Could you please add an explanation for this? I've never seen that happen. Curious. We've often used low carb food to steer a cat up and avoid an influx of unnecessary carbs.
Sure. I didn't want to get too far into the weeds and confuse things earlier while we were focusing on the numbers.
The key factors kicking around in my head when I made that comment:
- relatively newly diagnosed cat (1 month or so)
- started at 2U Prozinc and quickly moved to 3U without clear data to support it
-
Prozinc is an "in and out" insulin (no depot)
- there are multiple instances on the spreadsheet of having to stall a shot and feed just to get to a "shootable" number
- yesterday's AMPS was, yet again, not shootable, despite being fed an hour earlier. There were then multiple (hourly?) feedings from +12 to +17.
- the multiple feedings didn't spike the BG ... rather between +11 and +17, the BG went from 143 to 76 ... this at a point when
the last Prozinc shot should have been well out of his system.
Last night's recap from one of Kathy's posts:
UPDATE with
NO Shot:
+11.25=143 gave pills and fed Fancy Feast Kitten 0 carb
+12=131 Fed Fancy Feast Kitten 0 carb (actually 3 carbs)
+13=145 Fed Fancy Feast Kitten 0 carb (actually 3 carbs)
+14=110 Fed Fancy Feast Kitten 0 carb (actually 3 carbs)
+15=72 GAVE 1 TABLESPOON NULO WET FOOD WITH 3g CARBS
+16=81 Fed Fancy Feast Kitten 0 carb (actually 3 carbs)
+17=76 Fed Fancy Feast Kitten 0 carb (actually 3 carbs)
My thought at first glance is that it looks like Lewie
could be contributing some of his own (endogenous) insulin to explain the drop. It seems like too much of a delta to be explained by meter variance alone. Could the Prozinc still be working at +17? You sometimes see late nadirs when the cat is being overdosed so I guess it's possible ... I'm just not sure it's probable.
If this were Lantus or Lev, I would NOT have gone down that logic path. Rather, I would have suspected the depot was still working at +11-17 to handle the influx of food and postprandial needs. But the "L" insulins are very different from an in-and-out insulin such as Prozinc. When Prozinc is gone from the system, typically before the next shot, it's gone. Hence the typical "U" type curve of Prozinc rather than the flatter "averaging" you see with the L's.
So to finally answer your question...
In a cat whose pancreas might be "sputtering" and is therefore
potentially contributing endogenous insulin in addition to what has been shot exogenously, food can (at least theoretically) encourage the pancreas to try to kick insulin in an effort to offset the meal. When this happens when the cat is already at lowish numbers early in the cycle, you can actually exacerbate the low numbers...a "double whammy" so to speak of endogenous and exogenous insulins. A higher carb food ensures that you're overcoming the combination of insulins to stay safe.
I agree that
normally the "rules of the road" are to feed low carb to gently nudge up lower numbers. That is generally the case in cats where the exogenous insulin is doing most of the work. But when you throw in the variable of endogenous insulin, and it appears that the cat has at least some capability to handle some of the load on it's own, it might be wise to consider the carb load when making food decisions. I learned this from the great Jojo and Bunny back in the day when my cat was going on and off insulin and I saw first hand how his body's efforts and my food choices sometimes seemed to be at odds when trying to bring up his numbers.
As an aside... I've had three feline diabetics and still don't consider myself an expert. There has been a lot of cumulative knowledge gained here since I first joined this site nearly 14 years ago, and I'm probably a little "old school" when it comes to dosing and speed of moving up the scale. Thus I rarely giving dosing advice. That said, if I were holding the syringe and Lewie were my cat, I would NOT be dosing 2.75U at this point. I believe it's very possible that Lewie was started at too high of a dose, did some bouncing, and that he probably nadirs far sooner than +8 so some of the low numbers might have been missed. To me, it makes no sense to stay at a dose where you regularly have to stall shots and feed just to get to a shootable number. I'd personally drop to a lower dose and prove the need for more insulin by collecting data, then slowly moving back up the dosing scale as warranted. As I said, I'm more conservative in dosing. We're all colored by our experiences, and I've seen a hypoglycemic cat seize, so I'm probably biased toward underdosing, at least in the early days. As has been said here numerous times, in a cat who doesn't have a history of DKA, "better to high for a day than too low for a minute."
And that's my two cents (probably not worth a penny).
So Lewie never got a shot today, right? My gut feeling is that his pancreas might be kicking in some...you never got a food spike, and he has had a really LOVELY cycle today! Now the thing to remember IF that is true is that it doesn't mean he'll suddenly be in remission. Usually the pancreas sputter and sometimes show up for the party and sometimes don't. 
Poor guy! 
Then we can see where he's at tomorrow and go from there. Do you have a sense of what amount might be best?
