5/18 Henry C. AMPS, +2 455, +5 405

Roxana & Henry

Roxana & Henry

Active Member
Introduction Thread :

https://www.felinediabetes.com/FDMB...-and-henry-introduction-and-questions.263221/

Long story short: Decided to switch to TR today (dry food no longer offered). Previously went too high (5 units) per vet, missed the right dose (2 hypo events and tons of bouncing with no support from 3 vets), went back to 2.5, then 2.75 and now 3. Numbers seem to be increasing despite dose increase. Should have done 3.25 per TR today but was too tired to take a decision about switching from SGLS to TR . Cat is very picky. Possible highly sensitive to any food (especially raw and freeze dried) - will understand more once he drops to lower numbers.

With TR - keep the 3 units for 6 cycles, then up to 0.5 right? And if it goes to under 300 - go up with 0.25.

Hope to see some better numbers.
 
Roxana & Henry said:
Numbers seem to be increasing despite dose increase.
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Just FYI...many times right after an increase in dose, the numbers go up (which is exactly opposite of what you think they should do!) It happens so often we have a name for it! It's called New Dose Wonkiness (NDW).

So don't put too much worry into higher numbers for the first cycle or two after an increase.
 
@Chris & China (GA) - Thank you. I did see a few of these in the past and makes me go crazy. Sometimes it's hard to pinpoint whether it is the food or the NDW effect. I feel like he has been doing great with super low carb like FF in the past but now he pretty much hates all FF and have to go to higher carbs but still under 10%. Or sometimes it feels like feeding raw chicken which has zero carbs increases his numbers a lot. Will have to keep paying attention I guess. He pretty much gets bored very quickly of all the wet food but never the dry food (no more of that now).

QQ - If you test, then feed at 6.30 PM - do you wait half an hour AFTER he is done eating or can I shoot insulin at 7 PM (which i am doing now). Asking because Henry can take his sweet time eating when he does not like food. Have to top it off with something delicious like bonito treats or stella and chewy freeze dried morsels etc. I then feed a short snack at shot time to distract him from the injection otherwise it would be no go.

Due to the NDW effect (love the name) - do I wait for it to clear or follow TR regardless and wait 6 cycles and go 0.5 units if nadir is over 300?

Thank you.
 
Hi Roxanna, welcome to the LBL forum :)


Roxana & Henry said:
I feel like he has been doing great with super low carb like FF in the past but now he pretty much hates all FF and have to go to higher carbs but still under 10%.
Click to expand...
Some cats do better on slightly higher carbs 6-7% rather than extremely low carb. Maybe it's a matter of finding another brand/flavour that he likes? Of course, nothing is as delicious or addictive as kibble!
Feeding Low Carb vs Lower Carb Foods

Roxana & Henry said:
QQ - If you test, then feed at 6.30 PM - do you wait half an hour AFTER he is done eating or can I shoot insulin at 7 PM (which i am doing now). Asking because Henry can take his sweet time eating when he does not like food. Have to top it off with something delicious like bonito treats or stella and chewy freeze dried morsels etc. I then feed a short snack at shot time to distract him from the injection otherwise it would be no go.
Click to expand...
With Lantus you need not wait 30 mins after food to give insulin. That practice is for fast acting insulins like Cainsulin/Vetsulin/Novolin which hit hard on onset and you want to ensure that there is food on board when giving insulin. With depot insulins, it's typically test, feed, shoot - all within 10-15 mins. Some people shoot when the cat is eating and distracted. In fact, it is not necessary that Henry eats all his food at shot time. Lantus takes around 2 hours to onset (sometimes sooner for some cats or later for others) and you have that much time to get food into him. We advocate smaller meals through the cycle - it's easier on the pancreas, helps smoothen the curve and also keeps kitties happy (to have mulitple meals rather than just 2 meals twice a day)
Using Food to Manipulate the Curve

Roxana & Henry said:
Due to the NDW effect (love the name) - do I wait for it to clear or follow TR regardless and wait 6 cycles and go 0.5 units if nadir is over 300?
Click to expand...
NDW is not considered while counting cycles. It is the total number of cycles on the dose that matters. With nadirs over 300, you increase the dose by 0.5U (and not 0.25U) every 3 days/6cycles. You can take him up to 3.25U tonight.
 
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Hoping someone will help me with these 3 questions because I feel like I am failing my baby. Now PMS +4 he is 380 which is higher than at the prior lower dose.

Due to the NDW effect ( BG goes up after dose increase) - do I wait for it to clear or follow TR regardless and wait only 6 cycles and go up 0.5 units if nadir is over 300? I just wonder if that will shock his system even more. Or should I wait 10 cycles and see how he is doing?

If you test, then start feeding at 6.30 PM - do you wait half an hour AFTER he is done eating or can I shoot insulin at 7 PM (which i am doing now). Asking because Henry can take his sweet time eating when he does not like food (10-20 min sometimes). Have to top it off with something delicious like bonito treats or stella and chewy freeze dried morsels etc. I also feed a short snack at shot time to distract him from the injection otherwise it would be no go.

How much food he needs to eat in order to be able to shoot? at least half?
 
Hi Roxana, I already answered your questions above. :-)

You aren't failing your baby. He just needs to get to a good dose and with TR you can do that quickly. Like I mentioned earlier, when you see nadirs over 300, increases are in multiples of 0.5U and not 0.25U. So take him up to 3.25U tonight (if you haven't shot). Let's re-evalute the dose in 4 to 6 cycles.
 
Bandit's Mom said:
With Lantus you need to wait 30 mins after food to give insulin. That practice is for fast acting insulins like Cainsulin/Vetsulin/Novolin which hit hard on onset and you want to ensure that there is food on board when giving insulin. With depot insulins, it's typically test, feed, shoot - all within 10-15 mins. Some people shoot when the cat is eating and distracted. In fact, it is not necessary that Henry eats all his food at shot time. Lantus takes around 2 hours to onset (sometimes sooner for some cats or later for others) and you have that much time to get food into him. We advocate smaller meals through the cycle - it's easier on the pancreas, helps smoothen the curve and also keeps kitties happy (to have mulitple meals rather than just 2 meals twice a day)
Using Food to Manipulate the Curve
Click to expand...
I think you wanted to say that with Lantus you DON’T have to wait for 30 min to shoot but
bicely explained Bhooma, as always :)
 
@Bandit's Mom You posted this as i was replying. Sorry about that. Thank you so much for the clarifications.
I already did 3 units tonight only about 4 hrs ago or so. So tomorrow start at 3.25? Then hold for 3 days or 6 cycles?
Great there is no need to wait with Lantus 30 min after eating. His BG goes up pretty quick after eating. I tried many different flavors and types of food, he is just picky. I have to make sure he has something in his system or he may not eat anything the whole day just to show me he can.

Thank you so much.
 
Roxana & Henry said:
@Bandit's Mom You posted this as i was replying. Sorry about that. Thank you so much for the clarifications.
I already did 3 units tonight only about 4 hrs ago or so. So tomorrow start at 3.25? Then hold for 3 days or 6 cycles?
Click to expand...
No apologies necessaty. Cross posting happens quite often here :-)
Yes, please take him up to 3.25U tomorrow. And yes, let's take a call in 3 days.

Roxana & Henry said:
Ok, will start tomorrow at 3.25. I know the dose said increase 0.5 but the other day I was too cowardly to do it but you gave me courage. Thank you.
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He is still way over normal levels which are 50-100 mg/dl. The longer he stays in higher numbers, the more his body gets used to them and it becomes harder to bring numbers down. Increasing doses quickly and taking him to a good dose will break through that.
 
Thank you @Bandit's Mom! I did 3.25 this morning. Wil update spreadsheet and post new thread after my visit to new dentist. Yikes. He was 415 at AMPS and 438 at +2. Fingers crossed. Edited thread and deleted the help needed part since I got it. Thank you again!
 
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