1 Jan 2018 | Girlie AMPS 346

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Happy New Year!

If there is no fuel in and insulin at work - yeah I would expect a drop. I haven't seen stress drop BG's but Jone's last ER visit - his numbers were pretty reasonable without insulin. I thought they were be in the stratosphere.
 
Thanks for clarifying. I didn't register the AT meter and I automatically type "Lantus" rather than Lev. Sorry.

When trying to have an effect on bouncing, the idea is to try to keep the kitty in blue/green numbers as much as possible. With cats that only seem to want to bounce, given a drop into lower numbers, their pancreas and liver panic, and shoot numbers back up again. One theory is that is you get as much insulin as you safely can into your kitty and increase the carbs as you need to, you will theoretically have your cat's numbers in an overall lower range. You aim for a blue pre-shot and a green cycle. I tried this with Gabby and found it took a few weeks to see an overall change. It was by no means an overnight response. Also, I didn't really use food of varying carb amounts. I used corn syrup or honey to raise Gabby's numbers. (She was sensitive to gluten so I went for syrup. I varied the amount by number of drops of syrup.) Gabby also had a very early nadir. Her numbers could start to drop at +1 or +2 with her nadir usually being at +3. If I saw a drop by +2, I was reaching for the HC. This was allowing me to prevent a dose reduction which is the goal since your keeping your cat in blue/green numbers. One other thought may be to use a higher carb food (e.g., 5 - 8%) as your basic food all the time and add HC if you need to. Some cats actually do better with a baseline of higher carb food than a food that is 0 - 2%.

I was referring to the period around the middle of Dec. but I wasn't factoring in that you're using an AT meter. Also, "patience pants" tends to mean to hold the dose. However, if you need to increase and increasing in in keeping with the protocol, it's fine to do so. If may be a matter of it looking like a bounce is breaking and increasing the dose at the same time that a bounce is breaking could cause numbers to plummet due to the combined momentum of the two factors.

Let me know if this makes sense.
Hi @Sienne and Gabby (GA)
It does make sense, but I don't know whether it will work with Girlie, as it's what I've been working on and trying for a while now.

Girlie hates honey and won't eat food that has it, so that's a no go for us. Any idea how many carbs are in a drop of honey? Or a drop of glucose syrup (which I can easily get into her via syringe or in her food)?

One problem with the carbs is getting enough food into her while not carbing her up too much with food itself (rather than an addition like honey, as you did). She's also very, very picky, so it's hit or miss what she'll eat. She's older, and she prefers to eat more within about 2 hours of a shot and then she's just not interested. That, of course, doesn't work well on Levmir (which kicks in at +4 or +3.5) and also REALLY does not work well when I'm at work and not there to encourage her to eat.

So (work days especially) I either feed blind, assuming that she'll drop and giving her higher carb food just in case. You can see the problem.


One other thought may be to use a higher carb food (e.g., 5 - 8%) as your basic food all the time and add HC if you need to. Some cats actually do better with a baseline of higher carb food than a food that is 0 - 2%.

I agree with all you've said and have been trying to do that. However, the big problem is Girlie and her reaction to carbs. As you can see from her SS, she'll dive hugely on 6% and 8% food. 5-8% will not move Girlie or stop her from diving, as is clear from her SS.

Pre-shot: I usually give a 1/2 tsp of 6% (her fave food at the moment) or lower carb at PS to get the Miralax in and keep her numbers from rising too much. Then I wait until +2.5 or +3 or +3.5 to give her substantial food as that's when the Levemir starts to kick in. If I guess, and give her MC food at her PS or at +1 or +2 when she's still going up, then I'll just push her up further with the Levemir.

During the middle of December (and elsewhere), you can see that it was taking up to 20% and 22% carbs to keep her from diving too low. So I'm not sure how a dose increase from 0.5 to 0.75 @ 16 Dec would have helped there. Or are you talking about 19 - 22 Dec after her reduction to 0.25? I did wonder whether it was a failed reduction but the thought was that she was bouncing, so not to increase: wear patience pants.

And now, on 0.1, she's diving towards low greens even with MC food.

So are you suggesting that it's better to have Girlie on higher insulin and higher carb food (as it will take high MC (15%+) and HC food to keep her from diving if the insulin is increased) as we were doing before?

I spent a lot of time yesterday looking through Gabby's SS, and I don't see a sustained period where she held on to blue or green PS. Over all the years I still see a lot of PS at yellow. Is there a period I should look at in particular, do you think? I just want to try to focus on that correlation between your feeding the curve and the insulin and the corresponding steadiness in the PS and other numbers... Of course there's the difference, now, as we're on Levemir rather than Lantus, though, so Girlie's dives are now usually +4 or +5 on Lev (rather than +1 or +2 on Lantus).

Thanks so much, Sienne, and hope you have a happy new year!
 
So here's a typical Girlie right now on 0.1 of Levemir today:

AMPS 346: 1 tsp 6% food

+2= 277 (-69 pts in 2? hrs): 1/2 tsp 14% food (didn't want the food). Note: atypical for her to go down at +2

+3 = 137: (-140 pts in 1 hour): 2 tsp 16% gravy

I'm curious to see where she'll go with that when the Lev really kicks in at +4
 
Yes, on the possibility of going down with stress. Neko often dove at vetty.

Happy 2018!
Thanks, Wendy! Happy New Years to you in advance.

I wonder if she was eating as little at the vet's as they say they were, given that she didn't lose any weight there at all. Still, could them feeding her at the wrong times - or her eating too little - also cause those dramatic dives she did? I really find it hard to understand how she dove down to 49 on 26 December after two NS in a row.

I'd love to try to figure out what made her dive repeatedly and so low so that I can try to prevent that when I board her in future. Either that, or I'll never be able to leave Girlie's side, which isn't a realistic possibility given the need to visit an older parent overseas. :)
 
I have to laugh: Girlie would be a different cat on a human meter for sure! Maybe I should use the Freestyle Lite meter because that reads the lowest - so she'd look the best on that. :p

AM +8:30 readings (same drop of blood within seconds of each other):
  • Alpha Trak = 211
  • Contour Next = 133
  • FreeStyle Lite: 113
 
I have to laugh: Girlie would be a different cat on a human meter for sure! Maybe I should use the Freestyle Lite meter because that reads the lowest - so she'd look the best on that. :p

AM +8:30 readings (same drop of blood within seconds of each other):
  • Alpha Trak = 211
  • Contour Next = 133
  • FreeStyle Lite: 113
Yup I found the freestyle reads much lower than my Accucheck that’s for sure.
 
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