2/25 Miz Kirby AMPS 173 +2 91 +4 41 +5 80 +6 120 +12 170 Vomit effect?

Bandit's Mom said:
She's working the reduction :)
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Alas, dropped to 41. It seems like when she gets into blue/green, I almost need to test every hour to avoid dropping below 50. She is getting pretty sick of the constant pokes, and the more frequently I poke the more likely it is to take multiple stabs to get a drop, which makes it even more of a bummer. Doesn't even bother with the treat half the time, though it is still very sweet that she goes and climbs onto the cushion when she hears the cap from the strip container opening.

I decided to go with TR because I really want to aim for remission, but I'm starting to see the appeal of SLGS as a "well, it might not be all the way down to normal BG, but it also doesn't mean that half the time I'm worried about dipping into hypo at any moment" thing that would be pretty nice.
 
Bandit's Mom said:
That drop below 50 is another reduction. You would go down to 0.75u. Congrats! :)
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Thanks! Question for you (or anyone looking) about the impact of vomiting, in case the answer negates the reduction...

Kirby's a nervous-stomach cat, and before this whole diabetes thing, she used to get only a tablespoon of wet or dry food at a time (per vet advice) and still threw up half the time because she would eat so fast (she was an abandoned pregnant stray, and even though she has lived in comfort for 10 years, that "I've been starving and I can't eat fast enough because otherwise the feral cats will get all the food" behavior (lived in a place with a huge feral cat population at the time). With the diabetes diagnosis, I switched to wet food only, which she and the two civvies (one of which is her daughter) have been enjoying. The "feed half her food before each shot" instructions, on the other hand, didn't work, because it was too much volume and she would throw up everything. I have things now so I do about 1.8 ounces before each shot, and then an ounce at a time 2-3 in between times per day. Today, she threw up most of her food (no hairball) within 20 minutes of post-AMPS eating, and then threw up again (small hairball, not much food fluid) 2 hours later. Based on the amount she threw up the first time, I thought she probably didn't have enough food intake for the insulin (that was the reason I did the first BG check at +2 instead of +3). I would have fed her some more right then, but it looked like she would just throw up again, so I waited until after she'd taken a nap (the timing that usually works to settle her stomach back down). It was about 45 minutes later (after napping on her favorite spot) that I got ready to feed her more, and that was when I saw the 41. Fed her, she kept it down, and her blood sugar popped right back up (and she was back up into blue by +8).

Knowing that there wasn't really any food in her system when the insulin kicked in, I wonder if the insulin level is actually too high and needs reduction, or if the current level is still where she should be and the issue is that I should have fed her again right after the vomiting. I've seen some people on here talk about cats not wanting to eat, but that's never a problem with her, she definitely would eat again...but would probably throw up again if it was too soon. Any advice on the best way to react if she throws up everything right after eating? I usually shoot while she's eating so she's distracted, but chould change the timing if it would be better to separate them.

Since we switched to all wet food, she doesn't throw up anywhere near as much as she used to, but I see that the other day when she had a a weird down/up/down daytime cycle and dropped to 49 in the pm cycle, that was the last time she vomited. I had read on some websites that a diabetic cat's BG would go up after vomiting due to adrenaline reaction or something like that, but it looks like on all her vomit days her BG has gone down. Maybe because she's so used to throwing up from before she doesn't get a big adrenaline reaction? Whatever the reason, it seems like after vomiting the insulin doesn't have enough circulating blood sugar to act on without going hypo. I'll reduce to .75 with today's PM dose based on numbers, but am wondering if once the depot catches up to a reduction to .75 she'll be back in the yellow/pink if she's keeping her food down.

Any advice/thoughts appreciated!
 
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It's good you reduced. You can always go back up in 3 days if it's a failed reduction. TR is pretty nimble that way. On the food front, you don't have to feed a bulk of the food before the shot. You are fine with feeding her small quantities of food every hour from PS to +4 .
 
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