With Sprockets history of DKA, it's important that he eats, I don't see anything higher than 5% carb on the ss, if you find that this helps you keep him flatter, and in numbers that you are more comfortable with then that's ok.
HI Gill, gonna try this with different color for my response. Hope it works. I had more than 5 carb on 9/18, 9/20, 9/25, 9/27, 9/30, 10/1, 10/3, 10/7, 10/8, and 10/10. 6,7, and 8 carbs. Thats what I do when he drops into lower bgs. When at the 2am/2pm meal I try to feed him enough to raise him enough to be able to shoot a full dose at amps/pmps. He is far from flat bgs. I miss the flat numbers in 200s....lol. He got off his bupre on 10/7. before that date these meds were causing havoc.
Do remember that the effect carb will have on BG can be influenced by the point in the cycle you are feeding and whether kitty is clearing a bounce or dropping in a normal cycle.
Feeding 5% at +1 in a normal cycle, would have less of an impact on BG than feeding 5% at +8. ( Looking at the ss that is when I am seeing the higher LC have most of an impact on BG, as a general rule) The fact that he responds to carbs is a good thing it gives you a tool to steer his bg, and if he likes it better than his regular food, that is also useful if you find yourself in a situation where you need to steer (George loved his HC and I could count on him eating it whenever he dropped)
I would think that food at +1 would have more effect cause it would later in the cycle, no? I have HC food but have not used it in a while. I assume only if he is under 50 for gravy. Although, I think since I am home I can make sure he doesnt go down that far with feeding when he is starting to drop below 100.
That brings me to another question, how come you are feeding so late in the cycle??
If Sprocket is having problems with acid tummy, and you need to feed late in the cycle, it would be good if you could find something very low carb or zero carb that he would eat as a snack (perhaps some boiled chicken breast) Feeding 5% lat in the cycle, will tend to cause the BG to spike by PS, it kinda puts the breaks on the insulin, so if it were me I would avoid feeding higher low carb late in the cycle, unless it's necessary (ie he is dropping into low greens)
Late in cycle? I feed at 6am/6pm(amps/pmps) with test/feed/insulin & meds. Then at 1030am/pm, (+3 through+4). Then 2am/2pm (+7). I feed like this because he was dropping previously and I noticed that if I fed thoughout day and night he was staying more steady. I was going to try to feed every 6 hrs instead to allow me to sleep better and be able to leave house more but that didnt happen because he got the cystitis in mid july.
When he is lower at the 2am/2pm meal I feed a higher carb to allow him to come up enough by amps/pmps so I can shoot a full dose. When I shoot less of a dose he goes high into 300s.
I stopped the Ondansetron except for when he looks like he is nauseous or when he vomits. I am still giving famotidine because the vets told me not to take away too many meds at once as he has had so many meds over the summer. But he is on half the dose he used to be on. I give 0.25ml 2xday mostly except when he vomits then I give a few doses of 0.5ml to help him from getting too much acid churn from the vomit.
Does that make sense??
Looking at the ss it seems your routine feeding schedule is
approx
amps +4 +8 pmps +4+8
I would look to changing his regular meals so that he gets them earlier in the cycle, maybe +2 and +6, then if acid tummy is a problem give him a small treat of zero carb freeze dried treats or boiled chicken, to keep his tummy from getting upset.
If I fed at +2, then I would really get no sleep. As of now, I go to bed after his 1030pm meal, (try to fall asleep, as its hard cause I am a night owl), sleep till 2am, test n feed, back to bed till 6am, (which is more like 530am or 545am because the cats start making noise of walking on us to get up). then at 7am after test/feed/make bf lunch, & give all meds to 2 cats, I will go back to sleep till about 1030am or so depending on if he is higher or lower. So then I test n feed. then if still tired I try to get another hour of sleep. Its a horrible schedule. I want him back to predictable so I can sleep better. (I had a scary severe vertigo/vomiting weekend in july with day long hospital visit due to stress and lack of sleep as he was having cystitis flare up every few days mostly in morning about 7am so I had to stay away with him till the meds kicked in and he calmed down.)
Why am I suggesting this?
1) I see him dropping quite sharply at times early in the cycle, and it's been my experience that feeding earlier will help to flatten out the drops
2) Feeding late in the cycle +8 often results in higher PS, and rather counter intuitively, higher PS often lead to larger drops at onset, I'm sure you have heard 'shoot low to stay low', keeping the PS lower will often yield flatter cycles. And flatter, lower cycles, over time will help with some of the erratic bouncing that we sometimes see in kitties.
When I give a 3u dose or when I think he will drop fast n hard or when he is under 250 I will give 4 carb to try to slow down the drop. Usually it worked but sometimes it didnt and I had to give more 4 or 5 or higher carb after. If he drops about 100 pts or more I will usually give 4 or 5 carb to slow him down. he will usually still drop all day too.
The 2am/pm meal is at +7 or so. When he is lower I will usually see if he wants any food before 4pm before I pick up the food (2hrs before amps/pmps). but at 2am I feed and pick up food.
I tried the "shoot low to stay low" once when I got the balls to do it. Full dose at 123 bg with 5 or 6 carb meal. it didnt work, he went to 300s in a few hours. He is back to bouncing like he was months ago after he was in 300s and 400s with those sugar meds over the summer. So now he is bouncing again but I think he is starting to bounce a little less and not so high.
I would love to get the lower(100s) flatter cycles but he doesnt seem to like that. Before he was happy in 200s more. then would sleep in 100s. then last month or so he was 100s he was playing alot. Depends on day. He really doesnt like those nice rules that I want so bad.
FWIW I found that when I switched Georges feeding schedule so that he got most of his food early on in the cycle this helped flatten him out.
FWIW? forgot what that is.
If you were feeding MC consistently or HC consistently, then that would concern me, but I don't see anywhere on the ss where you have been doing this.
If he eats the 5% happily, and this makes managing the numbers less problematic, then go with the flow.
With SLGS, you should be holding the dose, he got to 91 in the last 5 days. That said, I do think there is room to take him up a notch, as his numbers are trending up a little, so perhaps give it another couple of days and if you don't see lower blues/green then take him up, try to keep in mind that insulin needs do change over time. So although 3u saw him dip below 90 previously, it may not necessarily do the same now. Combining an increase, with feeding earlier in the cycle, may help you moderate his fast drops, by having food in his system when the insulin onsets, you may not see so harsh of a drop (though TBH, though you find those drops scary, he is not, dropping that fast, compared to some kitties, just saying this for a bit of perspective)
Under 90 in past 5 days....that part I didnt know. While he was on the meds, it was impossible to hold a dose. When I do one dose of 3u, he will still drop low. Sometimes when I give 2.87u he will still drop low. Its weird, he will drop low then stay in higher 200s/lower 300s for a few days sometimes. Is that a bounce? or needing more insulin? how do you tell?? He usually isnt hungry again after amps/pmps until almost 11am/pm. Since off his buprenex I have had to wake him to test him at night no matter if he was high or low. I think the buprenex was keeping him more awake too. So now after pmps meal he tends to want a long nap. I do better with a plan like What carb to feed with what range of drop. I tried to take notes while on bupre to what carb seems to work better at certain times but those are not working.
I thought the same dose is usual when he gets regulated, no?
so how much should I change his dose? what if he goes low with a day or so? usually thats what happens.
When did you stop the meds that had sugar in them?
10/7 was first day off the bupre. That was last med that was raising his bg but the pharmacist said there is was not sugar at all, the medicine was pure powder not from a pill. He was actually trying to figure it out too which was nice.. My human pharmacist said that buprenex can also raise glucose of some human diabetics too but not all. So he must be one of the cats in that category too. The sugar meds we stopped awhile ago. I think the last one was in Sept 2 or so.
What is your goal with Sprocket? Regulation (ie normal numbers)?? remission??? keeping him under the renal threshold ( I know that ultimately you just want him to feel better and be happy, that's what we all want for our babies).
What is regulation/normal numbers?? I would like to keep him under renal threshold, and regulated with lows in low 100s and not higher then 250 would be ideal. Just not sure how to do that. And if I can stop testing so much, yet I cant use an auto feeder because he wont eat unless I give it to him and then put food back in center of dish with more toppings(fortiflora, parm cheese, bonita flakes, dry food crumble are the usual toppers to get him to finish the food). Plus now my other cat (hyper T) is liking the extra attention and is making me hold the dish wherever she is sleeping cause I am trying to get her to eat and she seems to not want to get up to go get food either. she is 17yrs though so I guess I can do that for her.
Sorry it took a while to get back to you, dogs, kitties, DH all needed feeding and watering
