often in tears with my baby, as the first 3 months nothing, then all of a sudden I had a good few weeks, then high again. Cat's are unpredictable. I looked at alot of SS other other kitties, not to copy dosage but to understand as many people kept telling me that most cats BG number until regulated is confusing. Plus I honestly had a hard time understanding onset, nadir and bounces, I am getting better, but this has been by seeing it on my own cat with the help here. The most important thing with suggestions for me was to feel comfortable with the person providing it and that the suggestion was from someone that has been here for a while, with good experience.

My Vet at first was also cautious on the insulin increases, however she did become more open since Marvin was a tough case, and we eventually saw results. Veterinarian Internist for the most part will give you very similar guidelines as here. Regular Vet's are trained more with kitties that are regulated easily and quickly, they are not used to harder cases and are not always up to date with the benefits of home testing. I was lucky mine (which I don't have any more as she moved) was great and open. I got her to visit this site, and she also read up on insulin resistance, to see what we could do for my baby.

 

[Deena and Malby]

Hi Nat,
Yes, I've often also looked at other people's SS's as well. I've learned by looking at other' s that many cats early on had scattered numbers that were never consistent. Atleast Malachai's are somewhat predictable being high in the AM, lowering a bit then go back up at the end of the day.
To clarify, you think I should hold the 3.5 dose for another week (or 2 weeks)? I'm supposed to run a curve tmrw and then go up if needed. I'm trying to follow the SLGS method. He's been on 3.5 for about a week now. Thanks for your help and encouraging words!

 

[Wendy&Neko]

SLGS has you hold the dose for a week or seven days, not five, then do a curve and evaluate the dose based on that data. It also means doing a test for every preshot. Random spot checks can help too . I would hold this dose and gather the data you need to figure out if it's safe to increase.

 

[Marvin's Mom - Nat]

To clarify, you think I should hold the 3.5 dose for another week (or 2 weeks)?

Hi Deena, no that not what I meant I mean for the next two weeks to do as Wendy mentioned in the post above. Plus create a post everyday with the results of the BG here. The experience folks will guide you through when you should increase, and based on extra BG test, and can explain some of the data. If it works well for you in the two weeks you can continue with the additional testing suggested.

I think doing the curve is a great idea, can't wait to see the results

 

[Deena and Malby]

Hi Deena, no that not what I meant I mean for the next two weeks to do as Wendy mentioned in the post above. Plus create a post everyday with the results of the BG here. The experience folks will guide you through when you should increase, and based on extra BG test, and can explain some of the data. If it works well for you in the two weeks you can continue with the additional testing suggested.

I think doing the curve is a great idea, can't wait to see the results

Hi Nat,
Thank you. Two things, would i post his numbers on this thread or create a new post each day with his numbers? If so, should it title that daily post something specific?
Also, I've also been somewhat confused as to what bouncing is but if I understand it correctly, it's when a cat has low pre-shot number but is injected anyways... then the body's self defense mechanism kicks in so the numbers jump up. Is this correct?
If so, if Malachai has high pre-shot numbers then slowly falls, levels off and goes back up at the end of the day, he would NOT be bouncing right?
I was able to get a few AM & PM shots in the last few days So I'm thinking he's not bouncing???

 

[Marvin's Mom - Nat]

Good morning Deena. Glad to see you on.
You would create a new post each day. The subject should be the date, cat name, plus his first BG of the day and you can add a question if you have one.

Example: 7/10 Malachai amps BG is 123 is this a bounce?

You can also use the ? Option that adds an icon at the beginning of the subjet. Experienced folks will look at those first.

I am on the road at the moment so regarding the bounce question will let another answer or will give you more clarification later as this is an important question

 

[Chris/China (GA)/Garfield]

Bounces happen for one (or more than one) of these reasons

1. A drop in the blood glucose that's too low....Like below 50 on a human meter
2. A fast drop in blood glucose....like going from 300 to 150 in 2 hours would be considered a very fast drop
3. A drop into a range that the cat's body just isn't used to anymore.....If the cat has been diabetic for awhile, it's body "learns" to accept those high numbers as normal....then we add insulin and bring it down and the body has to re-learn that it's OK to be there again. In the meantime, while it's re-learning, the liver can continue to "freak out" even though the actual blood glucose isn't anywhere close to "too low"

Bounces, no matter what caused them, are the body's reaction to a number it perceives as too low .....the liver releases stored sugars and hormones to bring the BG back up.

This is why mid-cycle testing is so important.....We have seen cats that had an AMPS in the 400's, drop to 40 by mid-cycle and "bounce" back to 400's by PMPS....without catching that mid-cycle, you might think the cat needed more insulin, when it fact, it needs less!!

 

[Deena and Malby]

Hi china,
Thanks for the response. So can you explain #3 a little more and maybe provide me with an example or two of this (when the cat drops to numbers it hasn't seen in a while).
Let's hypothetically say my cat were to drop to 150, which is completely safe, but he's been diabetic for 7 months now and wouldn't be used to those numbers since he spends the majority of his day in the 300's. Would you decrease the insulin or keep it the same since you know it's just a bounce?
OR, are you referring to the bounce being low numbers in the AM (let's say 150) and then it jumps up really fast after you give the insulin??
Just kinda confused on how #3 works.
Would I be right to assume that Malachai has never bounced if I've never seen him in low numbers before?

 

[Chris/China (GA)/Garfield]

So can you explain #3 a little more and maybe provide me with an example or two of this (when the cat drops to numbers it hasn't seen in a while).

OK....let's say he's usually in the 300's.....his body has re-learned that 300's are normal....so although he might drop to 150 (a number that's still too high, but a lot lower than 300's) his body says "Whoa! Wait a minute....that's too low!! We're used to the 300's!!!....The liver releases those stored sugars and hormones to bring him back up.

The key is to keep getting him lower and waiting for his body to re-learn that normal numbers are OK again.....this can take months (or years)...some cats are bouncier than others.

Another example....he drops to 70 at +7 one cycle......his body once again panics and releases those sugars and hormones and by PMPS he's in the 400's....that's a big time bounce. Once he bounces, it can take up to 6 cycles (3 days) for those sugars and hormones to work their way out of the body again, so it's important to have people here that know how to read spreadsheets help you until you learn to recognize bounces and when they've "cleared" for yourself.

If, for example, he was at 150 at AMPS, my first thought would be "I wonder how low he went last night?".....because generally speaking, the way it should works is the AMPS is a high number....then as the insulin kicks in, the BG starts to come down to nadir (the lowest point in the cycle, whenever it happens....usually around +6)....then as the cycle goes on, the numbers start to rise again until it's PMPS time.....think of it like a smile....starts in the upper left corner of your face, goes down to a low point and then goes back up to the top right corner (like 300, down to 120, up to 300)

As he gets better controlled, the cycle will get "flatter"....the smile won't be as "deep" and the numbers will be closer together (like 150, down to 80, back to 150)

SO, if he's usually around 300 at AMPS and he's only at 150, I'd wonder if he was "on his way up" from a low number on the night cycle

 

[Marvin's Mom - Nat]

Hello Deena, Chris has a better understanding of bounces than I.

Let's hypothetically say my cat were to drop to 150, which is completely safe, but he's been diabetic for 7 months now and wouldn't be used to those numbers since he spends the majority of his day in the 300's. Would you decrease the insulin or keep it the same since you know it's just a bounce?

Because there isn't much evening data, and not always am & pm pre-shot numbers, I would also have to assume.
I am going to assume that the pre-shots numbers are available and are over 150, and that there was at least before bed tests (+4 r +5) also are either higher than 150 or = to 150, and maybe a curve within the last few days. I would increase the dose by .25.

Would I be right to assume that Malachai has never bounced if I've never seen him in low numbers before?

We can't assume that because would need the am and pm pre-shots, and more data for the evening to be sure.

I think that Malachai, maybe have had bounces on:
- On June 12th I am pretty sure you had a bounce there, there is enough BG test to show a pattern for that morning (bounces can last 6 cycles (3days) I think).
June 30ths maybe a bounce too, from the 28th but missing the 29th, and would have been good to see at least one test in the evening, that one is a maybe.

I know all this is confusing and a lot of information, and A LOT of what ifs, maybes and it depends.... It hard to answer precisely because all cats are different, and the spread sheet data is really the tool you need to make those decisions.

Now don't worry, take a deep breath it's all good. If you are like me you will learn better hands on. Meaning as it is happening. Why? because if you are like me, you can see what's happening before, during and after. Too much information at once sometime just confuses things more if you are more of a hands on type of person.

It's a lot to take in, that is why creating a new post each day, with the data will help as we can go through it with you specific to the data you have and what's going on with Malachai.

If you look at mine today, I am not sure what to do with my kitty's dosage. For different reason than you, and not a normal reason at that. So I will make my decision based on feedback, and what I feel comfortable with. The decision is always mine to make. I've made mistakes, I too didn't really understand all the testing until I saw with Marvin how much his number varied during an active cycle.

Tomorrow, create a new post, and add a link to this post in the body of the post. I hope you can add a few more BG for today in your spread sheet and that is where you will want to start. Make sure to have the ? option selected in the subject field.

BTW, the tests that you were able to input today in the AM cycles will help a lot and you did very well. Now, I would review with someone who has a bit more experience than me and decide if you have enough data to safely decide to increase his dose. My gut says yes, but again I am still learning so lets see what others suggests.

 

[Deena and Malby]

Hi Nat,
Yeah I definitely wouldn't be able to "see" any bounces on my spreadsheet if they were there. I clearly don't understand all of that yet.
I think Inwould be able to spot something if it was a super low number which I'm not used to but again, I've never caught him below 249 in 7 months of testing.
I just added another BG test to his spreadsheet.

Also, you said to add a link to this post tmrw. Can I ask how you would do that? Any suggestions on what I should title the post tmrw so people will look at it? I will add the "?" As you suggested.

 

[Deena and Malby]

OK....let's say he's usually in the 300's.....his body has re-learned that 300's are normal....so although he might drop to 150 (a number that's still too high, but a lot lower than 300's) his body says "Whoa! Wait a minute....that's too low!! We're used to the 300's!!!....The liver releases those stored sugars and hormones to bring him back up.

The key is to keep getting him lower and waiting for his body to re-learn that normal numbers are OK again.....this can take months (or years)...some cats are bouncier than others.

Another example....he drops to 70 at +7 one cycle......his body once again panics and releases those sugars and hormones and by PMPS he's in the 400's....that's a big time bounce. Once he bounces, it can take up to 6 cycles (3 days) for those sugars and hormones to work their way out of the body again, so it's important to have people here that know how to read spreadsheets help you until you learn to recognize bounces and when they've "cleared" for yourself.

If, for example, he was at 150 at AMPS, my first thought would be "I wonder how low he went last night?".....because generally speaking, the way it should works is the AMPS is a high number....then as the insulin kicks in, the BG starts to come down to nadir (the lowest point in the cycle, whenever it happens....usually around +6)....then as the cycle goes on, the numbers start to rise again until it's PMPS time.....think of it like a smile....starts in the upper left corner of your face, goes down to a low point and then goes back up to the top right corner (like 300, down to 120, up to 300)
View attachment 29637

As he gets better controlled, the cycle will get "flatter"....the smile won't be as "deep" and the numbers will be closer together (like 150, down to 80, back to 150)
View attachment 29640

SO, if he's usually around 300 at AMPS and he's only at 150, I'd wonder if he was "on his way up" from a low number on the night cycle

Hi chris,
If you look at the curve I did on Malachai today, it looks like he has somewhat of a "flatter" cycle like depicted in the second photo.
I feel like he used to drop lower when he was first diagnosed. He was originally on Vetsulin and would go from the 600's to the 300's. Now, he seems to have pre-shots in the 400's and not go below 300. On a good day I'll see high 200's.
When I look at the data I collected from the curve today and also the few pre-shots from the previous days, I can also assume he will need a dose increase???

 

[Chris/China (GA)/Garfield]

When I look at the data I collected from the curve today and also the few pre-shots from the previous days, I can also assume he will need a dose increase???

Probably yes, but you don't have much data on the PM cycle and it's really important to get at least a "before bed" test ....Most cats go lower at night, so without getting those PM tests in, there's no way to know what he's doing overnight

 

[Marvin's Mom - Nat]

You can put something like this in the subject

In the body copy the url in your browser for this post, then paste in the body of the new post. I simply go find my previous post, copy the url, create the new post and paste it in the body. There is a way to use the chain icons in the edit box to add the url to a specific word similar to microsoft word if you know who to do that.

http://www.felinediabetes.com/FDMB/...-two-meals-a-day-or-many.180378/#post-1998121

In the body, reiterate what you want, Looking for help to better understand Malachi's numbers and to guide me through getting him regulated. Ask any questions you have in the moment, about His BG number or his behavior, etc..... Hint as you know you will get a lot of feedback some days, so I used to try and keep it to one or two specific questions. Made it easier for me to learn one thing new per day or two. I still took time to look at stickies, and read up on something I wasn't sure on, and trying to understand it. I learned quickly that if I read too much I just would get things confused so focused on the basics, and just a couple items at a time. I really understood, when I ran into the situation with Marvin though. I think that is cause it's our baby, and we are so scared and want things to happen quickly, it's hard to objectively take things in. In a way I guess, we need to look at ourselves as their nurse and not their mom

 

[Deena and Malby]

Probably yes, but you don't have much data on the PM cycle and it's really important to get at least a "before bed" test ....Most cats go lower at night, so without getting those PM tests in, there's no way to know what he's doing overnight

Hi Chris,
Last week (on the same 3.5 dose) I tested him at night several times at +4 and also +8 and he was in the mid-300's. Is that not enough data? Looks like he's having the same numbers at night as during the day...

 

[Deena and Malby]

You can put something like this in the subject

View attachment 29642

In the body copy the url in your browser for this post, then paste in the body of the new post. I simply go find my previous post, copy the url, create the new post and paste it in the body. There is a way to use the chain icons in the edit box to add the url to a specific word similar to microsoft word if you know who to do that.

http://www.felinediabetes.com/FDMB/...-two-meals-a-day-or-many.180378/#post-1998121

In the body, reiterate what you want, Looking for help to better understand Malachi's numbers and to guide me through getting him regulated. Ask any questions you have in the moment, about His BG number or his behavior, etc..... Hint as you know you will get a lot of feedback some days, so I used to try and keep it to one or two specific questions. Made it easier for me to learn one thing new per day or two. I still took time to look at stickies, and read up on something I wasn't sure on, and trying to understand it. I learned quickly that if I read too much I just would get things confused so focused on the basics, and just a couple items at a time. I really understood, when I ran into the situation with Marvin though. I think that is cause it's our baby, and we are so scared and want things to happen quickly, it's hard to objectively take things in. In a way I guess, we need to look at ourselves as their nurse and not their mom

This is a lot of help! Thanks I'll post tomorrow and hopefully get some suggestions. I'm pretty sure he needs an increase but sometimes I worry that I didn't "stick" with a dose long enough or test enough and that I might have missed a good dose. I've been trying to take it slow though, only until recently did I start to do increases more quickly (SLGS).

 

[Adrian and Chino]

Have you considered switching to a human meter? I moved a few weeks after starting Chino on insulin and the new vet only wanted me to test with the Alphatrak 2. Because the test strips were so damn expensive, I was only testing mid-cycle. I found this message board and started testing more frequently after switching to a human meter, and it paid off. While Chino ended up being a high dose kitty w/acromegaly, he did show green nadirs at night several times (when coming down from a bounce) before we found a good dose. Sometimes he bounces so high that it takes more than one cycle to come down to green, but these are patterns that are difficult to spot unless you're testing before each shot as well as mid-cycle.

 

[Marvin's Mom - Nat]

This is a lot of help! Thanks I'll post tomorrow and hopefully get some suggestions. I'm pretty sure he needs an increase but sometimes I worry that I didn't "stick" with a dose long enough or test enough and that I might have missed a good dose. I've been trying to take it slow though, only until recently did I start to do increases more quickly (SLGS).

Once a week increases is slow and good. Some vets want to wait longer, but it really isn't going to do a difference, under a week is fast. If you are testing enough then you have good data to do the increases each 7 days, and no worries is unsure, I have held the dose a couple days longer, especially if I knew I wasn't going to be around. When I work I try to schedule 7 days to fall on Friday, and do the increase friday night as I am off on the weekend. That way I can monitor how he reacts to the increase during the weekend, and by monday I should feel comfortable leaving him if his numbers are predictable.

 

[Chris/China (GA)/Garfield]

Last week (on the same 3.5 dose) I tested him at night several times at +4 and also +8 and he was in the mid-300's. Is that not enough data? Looks like he's having the same numbers at night as during the day...

But you didn't get Pre-shot numbers those days

Again, I think he could use an increase to 3.75, but it really is important to get at least 3-4 tests per day in....the 2 Pre-shot tests and (if possible) at least 1 test mid-cycle on the AM cycle and always a "before bed" test on the PM cycle

I think you could go up to 3.75 tomorrow unless he pulls something silly tonight (they are cats after all!!

 

[Deena and Malby]

Have you considered switching to a human meter? I moved a few weeks after starting Chino on insulin and the new vet only wanted me to test with the Alphatrak 2. Because the test strips were so damn expensive, I was only testing mid-cycle. I found this message board and started testing more frequently after switching to a human meter, and it paid off. While Chino ended up being a high dose kitty w/acromegaly, he did show green nadirs at night several times (when coming down from a bounce) before we found a good dose. Sometimes he bounces so high that it takes more than one cycle to come down to green, but these are patterns that are difficult to spot unless you're testing before each shot as well as mid-cycle.

Hi Adrian,
I have considered it but I do use Freestyle Lite test strips w/my AlphaTrak 2 so they aren't as expensive as the AT2 strips.
The lack of testing sometimes is that I'm simply not home to test on some days and I often travel for work.
What human meter is mostly used by the members here?

 

[Adrian and Chino]

What human meter is mostly used by the members here?

A lot of us use the Relion Confirm or Relion Prime. They require only a tiny amount of blood and are available at Wal Mart, though you can often find a better price for test strips on Ebay.

 

[Chris/China (GA)/Garfield]

The Relion Confirm or Micro are favorites here....You'll see in our signatures which meter we use and you'll see those names a lot!! These two take the tiniest sample size and the strips are affordable ($36/100)

The Relion Prime takes a bigger sample size and some people have had problems with error messages, but they have the cheapest strips at $18/100

 

[Adrian and Chino]

The Relion Confirm or Micro are favorites here....You'll see in our signatures which meter we use and you'll see those names a lot!! These two take the tiniest sample size and the strips are affordable ($36/100)

The Relion Prime takes a bigger sample size and some people have had problems with error messages, but they have the cheapest strips at $18/100

Sorry, I meant to say Micro, not Prime. Thanks for catching and correcting!

 

[Deena and Malby]

You can put something like this in the subject

View attachment 29642

In the body copy the url in your browser for this post, then paste in the body of the new post. I simply go find my previous post, copy the url, create the new post and paste it in the body. There is a way to use the chain icons in the edit box to add the url to a specific word similar to microsoft word if you know who to do that.

http://www.felinediabetes.com/FDMB/...-two-meals-a-day-or-many.180378/#post-1998121

In the body, reiterate what you want, Looking for help to better understand Malachi's numbers and to guide me through getting him regulated. Ask any questions you have in the moment, about His BG number or his behavior, etc..... Hint as you know you will get a lot of feedback some days, so I used to try and keep it to one or two specific questions. Made it easier for me to learn one thing new per day or two. I still took time to look at stickies, and read up on something I wasn't sure on, and trying to understand it. I learned quickly that if I read too much I just would get things confused so focused on the basics, and just a couple items at a time. I really understood, when I ran into the situation with Marvin though. I think that is cause it's our baby, and we are so scared and want things to happen quickly, it's hard to objectively take things in. In a way I guess, we need to look at ourselves as their nurse and not their mom

Hi Nat,
Good morning! I completed the curve yesterday and posted a new thread as you suggested for some additional help! His AMPS was 536!