06/02 JELLY BELLY +11 180 PMPS 180 PLEASE advise +2 61.5 HELP

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Hi Rochelle

I’m sorry I haven’t had a chance to check in. I read the condo when I first got up, and yes....I was the SS pixie and fixed it. However, then got a call that my mom has bronchitis so I’ve had to be dealing with that until now.

Lovely cycle stacking up here for Jelly especially after the skip last night.

RochellenJelly said:
i am just starting to understand the cycle and havent even figured out all the different carb amounts and have been trying to collect accurate BG and have a good picture for people to help me and when in trouble post and have been getting instruction and been ok. I dont think i can say i fully understand the cycle and the dropping in points so much yet at all because i dont i get scared of 5.3 and stuff so i am not nearly educated enough to decide on carb amounts and what to give him i am better following instructions for that stuff right now
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First....what can you tell me about what you’ve learned about Jelly and how carbs affect his numbers? I think you can look at his SS and know easier than we can because we don’t know what you’ve fed him. It can be very, very helpful to keep track of what you feed him when (you can use the Remarks section on the SS) so the next time he drops, you will know what you did, and how it affected his BG.

You also asked about when to worry about numbers. I’ll try to explain it clearly although it can vary cat to cat and cycle to cycle.

For others reading, this information is for Jelly and Rochelle so if you have specific questions about your kitty, don’t just assume this applies (it might, but it might not) so please ask for guidance about your kitty.

Some guidance I can give you is:
  • If you test and he’s dropping, study his SS to determine what his normal pattern is, when he likes to drop, how fast he drops, etc. before you determine if it’s ok to go out and be out a while or go to bed. However, dropping numbers require attention at some point so I would suggest you not leave a dropping number unattended without some action (e.g. either planning to test again in an hour or two or leaving him LC food and a Temptation, because those work well for him)
  • If he’s clearing a bounce, it is likely that the lowest part of his cycle will not be mid cycle but will be at the end of the cycle (+12) or even past it. Don’t expect that because he gets past +6 without dropping lower, that it will continue that way. Jelly’s cycle yesterday morning is a great example of this. Look at it closely and see how he just kept dropping all day long.
  • The BG you get at different times in the cycle might need a different action. Look at the examples below:
    • AMPS 282 +2 180 +3 70
    • AMPS 282 +2 246 +5 182 +9 70
    • AMPS 101 +2 92 +4 70
    • AMPS 101 +2 92 +5 83 +6.5 70 +10 84
In all four cycles above, you see a 70. Would you react the same way in all four examples? No, you wouldn’t. Here’s why:
    • In the first cycle, this kitty is clearing a bounce and doing it quickly. The +2 tells the CG that this is going to be an active cycle and because it is so much lower than the AMPS, it’s likely going to be active soon. Wisely, this CG tested at +3 and the kitty had also onset. But, if this CG was really smart, when she got the +2, she probably would have wanted to feed a really good helping of a higher LC food (maybe 10% depending on how her kitty responds to carbs) so she could slow the drop and also have some food on board for the onset at +3 when the number really dropped. Also, at +3 with a 70, she probably wants to even give a little MC to try and get the kitty to flatten out and stop dropping. If this was Jelly, I bet a Temptation with his LC would really help.
    • In the second cycle, this kitty is also clearing a bounce, but he’s doing it fairly slowly (yay!). At +9, he’s getting towards the end of the cycle but we want to be sure he doesn’t keep dropping so much that he’s below 50 at PMPS and the CG then has to stall or skip. For this kitty, a small helping of LC food might keep him surfing along in green without putting a screeching stop on his duration.
    • In the third cycle, this is a pretty flat cycle so even though the kitty is 70 early in the cycle, a small amount of LC food might just keep him surfing along in those nice green numbers until he nadirs and slowly starts back up.
    • In the fourth cycle, the CG would just feed regular LC meals at whatever schedule the kitty normally gets them but would not need to feed after +5 at the latest. Kitty has a nice nadir at +6.5 and then starts back up. Lovely.
Do you see the difference in these cycles and how a number like 70 can either require alot of management (e.g. food) and attention (e.g. testing sooner rather than later) by the CG, some management, or even no management. This is why we can’t tell you a specific number that you have to worry about except, in most cases, a kitty below 50 needs attention (food and regular testing). A very, very experienced CG with a very flat and tightly regulated kitty might not worry about a 50 but for most, a 50 means you must manage the curve with food and testing right then. And anything below that definitely requires immediate attention.

What I’d like to see as a goal for you and see you doing starting tonight, is making your own schedule and proposing to us when you should test. It’s not possible to make a schedule for all day or even all cycle because we don’t always know which way it will go. But you can make your schedule for at least half a cycle at a time based on the numbers you have. I think it would be an excellent learning tool.

BTW, if Jelly was my kitty and had dropped 60 mg/dL in two hours to 95, I’d be testing a lot sooner than +9 or +10. Just sayin. He might be just fine but you don’t have enough data yet to know that. There might be a time when you do, but, personally, I don’t think it’s now.

Two other quick things:
  • again, it is really, really important that you keep the subject line updated; I explained it in yesterday’s condo so please reread my post #69.
  • although Kris had you delete the numbers on the US SS, if you delete them there, you will lose the formatting and they will not auto populate when you then put the numbers in the World SS. It's important to enter your numbers on the World SS and let them auto convert.
Have a great day and please let me know if you have questions. Again...I know it’s a lot of info but I wanted to try and answer your question with examples.
 
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This a great guide, Marje. I will say, though, that the concept of "clearing a bounce" isn't easily grasped at the start of an FD journey.
 
Kris & Teasel said:
This a great guide, Marje. I will say, though, that the concept of "clearing a bounce" isn't easily grasped at the start of an FD journey.
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True. Good point.

Rochelle: I’m pretty sure, from what you’ve said before, you understand the concept of a bounce. When a kitty bounces (to keep it short and simple), the liver and pancreas dump extra substances in the blood to raise the blood glucose. It can take up to six cycles for these substances to clear the bloodstream and for the BG to fall. Some cats clear in one cycle, as Jelly has been doing. I’ve actually seen a few cats take as much as ten cycles to clear.

When a kitty “clears the bounce”, then as the extra substances leave the bloodstream, the BG comes down. Sometimes (very often, actually), it comes down very fast and, instead of a lantus nadir more around mid-cycle, it might be more at the next preshot. Bounce clearing cycles are almost always very active cycles. So if kitty starts at a higher PS and has a +2 that is similar or less than the PS, he/she is likely to clear the bounce and come down quickly. Bounce clearing cycles bear watching closely for many cats!

I do not think Jelly is clearing a bounce today as you skipped last night. He might have gone a little lower last night but he was likely flat at the end of the cycle and through this morning.
 
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Marje and Gracie said:
True. Good point.

Rochelle: I’m pretty sure, from what you’ve said before, you understand the concept of a bounce. When a kitty bounces (to keep it short and simple), the liver and pancreas dump extra substances in the blood to raise the blood glucose. It can take up to six cycles for these substances to clear the bloodstream and for the BG to fall. Some cats clear in one cycle, as Jelly has been doing. I’ve actually seen a few cats take as much as ten cycles to clear.

When a kitty “clears the bounce”, then as the extra substances leave the bloodstream, the BG comes down. Sometimes (very often, actually), it comes down very fast and, instead of a lantus nadir more around mid-cycle, it might be more at the next preshot. Bounce clearing cycles are almost always very active cycles. So if kitty starts at a higher PS and has a +2 that is similar or less than the PS, he/she is likely to clear the bounce and come down quickly. Bounce clearing cycles bear watching closely for many cats!

I do not think Jelly is clearing a bounce today as you skipped last night. He might have gone a little lower last night but he was likely flat at the end of the cycle and through this morning.
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he was only 10 at +11 and now at his PMPS .... i stalled no food not coming up ? do i shot?
 
Marje and Gracie said:
True. Good point.

Rochelle: I’m pretty sure, from what you’ve said before, you understand the concept of a bounce. When a kitty bounces (to keep it short and simple), the liver and pancreas dump extra substances in the blood to raise the blood glucose. It can take up to six cycles for these substances to clear the bloodstream and for the BG to fall. Some cats clear in one cycle, as Jelly has been doing. I’ve actually seen a few cats take as much as ten cycles to clear.

When a kitty “clears the bounce”, then as the extra substances leave the bloodstream, the BG comes down. Sometimes (very often, actually), it comes down very fast and, instead of a lantus nadir more around mid-cycle, it might be more at the next preshot. Bounce clearing cycles are almost always very active cycles. So if kitty starts at a higher PS and has a +2 that is similar or less than the PS, he/she is likely to clear the bounce and come down quickly. Bounce clearing cycles bear watching closely for many cats!

I do not think Jelly is clearing a bounce today as you skipped last night. He might have gone a little lower last night but he was likely flat at the end of the cycle and through this morning.
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hes only 10 at +12 and his PMPS i didnt fed now what?
 
Good job, Rochelle!

There was no reason to not shoot....he was on the way up. Can you please update the SS, etc? Thank you!!!

I'll check in later....just got home from a meeting and need to get my kitties fed and my dinner.
 
RochellenJelly said:
please help 61.2 gave gravy food ..... ugh scared
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Hi Rochelle,

How much gravy food did you give ? You don't want to give much because he might need more in small amounts. You don't want to fill him up. Test again in 20 minutes and post here right away.

I should be in bed by now. I hope Marie checks in soon. I'll stick around for now.
 
Kris & Teasel said:
Hi Rochelle,

How much gravy food did you give ? You don't want to give much because he might need more in small amounts. You don't want to fill him up. Test again in 20 minutes and post here right away.

I should be in bed by now. I hope Marie checks in soon. I'll stick around for now.
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2 teaspoons he's ok not showing low signs and will test in 15 minutes that's +3.5 because we didn't shoot till eight as I felt he was low at 10 am didn't get higher after i stalled so I fed and shot and studen huge drop
 
It's showing here
 

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I see it now - another 3.4 on the "world" SS. So his BG is holding for now. Try giving him a teaspoon of mostly gravy from the gravy food. Wait 20 minutes and retest. His poor ears won't like it but safety first!
 
RochellenJelly said:
Ok we are good he's going up phew...... ok what now ? 4.6 or 83 ..... so more food ? How often can we sleep ? More tests
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What was the time of that test that gave this number? Was it +4? The number is higher because of the gravy food and treats. You're not out of the woods yet.

You need to get to the point where his BG levels out without food to prop it up. Once it's holding on its own or even rising, you can stop the frequent testing. He still fairly far from his nadir time.
 
Yes his +4 was that last reading he's not had anymore food when should I test again or feed again ? I have autofeeder now and can set alarm to test him and I am ok with that better safe then sorry
Kris & Teasel said:
What was the time of that test that gave this number? Was it +4? The number is higher because of the gravy food and treats. You're not out of the woods yet.

You need to get to the point where his BG levels out without food to prop it up. Once it's holding on its own or even rising, you can stop the frequent testing. He still fairly far from his nadir time.
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++
 
OK. So he was 4.6 at +4 and he hasn't had any more food. Try this: no more food and test again in 20 minutes. You need to know if he's going to start dropping again.
 
Kris & Teasel said:
OK. So he was 4.6 at +4 and he hasn't had any more food. Try this: no more food and test again in 20 minutes. You need to know if he's going to start dropping again.
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Ok will you be here or if you need to go one of your lists would be great .... but please include worst case plan and actions or I will surely drop the bomb
 
RochellenJelly said:
Ok will you be here or if you need to go one of your lists would be great .... but please include worst case plan and actions or I will surely drop the bomb
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There won't be a worst case because you know what to do.

  • Give very small amounts of high carb food at about 20 minute intervals after you've tested BG beforehand.
  • Keep an eye on the time so you know how close to nadir range he is - usually +5 to +7-ish.
  • If the tests show the BG is fairly level or rising slightly you can try not feeding, wait 20 minutes and test (a no food test).
  • If the no food test shows that the BG hasn't dropped or, even better, is rising slightly you can wait an hour before doing another NO FOOD test.
  • If the one hour test shows a level BG or a rise, you can probably leave the autofeeder to do it's work.
 
Kris & Teasel said:
There won't be a worst case because you know what to do.

  • Give very small amounts of high carb food at about 20 minute intervals after you've tested BG beforehand.
  • Keep an eye on the time so you know how close to nadir range he is - usually +5 to +7-ish.
  • If the tests show the BG is fairly level or rising slightly you can try not feeding, wait 20 minutes and test (a no food test).
  • If the no food test shows that the BG hasn't dropped or, even better, is rising slightly you can wait an hour before doing another NO FOOD test.
  • If the one hour test shows a level BG or a rise, you can probably leave the autofeeder to do it's work.
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Ok I can do this thank you so much
 
Sorry girls.....I'm at urgent care using iPhone. Didn't forget you but Sliced a chunk off my finger. Waiting to get stitches.

You're doing great. Fixed SS while waiting (thankfully cut my left hand, not right).

Rochelle...please reduce dose to 0.5u in morning .

Not sure what time I'll be home but will at least check in tomorrow. Good luck.
 
Marje and Gracie said:
Sorry girls.....I'm at urgent care using iPhone. Didn't forget you but Sliced a chunk off my finger. Waiting to get stitches.

You're doing great. Fixed SS while waiting (thankfully cut my left hand, not right).

Rochelle...please reduce dose to 0.5u in morning .

Not sure what time I'll be home but will at least check in tomorrow. Good luck.
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Ouch marje! Sending vines.


Morning Rochelle, I'm just getting up. So I can hang with you till JB is safe.

Can you tell me when was the last time you fed him gravy or devil treats?

The gravy can take about two hours to clear the system, and when it does the blood sugar can drop.

So we need to make sure his numbers are staying up without extra carbs/gravy.

So far
You got
  • Shot at 8

  • 61@ +2 (10pm)gravy and 3 temptations
  • 61@ +3.5(11.30pm) gravy
  • 83@+4 (midnight)

Is the above correct? A list of when you tested, what you got and what you fed would be really helpful.

Please get a test at +4.5.

He's not out of the woods yet.
 
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Gill & George said:
Ouch marje! Sending vines.
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Thanks, Gill. Wasn’t sure when you’d be up. I’m back.....five stitches and tetanus. Such a klutz.

I’m not sure if @RochellenJelly is still checking the condo but hope she sees to reduce the dose to 0.5u in the morning. Also....Rochelle, since you shot at 8 tonight, you will need to shoot at 8 in the morning unless he is back in pink at +11. If he is pink at +11 (7 a.m. your time), you can shoot an hour early at 7 and get back on schedule.

Enough adventure for me...I’m headed to bed. Nighty night.
 
Marje and Gracie said:
Sorry girls.....I'm at urgent care using iPhone. Didn't forget you but Sliced a chunk off my finger. Waiting to get stitches.

You're doing great. Fixed SS while waiting (thankfully cut my left hand, not right).

Rochelle...please reduce dose to 0.5u in morning .

Not sure what time I'll be home but will at least check in tomorrow. Good luck.
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So sorry about you finger Marje!
 
I did what I could last night before I crashed myself. I hope it went OK. I know Rochelle's internet was down from a storm and she was using her phone to communicate.
 
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