3/15-Cini Mini -PMPS 204, +3/76 - Bounce is over!

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Re: 3/15-Cini Mini - AMPS 293 - Day 2 of Bounce

I think someone needs a lesson or two at the liver training school - yes Cini I mean you!
 
Re: 3/15-Cini Mini - AMPS 293 - Day 2 of Bounce

Cathy

I know you didn't want to take his dose up BUT.....I have to wonder that if you perhaps take up his %carbs of his food and bring his curve up a bit, if you would then be able to increase his dose and minimize or stop the bouncing.

I know Patty did that with Champ and I did it with Gracie and in both cases, it worked pretty well. Of course, it would have helped if I hadn't given a fur shot yesterday. Both of these kitties are still bouncing some but are bouncing into
blues instead of those yellows/pinks.

But you need to take up the %carbs first and see the curve flatten out overall before you increase the insulin. It took me a bit of time to understand all of that but you test enough to be able to do it. I really think it would be a good idea for Cini.
 
Re: 3/15-Cini Mini - AMPS 293 - Day 2 of Bounce

Hi guys .. ugh .. darn bounces anyways, who needs 'em?!?! Come on back down cini mini .. you got all eyes on you, don't disappoint us ok? Have a great day guys!
 
Re: 3/15-Cini Mini - AMPS 293 - Day 2 of Bounce

Hi Marjorie,

I think I understand what you are saying but want to make sure.

I should wait till this bounce clears and then increase the insulin to 0.50 units? At the same time feed Cini say, 2% carb food at +2 so that the higher carbs will carry him through the onset of the increased insulin?

I'm not quite following how this approach would be better than just feeding Cini 0% carb and letting the insulin do what it's supposed to do at the 0.25 unit dose and waiting out the bounces. Cini had a really nice flat curve on 3/13 it's just that 70 was the lowest he's seen in a month and a half.
 
Re: 3/15-Cini Mini -AMPS 293,+3/299,+6/276 - Marjorie Questi

Cathy....I'm out right now and its hard to post from my phone so i'll respond in detail when I get home :-D
 
Re: 3/15-Cini Mini -AMPS 293,+3/299,+6/276 - Marjorie Questi

OK Marjie no worries. Cini is chugging along in the yellow zone today which is good (in that he didn't go pink!). :-D
 
Re: 3/15-Cini Mini -AMPS 293,+3/299,+6/276 - Marjorie Questi

Cathy...obviously you absolutely have the option of leaving him where he is, same dose, same food, riding out the bounces between greens. There is nothing wrong with that at all.

I'm just throwing out another option but it is more akin to walking the edge.....and you might want to do less of a Dosecrease and see how he does. But yes...feed higher carbs before he onsets to bring up the numbers. He generally does not appear to be a diver although he has a couple of times. You might have to experiment a bit first ( before you increase his dose) to see how feeding the higher carbs at +2 and/or +3 affect his onset and nadir. If it brings his onset and nadir up...then great...you are looking to flatten the entire curve. Once you see that, then you can raise his dose...maybe just try a f.25u. That might not be enough but then again it might.

And the food depends upon how carb sensitive he is. When Grace was on lantus, I was like everyone else in thinking zero carbs was better than 2 or 3%. But she was diving, bouncing, etc. Jill suggested I up the carbs and use a feeding schedule. We increased to 4% and that helped. Now she is on lev and I often feed her 8 or 10% carbs or mix them in with her 4%. That allows me to keep more insulin in her. But you have to be able to test frequently.

When you raise the curve with carbs, you can give more insulin. More insulin decreases the bounce.

Bottom line is.....it's your decision. I just thought I'd offer an option to help minimize the bouncing.
 
Re: 3/15-Cini Mini -AMPS 293,+3/299,+6/276 - Marjorie Questi

Thanks for that explanation. That helps a lot ! I didn't know that more insulin decreases the bounce. I am still learning new things about Feline Diabetes every day! :-D

Now when you say
you are looking to flatten the entire curve.
Click to expand...

What exactly do you mean by that?

This whole "flat curve" thing is new to me. I always thought with Lantus you just wanted a "plain old curve" and then my Vet explained with Lantus you basically want to end the cycle at or near where you started with little variation in the numbers during the cycle. Since Cini's been on the new insulin pen (Feb 27) it looks to my untrained eye as if this is what's happening.

So when you say a "flat curve" am I looking for the same number throughout? For example, like the day he had on March 6th? I am more of a visual person so pointing to a template or an example of how something is supposed to look works better for me.

Marjorie, thank you so much for taking a personal interest in helping out Cini Mini. I always appreciate any help or suggestions to keep him as comfortable as possible. :YMHUG:
 
Re: 3/15-Cini Mini -AMPS 293,+3/299,+6/276 - Marjorie Questi

Yes...March 6 th is pretty flat!

You may not be able to get that flat with food management but you want to try and bring the mid cycle numbers up closer to the PSs and the PSs fairly close.

Look at Alex's SS particularly before today: https://spreadsheets.google.com/pub?key ... utput=html

See how flat her curve is ?

Gracie is still bouncing into blue but look at her 3/10 am cycle (the PMPS was higher because I fed her at +10 or else she could have been below 50 and too low to shoot since she has a very late nadir): https://docs.google.com/spreadsheet/pub ... utput=html

Eventually what you want to see with lantus or lev is a fairly flat curve. So what your vet says is true...end basically where you start with little variation in the middle.

Again...this is your decision and you have to factor in Cini's asthma. It doesn't look like right now the meds are affecting him since he's been in green after your changes you listed the other day.

And Cini is fairly flat within a cycle but you also want to bring the whole curve down once you get it flat.....in other words more normal numbers and less yellow/pink. So

Manage the curve with food----->flatten the curve------>adjust the dose (if you want more green, increase the dose)

And Champs SS of late since she went from feeding zero carbs to 5% and higher:
https://spreadsheets.google.com/pub?hl= ... utput=html
 
Thank you, Marje for explaining all that. I will definitely look at these other spreadsheets and think on this new approach. I'm sure Cini wouldn't mind if I fed him higher carb food. ;-)
 
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