? 8/10 Ivy amps 326, +3.25 99, +4 195, +6 279, +7 318+10 279 PMPS 380, +2 379 Fast Drop/Bounce

Staci & Ivy

Staci & Ivy

Member Since 2022
https://www.felinediabetes.com/FDMB/threads/8-9-ivy-amps-234-2-207-4-257-6-228-dose-increase.280345/
Day 2 on Increased dose of 2.5 units Lantus, SLGS. Watching her on Libre sensor. ) Will test with handheld meter if she drops very low)
Ivy stayed high yesterday on increased dose.
*Began a fast drop this AM cycle at +2 and still dropping fast.
I guess the dose is kicking in today?
Fed regular diet (lamb 12.5% homemade) snacks this am at +1, 2, 2.5.
At +3 (added bit of FF 13% and drop of karo). Still dropping. (She’s not too carb sensitive at all)

Looks like this am will be a battle to keep her boosted. Would love to see her surf a bit and stop diving.

Anything I can do other than give snacks till she gets past this dive?
How often is advised to feed while this goes on to keep her from earning a reduction?

She’s a real bouncer as we know.
@Wendy&Neko @carfurby (GA) @Sienne and Gabby (GA) @Ale & Bobo & Minnie (GA)
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Feeding her to keep her surfing is the best thing you can do. Just feed a teaspoon at time so she doesn't get full in case you need to keep feeding her. I don't know how often you get readings from the libre, but it you were testing I'd suggest testing every 30 minutes until she flattens out and stops dropping or starts going back up. Feed a teaspoon each time until she starts going back up.

@Bandit's Mom Are you around? Can you keep an eye on Ivy? I can't stay on the board much longer.
 
carfurby (GA) said:
Feeding her to keep her surfing is the best thing you can do. Just feed a teaspoon at time so she doesn't get full in case you need to keep feeding her. I don't know how often you get readings from the libre, but it you were testing I'd suggest testing every 30 minutes until she flattens out and stops dropping or starts going back up. Feed a teaspoon each time until she starts going back up.

@Bandit's Mom Are you around? Can you keep an eye on Ivy? I can't stay on the board much longer.
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Ok that’s good to know about feeding frequency.
The Libre 3 sensor is constant monitoring so I can see what’s happening. (You look on the app and don’t even have to scan the device). :bighug:
 
And now at +7 she bounced up to 317 (Libre).
Back to pink from a fast drop to lower blue this am.
Hope she waits until tomorrow to break this bounce and not all night tonight.
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Well, she certainly likes to bounce.

One observation... The drop from +1 to +2 was sizable (152 points). Generally, you would expect to see numbers rising until +2 due to the AM dose not yet kicking in and the dose from the previous cycle wearing off plus you just fed Ivy. If you see that numbers are dropping by a sizable amount at +2, you might want to try a slightly higher carb food in order to flatten out the curve a bit.
 
Sienne and Gabby (GA) said:
Well, she certainly likes to bounce.

One observation... The drop from +1 to +2 was sizable (152 points). Generally, you would expect to see numbers rising until +2 due to the AM dose not yet kicking in and the dose from the previous cycle wearing off plus you just fed Ivy. If you see that numbers are dropping by a sizable amount at +2, you might want to try a slightly higher carb food in order to flatten out the curve a bit.
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@Sienne and Gabby (GA)
Yes she’s a dive queen.
She’s already eating a 12.5% homemade carb diet, because she is not carb sensitive.
(When I was feeding low carb 6% I could barely get a rise at all.)
What would you advise percentage carb I would feed when I see those drops? (She does these nosedives constantly by the way).
She’s also starting to dive again at end of her cycle, we are 1.5 hours from feed/shot.
I gave her a tsp of FF 13% mc and a few drops karo about 2 hours prior to shot time coming up. But she’s dropping again.

**What is the latest time before a feed/ shot I can give her a tsp of food & or karo to try to stop her drop so she doesn’t go so low that I can’t give her her insulin???
 
Keep in mind that there can be a 20% variability with the reading of any test. The drop from +11 to PMPS on Thursday wasn't really a "drop" that I would be worried about. The 306 and 280 were essentially the same number.

Some cats also have a "double dip" toward the end of the cycle. They may not drop as low as their nadir but there's a drop late in the cycle. To be honest, I don't know that I would get hung up on the dip unless you see a trend for numbers to keep dropping. Remember, you're going to be feeding Ivy and the insulin from the previous cycle is wearing off.

I do suspect that some of what makes this more challenging for you is how much data you're collecting. Most people don't get readings every hour.

You can give food at any time providing the numbers dictate it. I doubt that I'd offer food unless numbers were below the reduction point.
 
Sienne and Gabby (GA) said:
Keep in mind that there can be a 20% variability with the reading of any test. The drop from +11 to PMPS on Thursday wasn't really a "drop" that I would be worried about. The 306 and 280 were essentially the same number.

Some cats also have a "double dip" toward the end of the cycle. They may not drop as low as their nadir but there's a drop late in the cycle. To be honest, I don't know that I would get hung up on the dip unless you see a trend for numbers to keep dropping. Remember, you're going to be feeding Ivy and the insulin from the previous cycle is wearing off.

I do suspect that some of what makes this more challenging for you is how much data you're collecting. Most people don't get readings every hour.

You can give food at any time providing the numbers dictate it. I doubt that I'd offer food unless numbers were below the reduction point.
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I get worried when I see her starting to dive around +10 and I want to keep her at a number where I can give insulin when it’s time 2 hours after that dive begins.
*I think you are saying I could give a small snack if she’s diving at any point (even in that “no food 2 hour window”) if the numbers are trending down at a fast rate? Is this correct?
 
It's not quite what I'm saying. I followed TR. If Gabby's numbers were in the 40s even if it was +11, I gave her high carb food to bring her numbers up. It wasn't a matter of bringing her numbers up high enough so I could shoot. Her numbers were low.

Those of us who follow TR will eventually shoot any number over 50. You're trying to second guess what's happening with the numbers. While you have tons of data, I'm not sure that the data you have gives you the answers to the question you're asking.
 
Sienne and Gabby (GA) said:
It's not quite what I'm saying. I followed TR. If Gabby's numbers were in the 40s even if it was +11, I gave her high carb food to bring her numbers up. It wasn't a matter of bringing her numbers up high enough so I could shoot. Her numbers were low.

Those of us who follow TR will eventually shoot any number over 50. You're trying to second guess what's happening with the numbers. While you have tons of data, I'm not sure that the data you have gives you the answers to the question you're asking.
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I’m not sure what you mean. (I’m so sorry if I’m being dense and mean no disrespect) @Sienne and Gabby (GA)
Please explain this sentence:
“While you have tons of data, I'm not sure that the data you have gives you the answers to the question you're asking.”
And how does it differ since I follow SLGS?
 
From what it sounds like, you get a reading that is indicative of a dropping numbers. However, in some cases, the numbers are not low enough to warrant a dose reduction. You may intervene with higher carb food to try and flatten out the curve. That's fine. However, you don't always know if the numbers would continue to drop. Going back to Thurs., you had a reading of 306 at AM +11. At PMPS, the reading was 280. I would not have been worried about the numbers continuing to drop since Ivy was still in a range that was very safe to shoot. As it was, her +1 was back in the 300s.

I would not be getting concerned about numbers being problematic at shot time unless you were seeing numbers that were in the lower 100s and trending down at shot time. Even then, you could shoot anything over 90 and just monitor closely to be sure you know where numbers are heading. It takes a while to get comfortable with shooting lower numbers. I'd encourage you to work at getting confident with shooting progressively lower numbers since keeping Ivy in blues and greens is that best way to get her curve into normal range.
 
Sienne and Gabby (GA) said:
From what it sounds like, you get a reading that is indicative of a dropping numbers. However, in some cases, the numbers are not low enough to warrant a dose reduction. You may intervene with higher carb food to try and flatten out the curve. That's fine. However, you don't always know if the numbers would continue to drop. Going back to Thurs., you had a reading of 306 at AM +11. At PMPS, the reading was 280. I would not have been worried about the numbers continuing to drop since Ivy was still in a range that was very safe to shoot. As it was, her +1 was back in the 300s.

I would not be getting concerned about numbers being problematic at shot time unless you were seeing numbers that were in the lower 100s and trending down at shot time. Even then, you could shoot anything over 90 and just monitor closely to be sure you know where numbers are heading. It takes a while to get comfortable with shooting lower numbers. I'd encourage you to work at getting confident with shooting progressively lower numbers since keeping Ivy in blues and greens is that best way to get her curve into normal range.
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Ok I see what you are saying. What sometimes happens is I see a downward trend (on the Libre) and can see she’s beginning a drop. Once she starts, it becomes a fast drop. She does have a history of dropping at +10 & +11.
And knowing how hard it is to bring her up with carbs, and I want to be able to give her the insulin when it comes to shot time I don’t want her dropping too low for me to give the shot.

I think what you’re saying is let her go lower (and shoot lower numbers) and unless she actually drops to lower 100s /lower numbers which are too low to shoot, then deal with it at that point.

I have hesitation in letting her drop low because it’s so hard to pull her back up with carbs. And I want to try not to have to miss giving a shot.
Thank you for explaining this to me. I appreciate your taking the time. :bighug:
 
It's important that you know your cat! I suspect that focusing on getting Ivy into an overall lower range will help since the drops won't be as dramatic. To the degree that you can, try to let her surf in lower numbers. The more time she spends closer to normal range, the more she'll get used to being in that range. Her liver and pancreas "panic" since she's not used to spending time in lower numbers. The more time she's in a better range, the more her body will get reacquainted with better numbers, bounce less, etc.

It may help to remember that with TR, the reduction point (50 for a cat in the year after diagnosis, 40 thereafter) is lower than with SLGS and is still considered safe. Don't be fearful of lower numbers (as long as your cat is safe).
 
Sienne and Gabby (GA) said:
It's important that you know your cat! I suspect that focusing on getting Ivy into an overall lower range will help since the drops won't be as dramatic. To the degree that you can, try to let her surf in lower numbers. The more time she spends closer to normal range, the more she'll get used to being in that range. Her liver and pancreas "panic" since she's not used to spending time in lower numbers. The more time she's in a better range, the more her body will get reacquainted with better numbers, bounce less, etc.

It may help to remember that with TR, the reduction point (50 for a cat in the year after diagnosis, 40 thereafter) is lower than with SLGS and is still considered safe. Don't be fearful of lower numbers (as long as your cat is safe).
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I’m trying to get her to those lower numbers and getting her to surf there.
It makes it hard since she is such a bouncer and goes so high then has so far to drop and she does it so fast. It’s terrifying. plus she’s not carb sensitive to LC foods at all.
It seems to take more to get her to boost up.

Is there a different reduction point for SLGS after 1 year as with TR?
 
There's no change in the reduction point with SLGS. SLGS applies to any insulin -- not just Lantus. It's a "generic" approach to dosing. TR is based on a study that was published in a leading vet journal.
 
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