2/17 Callie AMPS 96, +2 80, +4 84 - should we make any changes?

[Jessica A]

previous: https://felinediabetes.com/FDMB/threads/2-8-callie-amps-110-2-67-2-5-89.259055/#post-2911037

We've been holding at 1.25 U since Callie is doing pretty well on the dose but still has a fair number of blues. I am hoping to get some expert eyes on Callie's SS to see if you all think we should tweak anything at this point (dose, feeding, etc.)

We've been giving her 1/4 teaspoon of 35% HC mixed with her regular +1 snack to try to slow her onset drops, especially in the AM cycles. Not sure whether it is helping (some drops are still pretty steep) and I'm wondering if it could be affecting duration.

It seems like Callie's bg often rises mid-cycle and then falls again at PS. I would think that this is because she doesn't get food for 2+ hours before PS... but the same is often true of those mid-late cycle tests so I'm not really sure what to make of it. Sometimes the difference is within meter variance but last night's 130 at +9 to 96 at this morning's AMPS surprised me.

Any advice welcome

Hope everyone has a good day. Surf safely kitties

 

[Bandit's Mom]

What are the times that she gets food in both cycles? Does she get the HC at +1 only in the AM cycles?
Wondering if her onset is earlier than +1.5? Could you try getting a +1 in some cycles?

The dip at the end of a cycle is called a "Lantus double-dip". The BG rises from the nadir and then dips again at the end of the cycle - the second dip is shallower than the nadir.

 

[Jessica A]

Could you try getting a +1 in some cycles?

Sure, will get some +1s.

What are the times that she gets food in both cycles?

Current feeding schedule: We feed the largest meals at AMPS and PMPS.

AM: small snacks at +1ish, +2ish and after the +3/+4 test. Then at least one more snack, usually at +8 when she gets her afternoon gaba. Possibly also a +6 and/or +9 depending on how hungry she is and whether I am experimenting with feeding. I know that ideally we shouldn't feed after nadir ... but Callie definitely didn't get that memo And frequent feedings really help with her vomiting.

PM: same as AM through +4 and then I will usually either give her a small snack at +5/6 or +8/9. (Sometimes both if she's screaming loud enough to wake up our neighbors )

Does she get the HC at +1 only in the AM cycles?

Yes. Her night cycles seem pretty flat to me. I debated giving her HC at +1 on the nights that she had blue PMPS numbers but decided not to and she did not have hard, fast drops like she often does in the AMs.

The dip at the end of a cycle is called a "Lantus double-dip". The BG rises from the nadir and then dips again at the end of the cycle - the second dip is shallower than the nadir.

Ah, makes sense. Thanks!

 

[tiffmaxee]

I personally would continue the small meals as needed and stop the hc that you are feeding early in the cycle. Let her earn a reduction if that’s what she wants.

 

[Jessica A]

I personally would continue the small meals as needed and stop the hc that you are feeding early in the cycle. Let her earn a reduction if that’s what she wants.

Okay, we'll cut out the +1 HC, leave everything else as is and see what Callie does. Thank you!

 

[Bandit's Mom]

. I know that ideally we shouldn't feed after nadir ... but Callie definitely didn't get that memo And frequent feedings really help with her vomiting.

You have to do what works for her. Long gaps between meals can lead to stomach acid build-up and pukes. I am curious to know if her numbers drop after food in the second half of the cycle. That usually happens when a cat is on a very small dose.

 

[Jessica A]

I am curious to know if her numbers drop after food in the second half of the cycle.

We can try testing after her +8 snack. When best to do it - 30 mins after eating? Or an hour?

That usually happens when a cat is on a very small dose.

Very small dose meaning a smaller dose than Callie is on, like .5/ .25/ drop, yes?

Btw, I do think that Callie's onset could well be before +1.5 based on how she acts on the days that she drops hard and fast. She gets really restless and hungry and lately I've been noticing it happening earlier and earlier, like just after +1. You can see we have started testing her before +2 more and more in the AM and usually it is because she's going nuts. But I didn't know it was possible for onset to be that early so just thought that maybe she felt like something was starting to happen in her body pre-onset... will be interesting to see. I'm going to try to remember to get a +1 tomorrow morning since the day cycle is really where we see it happening.

 

[Bandit's Mom]

When best to do it - 30 mins after eating? Or an hour?

2-3 hours after food.

Very small dose meaning a smaller dose than Callie is on, like .5/ .25/ drop, yes?

Yes. 0.5 or even 0.25U and lower. Basically, the numbers falling after food (in the absence of insulin) indicate that the pancreas are producing insulin in response to food.

Btw, I do think that Callie's onset could well be before +1.5 based on how she acts on the days that she drops hard and fast. She gets really restless and hungry and lately I've been noticing it happening earlier and earlier, like just after +1. You can see we have started testing her before +2 more and more in the AM and usually it is because she's going nuts. But I didn't know it was possible for onset to be that early so just thought that maybe she felt like something was starting to happen in her body pre-onset... will be interesting to see. I'm going to try to remember to get a +1 tomorrow morning since the day cycle is really where we see it happening.

She might be one of those early onset early nadir kitties.