? 6/9 Ivy Lo/66 Contour, Dropping preshot +1 53/Libre, 86 Contour +1.75, 71 +2 Libre, 297 +8 Libre

Staci & Ivy said:
If it’s a late nadir, not sure, or a bounce breaking??
, I still don’t know the difference. I just know she dives in the hour up to dose time, very often.
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It's bounce breaking cycles that have later nadirs. Some cats nadir at the end of the cycle while Ivy seems to nadir later in such cycles.

Also, at such numbers, I would go by the meter number rather than the Libre.

What you could do is not stall when you get a lower PS but feed. Numbers can continue to drop without food making the shooting decision even more difficult. You now have data on how she behaves in cycles like this. As long as you can monitor, you have the tools to keep her safe. She might need some higher carbs at PS to prevent her diving further. You could give her a little honey or syrup with her usual food to boost the carb %.
 
Staci & Ivy said:
Update: At +1 she’s only at 53 on Libre and sleeping. (Probably around double on a human meter). Low for her to not get a rise at +1.
Gave a small lc snack @ +.45 with dab of karo. (No bump)
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Is it possible to ditch the Libre and use only a meter? Or will she tolerate only so many pokes?
 
Morning Staci, I see Ivy has been keeping you hopping this morning :). Keep a close eye as you did yesterday, her numbers may just stay flat, but you can use a couple drops of syrup in addition to your LC/MC blend to prop up her numbers.
 
Late nadirs are hard on the caregiver's nerves! It's challenging to decide if it's safe to shoot. At this point, you need to be doing what you're doing -- collecting the data.

I'm a little apprehensive to state that the low numbers on the Libre are roughly double what you would expect on a human meter. There's honestly no way to know that.

You had mentioned that you have a nutritionist for Ivy and you were going to check in re. an option for higher carb food. I would think about not only an option for bumping up her numbers if you don't want to use syrup. I'd also think about an option for a food that's around 8% carb. Some cats just do better on a food that's a bit higher in carbs.
 
Bandit's Mom said:
It's bounce breaking cycles that have later nadirs. Some cats nadir at the end of the cycle while Ivy seems to nadir later in such cycles.

Also, at such numbers, I would go by the meter number rather than the Libre.

What you could do is not stall when you get a lower PS but feed. Numbers can continue to drop without food making the shooting decision even more difficult. You now have data on how she behaves in cycles like this. As long as you can monitor, you have the tools to keep her safe. She might need some higher carbs at PS to prevent her diving further. You could give her a little honey or syrup with her usual food to boost the carb %.
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So what is she bouncing from? Yesterday am low drop at +12/13? and yesterday what was her drop from??

I will continue to cross check her Libre low numbers with Contour meter to see what her number is there.
Are you saying Ivy has a normal late nadir or only when she’s bounce breaking? And she keeps breaking bounces from a prior cycle but why can’t we get her to stop these extreme drops so she doesn’t just repeat the cycle all over again?!
Sigh :arghh::arghh:
Sorry to be so dense!
 
Sienne and Gabby (GA) said:
Late nadirs are hard on the caregiver's nerves! It's challenging to decide if it's safe to shoot. At this point, you need to be doing what you're doing -- collecting the data.

I'm a little apprehensive to state that the low numbers on the Libre are roughly double what you would expect on a human meter. There's honestly no way to know that.

You had mentioned that you have a nutritionist for Ivy and you were going to check in re. an option for higher carb food. I would think about not only an option for bumping up her numbers if you don't want to use syrup. I'd also think about an option for a food that's around 8% carb. Some cats just do better on a food that's a bit higher in carbs.
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When I hear back from the nutritionist I will ask that question about a slight higher formula for lc food. Good point.
I understand what you say about the Libre. Just using it really as a guide to alert me where she’s headed at best. It’s been very accurate when she is dropping low for her numbers, then I will cross check with the contour next human meter to be sure where she actually is.
 
Christie & Maverick said:
Morning Staci, I see Ivy has been keeping you hopping this morning :). Keep a close eye as you did yesterday, her numbers may just stay flat, but you can use a couple drops of syrup in addition to your LC/MC blend to prop up her numbers.
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I’m surprised she’s not bumped up at all. I’ve given her more mc Food than I have in the past plus some Karo syrup, and she still not going higher.
Wonder if this new dose it too high for her (3.5 units, given yesterday am & pm) ???
 
Just checked with Contour meter now at almost +2
86 on contour next meter & “Lo” on Libre (which is under 50)
 
Christie & Maverick said:
Morning Staci, I see Ivy has been keeping you hopping this morning :). Keep a close eye as you did yesterday, her numbers may just stay flat, but you can use a couple drops of syrup in addition to your LC/MC blend to prop up her numbers.
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I’ve never seen her stay flat at these low numbers before.
***Should I let her linger in these greens or try to prop her up????
 
Remember not all cycles will look the same, especially when kitties have bouncing going on. Staying in flat greens is a good thing, and if we focus in on the Contour readings, she’s looking good! You have the ability to monitor, so keep giving her a little food like you’ve been doing, and let’s see how things go. A favour to ask, could you put the latest Contour values in the SS? It’s easier to keep track.

Surf’s up, Ivy.:cool::D

img_0652-jpg.63769
 
Christie & Maverick said:
Remember not all cycles will look the same, especially when kitties have bouncing going on. Staying in flat greens is a good thing, and if we focus in on the Contour readings, she’s looking good! You have the ability to monitor, so keep giving her a little food like you’ve been doing, and let’s see how things go. A favour to ask, could you put the latest Contour values in the SS? It’s easier to keep track.

Surf’s up, Ivy.:cool::D

img_0652-jpg.63769
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I updated SS with contour info. Good point.
I’m giving snacks and she’s finally rising on Libre @ 91 now. She stayed very low for her for 3 hours. (That’s a first for duration so low).
Is that a good sign??
I assume she will repeat this bounce break cycle again tomorrow in am cycle (and then next day). Correct??

If numbers are high at a pmps today, do I give full 3.5 unit dose given how low the cycle took her today?
 
Way too soon to know about tonight. Remember she leads this dance. The more time she spends in the 70-200 range the better as her body will adjust to more normal bg. I hope the nutritionist figures out food with higher carbs as if that’s possible it will stay with her longer than adding honey. If not honey does the job by keeping her in safe numbers. It will make it easier to prevent bug drops.
 
Staci & Ivy said:
First time ever @tiffmaxee
Do you think I will be able to shoot full 3.5 dose at pm cycle?

Should I expect another bounce break tomorrow am cycle like the past 2 days??
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Got it. Pm cycle is in 7 hours… she’s staying low for her all morning so far.

I hope she can help with a better carbs in food to prevent screeching dives. Will take some time for her to reply then reformulate, then me to cook it up.

Is honey better to use than karo?

Should I expect another bounce break tomorrow am cycle like the past 2 days?? (I would think so…)

I assume I’m trying to get 3.5 units into her, or does the dose seem too high since she keeps diving so low for her?
 
Honey and karo work the same. I used Karo but mostly food. Max was very carb sensitive and reacted to small increases and decreases once he stopped bouncing which took at least 9 months but seemed like forever.

This is her longest green block so far and if I were to vet I suspect she will bounce. Clearing quickly is a sign of improvement. Feeding to prevent big drops is the only way I know of to land more softly. I don’t think she’s on too high a dose.
 
tiffmaxee said:
Honey and karo work the same. I used Karo but mostly food. Max was very carb sensitive and reacted to small increases and decreases once he stopped bouncing which took at least 9 months but seemed like forever.

This is her longest green block so far and if I were to vet I suspect she will bounce. Clearing quickly is a sign of improvement. Feeding to prevent big drops is the only way I know of to land more softly. I don’t think she’s on too high a dose.
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My bet is yes bounce also. Heavy Sigh.
Do you think tonight or tomorrow (if you had to guess based on her trends)
Since you say feeding to prevent the big drops, what do you think I should feed say at PMPS today and then tomorrow at a AMPS to try to prevent those drops.

She seems to start to drop an hour before it’s time to feed/shoot and I know I don’t wanna be giving food at that hour.
 
Looking at Ivy's spreadsheet, the 143 on the Libre at +4 cell should be color coded blue, not green.

Please consider that "low" is a relative term. Lantus, when it's doing what you want it to do, yields a flat "curve". If you take a look at some of the OTJ kitties' spreadsheets, you'll see what happens as a cat gets regulated. The numbers are largely all green.
 
tiffmaxee said:
I’d try a snack at +10 to see if that keeps her high enough to shoot comfortably unless the +10 is high. Then feed at shot time and try a snack at +1 and +2.
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If she’s low at +10, feed LC or MC snack?
(Problem is, she usually begins the drop at +11 to +12) I assume I can’t feed in that time to try to raise her up before shot time??
Looks like I will be getting up at 4 am tomorrow to check and give a snack since she wil most likely be breaking the bounce from this AM tomorrow morning.
 
Sienne and Gabby (GA) said:
Looking at Ivy's spreadsheet, the 143 on the Libre at +4 cell should be color coded blue, not green.

Please consider that "low" is a relative term. Lantus, when it's doing what you want it to do, yields a flat "curve". If you take a look at some of the OTJ kitties' spreadsheets, you'll see what happens as a cat gets regulated. The numbers are largely all green.
Click to expand...

Sienne and Gabby (GA) said:
Looking at Ivy's spreadsheet, the 143 on the Libre at +4 cell should be color coded blue, not green.

Please consider that "low" is a relative term. Lantus, when it's doing what you want it to do, yields a flat "curve". If you take a look at some of the OTJ kitties' spreadsheets, you'll see what happens as a cat gets regulated. The numbers are largely all green.
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I totally get that we are aiming for greens. It’s just that Ivy is getting there with deep, fast (almost daily) dives and I need to make sure she’s not going into hypo to be in the greens.
 
Staci -
When you have a few minutes, review Gabby's spreadsheet. She was very well know for her early, fast drops. She legitimately earned the name, "diving diva."

Dropping late can either be indicative of a late nadir or it's a "double dip." Some cat's numbers drop late in the cycle after their actual nadir. They just want to make you a little crazy and ensure they have your undivided attention!
 
Sienne and Gabby (GA) said:
Staci -
When you have a few minutes, review Gabby's spreadsheet. She was very well know for her early, fast drops. She legitimately earned the name, "diving diva."

Dropping late can either be indicative of a late nadir or it's a "double dip." Some cat's numbers drop late in the cycle after their actual nadir. They just want to make you a little crazy and ensure they have your undivided attention!
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I will do that!! So how did you deal with that??
 
I routinely fed her at pre-shot, +1, +2, and when I could or it was indicated, at +3. Whether I bumped up the numbers with carbs depended on what her numbers were telling me.
 
Sienne and Gabby (GA) said:
Looking at Ivy's spreadsheet, the 143 on the Libre at +4 cell should be color coded blue, not green.

Please consider that "low" is a relative term. Lantus, when it's doing what you want it to do, yields a flat "curve". If you take a look at some of the OTJ kitties' spreadsheets, you'll see what happens as a cat gets regulated. The numbers are largely all green.
Click to expand...
Sienne and Gabby (GA) said:
I routinely fed her at pre-shot, +1, +2, and when I could or it was indicated, at +3. Whether I bumped up the numbers with carbs depended on what her numbers were telling me.
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I see, that is what I am doing now. The problem is she dives BEFORE the meal, I can see her tanking on the Libre so I know it’s coming…but the hour before shot time we don’t want to carb them up…..so I just wait for her to fall.
Is there another strategy in that last hour - to give carbs to try to raise her BEFORE she dives so deep. I then spend 3-4 hours pulling her back up.
 
I have to admit I am struggling to see how a cat can go from +9 229 then +10 197 then +11 178 (and looking even prior arguably flattish) to Lo at PMPS one hour later. Something just doesn’t quite add up with that pattern even with a late nadir and bounce break. It just shouldn’t go from flat then Lo in 1 hour, at least not IMHO. Sorry to keep fussing the Libre values but it seems truly out of the ordinary even when comparing with other cats who occasionally have late nadirs.

Staci, we talked yesterday in your post about maybe adding a feeding at +6 since you said you typically stop at +3, just wondering if you did that last night? And what time do you give the shots? Just trying to line it up with the Libre screen shots.

As for dose tonight, with TR you’d take a reduction if Ivy was under 50 on the human meter, and while the Libre has presented lower values, I believe the consensus is that you should use the Contour meter readings when making decisions about whether to reduce or not which means staying at 3.5u.

I can imagine this is a little frustrating because there isn’t really one clear answer on what you need to do, since it appears Ivy’s shenanigans don’t even register on my shenanigan meter :p.

If feeding a little later in the cycle since her nadirs are coming later is something you would like to try, you could get an automatic feeder and set it for various times to turn and give her some snacks. I have a been using a Petsafe 5 autofeeder for years.
 
Sienne and Gabby (GA) said:
I agree with Christie. How about switching over to just the human meter over the weekend? I'm wondering whether you'd be seeing the same pattern with a human meter.
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Problem with her is poking her constantly. She’s fractious.
That’s why I try to limit poking to when it’s really needed, like when I see a very low value on Libre.
The Libre hasn’t been wrong that she’s low, for her, when I check with the Contour. (So I feel the Libre alerts me that she’s low, I double check Contour to find out HOW LOW.)
I could never poke her and get as much data in a day :(
 
How about a few data points, like preshot, +2 and a before bed test tonight, then preshot tomorrow? Is that maybe doable? It would give some good goal posts relative to the Libre, although there isn’t any direct calculation between the two.
 
Christie & Maverick said:
I have to admit I am struggling to see how a cat can go from +9 229 then +10 197 then +11 178 (and looking even prior arguably flattish) to Lo at PMPS one hour later. Something just doesn’t quite add up with that pattern even with a late nadir and bounce break. It just shouldn’t go from flat then Lo in 1 hour, at least not IMHO. Sorry to keep fussing the Libre values but it seems truly out of the ordinary even when comparing with other cats who occasionally have late nadirs.

Staci, we talked yesterday in your post about maybe adding a feeding at +6 since you said you typically stop at +3, just wondering if you did that last night? And what time do you give the shots? Just trying to line it up with the Libre screen shots.

As for dose tonight, with TR you’d take a reduction if Ivy was under 50 on the human meter, and while the Libre has presented lower values, I believe the consensus is that you should use the Contour meter readings when making decisions about whether to reduce or not which means staying at 3.5u.

I can imagine this is a little frustrating because there isn’t really one clear answer on what you need to do, since it appears Ivy’s shenanigans don’t even register on my shenanigan meter :p.

If feeding a little later in the cycle since her nadirs are coming later is something you would like to try, you could get an automatic feeder and set it for various times to turn and give her some snacks. I have a been using a Petsafe 5 autofeeder for years.
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Hi Christie,
I did not give any food past +3 last night since she was in 200’s all evening after dinner, Lantus & snacks (maybe I should have given a snack anyway at +6????)
Last night I gave her shot at 6:15 pm (Eastern) and by 5:30 am this am I could see she was heading down before the 6:15 am due time for shot (delayed until 7:15 am today)
As for the dosing for tonight PM Shot (she did not go below 50 on the Contour as far as I know this am, the lowest reading I got was 66 on Contour) - while the Libre said “LO” which corresponded to under 50.
So it doesn’t seem I should reduce her 3.5 dose tonight if possible.

I gave a 2.0 reduced dose this am…and it’s taken her about 7 hours to climb over 200 on the Libre today. Very unusual. Normally she bounces up within a few hours to high 300’s after a deep dive at +12-+13.

She really lingered in low numbers (under 100 on Libre) for 5 hours, her longest stretch in those number ranges.

She’s at 259 now at +7 on Libre.
No idea what to expect as we get closer to shot time and +12.
I’m going to feed her a snack at just before +10. Do you think it should be LC or a mix of LC. & MC to try to get some carbs onboard and see if that heads off a steep drop at her dinner/shot time.
And I am thinking of doing the same tomorrow early am 2 hours prior to breakfast and shot….give her some food to see if we can ward off the drop. I don’t know what else to do.

My fear of the self feeder is that she won’t eat it until AFTER she should, under the 2 hour NO FEED window (like past 4 am since I usually feed around 6 am) and I wouldn’t know!)
 
Correct, hold the 3.5u. Ok so the thing with the « no food » 2 hours prior, is it is just a guideline, not a hard and fast rule.

Normally until you get an idea of how food influences numbers, it is best to withhold food 2 hours before shot, in case the carbs artificially inflate the preshot number. However, that is usually more important for newbies who are just gathering data about how the insulin is working, and how carb sensitive their cat is. Once you have an understanding of that, this suggestion of not feeding 2 hours before shot can be relaxed. That said, it is certainly more relevant when dealing with lower preshot numbers.

Sure, let’s try as an experiment for this evening, feed LC/MC mix around +10. Since she is heading up now, I don’t think additional feeding is needed.

Speaking of dealing with low preshot numbers, here’s a great info post on the topic: https://www.felinediabetes.com/FDMB...y-to-shoot-handle-lower-pre-shot-numbers.147/

Maybe if the Libre gives you an alarm again tomorrow morning, you can try and double check the BG at +10 or +11 with the Contour? Gosh I feel like I’m asking a lot, just giving out a few suggestions
 
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Christie & Maverick said:
Correct, hold the 3.5u. Ok so the thing with the « no food » 2 hours prior, is it is just a guideline, not a hard and fast rule.

Normally until you get an idea of how food influences numbers, it is best to withhold food 2 hours before shot, in case the carbs artificially inflate the preshot number. However, that is usually more important for newbies who are just gathering data about how the insulin is working, and how carb sensitive their cat is. Once you have an understanding of that, this suggestion of not feeding 2 hours before shot can be relaxed. That said, it is certainly more relevant when dealing with lower preshot numbers.

Sure, let’s try as an experiment for this evening, feed LC/MC mix around +10. Since she is heading up now, I don’t think additional feeding is needed.
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So how much should I give her of the mixture at + 10? (tablespoon or 2?)

If I see her dropping @+ 11, do you think I could/should give some food to try to stop her so she doesn’t drop?

Ivy doesn’t really respond well to LC food, to bring up her numbers.
 
Christie & Maverick said:
How about a few data points, like preshot, +2 and a before bed test tonight, then preshot tomorrow? Is that maybe doable? It would give some good goal posts relative to the Libre, although there isn’t any direct calculation between the two.
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I can try to get those tests. She won’t be happy…I poked her several times this am within 1 hour.
 
Staci & Ivy said:
So how much should I give her of the mixture at + 10? (tablespoon or 2?)

If I see her dropping @+ 11, do you think I could/should give some food to try to stop her so she doesn’t drop?

Ivy doesn’t really respond well to LC food, to bring up her numbers.
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What if we try this. If she is dropping from high yellows through to @ +10 or +11 blues on Libre, if you can check BG on Contour at that time. If Contour is high blues or yellows, feed 2 teaspoons LC food. If Contour BG is low blues feed 2 teaspoons LC/MC blend which we are considering higher LC range.
Staci & Ivy said:
I can try to get those tests. She won’t be happy…I poked her several times this am within 1 hour.
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Gotcha. How about before bed test, then one at +10 or +11 as above? I can set an alarm to be up with you for moral support :)
 
Christie & Maverick said:
What if we try this. If she is dropping from high yellows through to @ +10 or +11 blues on Libre, if you can check BG on Contour at that time. If Contour is high blues or yellows, feed 2 teaspoons LC food. If Contour BG is low blues feed 2 teaspoons LC/MC blend which we are considering higher LC range.

Gotcha. How about before bed test, then one at +10 or +11 as above? I can set an alarm to be up with you for moral support :)
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Hi, I’m confused.
**Am I still giving her a snack at +10 this afternoon, in about 1 hour from now??

Am I testing her this afternoon at +11 With the contour?
Or just at pre-shot with dinner?
 
No need to feed at +10 in this cycle since her numbers are rising. That was suggested to try and get ahead of the drops to late nadir that you have been experiencing, which would then be suggested for tonight’s cycle +10.
 
Christie & Maverick said:
No need to feed at +10 in this cycle since her numbers are rising. That was suggested to try and get ahead of the drops to late nadir that you have been experiencing, which would then be for tonight’s cycle +10.
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Oh, ok, so tomorrow morning should I check 2 hours, then 1 hour before her AMPS, and if dropping like this am, test, on contour meter and feed her 2 tsp of LC & mc mixture??
If you look at the Libre screen shot at top of this post, you can see she begins a drop around 3 hours before AMPS was due…and then the 1 hour prior to AMPS time it’s free falling…..same pattern as her usual (bounce breaking).
Am I understanding the plan??
So her AMPS Should be 6:45 am tomorrow (Eastern) .
 
Depending on what the Libre is showing later tonight, I would say pick either +10 or +11 but both aren’t required for the additional test with Contour, since you’d be catching her in the middle of what seems to be when she is dropping on the Libre. Getting a spot check with the Contour at either +10 or +11 helps to establish a reliable point of reference. Feeding at either time will hopefully provide some stability into preshot. Sound good?
 
Christie & Maverick said:
Depending on what the Libre is showing later tonight, I would say pick either +10 or +11 but both aren’t required for the additional test with Contour, since you’d be catching her in the middle of what seems to be when she is dropping on the Libre. Getting a spot check with the Contour at either +10 or +11 helps to establish a reliable point of reference. Feeding at either time will hopefully provide some stability into preshot. Sound good?
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Christie & Maverick said:
Depending on what the Libre is showing later tonight, I would say pick either +10 or +11 but both aren’t required for the additional test with Contour, since you’d be catching her in the middle of what seems to be when she is dropping on the Libre. Getting a spot check with the Contour at either +10 or +11 helps to establish a reliable point of reference. Feeding at either time will hopefully provide some stability into preshot. Sound good?
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So if I see she’s dropping tomorrow early am at +10 or 11, (she doesn’t really tend to go LOW until +11 to +12, that’s when she dives….)
Do I Contour Test then only if dropping (or no matter what) feed snack (either LC or LC/MC mix, if going very low.) only if deep dropping?

Do I Test again at AMPS with contour (or only if going very low and Libre alarms going off)?
(That’s 2 pokes in an hour or 2) eek.
 
Just confirming, I’m only testing tomorrow am IF she’s (at +10 or 11) dropping fast, correct? (so sorry again, I’m exhausted and my brain is just not functioning correctly.)
 
That’s ok, you’ve had a tough several days. Yes, I would check at +10 or +11 with Contour IF she is appearing to be dropping into a late nadir again and depending on the drop you are seeing on the Libre. You may have to validate the AMPS depending on what the Libre is showing. And you don’t need to feed at that +10 or +11 if there isn’t a marked drop into late nadir appearing on the Libre.
 
Christie & Maverick said:
That’s ok, you’ve had a tough several days. Yes, I would check at +10 or +11 with Contour IF she is appearing to be dropping into a late nadir again and depending on the drop you are seeing on the Libre. You may have to validate the AMPS depending on what the Libre is showing. And you don’t need to feed at that +10 or +11 if there isn’t a marked drop into late nadir appearing on the Libre.
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Ok. I just tested her on Contour before pmps and it was 277, Libre was 311.
Do you still want me to do a +2 this evening on contour as well as a before bed (which would be +3 because I’m gonna go to bed at 10 PM because I’m exhausted. )
Do I need 2 hours in a row contour meter tests?

I will give her normal low-carb snacks during the first three hours of her cycle tonight before I go to bed.
And then I will wake up at 4:30 AM and see what’s going on on the Libre and then make decisions about what time to ear prick, if necessary, and feed, if needed. Hopefully you won’t hear from me again tonight or tomorrow.

Thank you so much and I hope you have a wonderful evening and that I don’t have to bother you again. You’re amazing. I really appreciate you. :bighug::bighug::bighug:
 
Thank you for catching a preshot on the Contour :). Since we’ve got the plan for possibly testing early next morning, let’s just leave Ivy be and give you a little breather as well. If even required, I think that test will be more important than anything now before you go to bed. Nothing at all has been a bother, far from it! I’m really glad to be able to help, and hoping something we cook up here will work to help keep her from dropping too quickly. Have a great night, Staci, and get a good sleep :bighug::bighug::bighug::bighug:.
 
Christie & Maverick said:
Thank you for catching a preshot on the Contour :). Since we’ve got the plan for possibly testing early next morning, let’s just leave Ivy be and give you a little breather as well. If even required, I think that test will be more important than anything now before you go to bed. Nothing at all has been a bother, far from it! I’m really glad to be able to help, and hoping something we cook up here will work to help keep her from dropping too quickly. Have a great night, Staci, and get a good sleep :bighug::bighug::bighug::bighug:.
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Sorry… you do want me to test before bed tonight???
 
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