Re: 05/02 J.D. PMPS 282, +2 302
Dyana
I'm sorry....I've been out all day and just got back. We do walk the edge with Gracie but because we can....as Sienne said, one of us is here with her 24/7 if her numbers are running in the normal range and usually we are both here.
We have a feeding schedule for her; we don't feed every two hours although it may seem that way. Gracie is pretty different on lev than most cats I've seen. From what we can tell, and we've tried to look at her curves every
which way, she is often at her nadir from about +12 to +16 (which is +4 of the current dose). In other words, for her shot this morning, she is now coming down to nadir anywhere between +12 to 3 or 4 hours after the shot I will give her tonight.
Sometimes I think she might nadir around +12 and then get a second dip later.
We feed her at PS and then either +1.5 or +2 depending on where she is dropping. We also feed her at about +3; she typically starts back up at about +5 or so of the current dose and then onsets from the current dose at about +7.5/+8. Since the insulin is "strongest" at that time (using that word for lack of a better one), we feed her around onset (from +7/+8 or +10 sometimes). We try to space out her normal amount of food she should get for her caloric needs based on her lowest times but sometimes she throws us a curve and we have to feed more. We use 4% and 8% primarily but if she is coming down fast or she goes low (30s), we use 10%. We've figured out, for the most part, which mix slows her down, which gets her to surf, etc. Sometimes she does not respond the same way. One morning her AMPS will be 66 and I'll feed her 4% and she'll surf and the next time, the 4% sends her up. We try to correlate it with how fast the drop is....sometimes there is one, sometimes not. I never feed anything over 10% any more and am extremely judicious with the karo now....she only gets it if she drops low and won't come up immediately with her 10%. If/when she is high, I feed only 4%.
It's alot of food management in order to manage the extra insulin in her and should it be this hard? No. But Gracie has never been easy or normal and what we are doing now is working better than anything we've done before. Because she is only five years old, I want her in normal numbers as much as absolutely possible to save organ damage. We try to keep her above 40 but really prefer her to be above 50. When she's ready for a reduction, she lets us know by dropping into the 30s regardless of how we feed the curve. I don't reduce her in the 30s is if she has had a reduction some time in the previous six cycles because she is one who, for right now at this dose, the shed from the higher dose affects her at least six cycles. If her dose is right, she gets amazing overlap where I can barely tell where one cycle starts and one ends.
I'm sure this is way more than you wanted to know and it has taken alot of trial and error and we still goof it up sometimes. I do know that when Jill was helping Angela with Blackie, feeding the higher low carb food took time before Angela saw the curve flattening a little bit. So I don't think there is a change overnight. Blackie is not really a bouncer.
I think Sienne is right that Jill might be the one to best help you with this. I know what is working for Gracie right now. I certainly would not want someone to try what we do because (1) Gracie is really different and (2) we are here and we test alot because she doesn't mind and we agree that safety is first.
If you have any specific questions about how we are managing her, please let me know. And again a warning to anyone who is reading this: please do not assume that you can do as we do and keep your cat safe. We test alot and we know how Gracie responds to food. We also have a feel for her onset, nadir, and duration.
