Re: 6/8 TASHIE AMPS=519+5+542
Lesson One...Feeding Low Numbers
The other day, we fed Tashie HC at 54 @+3.5. Usually we say, feed LC unless they are below 50. But....there are exceptions:
- a fast drop to a lower number
- a new kitty with little data and a nervous caregiver
- a low number really early in the cycle
Take a look at
Gabbys SS. Gabby generally has an early nadir and likes to drop early and fast. You can see how Sienne uses HC with her to slow her down.
The goal in a newly dx cat (dx less thwn one year) is NOT to prevent a reduction; it's to keep them safe and try to minimize the bounce that comes with a really fast and steep drop.
If you get a 54 midcycle from a glide down, you would use LC food. You will also learn what Tashie reacts to best. For instance, I used alot of HC gravy, food, karo when Gracie was newly dx and on Lantus. But then I figured out she responded really great to 10% food. I never use HC or gravy and restrict the use of karo to really really low numbers (20s/low 30s) when I want her up fast. ECID...learn what Tashie responds to and use what she needs.
If you get a 54 late cycle, you might not need to feed OR a tiny bit (1 tsp) of LC might work beautifully. So consider:
1. How fast is she dropping
2. Where is the number in the cycle
3. How does she respond
And lastly....feed the 40s. If you get a 40s number at PS, do not feed, retest in 15 mins. If she is not above 50, feed 1 small tsp LC and retest in 20 mins. In the meantime, you will be posting and asking for help
Lesson Two...Feeding the Curve (dives)
We have some champion diver kitties in LL. They especially like to dive when they are clearing a bounce which appears to be Tashies
modus operandi. It helps to try and flatten the curve so they don't scream down and then swoosh back up because they took such a dive. If you look around at different SSs, you will see people feeding their cat on a front loaded schedule. This is to flatten the curve.
If a cat doesn't dive and has fairly flat cycles, they can be free fed and don't need a plan to manage the curve. But if they dive, you might want to think about dividing the number of calories/day into the two cycles and then feed mini meals on a schedule.
Most will feed a portion at PS, +1, +2, and +3 to control the dive. I did this when Gracie was on Lantus and Sienne does it with Gabby. (I still feed on a schedule for her lev onset). It doesn't flatten the cycle over night but patience and it does help. You will also have to see what best helps Tashie. Maybe it's PS, +2, +3....and since you work, you may need to use an auto feeder.
Lesson Three...Counting drops
If you are going to use calipers, you might not need to do this but it's a good idea to see how many drops you get to a unit. Typical is five drops to .5u, ten drops to 1u. For a while, I was counting 7 drops to .5u, 14 drops to 1u because that's what Gracie was best responding to....smaller dose changes. But now I use ten drops to the unit so every dose change for her is 0.1u.
Counting drops takes patience. Ideally, you slowly (very slowly) expel a tiny bit of insulin from the syringe and it will form a drop on the tip. When it starts to roll off the bevel, that is one drop. It's the way most of us used to dose until we started using calipers.
Let me know if you or Jim have questions on the post on Dosing with Calipers. If you are using Relions, I'd measure a bunch of them at 1u and see how accurate they are. You might find they aren't but none of them are. Be consistent on measuring from the needle side of the plunger at 1u to where the zero line "should be". The zero lines from syringe to syringe are often off by alot from syringe to syringe.
Lots of info....questions?
