8/11 Ebby AMPS 193 +3 392 Advice ??

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MelissaEbby

MelissaEbby

Member Since 2012
AMPS 193
+3 392

Yesterday's:
viewtopic.php?f=9&t=102012

I'm confused by today's numbers. I thought she cleared the bounce, but maybe there was a low last night that caused another. I lowered the dose back to .75 because of yesterday's low. I'm feeling a little overwhelmed as to what dose I should be giving her. Doesn't seem like any dose is working well. 1 unit was too much, but sometimes not enough....same story with .75.

Is there anything more I can do for this sweet kitty? I feel so bad when her numbers are high, and wonder if there is more I should be doing. Should I consider using R insulin?
 
Welcome to the "Confused Club" Melissa!! :dizcat :?

I think you're probably just still working on clearing that bounce from the 38 only 24 hours ago. I'd just hold the .75 and if your patience pants are dirty, throw them in the wash! You might need them :-D

It can take a full 72 hours to clear...even if they usually clear bounces quickly, that doesn't mean they're going to clear the next one just as fast .....Sigh

Hope your numbers make better sense to you soon! I know it can be really frustrating
 
Chris & China said:
Welcome to the "Confused Club" Melissa!!
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Thanks Chris, I'm glad there is a club for us!

The reason I thought that second bounce had already cleared is she was 130 at +11, but maybe there was still "bounce" being released in her system. Well, thanks for the support. I just wanted to make sure I was handling the numbers ok, and that there wasn't something I'm missing. I will stain treat, soak, wash, and re-wash my patience pants because they are really dirty.
 
I'm glad there is a club for us!
Click to expand...

Of course! I think we're one of the bigger clubs here!! :lol:

The other thing I can suggest is something I just had pointed out to me a few days ago....Ebby dropped almost 400 points in 12 hours...that in itself can cause it's own bounce
 
Chris & China said:
The other thing I can suggest is something I just had pointed out to me a few days ago....Ebby dropped almost 400 points in 12 hours...that in itself can cause it's own bounce
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Yes, that's true! I was aware that can happen, but hadn't even thought of that in this case. I bet that's what caused it. 400 points is a lot!
 
I was going to post exactly what Chris noted -- Ebby dropped in the neighborhood of 400 points last night. Big drops, along with low numbers, can also trigger a bounce.

While R may be an option, seeing yesterday's numbers, I'd be attentive and collect data with the idea of using R in mind. I would want to see what Ebby does the rest of this cycle. She's been clearing bounces quickly. I'm not the best person to offer any insights on R since I've not used it with Gabby.
 
Thanks Sienne, I'll try to collect data on how long it takes her to clear the bounces. I just want to do anything and everything to help Ebby, and sometimes when I see those bounce numbers I feel like I'm failing her. Well, thanks for stopping by with the input and support.
 
Melissa

I have used R and it can be a great tool but I think what I would try with Ebby first is to control the dives. I have found that the dives in some cats (including my own) can trigger a higher bounce than just the low numbers. If you flatten the cycle, then the dives don't have as much impact.

Ebby is not diving every cycle but she's diving enough of them.

So how do you flatten the cycle? Manage the curve with food and front load it. In order to do this, you would want to take her normal portion of food and normal carbs that you give her and divide it into four mini meals in the a.m. and four in the p.m. You could start by feeding 1/4 of the each portion at PS, +1, +2, +3. Give it a bit of time to see if it helps....it's not an overnight resolution.

You might find that you will need to adjust it for her. For example, when Gracie was on Lantus and was an early diver, I started as above. But then I found what worked better for her was to give larger amounts at PS and +1 and smaller amounts at +2 and +3. You will have to experiment on what works for Ebby.

I'd also recommend you keep it noted on her SS. You can see how I've done it on Gracies SS (Gracie is on levemir now so I have a different feeding schedule). This helps you and us determine if its working or not.

Flattening the curve can help stop the dives. If it stops the dives and the overall curve comes up, then you can add more insulin.

manage the curve with food--------->flatten the curve----------->adjust the dose (if necessary).

Lets take baby steps and see if it helps. Any thoughts or questions?
 
Hi Marje,

I study your ss a lot, just to see how to handle the curves, and noticed you fed like this. I think you're right that it might help, and would be the first thing to try.

So, in the AM cycle this is possible because I am around at +1,2, and 3. (not always 4.)

The PM cycle is different. I work part-time evenings and because of this have to give her shot at 11:00 P.M. So, I could feed at PM+1, but probably not +2. I set the alarm to test at +5, trying to catch the lows. What if I changed this test to +4, and then fed her after the test. This would be feeding at PS, +1, and +4 in the evening. Would getting a +4 test tell me enough? (Specifically if it was safe to go back to sleep?)

In your opinion, is there another time you would set the alarm to test and feed? Maybe a +3 instead? I just don't want to have her go low overnight and miss it, so that is why I was going for the mid-cycle, but maybe a +3 would tell me enough about the cycle, and then I could get more food in her early on. Well, thanks for the help on this.
 
If possible, the goal would be to feed the same schedule a.m. and p.m. but I can understand why it might not be possible and so you do the best you can. It looks to me like her preferred diving is at night....of course :-D

Do you have other cats? If not, what do you think about trying an auto feeder at night? Also, I'm assuming by what you said that you a not home by 10 PM? Just brainstorming because if you had any flexibility on moving her shot back, you could get a +2 as well. However, I will assume that if you were home by then consistently, you'd probably be shooting by then.

BTW, considering your schedule, you are doing great by getting up and catching those mid cycle tests.

What I hate to do is have you getting up alot because everyone needs sleep. In an ideal world, you could use an auto feeder at +2 and then test/feed at +3. Then you could decide from there when you need to test next. The only reason I suggest +3 is because you could slow her down more if she's down alot by +3.

If you look at the evening of 8/3, she came down really fast and probably got into green...then bounced back up. I wonder if you had been able to slow her down early, she might have flattened a bit.

But, again, I don't want to make it where you are getting up alot. You have to work and you are taking care of her all day.

What do you think based on what is also best for you?
 
Marje and Gracie said:
Do you have other cats? If not, what do you think about trying an auto feeder at night?
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We have one other cat, her brother, who gets very anxious if there is not food down at all times. The main problem with the auto feeder, is I don't think Ebby would get up to go eat when she is supposed to.

Marje and Gracie said:
Also, I'm assuming by what you said that you a not home by 10 PM?
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So, I'm home at 10 on Tues, Friday, Saturday, Sunday. On my work nights, (Mon, Wed. Thurs.) I'm usually home by 10:30, but to play it safe I do 11:00. I would LOVE to give the shots at 10:00. What if I did 10:00, and then 10:30 on the work nights? The only problem is sometimes (rarely) I don't get off work and home until 11:00 or 11:30. Sometimes I'm only at the restaurant 2 nights a week too.

Marje and Gracie said:
BTW, considering your schedule, you are doing great by getting up and catching those mid cycle tests.
Click to expand...
Thank you. :YMHUG: I fought setting the alarm for awhile, but found it's just easier to give in and do it. The nights I didn't set it, I was worrying too much anyways.

Thanks for brainstorming with me. :-D
 
When you say "we" does that mean there is someone at home at 10 pm that could give her the shots on the nights you have to work? Is that possible? If it's a spouse, they can learn to test and shoot :-D :-D Don't mean to get personal but it would help you in the long run. If you were able to get a +2 and she was higher, you could get more sleep.
 
Marje and Gracie said:
When you say "we" does that mean there is someone at home at 10 pm that could give her the shots on the nights you have to work? Is that possible?
Click to expand...

Ha, Well, I already talked to the DH briefly this morning about coming on board for testing and shooting. Lets just say he is not thrilled with the idea, and initially put up a fuss. After I cried though, :lol: he said he could try and learn. He is very supportive of all of this, and also loves Ebby so very much.

He does work a lot of evenings too, and does not have a set schedule, but sometimes is home when I'm at work, and he is always home by 10:30. So, having him be able to shoot would help. The MAIN problem is: He is a little scared of Ebby. Ebby is such a sweetheart, but she has a nasty hiss, and typically only lets me pick her up. He does not have much confidence in handling the hissy kitty. That's something that could probably be worked on though.

So, say he can learn. Could we go with a 10 pm shot even if there is a possibility of a couple nights a week it being at 10:30?
 
Is 10:15 a possibility for AM? Then you'd on be off 15 minutes a couple nights a week...and could get a +2 at 12:30am and if it's looking good, get some sleep?

Not sure about it, but I know I've been told it's safe to move 15 minutes back per cycle or 30 min once/day...but I also know it's best to give the shots at the same times every day. (and that's when you have had to stall and are trying to get back on a regular schedule)

Be interesting to see what Marje says!
 
I don't think shooting within 30 min. of your usual shot time will make any appreciable difference. I would just keep good notes on your SS so you have a record of what is or isn't happening.
 
melissa, i noticed marje mentioned using food to help flatten ebby's curve. here's a post i left in bern/tashie's condo a few days ago which you might find helpful:


hi bern. i've been using a method i dubbed "using food to manipulate the curve" to help control alex's curves for years. i've taught the method to sienne, marje, and scores of others. i don't necessarily consider it an advanced technique. however, a caregiver better pay close attention when using food to manipulate a curve or it can become risky business.

here are the basics:

what is meant by using food to manipulate the curve?
simply put, it's a method of feeding used to prevent kitty from dropping too fast and/or too low.
the amount of food usually fed to the cat is broken down into several mini-meals fed throughout the course of the day with the intention of flattening out the curve. lc is normally fed to all numbers except possibly in the case of a significant or fast drop or fed to a drop below 50.

the only time you might want to feed a little higher carb food at shot time is to bump the numbers up so the insulin is starting from a higher number when onset occurs if you're running out the door and will be unable to monitor.

if you're around to monitor, there's no reason to bump the numbers up at shot time. the beauty of lantus and levemir is being able to shoot low to stay low. shooting low is how you obtain the low flat curve with lantus and levemir.

whether you'd want to feed lc, mc, or hc to slow a drop depends on two things:
1. the carb sensitivity or lack of of your particular cat.
2. the point you're at in the cycle. a drop early in the cycle *may* require big guns. a drop at nadir (unless nadir is less than 40) or late in the cycle usually only requires lc to bump the numbers up. however, if you have a carb sensitive kitty, you may not have to use anything except lc to bump up the numbers. "KNOW THY CAT".

why would you want to manipulate the curve with food?
--- bouncers: kitties who drop low and then bounce to the moon benefit from food manipulation. using food to manipulate the curve will tend to flatten out the curve. flattening out the curve helps to prevent huge bounces.
--- carb sensitive kitties: kitties who experience large food spikes when consuming even lc benefit from manipulating the curve with food. strategically spacing out meal times will help flatten out the curve.

why do i want to use food to flatten out the curve ?
--- flattening out the curve allows you to get as much insulin into the cat as safely possible without having kitty bottom out on you.
--- flattening out the curve *usually* allows you to hang onto a dose longer
--- flattening out the curve allows you to shoot higher doses of insulin than you would have been able to otherwise.

why would i want to get as much insulin as possible into the cat?
lantus and levemir are known to have a harder time bringing down higher numbers. more insulin helps bring down the higher numbers in a bouncer's cycle. more insulin will help counteract the spikes in a food spiker. using food to manipulate the curve will flatten out the curve and help keep your kitty safe.


when using food to manipulate the curve, i generally recommend starting with dividing up the normal amount of food your kitty should be eating into 8 mini-meals to be fed at preshot, +1, +2, and +3 of each cycle. however, that recommendation is strictly a starting point. a plan customized for YOUR cat is YOUR goal. frequent testing and learning how YOUR cat responds not only to food, but to the insulin itself will help you tweak the plan.

a quote that goes along with this subject from Libby/Lucy found in one of Mocha's condos:

"carb manipulation is more about learning what your cat's response is to varying amounts of carbs at different times during the cycle, and using that information to your advantage. Learn how many points bump she gets from LC, MC, and HC, both early in the cycle and later in the cycle. Use that information to guide her cycles the way you want them to go. Mocha's AM and PM cycles are very different, so the best feeding times for her might not be the same in each cycle. Take the amount you would feed her over the 12 hour period, divide it into 3-4 meals, and experiment with when to feed them. Whatever changes you make, write them in your spreadsheet and hold it for at least 3-4 days to see if it is changing anything. Mocha drops later at night than she does during the day, so your food schedule might need to be different at night.

Many cats benefit from front-loading the cycle with food. That means feeding at PS, +1, +2, +3 (when the insulin is kicking in) and then NOT feeding after +6 (because for a carb sensitive cat, you would be adding food at the same time the insulin is wearing off, driving the numbers higher). The +9 snack is helpful for some cats when they are trying to go OTJ, because it can stimulate their pancreas. That is more useful if the cat is generally flat, but spikes up just before PS. I wouldn't worry about that yet, until you get to a lower dose."




experimenting is how YOU learn how YOUR cat responds not only to food, but to the insulin itself. no one feeding plan will affect two different cats in the exact same ways. experimenting, testing, recording your observations... these are the things which will help YOU with YOUR kitty because like you'll often hear around here...ECID. :mrgreen:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=101989&p=1087990#p1087990
 
Thanks everyone! This is so helpful, and gives me some hope. Jill, thanks for sending the info to me. So for now my plan is as follows:

Move shot time to 10:30 for now, giving me a little more time to feed in the pm cycle. I will try to train DH how to test and shoot, then hopefully we can move shot time to 10:00. I think for now, since the +3 in the pm cycle is so late, I will only be able to feed a +1 and +2 in the pm. I'm thinking on the +2 in pm I will use the wellness 8% to give slightly more carbs to make up for not feeding the +3.

I will try to keep food from Ebby after +6. We'll see how this goes....might be a challenge with her brother wanting food all the time.

Thanks again :YMHUG:
 
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