6/13 Newman AMPS 250 increase dose

About all this feeding business... if Newman eats a meal at 6:00 p.m., that's going to be approximately +10 (if it's a day when he's going to get his shot at 8:00 p.m.) So if the test is conducted at 8:00 p.m., it would not be a "food-influenced" test. However, Newman would need to be willing to eat again at shot time in order to have food "on board" to protect him from the insulin hitting too hard. Is this roughly the procedure that's being followed? I'm sorry if I am dense about this. I'm trying to make sure that I get it!
 
Linda and Newman said:
As you are aware, I am trying to adjust the normal feeding schedule to accommodate Newman's diabetes. He is fed dinner between 4:30 and 5:00, but he is a grazer. I always remove all food no later than 6:00 so that I have the 2 hour "no food window." Then, using this example, I test at 8:00 PM for his PMPS, using a couple treats to bribe and distract. After testing, I shoot him and then for the rest of the evening before bedtime, he can graze to finish his dinner food. I have been diligent to enforce the 2 hour fast before PMPS testing.
Finally, I roll the insulin vial to mix it.
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Okay. I think you answered my questions, too. Sorry to be a bother when you're trying to wrangle Newman this morning! I know the whole feeding thing has been difficult with Newman being a grazer and having done this his whole life. The only other thing I would ask is ... does he graze a good bit after his shot? He doesn't seem to be doing dives, so I'm thinking he's taking in enough food in the hours between (in this example of an evening cycle) his shot and bedtime.
 
He will seclude himself, ready to hide.
Suzanne & Darcy said:
About all this feeding business... if Newman eats a meal at 6:00 p.m., that's going to be approximately +10 (if it's a day when he's going to get his shot at 8:00 p.m.) So if the test is conducted at 8:00 p.m., it would not be a "food-influenced" test. However, Newman would need to be willing to eat again at shot time in order to have food "on board" to protect him from the insulin hitting too hard. Is this roughly the procedure that's being followed? I'm sorry if I am dense about this. I'm trying to make sure that I get it!
Click to expand...
He eats no food after 6:00 PM.
Two hours later, I test for his PMPS. At that time if the test result supports the planned dose I give the insulin.
He is then free to eat up until I go to bed.
 
I never did those test after he eats to determine the immediate effect of food, because I am testing him so much and he has just that one good ear to use for pokes. I think his ear is extra sensitive now and that is why he didn't want to come to me this morning, wise to the anticipated ear poke. He is wincing just the slightest the last few pokes.
 
Linda and Newman said:
I never did those test after he eats to determine the immediate effect of food, because I am testing him so much and he has just that one good ear to use for pokes. I think his ear is extra sensitive now and that is why he didn't want to come to me this morning, wise to the anticipated ear poke. He is wincing just the slightest the last few pokes.
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Oh, poor Newman. You do go up and down the outer part of the ear a little bit, right? Some people use the paw for testing. I was just talking to a member yesterday and she said her cat was just fine with it. I can't even imagine it. Even Darcy might not have gone for that, and he was really compliant.
 
Linda and Newman said:
As you are aware, I am trying to adjust the normal feeding schedule to accommodate Newman's diabetes. He is fed dinner between 4:30 and 5:00, but he is a grazer. I always remove all food no later than 6:00 so that I have the 2 hour "no food window." Then, using this example, I test at 8:00 PM for his PMPS, using a couple treats to bribe and distract. After testing, I shoot him and then for the rest of the evening before bedtime, he can graze to finish his dinner food. I have been diligent to enforce the 2 hour fast before PMPS testing.
Finally, I roll the insulin vial to mix it.
Click to expand...

Thanks Linda,
The thing that i'm concerned about is that you are giving Newman his full meal two hours to his pre shot meaning his BG rises and there in no insulin in him to reduce the big spike that's happening.
Why not try a very small snack before the 2 hour window and then if you follow the 15/20 minute Test-Feed-Shoot procedure i'm sure you will see a lot better results with his blood glucose.
 
Teetee (UK) said:
Thanks Linda,
The thing that i'm concerned about is that you are giving Newman his full meal two hours to his pre shot meaning his BG rises and there in no insulin in him to reduce the big spike that's happening.
Why not try a very small snack before the 2 hour window and then if you follow the 15/20 minute Test-Feed-Shoot procedure i'm sure you will see a lot better results with his blood glucose.
Click to expand...
Hmmm. Are we seeing big spikes? I'm looking now. I do see that some evenings, the PMPS is a lot higher than one of the later tests.
 
The insulin is supposed to be administered 12 hours apart. If procedure is to test, feed and shoot, are meals fed 12 hours apart also?
 
Linda and Newman said:
The insulin is supposed to be administered 12 hours apart. If procedure is to test, feed and shoot, are meals fed 12 hours apart also?
Click to expand...
Yes, main meals should be fed at the same time as the insulin is given.
Why not try an experiment Linda to see if it helps Newman get his bloods in order.
6 am/pm test his blood (i presume this is your normal time)
6:05 am/pm feed his main meal.
6:20 am/pm shoot his insulin.
So at am/pm +3 give Newman a small meal, say 10 grams and do the same at +4 and +5.
Then no more food until pre shot not even two hours before and repeat the cycle for 1 week then let's see what happens.
Is that plan ok to you?
I know he's a grazer but he will learn, many cats including mine were constant grazers but the do learn their new routine very quickly.
 
Linda and Newman said:
The insulin is supposed to be administered 12 hours apart. If procedure is to test, feed and shoot, are meals fed 12 hours apart also?
Click to expand...
Not necessarily. Below is something I copied out of the new to prozinc... know the basics thing... so it's very general and, of course, there's the caveat about the no food for two hours before preshot test rule (which is also in that same document.) Some people do feed only twice a day, some people take the amount of food they want their cat to eat and break it up into smaller meals and feed it like that. We don't really know if Newman is not getting good duration of action with his insulin or if the duration is being shortened by feeding him his big dinner two hours before his PM shot. The only way to determine that would be a trial of a different feeding schedule. On the Lantus/Levemir forum, we counsel people to not feed after nadir because it can shorten the duration of the insulin. The action of the insulin is waning toward the end of the cycle and adding too much food in at that time can shorten duration. Sometimes it's still okay to give a small very low carb snack. Anyway, below is what the "basics" article says.
  • "Feeding Schedules:
There is no "right" or "wrong" approach to feeding; rather it's a personal choice. Some people like to feed twice daily, with the shots. Others like to give several small meals during the day (and perhaps the night).

We would recommend that you base your feeding schedule on your own particular situation (whether you're able to be around to monitor BG or not, etc.) and your own cat's response to the insulin. It is very helpful if you can determine when your cat's nadir (lowest blood glucose) occurs during a 12-hour cycle. If you work outside the home during the week, this might best be discovered over a weekend when you can be around to do a bit of a curve (feeding at pre-shot time, dosing the insulin, then testing every 2 hours until you see where in the cycle your cat's nadir happens while on insulin). Taking the extra time, early in treatment, to find out when your kitty's nadir occurs can help you determine when to have extra food available for those times when you're not around, so that your kitty stays safe if the blood glucose were to drop lower than is safe range."
 
Suzanne & Darcy said:
some people take the amount of food they want their cat to eat and break it up into smaller meals and feed it like that. We don't really know if Newman is not getting good duration of action with his insulin or if the duration is being shortened by feeding him his big dinner two hours before his PM shot. "
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This is something along the lines i suggest Linda should try with Newman just to see if there is any improvement.
 
Teetee (UK) said:
Thanks Linda,
The thing that i'm concerned about is that you are giving Newman his full meal two hours to his pre shot meaning his BG rises and there in no insulin in him to reduce the big spike that's happening.
Why not try a very small snack before the 2 hour window and then if you follow the 15/20 minute Test-Feed-Shoot procedure i'm sure you will see a lot better results with his blood glucose.
Click to expand...

Here's what my schedule looks like. All times are approximate on any given day, but generally within a 30 minute fluctuation.
Newman is allotted 3 cans of Fancy Feast Chicken Pate per day. He is a grazer. A typical day would be as follows:

7:30 am test

Feed 1/3 can of food (laced with Zobaline) which he usually eats entirely.

At 8:00 am I shoot his morning insulin.

8:00 - 12:00 He returns to complete his morning can of food which I dole out from the initial can of Fancy Feast.

4:30 pm I feed about 1/2 can of Fancy Feast allowing him to graze until 6:00 pm at which time food is removed.

8:00 pm I test for the PMPS value. Based on that number I shoot the evening dose.

The 2 hour fast actually starts from the time that he is no longer grazing on his dinner. So if he eats at 4:30 and doesn't eat again after say 5:00 pm, I consider the fast started at 5:00, so the evening procedure may move accordingly. I would test for the PMPS closer to 7-7:30, shoot and then allow him to graze again until bedtime.

I think I have covered a typical day. Please ask questions and make suggestions if changes are warranted. I have always fed multiple small portions of food to Newman because he tends to regurgitate.

Tee, as Suzanne knows, I am disabled and used a wheelchair, so I have to rely on Newman's good nature to cooperate and come to me. If he is stretched out relaxing on the floor, I cannot each him to pick him up. I have to get him to decide to stand up and allow me to snatch him up, or come to my desk for testing and treating. My son and grandson live with me, but they both go out to work. So I do have some help, some of the time.
@Suzanne & Darcy @Teetee (UK)
Thank you both.
 
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Linda and Newman said:
4:30 pm I feed about 1/2 can of Fancy Feast allowing him to graze until 6:00 pm at which time food is removed.
Click to expand...

So that's about 1.5 oz of food for that grazing time.

Linda and Newman said:
I have always fed multiple small portions of food to Newman because he tends to be regurgitate.
Click to expand...

Yes. This vomiting is a problem with Newman (and we especially don't want that at shot time.)
 
Linda and Newman said:
Here's what my schedule looks like. All times are approximate on any given day, but generally within a 30 minute fluctuation.
Newman is allotted 3 cans of Fancy Feast Chicken Pate per day. He is a grazer. A typical day would be as follows:

7:30 am test

Feed 1/3 can of food (laced with Zobaline) which he usually eats entirely.

At 8:00 am for before I shoot his morning insulin.

8:00 - 12:00 He returns to complete his morning can of food which I dole out from the initial can of Fancy Feast.

4:30 pm I feed about 1/2 can of Fancy Feast allowing him to graze until 6:00 pm at which time food is removed.

8:00 pm I test for the PMPS value. Based on that number I shoot the evening dose.

The 2 hour fast actually starts from the time that he is no longer grazing on his dinner. So if he eats at 4:30 and doesn't eat again after say 5:00 pm, I consider the fast started at 5:00, so the evening procedure may move accordingly. I would test for the PMPS closer to 7-7:30, shoot and then allow him to graze again until bedtime.

I think I have covered a typical day. Please ask questions and make suggestions if changes are warranted. I have always fed multiple small portions of food to Newman because he tends to be regurgitate.

As Suzanne knows, I am disabled and used a wheelchair, so I have to rely on Newman's good nature to cooperate and come to me. If he is stretched out relaxing on the floor, I cannot each him to pick him up. I have to get him to decide to get up and allow me to snatch him up, on come to my desk for testing and treating. My son and grandson live with me, but they both go out to work. So I do have some help, some of the time.
@Suzanne & Darcy @Teetee (UK)
Thank you both.
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I'm really sorry Linda to hear that and it must make things really difficult for you.
Are the cans 3oz size (85 grams)?
If so then what i would do is feed Newman one 3oz can at each pre shot and divide the last can into 6 feeding times
As in
7:30 am/pm Test Newman
7:35 am/pm Feed Newman one full can.
8:00 am/pm Shoot
Then am/pm +3, 4 and 5 feed Newman 15 grams each time and nothing else.
This way he still gets his three cans daily.
Although i'm concerned about the regurgitation, how long after eating does he do this, do you have any idea or is it just random?
 
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Suzanne & Darcy said:
So that's about 1.5 oz of food for that grazing time.

No, he can have up to one and one half 3 oz cans per meal. Most usually, he only eats one 3 oz can between AMPS and about noon.

He gets an initial 1/3 can after testing. The remainder of the can is covered until he comes back to his feeding station, which is in my line of view. At that time I spoon out another portion for him from the 3 ounces, and so on until it is used up or he is no longer showing up for food.
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I just thought…. You said at 4:30 you dole out about 1/2 can of Fancy Feast. Fancy Feast cans are 3 oz. So I said 1.5 oz. Of food at the 4:30 snack time for grazing until 6 pm when the food gets covered up. I did not mean the whole day’s allotment. Just the 4:30 - 6 timeframe. Sorry
 
Pink preshot this morning… seriously, Newman? I saw the pink last night so I guess it’s not surprising. He does have a history of bouncing after blue numbers so I guess that’s what it is.
 
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