7/28 Emma AMPS (205) | +2 (61) | +4 (99)

Hello and welcome! Can you please tell me how you have been choosing your doses. I see they’re a bit all over the place. This is not a criticism. I want to help you and keep your kitty safe. I see that you are new to this and am very pleased that you are testing!
 
Also, may I ask your kitty’s feeding schedule. It looks like you need to feed a snack at +1 and possibly also +2. That was quite a drop today very early in the cycle.
 
So, I appreciate that you are trying to be more consistent in your dosing, but I see that your Emma (I have an Emma too :) ) dropped to 61 today. According to the rules of SLGS protocol, you need to reduce her dose by .25 units. Her new dose will be 1.75 units. Can you please do this on her next cycle? Under SLGS, if your cat drops below 90, that calls for a reduction.
 
Suzanne & Darcy said:
@Manuel I am hoping that you saw this post about Emma earning a reduction to 1.75 units and that is what you will shoot this morning.
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Hi Suzanne - thanks for your replies! Somehow I missed your message yesterday evening, though I checked my alerts.

Re: dosing: I've slowly been reducing from the 2.5u and then 3.0 which my vet recommended. For the last last calendar week (14 cycles), it's set consistently at 2.00u, and I've given a lower dose only twice. Per SLGS, when there is a lower-than-usual pre-shot BG, I am encouraged to give a reduced or token dose. I've done this twice, both in the evening. The one at 1.00 was because my wife bathed the cat after a flight before I could test; her fur was so wet I couldn't get a test in so I opted to give just a half-dose. The rest have been 2.00 shots.

Re: reduction and feeding: Thanks for this! I will reduce to 1.75u starting this morning. Emma's nadir is often early from what I can tell. I give her 80% of her meal at insulin time and 20% delivered 2 hours later using an automatic feeder. Do you recommend that I split the smaller portion instead it into two smaller snacks? How long does dry food usually take to "kick in"?

Luckily, Emma is really quite consistent so far, with the main deviation being that she also takes (for IBD) prednisolone every second day which tends to raise her BG a bit.
 
Would you please add Prednisolone to your signature. You can put EOD or every 48 hours. Whatever works for you.

And she eats the Z/D dry food exclusively? And it's for IBD?
 
Manuel said:
Do you recommend that I split the smaller portion instead it into two smaller snacks? How long does dry food usually take to "kick in"?
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It might be a good idea to split it into two snacks at +2 and +3, but this is something you may need to play around with to see what works (and what/when she will eat.) Dry food does take a little longer to "kick in" and raise BG than wet food, and it tends to last longer before it "wears off."
 
Oh, and can you please indicate on your spreadsheet when she gets the Prednisolone? I've seen people just write into a cell when they give the Pred. Or you can put it in the remarks colums. That way you (and we) can see when she is getting the Pred and how it is impacting her blood sugar. This can help with dosing adjustments/decisions.
 
Suzanne & Darcy said:
It might be a good idea to split it into two snacks at +2 and +3, but this is something you may need to play around with to see what works (and what/when she will eat.) Dry food does take a little longer to "kick in" and raise BG than wet food, and it tends to last longer before it "wears off."
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Thank you. If dry food takes longer to raise BG, then that would explain why her dip comes sooner after insulin than for other cats. I have been in communication with the vet about switching to wet food, but the vet wanted a proper BG curve before okaying anything. I am quite sure it's the pred which is preventing Emma from vomiting and not the Royal Canin Hydrolyzed Protein which I've now been feeding her from some time. In a pinch during the pandemic, Emma ate FF chicken for 2-3 days and seemed fine, but of course never long term. I can add pred into the comments section. Typically it's every second day in the evening with food (thus, after the shot).
 
Manuel said:
Thank you. If dry food takes longer to raise BG, then that would explain why her dip comes sooner after insulin than for other cats. I have been in communication with the vet about switching to wet food, but the vet wanted a proper BG curve before okaying anything. I am quite sure it's the pred which is preventing Emma from vomiting and not the Royal Canin Hydrolyzed Protein which I've now been feeding her from some time. In a pinch during the pandemic, Emma ate FF chicken for 2-3 days and seemed fine, but of course never long term. I can add pred into the comments section. Typically it's every second day in the evening with food (thus, after the shot).
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Have you considered a novel protein diet for her? That works for some people instead of the hydrolyzed.
 
Suzanne & Darcy said:
Have you considered a novel protein diet for her? That works for some people instead of the hydrolyzed.
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Thank you, yes. @Wendy&Neko recommended this to me in my welcome thread, but advised that I should stick to the HP dry food until some period of testing stability and insulin reduction from what the vet initially prescribed. It's only yesterday that I was home for a few days and could do a proper glucose curve. In my email to the vet last night I mentioned wanting potentially to switch to wet food.

Wendy's post was #17 in this thread.
https://www.felinediabetes.com/FDMB...stion-about-transitioning-to-wet-food.265735/
 
Manuel said:
Thank you, yes. @Wendy&Neko recommended this to me in my welcome thread, but advised that I should stick to the HP dry food until some period of testing stability and insulin reduction from what the vet initially prescribed. It's only yesterday that I was home for a few days and could do a proper glucose curve. In my email to the vet last night I mentioned wanting potentially to switch to wet food.

Wendy's post was #17 in this thread.
https://www.felinediabetes.com/FDMB...stion-about-transitioning-to-wet-food.265735/
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Yes. That's absolutely the right thing to do. You have to be careful to watch their BG very carefully when doing a food transition to lower carb food.
 
Manuel said:
If dry food takes longer to raise BG, then that would explain why her dip comes sooner after insulin than for other cats.
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This could be true, but we do have other cats on the Board who are on low carb wet food and start to dive at +1 or +2 so very early in the cycle. Every cat is different. You will soon know Emma's patterns and responses very well.
 
Dry food does not take longer to get into the system, but it does take longer to get out.

Now that you are getting the hang of testing, you can consider a slow switch to a novel protein diet. I would start with just a tsp or two and see how she does on it. Then increase that amount every couple days. Try to give same amounts AM and PM.
 
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