2/24 - Bandit - AMPS 383 - Lessons from yesterday?

[Bandit's Mom]

http://www.felinediabetes.com/FDMB/...68-6-61-7-60-9-61-11-62-12-49-skipped.226080/

Wondering if I should have done anything differently yesterday? To avoid skipping a shot? Or is skipping a shot par for the course? Worried I might have disrupted Bandit's transition into lower numbers with the skipped shot.

She would have happily gobbled the HC kibble she loves if I had given to her at shot time but wasn't in a mood to eat YA till nearly 3 hours after her shot time.

Though her cycle yesterday was unlike anything I have seen in the last 3 months. She usually bounces within 2-3 hours in lower numbers (even mid-blues!).

 

[tiffmaxee]

I don’t think you could have prevented the skipped dose. You couldn’t stall without food with that 49. He will get back on track.

 

[Nan & Amber (GA)]

She'll get back on track, don't worry. You couldn't have shot below-50 numbers, the only thing you could have done would have been to delay the shot longer hoping for her to come up enough. Given that she surfed in greens for quite a while even after eating breakfast, I really doubt it would have happened, though.

The whole thing was so out of character, there was no way to predict or prevent what was happening-- you simply don't have any data of what she does in greens. Now you have a little info, and hopefully soon you'll be back in the lagoon, gathering more!

 

[Bandit's Mom]

yes, with her being below 50, i couldn't stall any more. plus the entire day's cycle was out of character, like right you rightly pointed out. am still wondering what prevented her from bouncing from the low numbers mid-cycle itself. that would have been typical behaviour for her.

 

[Waheeda]

Just wondering. Would it be better to give half or quarter dose instead of skipping? Is that safe to do?

 

[tiffmaxee]

With the depot in effect shooting a lower dose might still have kept her low and could be dangerous.

 

[Waheeda]

With the depot in effect shooting a lower dose might still have kept her low and could be dangerous.

Why was the depot suddenly overflowing the whole cycle? Was it because we didn’t expect it as Bandit was bouncing in the earlier cycles? If she wasn’t bouncing, we would have seen her going low when dose was increased?
Just trying to understand how it works in case happens to me too.

 

[Bandit's Mom]

Why was the depot suddenly overflowing the whole cycle? Was it because we didn’t expect it as Bandit was bouncing in the earlier cycles? If she wasn’t bouncing, we would have seen her going low when dose was increased?
Just trying to understand how it works in case happens to me too.

Yeah, this is something that too me by surprise too. In the past also (Jan 29, Feb 15) when her depot seemed to be full, she did bouce mid-cycle. But not yesterday.

 

[Waheeda]

Yeah, this is something that too me by surprise too. In the past also (Jan 29, Feb 15) when her depot seemed to be full, she did bouce mid-cycle. But not yesterday.

Lucky you were around to monitor. What if it happens when no one is around?

 

[Si am cat mom]

Yeah, this is something that too me by surprise too. In the past also (Jan 29, Feb 15) when her depot seemed to be full, she did bouce mid-cycle. But not yesterday.

I think it had something to do with increasing the dose instead of taking those other reductions maybe

 

[Bandit's Mom]

Lucky you were around to monitor. What if it happens when no one is around?

Fortunately I am at home and can monitor.

 

[Waheeda]

I think it had something to do with increasing the dose instead of taking those other reductions maybe

But Bandit never went below 50 before for those supposedly reductions. If u look at her SS, she was at 60 the lowest. If @Bandit's Mom had set her reduction at 50, then she would not have reduced dose and this wld happen too. How to prevent this?

 

[Si am cat mom]

But Bandit never went below 50 before for those supposedly reductions. If u look at her SS, she was at 60 the lowest. If @Bandit's Mom had set her reduction at 50, then she would not have reduced dose and this wld happen too. How to prevent this?

On SLGS, she would have technically earned those reductions.
There was a 59 and a 56.... then Bandit got an increase.
Even on my modified SLGS, I would have given Makoto a reduction but

 

[Waheeda]

On SLGS, she would have technically earned those reductions.
There was a 59 and a 56.... then Bandit got an increase.
Even on my modified SLGS, I would have given Makoto a reduction but

Ok, I saw the 59 and 56. But the 59 was so Long ago when she was on 1.75u. Eventho dose was increased, she never went very low. I can understand the reluctance to reduce dose cos u end up increasing again after few days. That’s the dilemma I’m in also. If I don’t see jebat going low more than once in a dose, I would hesitate to reduce. But seeing what happened to Bandit, I’m a bit worried too esp when he has lower cycle when I’m at work.

 

[Si am cat mom]

Ok, I saw the 59 and 56. But the 59 was so Long ago when she was on 1.75u. Eventho dose was increased, she never went very low. I can understand the reluctance to reduce dose cos u end up increasing again after few days. That’s the dilemma I’m in also. If I don’t see jebat going low more than once in a dose, I would hesitate to reduce. But seeing what happened to Bandit, I’m a bit worried too esp when he has lower cycle when I’m at work.

I think it's more about the pattern
It was a 59 - and an increase to 2 units
It was a 60 - and later an increase to 2.25 ( after an accidental 4 unit dose also)
Then it was a 56 - and an increase to 2.5

I think with the lower numbers that would usually be met with a bit less insulin being met with the same initially and then more insulin is maybe how it happen....but who really know

I'm still not convinced waiting to go below 50 on SLGS/ dry food is a good idea

 

[Crista & Ming]

It could be the kibble too. Dry food works differently in the body. It's one of the reasons why on SLGS, the reduction point is higher. We don't really know how dry food affects kitty's numbers as opposed to wet food.

But I do think it was wise to skip seeing as Bandit was green for the majority of the day.

Bhooma, do you have HC in wet form? We tend to see results from HC after 20-30 minutes and you can feed less and not fill up kitty. This is important to have especially when numbers go really really really low, You don' thave time to wait for dry to kick in.

 

[Bandit's Mom]

I'm still not convinced waiting to go below 50 on SLGS/ dry food is a good idea

Your point in taken. It doesn't have to be 50. I could do a decrease for a drop below 70 or 60. I haven't taken the reductions because Bandit's numbers have not trended downwards save for the rare drop into the green. I find that SLGS lacks the momentum required to preven glucose toxicity. Hold each dose for a week, hold failed reductions for a week, reduce below 90 etc. Will hold this dose of 2.25 and see if anything happens. Fingers crossed.

Bhooma, do you have HC in wet form? We tend to see results from HC after 20-30 minutes and you can feed less and not fill up kitty. This is important to have especially when numbers go really really really low, You don' thave time to wait for dry to kick in.

Bandit does not touch wet. I have tried everything. She may take some licks of the jelly if her numbers are high and she is ravenous/thirsty and has no other choice. But she is the kind who will starve rather than eat something she doesn't want to. It has happened in the past. I cannot get her to eat unless she wants to - I do my best to make sure she eats a bulk of her daily intake in the first 2 hours of the shot. The only thing she will eat at all times and absolutely loves is this brand of 18%carb kibble. I was half tempted to feed that to her and give her the shot last night but I've had difficulty weaning her off that and on to YA kibble (which she just about tolerates).

She is the most finicky eater I have seen. Have tried every kind of wet food available here (and the lowest carb content is 9%!), boiled egg, chicken liver treats (to be crumbled on food). No means NO!

I had to resort to a dash of honey at 49. She would have happily gobbled the 18% carb kibble. I thought honey would be faster and leave the system sooner than the HC kibble. Was I right?

 

[Crista & Ming]

Dang, I'm sorry Bandit is so difficult. What was your process when trying to introduce wet food to her?

 

[Si am cat mom]

Your point in taken. It doesn't have to be 50. I could do a decrease for a drop below 70 or 60. I haven't taken the reductions because Bandit's numbers have not trended downwards save for the rare drop into the green. I find that SLGS lacks the momentum required to preven glucose toxicity. Hold each dose for a week, hold failed reductions for a week, reduce below 90 etc. /QUOTE]

I agree there are limitations with SLGS for sure....it is frustrating

 

[Wendy&Neko]

Would it be better to give half or quarter dose instead of skipping? Is that safe to do?

No, you don’t shoot below 50 if following TR, or below 90 if following SLGS. Safety first.

Why was the depot suddenly overflowing the whole cycle?

Because reductions were not taken when they should have been.

An interesting post on reductions, and what can happen if you don’t take them. This example was TR. http://www.felinediabetes.com/FDMB/threads/reductions.81242/

 

[Bandit's Mom]

Dang, I'm sorry Bandit is so difficult. What was your process when trying to introduce wet food to her?

Tried everything given in Dr. Lisa Pierson's website. The other limitation with wet food available here (other than they not being sufficiently low in carbs) is that they are very moisture heavy. So Bandit would need to eat nearly an lb if wet food to get her calorific requirements. Just the water fills her up.

My civvie Budge is enjoying all the food experimentation that is going on. She is happily eating everything - dry, wet, treats etc etc.

 

[Bandit's Mom]

An interesting post on reductions, and what can happen if you don’t take them. This example was TR. http://www.felinediabetes.com/FDMB/threads/reductions.81242/

Thanks for this. Looks like this is exactly what happened. Any reason why some flexibility for kitties tending to fail reductions is not built into SLGS? From this sticky:

"

• For kitties that tend to fail reductions, a dose can be held and the reduction not taken
  until the kitty's BG has dropped between 40 and 50 three times on different days on that specific dose. The reduction taken should be .25u because this is an aggressive method of earning reductions."

I presume this applies to TR - why not have something similar for SLGS? Not the numbers, of course, but the concept of multiple drops below a certain number on a certain dose? At least for caregivers who monitor as much as those on TR do.

 

[Waheeda]

No, you don’t shoot below 50 if following TR, or below 90 if following SLGS. Safety first.

Because reductions were not taken when they should have been.

An interesting post on reductions, and what can happen if you don’t take them. This example was TR. http://www.felinediabetes.com/FDMB/threads/reductions.81242/

But I thot for SLGS, I can decide to lower the reduction limit?

 

[Si am cat mom]

But I thot for SLGS, I can decide to lower the reduction limit?

It's a little confusing but...my understating was if you are following the requirements for TR- wet food, testing enough, and know your cats trends pretty well....you can adjust a bit. It seems to be the dry food only that is preventing other on SLGS from being " encouraged " to try and do the same....

 

[Bandit's Mom]

It's a little confusing but...my understating was if you are following the requirements for TR- wet food, testing enough, and know your cats trends pretty well....you can adjust a bit. It seems to be the dry food only that is preventing other on SLGS from being " encouraged " to try and do the same....

But, if one was following the requirements of TR, one could follow TR itself and not need to follow SLGS and look to modify it!

 

[Waheeda]

It's a little confusing but...my understating was if you are following the requirements for TR- wet food, testing enough, and know your cats trends pretty well....you can adjust a bit. It seems to be the dry food only that is preventing other on SLGS from being " encouraged " to try and do the same....

My cat does eat some dry but not really a lot. He prefers wet. Sadly I can’t remove the dry cos my scrawny civvie likes it. I’m not keen to reduce at 90, I set it at 60. So far he doesn’t bounce much and he has predictable trends, touch wood, he stays this way.

 

[Si am cat mom]

But, if one was following the requirements of TR, one could follow TR itself and not need to follow SLGS and look to modify it!

I meant meeting the requirements to do TR but not following it yet for whatever reason....like we are. Makoto and I could be doing TR, but there are nights I am gone and can't always test through a cycle. So, I'm not completely comfortable with TR and increasing doses but not being home, so we started the modified reductions ( mainly when we started running out of room to reduce his dose )


I get what you are saying though

 

[Sue and Luci]

You've had a couple of busy days....one thing that I was wondering about - have you tried raw for Bandit?

I know there are supplements that you can get to mix with the raw meats to make the diet 'complete' for kitties...

If you've mentioned this previously just disregard...I can't always keep up with all the discussions here...but I was curious since Bandit will not touch canned wet foods that are available in your area.

Thanks and have a good evening!

 

[Bandit's Mom]

You've had a couple of busy days....one thing that I was wondering about - have you tried raw for Bandit?

I know there are supplements that you can get to mix with the raw meats to make the diet 'complete' for kitties...

If you've mentioned this previously just disregard...I can't always keep up with all the discussions here...but I was curious since Bandit will not touch canned wet foods that are available in your area.

Thanks and have a good evening!

replied by PM - i have mentioned this previously but didn't want to disregard. thanks for checking

 

[Sandy and Black Kitty]

Though her cycle yesterday was unlike anything I have seen in the last 3 months. She usually bounces within 2-3 hours in lower numbers (even mid-blues!).

Expect the unexpected.
you are working at gaining positive change via insulin therapy. One of the changes is the counter regulatory reactions eventually calm down. Back in the day we called it “liver training “

When it comes to treatment decisions it’s best to focus on what you see in the data from the past 2 weeks. Anything older is pretty much ancient history.