11/7 Junga AMPS 156, +1 95, +2 58, +3 76, +4 95, +5 82

[jldnvjld]

Well, today's my day to get data -- a first-time curve.

Since I don't know what Junga's 'no-shot' number should be, I'd skipped his insulin the last two nights since I wouldn't be home to monitor him. This morning he came up low-ish, but since I'd be home, I figured this was a time to get data.

I suspect my planned insulin curve is pretty much shot, since I will probably spend the rest of the day dealing with his low.

Questions:
1. Was giving him HC the right move at 58?
2. Given the data on his sheet, what would you guess his no-shot PS number ought to be?
3. Would you say, based on what data I have, that 0.25 is too high a dose? What would you suggest? I won't be able to do a curve until next weekend at the earliest, but can spot-check him during the week if I were to start a lower dose tomorrow.

Note: the HC is hypoallergenic kibble, since we suspect he's allergic to grain. I don't want him throwing up when his BG is already low.

J.
Previous request for curve assistance:
viewtopic.php?f=9&t=29124

 

[Laurie and Mr Tinkles]

Re: 11/7 Junga AMPS 156, +1 95, +2 58 -- dosage and curve he

First, let's deal with the low number...I see on your SS that you gave some ice cream...that was after the +2 58, correct? Please get another test after 15 minutes and post the results in your header as you get them, ok?

 

[jldnvjld]

Re: 11/7 Junga AMPS 156, +1 95, +2 58 -- dosage and curve he

First, let's deal with the low number...I see on your SS that you gave some ice cream...that was after the +2 58, correct?

Yes, that was after the +2 58. His behavior was pretty normal, BTW. During our other low last Wed. he was obviously groggy.
We're back up to 76. I'm wondering if I should leave that, or give him more kibbles.

 

[Laurie and Mr Tinkles]

Re: 11/7 Junga AMPS 156, +1 95, +2 58, +3 76 -- dosage?

Frankly, I would not use kibbles for HC. It usually takes too long to get into their system, and hangs around too long. The ice cream is ok to use instead of gravy. I would try giving him just a tsp of LC food and test again in 1/2 hour. Because it is early in the cycle, you will need to be vigilant on testing.

 

[Sienne and Gabby (GA)]

Re: 11/7 Junga AMPS 156, +1 95, +2 58, +3 76 -- dosage?

I agree with Laurie.

I also would suggest you stock up on high carb canned food -- the kinds with gravy. Feeding ice cream may work if you have absolutely nothing else on hand. Most cats are lactose intolerant. If you try to manage the curve with milk products, you may have a kitty with diarrhea the next day.

 

[jldnvjld]

Re: 11/7 Junga AMPS 156, +1 95, +2 58, +3 76 -- dosage?

I agree with Laurie.
I also would suggest you stock up on high carb canned food -- the kinds with gravy.

Which canned gravy foods are grain-free? I looked a bit in the pet food store and didn't find a likely candidate.
Junga has food intolerances and allergies. I don't want him throwing up when his BG is low (intolerance reaction) and I've been trying to avoid an allergic reaction, since we've controlled that in the past with a cortisone (steroid) shampoo.

 

[Laurie and Mr Tinkles]

Re: 11/7 Junga AMPS 156, +1 95, +2 58, +3 76 -- dosage?

I did see that you are dealing with food allergies, that does make it more challenging. Maybe you could post a question on Health about HC foods that are grain free? I'm sorry I'm not much help with that, but I'll see if I can dig up some info.

Sienne makes a good point about the ice cream, do you have karo syrup in the house? It might be better to put a drop of that on a small amount of his regular food to boost numbers.

BTW, not shooting those lower numbers was a good choice IMO. You're doing a good job!

 

[Laurie and Mr Tinkles]

Re: 11/7 Junga AMPS 156, +1 95, +2 58, +3 76, +4 95 -- dosag

The Wellness pouches are a MC grain free alternative...not HC but some of them are around 12-13%. Ann & Tess posted info on another thread about them. (Thanks Ann!) viewtopic.php?f=9&t=29189&p=299513&hilit=wellness+pouches#p299513

You might be able to use the pouches and add a little syrup (maple if karo is no good, or even honey) if necessary.

I see he's up to 95 now...did you give kibble earlier? If so, when? I'm just curious about the timing and the effect. Did you try the LC at +3?

 

[jldnvjld]

Re: 11/7 Junga AMPS 156, +1 95, +2 58, +3 76, +4 95 -- dosag

The Wellness pouches are a MC grain free alternative...not HC but some of them are around 12-13%. Ann & Tess posted info on another thread about them. (Thanks Ann!) http://www.felinediabetes.com/FDMB/view ... es#p299513

You might be able to use the pouches and add a little syrup (maple if karo is no good, or even honey) if necessary.

I see he's up to 95 now...did you give kibble earlier? If so, when? I'm just curious about the timing and the effect. Did you try the LC at +3?

I will look for the Wellness pouches.

My notes from the spreadsheet:
8:00/+2: 10 kibbles + 1/3 tsp. melted ice cream. +3.5 1 tsp LC duck.

To clarify:
So I gave the kibbles and ice cream (only) at +2, when he was at 58.
+3 was 76; I gave the 1 tsp LC (duck) at 3.5.
He's at 95 now, as you noted.

When we're done with this low BG day, I would still like advice on the following:

1. What should Junga's no-shot PS number be?

2, What dose should I have him on for (say) the next week? I know per protocol I'm not to adjust the dose downward without a nadir from a curve, but it seems I'm having trouble producing a curve without a workable dose to start from.

J.

 

[Laurie and Mr Tinkles]

I understand your quesions, and I don't blame you for wanting answers. I'd like to see how this cycle plays out a bit more, ok? I see he's on his way back down now....good. I would suggest that you hold the kibble for the rest of this cycle.

I also realized that you posted a question in Mr Tinkles' condo a few days ago, and I didn't answer you. I'm sorry about that! It's pertinent to this situation, so let me answer you here.

PMPS ~ 203 S1.5u (4th cycle)
+2 ~ 143 mm
+3 ~ 103 mm
+4 ~ 76 1 tsp LC
+5 ~ 72 1 tsp LC
+6 ~ 62 1 tsp LC
+7 ~ 74 1 tsp LC
+10 ~ 104
AMPS ~ 138 S1.5u (5th cycle)

LC is low-carb (i.e. his regular?) canned cat food?
In this situation, is it important to restrict his intake to 1 tsp per hour?

Yes, LC is his regular canned food. My normal feeding schedule is mini meals (mm) at PS, +1, +2, +3 (about 1/2 oz each) and then about 1 tsp for each snack at +6 and +8. The reason I fed him those 1 tsp snacks at +4, +5, +6 and +7 that night was to try to help him "surf" at about the numbers he was at....I didn't want him to drop below 60. Often if you just give small frequent snacks of their regular LC food, they will maintain their BG around that level. Naturally, it doesn't always work exactly that way, and every cat is a little different so you need to experiment to see what works for yours. Many people here use this technique.

That was an excellent question, and I put that info there just for that purpose...for others to see the effect that little snacks of their regular food can have in controlling the cycle. Sorry for the delay in answering you...I've had an unusually busy week!

 

[jldnvjld]

I'd like to see how this cycle plays out a bit more, ok? I see he's on his way back down now....good.

If you have suggestions for this evening's shot, I'd love to hear them.

Thank you for answering the question about the surfing snacks.

J.

 

[Laurie and Mr Tinkles]

He's on his way back up and it appears that the PMPS will be high enough to shoot comfortably. What is your schedule like? Will you be able to monitor tonight? Do you have all of the necessary supplies..strips, karo, etc?

 

[Libby and Lucy]

Laurie asked what I was going to ask, which is whether you can monitor tonight. I would love to see what he does when he gets two shots in a day on this dose. Junga is looking great!

 

[jldnvjld]

He's on his way back up and it appears that the PMPS will be high enough to shoot comfortably. What is your schedule like? Will you be able to monitor tonight? Do you have all of the necessary supplies..strips, karo, etc?

I have supplies, but I won't be home until late. The in-laws are in town. So if he's to have a shot, it'll be without monitoring.
Sigh.
J.

 

[Libby and Lucy]

how late?

 

[jldnvjld]

how late?

Maybe 10:00 or 11:00.

Given it looks like his PMPS will be similar to his AMPS, I'm disinclined to shoot the same dosage, as we had a low number at +2 this morning, and I won't be home at +2 to deal with it.

Is that how you'd analyze this one?

J.

 

[Libby and Lucy]

I'm not sure what + hour 10:00 and 11:00 are... Will you be home at +1 to see if he's rising before you leave?

there's always the option of doing a BCS (Big Chicken S**t) dose if you're not sure what to do at shot time. Another thing I have done (not really recommended, but occasionally it is what I have to do) is shoot and then feed a little higher carb than usual, or some people drizzle HC gravy on the food if they're going out and the numbers are dropping.

This doesn't help for tonight, but next time he's in the 50's, try feeding a little low carb food and testing in 1/2 hour. That way you'll be able to see if the low carb food is enough to get Junga surfing (and if it's not, you can always feed HC at the next test). On such a small dose, most likely low carb would do the trick. Once I knew Lucy could surf in the 50's and keep herself safe with low carb, I felt comfortable going out while she was surfing.

 

[jldnvjld]

I'm not sure what + hour 10:00 and 11:00 are... Will you be home at +1 to see if he's rising before you leave?

there's always the option of doing a BCS (Big Chicken S**t) dose if you're not sure what to do at shot time. Another thing I have done (not really recommended, but occasionally it is what I have to do) is shoot and then feed a little higher carb than usual, or some people drizzle HC gravy on the food if they're going out and the numbers are dropping.

This doesn't help for tonight, but next time he's in the 50's, try feeding a little low carb food and testing in 1/2 hour. That way you'll be able to see if the low carb food is enough to get Junga surfing (and if it's not, you can always feed HC at the next test). On such a small dose, most likely low carb would do the trick. Once I knew Lucy could surf in the 50's and keep herself safe with low carb, I felt comfortable going out while she was surfing.

10:00 would be +4.
I won't be home for +1.

He's eating his LC dinner now. I don't feed gravy food since he's got a (presumed) grain intolerance/allergy and I don't want him throwing up or getting all itchy and needing cortisone baths.

What number would his PS be before you'd skip a shot?
Are you thinking I should keep him on 0.25 BID (or attempted BID)?

J.

 

[jldnvjld]

Re: 11/7 Junga AMPS 156, +1 95, +2 58, +3 76 -- dosage?

do you have karo syrup in the house? It might be better to put a drop of that on a small amount of his regular food to boost numbers.

This morning I tried a little karo in duck (the only canned food he really *likes*) and he did eat it. I ended up using two tsps of LC food because I'd also added some (too much) warm water to take the chill off the food. So it looks like I can successfully hide small amounts of Karo in duck canned food. Thanks for the suggestion.

 

[jldnvjld]

there's always the option of doing a BCS (Big Chicken S**t) dose if you're not sure what to do at shot time.

What would be your suggestion for BCS dosage?

This doesn't help for tonight, but next time he's in the 50's, try feeding a little low carb food and testing in 1/2 hour. That way you'll be able to see if the low carb food is enough to get Junga surfing (and if it's not, you can always feed HC at the next test). On such a small dose, most likely low carb would do the trick.

Thanks for the suggestion; I can most likely try this later in the week (evenings) or perhaps next weekend. I'll be out a lot on Sat., but around most of Sunday.