? 1/2 - Bandit - PMPS 513 - New dose wonkiness?

[Bandit's Mom]

Bandit is at 513 at PMPS today. She is rarely above 400. We've completed 5 cycles of the new dose (1.75U). Is this new dose wonkiness?

The only time she was above 500 was when she went to the vet last week and one day when she ate her sister's HC kibble.

Really scary to see such a high number! Could use some inputs on what this could be!

 

[Bandit's Mom]

@MrWorfMen's Mom could you please, please take a look at Bandit's SS and see if you are able to make any sense of the numbers? You've had experience with attempting to regulate a kibble addict. I feel like her numbers are only going up! We are seeing blacks now where we barely saw reds a month back when we started her on insulin!

what are we doing wrong? i am beginning to seriously panic now.

We changed her from a 26% carb kibble (which had corn gluten and oats) to a 16% grain-free kibble (which has sweet potato/potato but claims to have a low glycemic index!) from Dec 26th. wondering if that has made matters worse.

Hoping to transition her to YA zero carb kibble from next wednesday when I get some from the US. canned food is still something Bandit eats only very sporadically. she doesn't seem to care for any of the canned food available here (probably doesn't like fish and all of them are fish based).

 

[MrWorfMen's Mom]

Deep breathes. I really don't think Bandit's numbers are worse...they're different. It also doesn't look to me like the change to 16% carbs from the 26% has made an appreciable difference either way. I had the same experience with my girl when I switched her to lower carb dry food.....it didn't seem to make much if any difference in her numbers. It's quite possible that Bandit reacts more to sweet potato than she does to the corn gluten and oats, cancelling out the effects of the carb difference. I think some of the reason for those black numbers is bouncing from large BG drops during the cycles. On a number of days, Bandit has dropped over 100 points in 2 to 3 hours and that can set off some bouncing to higher numbers. Some cats are just bouncier than others.

You've been methodically changing doses albeit a little faster than prescribed for SLGS but with the kibble in play, the dose needed to regulate Bandit is going to be higher than if she was on a low carb wet diet. I'd continue to follow SLGS and doing increases as needed and eventually you will start to see better numbers but you may have to take the dose up a fair bit more before you start getting the nadirs down to some blues and greens.

 

[Bandit's Mom]

Deep breathes. I really don't think Bandit's numbers are worse...they're different. It also doesn't look to me like the change to 16% carbs from the 26% has made an appreciable difference either way. I had the same experience with my girl when I switched her to lower carb dry food.....it didn't seem to make much if any difference in her numbers. It's quite possible that Bandit reacts more to sweet potato than she does to the corn gluten and oats, cancelling out the effects of the carb difference. I think some of the reason for those black numbers is bouncing from large BG drops during the cycles. On a number of days, Baratndit has dropped over 100 points in 2 to 3 hours and that can set off some bouncing to higher numbers. Some cats are just bouncier than others.

You've been methodically changing doses albeit a little faster than prescribed for SLGS but with the kibble in play, the dose needed to regulate Bandit is going to be higher than if she was on a low carb wet diet. I'd continue to follow SLGS and doing increases as needed and eventually you will start to see better numbers but you may have to take the dose up a fair bit more before you start getting the nadirs down to some blues and greens.

thank you for writing back. i keep tell myself this is a marathon and not a sprint but then i see a black number and i FREAK OUT. it doesn't help that bandit is still highly symptomatic. when her sugar falls below 300 she is fine, but i can almost predict the reading i am going to get when she goes to the litter box and pees a bucket!

i too wondered if the sweet potato/potato would cancel out the effects of the carb difference though i hoped that wouldn't be the case.

as far as dose increase goes, the latest increase to 1.75 was a little sooner than 14 cycles by mistake. but then i decided to go ahead anyway because she wasn't falling significantly below 200.

i will start her on the YA zero carb kibble next wednesday and like any food transition, I will spread it out over a week (25% new food, then 50%, 75% and 100%). i expect (or hope) her BGs to come down significantly and I was hoping you could guide me on how to adjust the dose downwards - as per SLGS and TR, dose reductions are in batches of 0.25, but what if Bandit's insulin requirements are significantly lower than 1.75 (current dose) - 0.25 at the end of the week?

i also read somewhere that taking a cat off insulin cold turkey (without gradual reduction) could affect its chances of remission or rather increase chances of relapse after remission.

of course, all of this is premised on the hope that the YA kibble will cause her to go into remission at some point!

 

[MrWorfMen's Mom]

You are testing enough to keep the food transition safe so I wouldn't be too concerned there. Let Bandit's BG readings be your guide as you make the food transition slowly as you've suggested and if BG drops below 90, decrease the dose by 0.25u. The higher carb food may take a few days to totally stop influencing numbers so be patient and don't expect an immediate drop but be prepared for it.

We recommend reducing the insulin dose gradually to provide support to the pancreas for as long as possible to ensure a strong remission but the numbers have to be your guide and any dosing is done with safety first. Take it one day at a time. The reduction of carbs should improve numbers but it doesn't guarantee remission.

 

[Bandit's Mom]

You are testing enough to keep the food transition safe so I wouldn't be too concerned there. Let Bandit's BG readings be your guide as you make the food transition slowly as you've suggested and if BG drops below 90, decrease the dose by 0.25u. The higher carb food may take a few days to totally stop influencing numbers so be patient and don't expect an immediate drop but be prepared for it.

We recommend reducing the insulin dose gradually to provide support to the pancreas for as long as possible to ensure a strong remission but the numbers have to be your guide and any dosing is done with safety first. Take it one day at a time. The reduction of carbs should improve numbers but it doesn't guarantee remission.

thank you! will do. will seek you out for your advice/inputs when i get there.

 

[Wendy&Neko]

To answer the question in your subject line, New Dose Wonkiness typically happens around cycle 2-3 after the dose increase. That black you saw was more likely a bounce, from either the steep drops the cycle or two before that, or going lower than she was used to.

Are you switching her sister to lower carb kibble too? So you don't have problems with Bandit raiding it.

i also read somewhere that taking a cat off insulin cold turkey (without gradual reduction) could affect its chances of remission or rather increase chances of relapse after remission.

It is the experience we have seen here. The injured beta cells in the pancreas benefit from healing time, where the injected insulin does the work to put kitty into normal numbers, so those pancreas cells can rest and recover. You might want to read this post, starting around post 17 for discussion of strong remissions.

 

[Bandit's Mom]

To answer the question in your subject line, New Dose Wonkiness typically happens around cycle 2-3 after the dose increase. That black you saw was more likely a bounce, from either the steep drops the cycle or two before that, or going lower than she was used to.

Are you switching her sister to lower carb kibble too? So you don't have problems with Bandit raiding it.

It is the experience we have seen here. The injured beta cells in the pancreas benefit from healing time, where the injected insulin does the work to put kitty into normal numbers, so those pancreas cells can rest and recover. You might want to read this post, starting around post 17 for discussion of strong remissions.

Do I have to be concerned that her bounces are taking her into the black these days? Even high reds were a rarity for Bandit earlier.

I have to get friends coming from the US/Singapore (where it is available) to get me the YA low carb kibble for Bandit. Just getting enough for Bandit for the rest of her life is quite the challenge. So her sister (Budge) will continue to have be on food that is available in India. The good thing is that Budge is a glutton, so she is happily eating all Bandit's "rejects" i.e. all the wet food available here that Bandit refuses to touch. So going forward, Bandit would be on the YA zero carb kibble and Budge would be on locally available canned food (and kibble should she get bored of canned food). Budge never leaves anything in her bowl for Bandit to raid! It's always the other way around.

(That one occasion that Bandit ate Budge's kibble was our mistake. In her sleep, my sister fed Bandit, Budge's kibble when she asked to be fed at 2am or so. Automatic feeders are another thing that are not available here! And right now I am using all my goodwill with friends/family living in the US to source 1/2 unit syringes and YA kibble! Don't dare to ask for an automatic feeder! )

And thank you, I will read the thread on strong remission. Don't want to screw-up her chances when transitioning her to the YA kibble.

She was at 207 at AMPS today (on the same feeding schedule as every day). She is ALL OVER THE PLACE these days. Hopefully, I will get some kind of decipherable pattern once she is on the YA kibble.

 

[Wendy&Neko]

Awesome AMPS! As ugly as the black bounces are, try to ignore them as long as she doesn’t stay there. When they happened to me, it helped if I thought of them as a reaction/sign I was finally getting my girl into better numbers.

 

[Bandit's Mom]

Awesome AMPS! As ugly as the black bounces are, try to ignore them as long as she doesn’t stay there. When they happened to me, it helped if I thought of them as a reaction/sign I was finally getting my girl into better numbers.

106 at +3. Am now s***ing bricks. Have to leave home. Delayed it by an hour so I can test at +4.

Was mixing two variants of the grain-free kibble - chicken/potato & herring/sweet potato (same carb %, calories etc. just different ingredients). Took out the potato one last night and she is only on the herring/sweet potato kibble. Maybe she doesn't react to sweet potato as much as potato. Wondering how else to explain these low numbers.

Oh, what a mother of all bounces I can expect after this!

 

[Si am cat mom]

106 at +3. Am now shitting bricks. Have to leave home. Delayed it by an hour so I can test at +4.

Was mixing two variants of the grain-free kibble - chicken/potato & herring/sweet potato (same carb %, calories etc. just different ingredients). Took out the potato one last night and she is only on the herring/sweet potato kibble. Maybe she doesn't react to sweet potato as much as potato. Wondering how else to explain these low numbers.

Oh, what a mother of all bounces I can expect after this!

that's a start
hopefully she starts to level out more and more. I am sure once the lower carb food switch happens it will help

 

[Wendy&Neko]

What a great cycle!

 

[Bandit's Mom]

What a great cycle!

yes, best so far. hopefully not a flash in the pan.

 

[Bandit's Mom]

You are testing enough to keep the food transition safe so I wouldn't be too concerned there. Let Bandit's BG readings be your guide as you make the food transition slowly as you've suggested and if BG drops below 90, decrease the dose by 0.25u. The higher carb food may take a few days to totally stop influencing numbers so be patient and don't expect an immediate drop but be prepared for it.

We recommend reducing the insulin dose gradually to provide support to the pancreas for as long as possible to ensure a strong remission but the numbers have to be your guide and any dosing is done with safety first. Take it one day at a time. The reduction of carbs should improve numbers but it doesn't guarantee remission.

@MrWorfMen's Mom how long does kibble take to spike blood sugar in the kitty? I presume it depends on carb % in the kibble? And how long does it take to pass through the system? I'm trying to see if I can "manipulate" Bandit's curves with food during the transition to YA zero kibble. She is on a significantly high dose (1.75U) for zero carb kibble and I don't want her falling hard. Ideally would like to ease her down the decrease in dose from 1.75 to wherever she ends up over a few weeks. Don't want to take more than one dose decrease (of 0.25) per week.

Do I make sense?

 

[MrWorfMen's Mom]

How a kitty reacts to carbs is an individual matter as is how fast they process the carbs so there is no way to provide a formula to use. Some kitties will show a change quickly while others may take a few days.

1.75u of insulin is not a high dose at all and most kitties eating kibble of 16% or 26% carbs would require a higher dose than that. My kibble addicted girl had a secondary condition called IAA so she wasn't typical but one thing I did notice with her was that change from 21% carb down to 8% made absolutely no difference in her BG or her dose requirements. At the time I had no way of knowing if that was because of her secondary condition or if she just wasn't particularly carb sensitive and all I could do is monitor to make sure her BG didn't suddenly drop during the food transition.

I'd do the transition to the new food slowly and methodically in order to avoid any GI issues and just keep monitoring to determine whether a dose adjustment is needed or not.

 

[Bandit's Mom]

How a kitty reacts to carbs is an individual matter as is how fast they process the carbs so there is no way to provide a formula to use. Some kitties will show a change quickly while others may take a few days.

1.75u of insulin is not a high dose at all and most kitties eating kibble of 16% or 26% carbs would require a higher dose than that. My kibble addicted girl had a secondary condition called IAA so she wasn't typical but one thing I did notice with her was that change from 21% carb down to 8% made absolutely no difference in her BG or her dose requirements. At the time I had no way of knowing if that was because of her secondary condition or if she just wasn't particularly carb sensitive and all I could do is monitor to make sure her BG didn't suddenly drop during the food transition.

I'd do the transition to the new food slowly and methodically in order to avoid any GI issues and just keep monitoring to determine whether a dose adjustment is needed or not.

OK. Thank you. Will do as advised.

Speaking of monitoring, Bandit fell to 106 at AMPS+3 yesterday and was up to 122 when I checked at +4. In future, when she falls close to the double digit mark, do I check her more frequently (like half an hour or less) to see if she falls below 90 (that being the level to qualify for a dose decrease) or does a fleeting drop to 90 or below not qualify for a dose decrease?

 

[MrWorfMen's Mom]

Yes Bandit gets a dose reduction if she drops below 90 but 90 is a safe BG that doesn't necessarily require intensive monitoring. If Bandit drops to 90, you can feed her some LC food and recheck in an hour to see what she is doing. If she's continuing to drop, then more monitoring is in order but if she is surfing along at basically the same level, you try to keep her there as long as possible.

That 106 yesterday was great. Hopefully more of those beautiful blues will start showing up soon.