01/28 Blackie PMPS 145

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Angela & Blackie & 3 Others

Angela & Blackie & 3 Others

Member Since 2010
Yesterday's condo:
viewtopic.php?f=9&t=62195&p=672831#p672831

MY WISH: For God to help those ailing make a full and speedy recovery... For God to help heal the broken hearts of those who lost a beloved pet and/or human... For everyone to have great #s... For everyone to be OTJ.
 
Re: 01/28 Blackie AMPS 148

copied and pasted from yesterday's condo:
Angela & Blackie & 8 Others said:
Jill & Alex said:
blackie's been on the same dose for about 2 months now. she's maintaining beautifully, but the range hasn't come down any further. if you'd like to pull her numbers down into the normal range for more hours in each cycle to afford her the best chance of remission you'll probably have to increase the dose. if you increase the dose, slacking off on testing won't be safe.
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To increase her dose would mean that she'd go below 50, and possibly below 40, which would mean that I would need to decrease the dose if she hits any # below 40. Again. Past history with a snack between +5 and PMPS, or vice versa, means that her PS #s go high. I tried that, and it didn't work for her. The data on her 2011 SS shows it. From December 13, 2011 - December 16, 2011 she had a snack at AMPS +8 and again at PMPS +4, and on December 17, 2011, her evening PS went right up to almost 190.

My goal is to hopefully get her diet controlled.
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you've given the current dose almost two months. you've more than given the dose a fair shake. you can see blackie has been maintaining status quo beautifully, but those ps numbers are not coming down as you would like.

angela, in order to progress an increase will be necessary. after two months at this dose, you can see blackie is stuck. when kitties get stuck in a situation like this using food manipulation to prevent kitty from dropping too low has proved to be very successful. when using food manipulation to control the curve you'd prop her up with food mid-cycle to prevent her from going too low in order to be able to hang onto the dose safely.

BUT... there's nothing wrong with maintaining status quo. blackie is doing very, very well. using food manipulation is just another method available to reach your goal.

let us know if we can be of any help...
 
Re: 01/28 Blackie AMPS 148

responding to angela's PM here:

yes, i agree with increasing the dose to a fat 1 unit to start.

when using food manipulation, you'll want to prevent lows from happening BEFORE they happen. i know you've worked very hard at coming up with the right diet and amounts fed. you don't want to have to end up feeding more than usual (although sometimes it does happen). what you want to do is feed the normal amount in each cycle. the difference is changing the times and/or the portion size blackie will be fed to prevent her from dropping too low. think of it as developing a strategy to avoid lows. this is where "knowing thy cat" comes into play. use what you already know about blackie to help you know when to feed.

here's some notes i wrote some time ago in mocha's condo. not all of the points apply to blackie, but they include some info you might be interested in.

why would you want to manipulate the curve with food?
--- bouncers: kitties who drop low and then bounce to the moon benefit from food manipulation. using food to manipulate the curve will tend to flatten out the curve. flattening out the curve helps to prevent huge bounces.
--- carb sensitive kitties: kitties who experience large food spikes when consuming even lc benefit from manipulating the curve with food. strategically spacing out meal times will help flatten out the curve.

why do i want to use food to flatten out the curve ?
--- flattening out the curve allows you to get as much insulin into the cat as safely possible without having kitty bottom out on you.
--- flattening out the curve *usually* allows you to hang onto a dose longer
--- flattening out the curve allows you to shoot higher doses of insulin than you would have been able to otherwise.

why would i want to get as much insulin as possible into the cat?
lantus and levemir are known to have a harder time bringing down higher numbers. more insulin helps bring down the higher numbers in a bouncer's cycle. more insulin will help counteract the spikes in a food spiker. using food to manipulate the curve will flatten out the curve and help keep your kitty safe.
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=23446&p=234616#p234616


hope this helps...
 
I've already PM'd Jill, but I'll cross post my comments and question in here:

I read your post on my condo, and unfortunately, I can't change her feeding schedule very much. She's on the following:

AMPS, +2, +3, +5, PMPS, +2, +3, +4.5

We live in a rural area where the nearest town is at least 21 miles away, and that's just a country town. The next major town is an hour away, where we need to go sometimes, and/or visit with friends. If I'm to stretch out her feeding schedule to putting a meal between the +5 and the PMPS, or sometime, that's simply not going to work, nor did it work for her.

I've reduced her food to 0.70 oz. 6x/day due to the lack of activity on her part (ie. she doesn't play, even if I try to instigate it). She's on Evo 95% Chicken & Turkey, which is 38.2 calories/oz. for a total of 160.44 cal/day. Her snack is reduced to 0.10 oz. 2x/day to try and lower the PS #s. I've reduced the snack yesterday, and won't eliminate it out her diet. I can't afford to reduce her Evo anymore, nor do I want to. If I feed her more food, she's going to go up. If that's the case, do I give her more insulin to counter that?
 
Hi Angela. Jill asked me to stop by -- she came down with the flu overnight and didn't want you to think she was ignoring your questions. Jill helped me with manipulating Gabby's curve with food so hopefully, I can answer your questions or give you some additional insight.

The idea here is not to change the overall amount that you're feeding (which is a good thing because Gabby can be rather ummmm..... "motivated" by food). Rather, you change the pattern/timing of when you feed. Let me use Gabby as an example. As you've probably seen, Gabby tends to dive early in the cycle and was much bouncier back at the end of April 2010. What we did was move Gabby's feeding times based on her Lantus onset and nadir. Gabby's onset is typically early, as is her nadir -- you can see her BG dropping often at +1 and her nadir is usually around +4. As a result, her food is front-loaded in the cycle. She's fed at pre-shot, +1, +2, and +3. She does get a small snack (if Gizmo doesn't eat it which I think happens more often than not) at +8 but that's more because she is prone to a bit of an acid stomach than trying to use the food to lower her pre-shot. Once you know when onset and nadir are, you can increase the dose so you see blue pre-shots and green during the cycle as a first step. You then use food, both your regular feeding and if necessary, some extra, to prevent your cat from getting a dose reduction. The idea here is you are trying to flatten out the cycle so you are getting mostly green. In Blackie's case, this would mean that you are looking to get the pre-shots to begin to drop into green.

One thing to be aware of. Making changes in the food pattern does not result in an immediate effect. I changed how I was dosing/feeding on 4/30/2010. It took about 2 months before I saw any results. Michelle is using this approach with Mannie and Patty has just started this process with Champ.

I hope this helps. Let me know if you have questions.
 
Recap:

AMPS 148, 1u, 0.70 oz. Evo 95% C&T
+2 - 0.70 oz. Evo 95% C&T
+3 - 0.70 oz. Evo 95% C&T
+5 - 0.10 oz. raw turkey cutlet
PMPS 145, 1u, 0.70 oz. Evo 95% C&T
+2 - 0.70 oz. Evo 95% C&T
+3 - 0.70 oz. Evo 95% C&T
+4.5 - 0.10 oz. raw turkey cutlet
 
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