11/15 TIFIL PMPS 358, +3 338, +4 274

[ISIL&TIFIL]

Yesterday's condo

viewtopic.php?f=9&t=56451


Dear Marjorie,

Isil:

Sandy asked me to help you with food management of the curve. I'll see if I can but it also depends on Tifil and it doesn't work overnight.

Early on, we went to Jill for advice on feeding and she told me:
manage the curve with food---->flatten the curve---->adjust the dose as necessary

Gracie was a diver on lantus...she could drop very fast. We started doing a better job of scheduling her feeding and it did help alot although she occasionally continued to drop fast.

My suggestion to you, as Sienne suggested to us, is to "front load" her cycle. That is to try and get as much of her food into her early in the cycle to try and lessen the dives. We calculated how many calories/day Gracie needed and then divided it by two for the a.m. and p.m. cycles. As it turned out, she gets 1.3 oz for the a.m. and p.m. cycles each. We fed her the majority at PS and +1 so she would get .45 oz at PS and +1 and then .2 oz at +2 and +3. By having more food early on, it helped the dives at +2/+3.

When you say you feed her at 12, 3, 6, 9....I'm not sure if you mean +12, +3, +6, +9?? I think if that is the case, you need to condense it and not feed her after her nadir. If she is really hungry, you could give her a very low carb, small snack like boiled chicken breast. But when Gracie was on lantus, her last snack was at +5. If you are feeding at +9, you could be influencing her PSs and causing them to be higher. She might seem a little hungry at first but if you can ease her into the new schedule with the boiled chicken breast, then she should be ok. Before Gracie was diagnosed, we fed her small amounts all day and evening and she adjusted to her feeding schedule just fine.

I also recommend no dry food.....it is really counterproductive to managing diabetes.

I don't feed Fancy Feast but some of the carbs of the varieties others feed are:
FF tuna/chicken feast 8%
FF Elegant Medley Turkey Florentine 10%
FF trout feast 7%
FF Glovers Beef Feast w/gravy 14%
Many of the roasted varieties are MC foods
Grilled varieties are usually around 17-18%
Gravy lovers are usually around 17%

When she is dropping quickly, you want to try and slow the drop down by giving her a little higher carb food....maybe something in the 8-10% range.

Here is the difficult part.....it is truly ECID. Jill's Alex is extremely carb sensitive and reacts to very low carb foods; some of the other kitties need 18% foods to slow them down or bring up low numbers. I can't use anything more than 10% on Gracie. This was the hardest part for us was finding the foods that controlled her curve the best. You'll have to experiment and find out what works for Tifil.

I hope this helps some .....especially with the bounces by feeding more food early on in the cycle. The other thing is a couple of us (Ann/Tess) have switched our diving kitties to levemir. For us both, it has made a huge difference and curves have flattened out a lot more. I'm pretty sure you can get levemir in Turkey.

Let me know if you have any questions. Good luck.

Thank you very much for paying attention to tıfıl and me, I am really grateful :smile:
Today after I read your message I fed tıfıl at +1. Her numbers seems to be better today, I hope it will go this way.
I have a question about Levemir; is it much better at making the kitties dive? I mean if tıfıl stops diving with this feeding schedule that you proposed, do you think I should go on with Lantus and If she continues diving I should try levemir?
What are the advantages of Levemir to Lantus?
I know I asked too much but I am a curious person

 

[Sandy and Black Kitty]

Re: 11/15 TIFIL AMPS 371, +1 354, +3 403, +5 372

Merhaba Isil,

I don't personally have experience with Levimir - I'm sure Marjorie can answer your questions. She usually comes along later as she is farther west.
In the mean time I think it's time to increase Tifils Lantus dose to 3.5u.

 

[ISIL&TIFIL]

Re: 11/15 TIFIL AMPS 371, +1 354, +3 403, +5 372

Merhaba Isil,

I don't personally have experience with Levimir - I'm sure Marjorie can answer your questions. She usually comes along later as she is farther west.
In the mean time I think it's time to increase Tifils Lantus dose to 3.5u.

Ok tonight I will shoot 3.5 I think it is going to be better

 

[Sienne and Gabby (GA)]

Re: 11/15 TIFIL AMPS 371, +1 354, +3 403, +5 372, +7 334

Lantus and Levemir are very similar -- both are long-acting types of insulin. The biggest difference is that the nadir with Lev is later in the cycle.

FWIW, I manage Gabby's cycle with food. I do not use all of the different carb foods that Marje uses. I have Gabby's regular food (4% carb) and I use either corn syrup or honey for my high carb management. What a vary is the amount of syrup that I add in order to increase the carb level. (Gabby can sometimes get an upset stomach from the gravy-type food so I tend to not use those foods a great deal.)

 

[ISIL&TIFIL]

Re: 11/15 TIFIL AMPS 371, +1 354, +3 403, +5 372, +7 334

She didn^t dive today. Maybe we don't need levemir, let's see what happens....she feels good today, very playful

 

[Sandy and Black Kitty]

Re: 11/15 TIFIL AMPS 371,+1 354,+3 403,+5 372,+7 334,+10 414

Ok tonight I will shoot 3.5 I think it is going to be better

Do you have honey or corn syrup at home, in case you need to bring up a low number?

Also, have you tested for ketones? (they are very sneaky)

 

[Marje and Gracie]

Re: 11/15 TIFIL AMPS 371,+1 354,+3 403,+5 372,+7 334,+10 414

Isil

Sienne is right and I do also use karo to steer Gracie somewhat but I know there are some who dislike the idea of giving karo to a diabetic cat. I only use three different carbs for Gracie: her every day meals when she needs no steering are Wellness 4% like Sienne uses. But I also use some Wellness 8% and another that is 10%. If she drops into the 30s, I use karo. We've been trying to use food more and karo less just because the karo wears off, for Gracie, in a couple hours and the food lasts her a tiny bit longer. I gave you the Fancy Feast info because that's what Sandy asked for. You can use karo and I have, in the past, even used it if Gracie was dropping quickly because it slowed the drops. It is an option as Sienne said.

The levemir idea is just for "in case". I would keep Tifil on lantus for now and then see how she does with the feeding. I think it will take a bit of time for you to see a big difference so be patient. We did food management for Gracie for almost a year; her cycles improved but were still not nearly flat enough and that is when we switched to levemir. But just so you know:
1. levemir works well for cats that have problems bouncing or diving and you can't get the cycle flattened out
2. levemir has a much later onset....Gracie often does not onset until +5 but it will vary...ECID. Typical onset is about +4. Lantus onset is typically +2-+3.

3. levemir has a later nadir....typically it is around +8 but Gracie likes to nadir at +12 when I am giving her next shot. The advantage to that is I can shoot low numbers (50s) consistently because I know she will then come up before
she onsets.....most of the time ;-)

As you can see, your schedule probably needs to be a little more flexible to use levemir; we waited until I was only working one day a week but I have found that Gracie is so much more stable and we don't have to test as often unless she is really, really low. Her hourly decreases in BG to nadir are more like 10 mg/dl instead of 30-50 mg/dl on lantus.

Something to think about but see how Tifil does on lantus with the food management. I hope it will help.

One other thing....when Gracie was on lantus, she didn't dive every single day. But I'm happy to see Tifil get a food spike today instead of a dive! She's so lucky to have you!!!

 

[ISIL&TIFIL]

Re: 11/15 TIFIL AMPS 371,+1 354,+3 403,+5 372,+7 334,+10 414

Ok tonight I will shoot 3.5 I think it is going to be better

Do you have honey or corn syrup at home, in case you need to bring up a low number?

Also, have you tested for ketones? (they are very sneaky)

No I couldn't catch her going to the toilet, tonight I will.
Yes I have honey at home, but I am not sure if 3.5 will be enough for her, doesn't it look like she needs more? there isn't any proper curve, am I wrong? on +10 she is up to 414

 

[ISIL&TIFIL]

Re: 11/15 TIFIL AMPS 371,+1 354,+3 403,+5 372,+7 334,+10 414

Isil

Sienne is right and I do also use karo to steer Gracie somewhat but I know there are some who dislike the idea of giving karo to a diabetic cat. I only use three different carbs for Gracie: her every day meals when she needs no steering are Wellness 4% like Sienne uses. But I also use some Wellness 8% and another that is 10%. If she drops into the 30s, I use karo. We've been trying to use food more and karo less just because the karo wears off, for Gracie, in a couple hours and the food lasts her a tiny bit longer. I gave you the Fancy Feast info because that's what Sandy asked for. You can use karo and I have, in the past, even used it if Gracie was dropping quickly because it slowed the drops. It is an option as Sienne said.

The levemir idea is just for "in case". I would keep Tifil on lantus for now and then see how she does with the feeding. I think it will take a bit of time for you to see a big difference so be patient. We did food management for Gracie for almost a year; her cycles improved but were still not nearly flat enough and that is when we switched to levemir. But just so you know:
1. levemir works well for cats that have problems bouncing or diving and you can't get the cycle flattened out
2. levemir has a much later onset....Gracie often does not onset until +5 but it will vary...ECID. Typical onset is about +4. Lantus onset is typically +2-+3.

3. levemir has a later nadir....typically it is around +8 but Gracie likes to nadir at +12 when I am giving her next shot. The advantage to that is I can shoot low numbers (50s) consistently because I know she will then come up before
she onsets.....most of the time ;-)

As you can see, your schedule probably needs to be a little more flexible to use levemir; we waited until I was only working one day a week but I have found that Gracie is so much more stable and we don't have to test as often unless she is really, really low. Her hourly decreases in BG to nadir are more like 10 mg/dl instead of 30-50 mg/dl on lantus.

Something to think about but see how Tifil does on lantus with the food management. I hope it will help.

One other thing....when Gracie was on lantus, she didn't dive every single day. But I'm happy to see Tifil get a food spike today instead of a dive! She's so lucky to have you!!!

It's so hard for me to see her with those big numbers The nadir is so high, doesn't she need .50 increase