11/21-Cini Mini-OTJ Trial Day4-Update and one more Question

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Cini Mini's Mom

Cini Mini's Mom

Member Since 2011
Yesterday's Condo here: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=56899

This is how Cini's day went yesterday:

(Keep in mind to subtract 30 points from each reading for AlphaTrak monitor)

Pepcid @ 7am
AMBG 175 @ 8am
Fed 1/4 can Friskies Special Diet Beef and Liver entre' (4%) @ 8:10am
Metoclopramide @ 9am
+3 - 181 @ 11am
Fed 1/4 can Friskies Special Diet Beef and Liver entre' (4%) @ 11:05am
+7 - 185 @ 3pm
Fed 1/4 can FF Classic Beef Feast (~3%) @ 3:15pm
+9 - 221 @ 5:00pm
Pepcid @ 6:30pm
PMBG - 224 @ 8:00pm
Fed 1/4 can Friskies Special Diet Turkey and Giblets (5%) @ 8:15pm
Set up PetSafe Auto Feeder to go off at Midnight and 4am with 1/4 can Friskies Special Diet Turkey and Giblets (5%)



Today Cini's AMBG is 198 ( or 168 for the AlphaTrak adjustment)

I think I'm going to continue with the trial. I just don't feel comfortable shooting him if his BG is below 200.
If you look at the adjusted tab on his SS the highest he's gotten on the trial is 194 and the lowest has been 125.

I think I need more data.

I'm going to cross post in the Main Forum as well to get a larger consensus.
 
Re: 11/21-Cini Mini-OTJ Trial Day4-AMBG 198 ATrak-1 More Day

Hi guys .. wow, didn't realize cini mini was on a trial already! I don't have any advice on going ahead or stopping, but there are lots of experienced people on here that can help with those choices .. have a great day!
 
Re: 11/21-Cini Mini-OTJ Trial Day4-AMBG 198 ATrak-1 More Day

Hi Devon. Thank you (and everyone else) for the kind words of encouragement. Even when I feel a bit "stuck in the rut" postings like yours make me feel better knowing people are thinking of Cini.
 
Re: 11/21-Cini Mini-OTJ Trial Day4-AMBG 198 ATrak-1 More Day

whatever makes you comfortable. We certainly shoot lower than that here, but Cini has a pretty big response to insulin so you would need to be able to monitor and feed.

Another option would be to see if you can measure a dose smaller than 0.1u. Practice with water and see if you can get consistently sized drops that are smaller than whatever you were calling 0.1u. Some cats are sensitive to teeny changes in their doses and it might make a big difference.
 
Re: 11/21-Cini Mini-OTJ Trial Day4-AMBG 198 ATrak-1 More Day

IMHO, I think you should be re-starting insulin. Cini's numbers have not been in a normal BG range for most of this trial and there are no values that are below below 130 (which would be greens on the AlphaTrack). In all honesty, by the time you get to an OTJ trial, you should be more comfortable shooting below 130.
 
Re: 11/21-Cini Mini-OTJ Trial Day4-AMBG 198 ATrak-1 More Day

I tend to agree with Sienne, and Libby as well! :lol: Libby has a good suggestion of shooting a smaller dose than the .1u tho. It may make you feel more comfortable shooting such a teeny tiny amt. It does take practice to get the right size drop tho! And that may very well be all Cini needs for support for just a while longer. Good luck with whatever you decide to do.
 
Re: 11/21-Cini Mini-OTJ Trial Day4-AMBG 198 ATrak-1 More Day

It's your choice, Cathy. I agree with Libby's post from yesterday's condo...if he were my cat, I would be shooting. However, I'm not you! You have to be comfortable with what you're doing.

I agree with Sienne....I see no normal numbers at all during this trail. I don't think he is healed enough to be successful. Staying above normal numbers isn't helping his pancreas heal further, either. I think he needs more support for a while.

I think Libby has given you several good ideas about how to shoot and manage the numbers. The goal is to get Cini Mini to a strong remission. Please tell us how we can help.
 
Re: 11/21-Cini Mini-OTJ Trial Day4-AMBG 198 ATrak-1 More Day

Good luck to you and Cini, whatever you decide. It's been a whirlwind trip for you both!
 
Re: 11/21-Cini Mini-OTJ Trial Day4-AMBG 198 ATrak-1 More Day

Hi guys. Thanks for all the support, input and advice. I'm not trying to be difficult and definitely want what's best for Cini.

It's just very hard to determine which way to go with his regulation because when he was on the insulin I felt like he was dropping so low from just a tiny bit of insulin that I 'm unsure if I want to put him through that every day.

The poor cat has been through so much in his life already with being born blind, liver disease, vaccine reactions, feline asthma, toxoplasmosis, reactions to drugs, throat surgery and on top of all that diabetes.

I am fortunate that I work from home and Cini spends most of his time in his bed at my feet. But,I feel like if I turn my back for just a minute to focus on work that I may miss a BG reading and Cini will sit here in a hypoglycemic episode until I can get to him again. Am I torturing the cat? I sure do feel bad when it happens.
 
Re: 11/21-Cini Mini-OTJ Trial Day4-+4/203 ATrak-1 More Day ?

Kazi has never seen a dose higher than .25 since being diagnosed - much of the past year she has been .10 and under. For a long time Kazi's dose was me dialing down so that the plunger was even with the baseline, and then pushing out half of what was left from that. You wouldn't think that tiny bit of insulin would do anything, but without it she went too high and even a tiny bit more insulin pushed her down too low.
 
Re: 11/21-Cini Mini-OTJ Trial Day4-+4/203 ATrak-1 More Day ?

Hi Cathy:

I have to agree with the rest of the crowd.....I think he needs insulin. His numbers seem to be coming up. Gracie is also one that is very sensitive to even a drop. I would suggest that you try doing a drop and see what it does.

I totally understand your concerns for him and all he has going on but if you have the chance to totally get him into a solid remission even if you have to give him a small dose for now, IMHO, that would be a great thing. Otherwise,
you may see him continue to come up and stay at numbers he doesn't need to be at.

Good luck....we support you whatever your decision is.
 
Re: 11/21-Cini Mini-OTJ Trial Day4-+4/203 ATrak-1 More Day ?

Thanks everyone for your concern and encouragement. I think I am going to give Cini a rest tonight and we'll start fresh in the morning with an AMBG and try doing a drop of Lantus at that time.

One last question....

Once I give the drop of insulin, what's the best interval to do feedings and follow up readings?
 
Re: 11/21-Cini Mini-OTJ Trial Day4-Update and one more Quest

How were you feeding before the trial?

Many people front load the cycle.....feed most of the food before nadir. That helps to manage the drops. The usual schedule is PS, +1, +2 and +3, and some people give a snack later. I would start with that and see how it works.

As far as testing, I am a big fan of +2s....if that number is lower than PS, that is usually a sign of an active cycle ahead, and you would want to keep monitoring closely. If you have a low PS, I would start with +1.
 
Re: 11/21-Cini Mini-OTJ Trial Day4-Update and one more Quest

i think you would just return to the pattern of testing and feeding you were following before starting the OTJ trial.

good luck! fwiw, i would also be restarting the insulin. i don't think it's torturing him. a non-diabetic cat is at under 100, so those will become the numbers he feels best at.
 
Re: 11/21-Cini Mini-OTJ Trial Day4-Update and one more Quest

Hi Laurie,

Before the trial I would feed Cini about a 1/4 can of food and then he would eat it and nap for the rest of the morning till 11 am or Noon. Cini's most active times to eat were from about Noon to 3pm, and then in the evenings around 6 or 7 pm.

That's why I'm a little concerned about how to feed him mini-meals or front load with food. Maybe if I used a higher carb food in the morning? Like a 8 or 9% (maybe 10 or 11%) carb food?

I'd have to wake him up every hour to do that. I used to think this was just him but all three of my cats nap all morning and do the same thing. Maybe I put them to sleep with all my talking on the phone in meetings :lol:


While on the OTJ trial I was keeping him on a schedule of AMBG (8am), +4 (Noon), +8 (4pm), PMBG (8pm), then at night I got a two compartment autofeeder that opens at Mindight and 4am. He seems to like this schedule a lot.
 
Re: 11/21-Cini Mini-OTJ Trial Day4-Update and one more Quest

Hi Julie, thanks for the good wishes. I think I need them and so does Cini.

Thank you for putting up with me too. I know I have been a nervous Nellie throughout this whole thing!

I'm thinking once we re-start this routine that I need to refine my technique.

Like, I noticed that I would get up at 6:00am and give Cini his Pepcid at 6:30am (he has to wait to eat 30 mins) and then feed Cini at around 7am and then take his AMBG at 8am, well that's when the food would be hitting him and bringing his reading down, right?

So I stopped doing that and now and instead I give him the Pepcid at 7am and I make him wait to eat after I take the AMBG at 8am. He's not too happy about it but he seems to be getting used to waiting.
 
Re: 11/21-Cini Mini-OTJ Trial Day4-Update and one more Quest

I would try to get most of the food into him early, when it will help slow the drops. If you have to wake him up to do it, then wake him up....I'm sure he will catch up on his sleep later! :lol:

The point is that the way you were feeding was not slowing the drops....please give this a try. This may be all you need to even him out.

I would not try a higher carb food until you try this first. If you find that he is getting low when you test, then give him the appropriate higher carb food to bring him up....but I wouldn't start out the cycle giving higher carb food until you try his regular food first.

This is the way many, many people have helped even out diving kitties.
 
Re: 11/21-Cini Mini-OTJ Trial Day4-Update and one more Quest

Laurie and Mr Tinkles said:
How were you feeding before the trial?

Many people front load the cycle.....feed most of the food before nadir. That helps to manage the drops. The usual schedule is PS, +1, +2 and +3, and some people give a snack later. I would start with that and see how it works.
Click to expand...

OK, so when you say "PS, +1, +2 and +3, and some people give a snack later", what does that mean exactly in terms of the amount of food? A teaspoon? Tablespoon? Maybe I am feeding him too much at one time? Maybe a 1/4 can is too much and he (and the other two cats) just gets stuffed and wants to nap?

Who's SS is that with the stars on it for when they feed their cat? Maybe I should look at that one again and use it as a guideline?
 
Re: 11/21-Cini Mini-OTJ Trial Day4-Update and one more Quest

I fed Mr T at PS, +2, +3, +4 and a snack at +6 for a long time. I took his total amount of food for the cycle and split it into 5 portions....4 equal ones for the beginning of the cycle, and a snack of about half as much. That was my schedule, tweaked for my cat. Mr T didn't start diving until +2, so he didn't need the +1 mm....I just shifted everything a bit later. His nadir was around +6-+7.

Sienne uses the PS, +1, +2, +3 schedule, I believe. Michelle and Mannie, Ann and Tess, Marje & Gracie are more examples....however, I'm not sure what Ann and Marje are doing for timing....they are using Levemir now and the nadir is later so the meals are likely later too. Michelle does a nice detailed recap in her condo every day.

Did you look at the SSs that Libby linked in your condo yesterday?
 
Re: 11/21-Cini Mini-OTJ Trial Day4-Update and one more Quest

Cathy:

I divide Gabby's food into portions as Laurie noted. What I want to stress, though, is that manipulating the curve with food is a trial and error process. I feed the way I do because Gabby dives early in the cycle. (Tonight, for example, she's already dropping by +2.) It may be that Cini will benefit from a feeding schedule like Laurie and I use. Or, it may be that using a higher carb food will work better for you -- Ann/Zener do this. The most important factor to keep front and center is "know thy cat." You are the person with the food and you know Cini best. We can help you with ideas but don't hesitate to come up with a plan on your own. You are there watching Cini and he's talking to you.

Also, FWIW, unless Cini has been symptomatic, he hasn't had a hypoglycemic episode. Many of our cats bump into low numbers but do not have hypo symptoms. As long as you test and have HC food, you can and do keep your kitty safe.
 
Re: 11/21-Cini Mini-OTJ Trial Day4-Update and one more Quest

Thanks Laurie and Sienne for the suggestions and the names of the other people who follow the same routines. I picked up doing the daily recap from Michelle's condos. Maybe I can pick up a few other good habits from the other condos you suggested.

I think I will feed at PS, +1, +2, +3 and take readings at PS, +2, and +3 (if needed), but definitely at +4 and +6 during the day, it will be difficult for me to do anything past a +3 reading at night.

I have off for the holidays from Wednesday night till Sunday, so maybe I can try to stay up a little later and get some later readings.

I'm going to start with 1 drop tomorrow morning and see how it goes from there.
 
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