Nov 30 Lily dosing help AMPS 162

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Hi Sally,

Sorry I wasn't around earlier and that you didn't get a response in time.

When you get a moment it would be a good idea to grab a test to see what sort of rise Lily got from her brekkie. Info like that will help you to lower the 'no shoot' limit with confidence.

How's her ladyship eating today?


Mogs
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Critter Mom said:
Hi Sally,

Sorry I wasn't around earlier and that you didn't get a response in time.

When you get a moment it would be a good idea to grab a test to see what sort of rise Lily got from her brekkie. Info like that will help you to lower the 'no shoot' limit with confidence.

How's her ladyship eating today?


Mogs
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Hi Mogs, she is doing well!! Ate all her breakfast and is 187 at +5.
 
Hi Sally,

Just been looking at Lily's spreadsheet. Have you by any chance been giving her some mid-cycle mini feeds today?


Mogs
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Critter Mom said:
Hi Sally,

Just been looking at Lily's spreadsheet. Have you by any chance been giving her some mid-cycle mini feeds today?


Mogs
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Hi Mogs, yes at +2 she ate a little LC and wouldn’t eat anything at +4 or +6. That 262 threw me for a loop at +5. No idea how she could have gone so high.
 
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Lily had similar cycles on 23 and 25 November AM cycles. I think perhaps because, based on Lily's data, it looks like her pancreas produces basal trickles of insulin and because she doesn't eat much, if anything, in the middle and later parts of the cycle her BG levels slide down as the cycle progresses. Then she gets another food bump after her evening feed.

The only thing I can think of to compensate and give you two PS levels where you are able to give insulin is to work on modifying her feeding schedule to balance out the action of the insulin over the course of the cycle as we've previously discussed. Given that she was OK to have a little bit at +2 but not at +4 or +6 then I wonder whether the large feed at preshot time filled her up?

I'm tagging @tiffmaxee to ask for her input.


Mogs
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Sally and Lily said:
She is 93 at PMPS, should I feed her and skip her insulin?
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While it is technically possible to give insulin at lower numbers with Lantus (with appropriate monitoring as dictated by Lily's levels), I think because of Lily's pattern of response it would be better to skip. If you could find a feeding schedule that she'd accept that worked OK on the daytime cycles and kept her in safe numbers it would then help you with the PM cycles too. If it was my cat, I would skip tonight. @tiffmaxee, what do you think?


Mogs
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Critter Mom said:
While it is technically possible to give insulin at lower numbers with Lantus, I think because of Lily's pattern of response it would be better to skip. If you could find a feeding schedule that she'd accept that worked OK on the daytime cycles and kept her in safe numbers it would then help you with the PM cycles too (with appropriate monitoring as dictated by Lily's levels). If it was my cat, I would skip tonight. @tiffmaxee, what do you think?


Mogs
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I will feed her less at her pre shots tomorrow and try to get her to eat at +2,+4, and +6. I did get the automatic feeder and have been using at night but she only eats at +2.
 
Sally and Lily said:
I think you are right, no insulin tonight and I won’t feed her as much so she will eat again at +2,+4, and +6.
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It might take a little bit of experimentation and acclimatisation. :)

Sally and Lily said:
I did get the automatic feeder and have been using at night but she only eats at +2.
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It's good that she's started eating out of it, Sally. Little victories! :cat:


Mogs
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Morning, Sally.

I crave a favour: is there any chance you could make very brief notes of when Lily eats in her spreadsheet remarks, please (e.g. +?? mini feed, +?? small snack - or something along these lines that works for you). As you know, I follow along on her spreadsheet every day and having the little bit of feeding info will help me understand her numbers better.

Wishing you both a grand day.

:bighug:


Mogs
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Critter Mom said:
Morning, Sally.

I crave a favour: is there any chance you could make very brief notes of when Lily eats in her spreadsheet remarks, please (e.g. +?? mini feed, +?? small snack - or something along these lines that works for you). As you know, I follow along on her spreadsheet every day and having the little bit of feeding info will help me understand her numbers better.

Wishing you both a grand day.

:bighug:


Mogs
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I sure will, thanks for following us, greatly appreciated! Hope you have a great day too! :bighug::bighug:
 
Choices:

1. If you're happy that Lily is high enough to give insulin, feed her normal big preshot meal and give insulin, followed by normal 'before bed' BG test.

2. Skip the dose, feed Lily a smaller preshot meal and set up the timed feeder to dispense mini meals at +2, +4, +6. Set the timed feeder to rotate to an empty compartment at +8. That way you'd be able to safely determine, without staying up all night, whether she eats enough at the right times if all the compartments that contained food are empty in the morning.

What do you think, Sally?


Mogs
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Critter Mom said:
Choices:

1. If you're happy that Lily is high enough to give insulin, feed her normal big preshot meal and give insulin, followed by normal 'before bed' BG test.

2. Skip the dose, feed Lily a smaller preshot meal and set up the timed feeder to dispense mini meals at +2, +4, +6. Set the timed feeder to rotate to an empty compartment at +8. That way you'd be able to safely determine, without staying up all night, whether she eats enough at the right times if all the compartments that contained food are empty in the morning.

What do you think, Sally?


Mogs
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So if I do give her insulin I wouldn’t need to feed her at +2,+4 and +6?
 
Critter Mom said:
Choices:

1. If you're happy that Lily is high enough to give insulin, feed her normal big preshot meal and give insulin, followed by normal 'before bed' BG test.

2. Skip the dose, feed Lily a smaller preshot meal and set up the timed feeder to dispense mini meals at +2, +4, +6. Set the timed feeder to rotate to an empty compartment at +8. That way you'd be able to safely determine, without staying up all night, whether she eats enough at the right times if all the compartments that contained food are empty in the morning.

What do you think, Sally?


Mogs
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I think I am am not going to give Lily her dose tonight. I would like to see if she eats tonight at +4 and +6.
 
I think that's a good choice, Sally. In order for her to receive insulin on both cycles safely she needs the smaller meals to balance out the insulin (both the injected and that from her own little pancreas). During the day you can check her BG levels while getting her accustomed to the mini meal feeding and intervene if needed. Obviously that's not so easy during the night. Over the next few days and nights, BG levels permitting, it might be an idea to give insulin in the morning and following the mini meal schedule the same way you did today, then skipping the night time dose and dispensing the mini meals from the auto feeder to see how she gets on without any risk of her going low while you're asleep. Once you're confident she'll eat OK for you overnight from the feeder it should then become more straightforward to give her insulin twice a day. Perhaps for the first night time runs of giving insulin and using the feeder you could set alarms to test at intervals to check how she's running and make sure she's safe.

Thoughts?


Mogs
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Critter Mom said:
I think that's a good choice, Sally. In order for her to receive insulin on both cycles safely she needs the smaller meals to balance out the insulin (both the injected and that from her own little pancreas). During the day you can check her BG levels while getting her accustomed to the mini meal feeding and intervene if needed. Obviously that's not so easy during the night. Over the next few days and nights, BG levels permitting, it might be an idea to give insulin in the morning and following the mini meal schedule the same way you did today, then skipping the night time dose and dispensing the mini meals from the auto feeder to see how she gets on without any risk of her going low while you're asleep. Once you're confident she'll eat OK for you overnight from the feeder it should then become more straightforward to give her insulin twice a day. Perhaps for the first night time runs of giving insulin and using the feeder you could set alarms to test at intervals to check how she's running and make sure she's safe.

Thoughts?


Mogs
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Yes, I think that is a good idea. I really need to make sure she will eat when she needs to if she is dosed. Thank you Mogs, for being here for me. You are so knowledgeable and so nice to share it!! :bighug:
 
I was lucky in some respects that Saoirse metabolised her insulin quite quickly which meant that I'd know where she was at nadir round about the +3 mark. If she was OK at that point then I knew her timed feeds would see her OK for the rest of the cycle (after I'd stayed up quite a few nights to make sure!). I need meds to help me sleep. Once they're on board no way I could wake to an alarm to do sugar checks so I had to be certain she was safe before I could take them. With Saoirse's pancreatitis issues, I had to feed her every three hours, otherwise tummy acid build-up would make her vomit. The steady feeding balanced her out through the cycles, AM and PM.

Lily's tricky because she's producing that little stream of basal insulin which sees her numbers drift downwards as the cycle progresses if she's only fed the one meal at preshot time. Saoirse had the opposite problem: if she fasted for too long, her numbers would really spike upwards because that little basal trickle was missing (impaired fasting blood glucose).

Fingers and paws crossed for empty compartments in the morning! (((Lily)))

:bighug:


Mogs
.
 
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