4/27 Ivy Amps 345, +2 388, +5 312, +8 353, +10 245,Pmps 280,+2 336,+4 231 Libre, Carbs/Dose Increase

4/26/24
Amps 345 Libre
Mostly flat yesterday both cycles. Gave increase to 4.5 Units Lantus today am dose.

Question:
I’m wondering if I should increase what I’m feeding all meals and use 9.25% (instead of the 6% I feed now.)
My concern is that the 6% doesn’t seem to give her enough oomph to handle the higher doses.
(Or, is a slightly higher carb counterproductive?)

I’m wondering if it’s worth a try at 9.25% at this higher dose. Anybody have any thoughts? Thanks.

Out to dinner tonight. Will feed 12.5% for that one meal and snacks +1,2,3 hoping she eats snacks and stays a bit higher for a few hours (she’s not reliably eating from auto feeder).

Have a nice day everyone, safe surfing.

 

Good morning Staci,
Good luck with the increase.
Carb adjustment is such an art and every cat seems to respond differently!
I would think that you just need to experiment - maybe to feed her higher in the evening and go with 6% food when you can monitor during the day?
I'll tag @Angela & Cleo who has provided a lot of great tips on this subject.

Busy day ahead for you. Hope you have a moment to yourself to enjoy the day

 

Hi

Kit, thanks for the suggestions. So much to consider. And so hard to know what’s right, and ECID.

Yep gonna be a busy 2 days to entertain family for dinner tomorrow
I used to enjoy these kinds of things, but now it’s just so much to take on, throwing dinner parties while running up and down the steps, dealing with Ivy bg dropping and testing and having to leave in the middle of a meal for 40 minutes between the routine of prepping, feeding, shooting, etc.
Just doesn’t make for an enjoyable evening for me at this point. (Hopefully the family being invited appreciates my efforts to keep everyone happy)

Hope you and Mikan have a happy day

 

I do not mean this as a criticism, where do you want Ivy's numbers to be?

When you say

, how much of an "oomph" are you looking for?

Since you are custom dosing, why did you decide to increase this morning? (Also not a criticism, just fact gathering)

 

Hi Angela, Ideally I’d like her numbers to be 80-180 on the Contour meter when checked.
As we know, The Libre with Ivy reads Lower than the Contour meter will be.
Since I am seeing a lot of yellow and higher blue cycles that means she’s above the threshold I would like her to be on the Contour meter.
When I have tested the blues on the Contour, it is higher than the Libre numbers of course. So an increase was given to try to bring the range down a bit so she spends more time in the desired range. And Less time in the higher ranges.

In terms of oomph (not sure how else to phrase it) when I raise her dose, she seems to really get whooped while eating 6% only, going lower than I’d like her to be. And when I’ve encountered cycles where she’s much lower at PS I have been feeding the 9.25% to try to keep her a bit elevated anyway. (I think it helps).

She’s not carb sensitive to 6% but is a bit more so to 9% or 12% (that I have with my recipes I cook for her).
I hope this answers your questions

 

Thank you!
IMHO, if the current feeding schedule with carb % didn't get Ivy into the range you want her to be and therefore had to increase, then why would you change what you are feeding?

 

It’s a perfectly good question Angela. And that’s why I’m asking questions.
Only because as I mentioned when I see her much lower at a PS and use 9% for her meal and snacks in that cycle to keep her elevated from going too low, that’s why I thought maybe a slight increase in carbs may help.

Maybe my thinking is completely off and that’s why I’m questioning what is the best course while I increased to a dose I believe may cause her to be lower than I’d like.
I’d like to be able to make sure I can give her shots and that she’s not too low at PS.

 

I am looking at your SS and it seems that it is very very rare when the lime (on Libre) correspond to greens on Contour. More often than not, they are blues, or even high greens. I think in your case I would keep feeding the 6% except when you need her to stay higher. She seems to switch to yellows and pinks on the Libre after you feed her 9.5 and 12%.
By curiosity, did you check the higher ranges on the Contour as well, to get an idea? Are the numbers more similar in those ranges?
I hope your weekend goes well. I don't like having too many people here, that stresses me so much that I do not really enjoy the moment!

 

Hi Staci,
I think you'll have to experiment with food and her numbers and see what she shows you. You know her best and ECID so not much advice from me.

I hope she gives you stress free cycles today and tomorrow so you can enjoy your dinners.
Is, as Diane would say, mommy dearest attending tomorrow? I hope not! Either way good luck with the prep and hosting.
Will check on you later today

 

Yes, Cecile, the LIBRE limes usually are either a higher green or even blue on the Contour meter. Plus the LIBRE meter is constantly fluctuating and reads every few minutes. So it’s a moving target.
I assumed when I fed the 9% and she went higher it seemed it was as a reaction to her having been in lower numbers, (what goes down must come up?) and the 9% just held her up a bit better than if I’d fed 6%.
Isn’t that why we feed a higher carb at a PS if we want to give them a better support at PS if they are lower?
Yes I’m trying to check some of the blue numbers on LIBRE to better see how they correlate to the Contour and the Contour is still higher.

I agree with your feeling of lots of guests too. Especially my in-laws. They’re never helpful guests and just like to be waited on. So it’s more work and less fun for me.
Oh well. It’s what’s why I don’t do that much these days, especially with what’s going on with Ivy.
I hope you are having a nice weekend

 

Hi Karolina, I guess you’re right it is constantly an experiment isn’t it? Just figured I’d tap the experts, since they have so much more experience than I do. I’m always looking to learn.

Unfortunately, she seems very unhappy and growly today. Her numbers are very high and she just wants to be left alone. I feel so bad. I hope nothing more is going on then she’s just not liking being in very high numbers.
I hope it’s only NDW and she will come down a bit and acclimate OK to the dose.

Yes, you were correct in your guess that Mommy Dearest is on the hit list tomorrow. You know how thrilled I am about that
Hoping I can get them in and out early so I can try to recover and just take care of Ivy.

Wishing you, Nestle and Peanut a stress-free, efficient packing weekend

 

Well not sure why she’s so, so high all day today. I don’t know how to interpret this cycle. She seems so miserable. Poor girl
She was drinking a lot this morning from being so high

 

I agree with what @cecile & bella sees on the SS

So a clarification:

From Using Food to Manipulate the Curve link:
" the only time you might want to feed a little higher carb food at shot time is to bump the numbers up so the insulin is starting from a higher number when onset occurs if you're running out the door and will be unable to monitor.

if you're around to monitor, there's no reason to bump the numbers up at shot time."
(additional emphasis mine)

From New Dose Wonkiness" (NDW) link: "is usually seen in the second day following a dose increase."

 

I was going to ask the same thing Karolina, I see she will be there
@Karolina KJ & Nestle

 

Oh boy! Oh no don't put her on the hit list you might get arrested
Hang in there and just smile lol
If she gets to be to much just slap her around a little
Oh God I'm going definitely to hell


@Staci & Ivy

 

Love this, thank you Diane!! (I’m going to hell, too. lol)

 

Ha ha ,I'll meet you there

 

Thank you, Angela

 

What a very high am cycle. Came down some toward the end.
Pmps 280 Libre.
Now hoping she eats her snacks while I’m out for a few hours. Be back by +3ish.
I can only imagine she will come down tonight with second increased dose.

 

I did a long discussion on this in this post on Ivy’s condo.

I agree with this.

Normally, if we have a bouncy cat, we can feed a little higher LC to try and flatten the curve. If the curve ends up with higher BGs, then we can raise the dose to try and keep the overall curve a little lower. We don’t usually raise the dose and just feed higher LC just because we don’t want them to drop too low although if they do drop low, we have to sometimes feed a little more carbs depending where in the cycle the BG is lower and how low it is.

It’s really important to remind everyone that ECID and we cannot predict what any specific carb food will do to the BG in a specific cat without trying it. You’ve raised the dose and if she starts to get bouncy, then you can try and use the 9% to flatten the curve a bit.

The thing that will be most helpful to those helping you is if you can try as much as possible to (1) test any PS that is in the 40s on the Libre or lower to see what it is on the C (2) get some test with the Contour at different parts of the cycle. This doesn’t have to be 4 or 5 tests in a cycle but maybe one or two, if possible. It just makes it very difficult to make dosing decisions if you aren’t really sure where she is. While it appears that if she is in mid to high blue on the Libre, she’s in yellow on the C, there is so much variability that it’s hard to really tell what her cycles actually look like.

 

I forgot to wish you good luck with the increase

 

I'm certainly don't have the knowledge to comment with feeding suggestions.

But I can send some good wishes for Ivy and especially for you for the dinner party situation. I hope things go smoothly. Maybe MIL will develop a "headache" and have to leave early.