8/2 Tessa AMPS 129 +2 43 +2.5 58 +3 60 | How to stop/slow BIG early drops????????

Angela & Cleo said:
Hi Jess, take a look at this link http://www.felinediabetes.com/FDMB/threads/8-10-tashie-pmps-high-questions.101989/#post-1087990

Do you know how carb sensitive Tessa is? What did you feed (%carb) and when? YOu might need to alter the feeding times a bit to right before onset to slow the drop.
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Thank you for responding Angela! I really appreciate it. Sometimes I feel like I did something wrong because my posts often get ignored.

I'm really not sure how carb sensitive she is. I give medium carb (15%) when she's on the low side and her numbers start to rise but not a crazy amount. I gave ~2 tsp of MC (15%) yesterday when her BG was 44 and she was at 60 30 minutes later but who knows if the food did that or her liver did?

She normally gets Fancy Feast pate (3-5%) for her meals and I gave her that today at AMPS, +1, +1.5 (where I think insulin onsets), and +2. She had had an entire can of Fancy Feast by +2 today so she's definitely getting plenty of food in her before and around onset but it doesn't really seem to help. I guess maybe adding a teaspoon of MC to her food at +1 or +1.5 might be helpful?
 
If I'm being honest, I'm hesitant to add MC to her food because that locks me into testing her 2-2.5 hours after that (because the food wears off) which means if I give it at +1 then I have to get a +3 or +3.5, if I give at +1.5 that means I have to get a +3.5 or +4. I do try to get a PM +3 every night but sometimes I'm so wiped out that I just have to get to sleep earlier than that. I don't think I could commit to getting a +4, that's really late for me.
 
You're not being ignored :bighug::bighug:
Looks like she's got an early onset (at least for now :rolleyes:). Do you have any carbs in the 6-9% range you can try at her +1.5 feeding/snack? Food experiments take time.
 
tessa's mom said:
If I'm being honest, I'm hesitant to add MC to her food because that locks me into testing her 2-2.5 hours after that (because the food wears off) which means if I give it at +1 then I have to get a +3 or +3.5, if I give at +1.5 that means I have to get a +3.5 or +4. I do try to get a PM +3 every night but sometimes I'm so wiped out that I just have to get to sleep earlier than that. I don't think I could commit to getting a +4, that's really late for me.
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I believe the rule is to test 2 hours after using high carbs, isn’t that correct? @Angela & Cleo
 
Staci & Ivy said:
I believe the rule is to test 2 hours after using high carbs, isn’t that correct? @Angela & Cleo
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Yes and it also depends at where you are in the cycle. If you give HC food in the first half of the cycle when the insulin is at its strongest, then you continue testing hourly for up to two hours after giving the high carb food. This also applies if kitty is clearing a bounce and having a late nadir. However, if giving higher carb food after nadir its, as Wendy explains so eloquently here, its like applying brakes on a car.
Sometimes there are situations where you will have to "abort" the cycle to keep kitty safe and give yourself a break. If you look at my SS, I did exactly that in the AM cycle on 6/25/24.
 
Angela & Cleo said:
Yes and it also depends at where you are in the cycle. If you give HC food in the first half of the cycle when the insulin is at its strongest, then you continue testing hourly for up to two hours after giving the high carb food. This also applies if kitty is clearing a bounce and having a late nadir. However, if giving higher carb food after nadir its, as Wendy explains so eloquently here, its like applying brakes on a car.
Sometimes there are situations where you will have to "abort" the cycle to keep kitty safe and give yourself a break. If you look at my SS, I did exactly that in the AM cycle on 6/25/24.
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Thank you, I knew it was at least 2 hours but wasn't exactly sure so that's why I said 2-2.5. Still, I think 2 hours past +1.5 might be pushing it for me sometimes. I have a chronic illness that takes a lot out of me and I've been really struggling lately. I even took this week off work just to catch up on sleep and thankfully she's been doing her big drops during the day so I've been able to sleep more.

Quoting Wendy's comment over here so people know what I'm asking about:

If you have to feed after nadir, try to do zero carb, maybe just freeze dried treats. Otherwise feeding after nadir can shorten duration and give you higher preshot. Think of the insulin cycle like driving a car. The first part of the cycle the insulin is pressing on the gas and taking down the BG. After nadir, the foot is off the gas and you are coasting towards that stop sign (end of cycle) as the BG numbers go up. If you give any carbs after nadir, that can tap on the brakes of the insulin action and cause the car to stop earlier than that stop sign. Meaning insulin effect wears off early = higher number for preshot.
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What about when her nadir is at +2? I've still been giving her food at +3, should I only feed up until +2 since that's her lowest point most days? I don't think Tessa will like that but if that's what I have to do, that's what I'll do.
 
tessa's mom said:
Thank you, I knew it was at least 2 hours but wasn't exactly sure so that's why I said 2-2.5. Still, I think 2 hours past +1.5 might be pushing it for me sometimes. I have a chronic illness that takes a lot out of me and I've been really struggling lately. I even took this week off work just to catch up on sleep and thankfully she's been doing her big drops during the day so I've been able to sleep more.

Quoting Wendy's comment over here so people know what I'm asking about:
What about when her nadir is at +2? I've still been giving her food at +3, should I only feed up until +2 since that's her lowest point most days? I don't think Tessa will like that but if that's what I have to do, that's what I'll do.
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Kit loves her early drops and early nadirs. I try to get all her food with carbs in by +3 most days, unless she's pulling shenanigans. Then after that if she's hungry I'll feed freeze dried treats. Which is basically what Wendy had said. You're probably okay with still feeding until +3 - some cats don't experience as much of a loss of duration, and because it's so early in the cycle, it might be okay. My suggestion would be to test the theory. See what happens if you stop feeding by +2 (it does mean you have to make sure she gets all her necessary calories, unless you're feeding 0% food or freeze dried treats). Test what happens if you keep feeding until +3. If possible, because I know you mentioned a chronic illness, test for several days (a week if you can manage), because as Angela said, experimentation will take time. It took a fair amount of time before I got a system for Kit that mostly works (some days she will drop regardless because that's just what she's gonna do).
But also - that +1.5 feeding can do wonders on the days Kit let's it work. :rolleyes:
 
tessa's mom said:
What about when her nadir is at +2? I've still been giving her food at +3, should I only feed up until +2 since that's her lowest point most days?
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What you're seeing at +2 is onset. At this point you'll want to encourage the surf without slowing the duration. Once you know the carb sensitivity of your cat, you'll be in a better position to steer the curve. Its a bit of trial and error.
 
Alicia & Kit cat said:
Kit loves her early drops and early nadirs. I try to get all her food with carbs in by +3 most days, unless she's pulling shenanigans. Then after that if she's hungry I'll feed freeze dried treats. Which is basically what Wendy had said. You're probably okay with still feeding until +3 - some cats don't experience as much of a loss of duration, and because it's so early in the cycle, it might be okay. My suggestion would be to test the theory. See what happens if you stop feeding by +2 (it does mean you have to make sure she gets all her necessary calories, unless you're feeding 0% food or freeze dried treats). Test what happens if you keep feeding until +3. If possible, because I know you mentioned a chronic illness, test for several days (a week if you can manage), because as Angela said, experimentation will take time. It took a fair amount of time before I got a system for Kit that mostly works (some days she will drop regardless because that's just what she's gonna do).
But also - that +1.5 feeding can do wonders on the days Kit let's it work. :rolleyes:
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Thank you. Luckily I'm home during the day so I can always get in lots of tests during the day, nights are what give me trouble. My husband could do some tests at night (he's the one who gets up in the middle of the night to test her when we need to) but Tessa tends to hide from him so sometimes that doesn't work out. We think she's afraid of men, we adopted her when she was about 6 years old and all we knew about her former family is that they brought her to the shelter because of a divorce.

Do I keep her at this dose and keep testing or do I reduce if she gets another under 50? I just want to be clear on what I'm supposed to be doing.
 
Angela & Cleo said:
What you're seeing at +2 is onset. At this point you'll want to encourage the surf without slowing the duration. Once you know the carb sensitivity of your cat, you'll be in a better position to steer the curve. Its a bit of trial and error.
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So she doesn't have a nadir yet then? This is all so confusing and I really don't understand why things are so difficult this time around. Last time she was on Semglee glargine and this time she's on Lantus but could the switch to brand name make that big of a difference?

Is it at all possible that her dose is just too high? She was getting decent numbers on 3.25 and even at 3 and I really wonder if I'm just pushing things too hard.
 
tessa's mom said:
Thank you. Luckily I'm home during the day so I can always get in lots of tests during the day, nights are what give me trouble. My husband could do some tests at night (he's the one who gets up in the middle of the night to test her when we need to) but Tessa tends to hide from him so sometimes that doesn't work out. We think she's afraid of men, we adopted her when she was about 6 years old and all we knew about her former family is that they brought her to the shelter because of a divorce.

Do I keep her at this dose and keep testing or do I reduce if she gets another under 50? I just want to be clear on what I'm supposed to be doing.
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She's an out of remission kitty, so in theory you wouldn't reduce the dose until she drops under 40. Dosing is hard for me (I get impatient and have to be reminded to wait out the bounce) and I don't feel super experienced in it. Experimenting with food and figuring out how to best feed the curve can help with the bounces, but sometimes you also have to increase to get rid of bounces (currently you don't have room in the numbers since she's dropping so low). My gut reaction would be to stay at the dose until she earns the reduction (unless you're struggling to keep her in numbers above 50 - I had to take a couple of reductions because, although she didn't drop below 40, she was spending way too much time in the 40s).
The thing that makes this stupid disease so hard is that there's so many variables and what works for one cat might not work for another, and vice versa, so all you can do is try some things (making sure to give them time to work as long as they are safe), and then adjust. Which sucks to hear, I know. Angela could tell you that I reach out a lot with questions.

tessa's mom said:
So she doesn't have a nadir yet then? This is all so confusing and I really don't understand why things are so difficult this time around.
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I get this so hard. The first go round Kit was on insulin for maybe 6 months and spent most of her time under 1 unit. It's so much harder the second time. :bighug::bighug::bighug:
 
Alicia & Kit cat said:
She's an out of remission kitty, so in theory you wouldn't reduce the dose until she drops under 40. Dosing is hard for me (I get impatient and have to be reminded to wait out the bounce) and I don't feel super experienced in it. Experimenting with food and figuring out how to best feed the curve can help with the bounces, but sometimes you also have to increase to get rid of bounces (currently you don't have room in the numbers since she's dropping so low). My gut reaction would be to stay at the dose until she earns the reduction (unless you're struggling to keep her in numbers above 50 - I had to take a couple of reductions because, although she didn't drop below 40, she was spending way too much time in the 40s).
The thing that makes this stupid disease so hard is that there's so many variables and what works for one cat might not work for another, and vice versa, so all you can do is try some things (making sure to give them time to work as long as they are safe), and then adjust. Which sucks to hear, I know. Angela could tell you that I reach out a lot with questions.


I get this so hard. The first go round Kit was on insulin for maybe 6 months and spent most of her time under 1 unit. It's so much harder the second time. :bighug::bighug::bighug:
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Oh, I thought 3 times under 50 earns a reduction in cats who were diagnosed more than a year ago. If she needs to stay at this dose, I can do my best to keep her there. I'm just nervous about it.

I ordered some 8% carb food (Weruva Lamb Burgini and Funk in the Trunk and Instinct Chicken for anyone also looking for this percentage) and my husband is going to pick it up after work. I think I'll try giving it in place of the +1 meal that way if her onset is between +1 and +1.5 the food should be helping prop up the numbers. I'll give her normal food for other meals unless her numbers drop enough to necessitate medium or high carb.

Thank you again for your help, I really appreciate it. :)
 
tessa's mom said:
Oh, I thought 3 times under 50 earns a reduction in cats who were diagnosed more than a year ago. If she needs to stay at this dose, I can do my best to keep her there. I'm just nervous about it.

I ordered some 8% carb food (Weruva Lamb Burgini and Funk in the Trunk and Instinct Chicken for anyone also looking for this percentage) and my husband is going to pick it up after work. I think I'll try giving it in place of the +1 meal that way if her onset is between +1 and +1.5 the food should be helping prop up the numbers. I'll give her normal food for other meals unless her numbers drop enough to necessitate medium or high carb.

Thank you again for your help, I really appreciate it. :)
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I always forget about the 3 drops under 50 - that is absolutely an option. One of the things that was mentioned to me early on when she came out of remission and I asked about the 3 drops under 50 was to think about how difficult it was to get them to safer numbers. Like if she drops to upper 40s and higher LC or MC gets her to raise to higher greens. If it's easy to bring her up, and there aren't a lot of limes, then I stuck with the dose. But you also don't want a lot of time in limes.

Just for an example of feeding if it helps - I eventually got to a plan where of Kit is above 150, I feed 7% at +1 and 9% at +1.5 - a tbsp each time. If I missed either, she would be more likely to have a steeper fast drop. Only to say - don't be afraid to try new things, but also make sure you're writing them down somewhere.
The other thing to try is maybe getting some +1.5 tests to see what she's doing?
I for sure wouldn't have the knowledge I have without the folks on here.
 
Alicia & Kit cat said:
I always forget about the 3 drops under 50 - that is absolutely an option. One of the things that was mentioned to me early on when she came out of remission and I asked about the 3 drops under 50 was to think about how difficult it was to get them to safer numbers. Like if she drops to upper 40s and higher LC or MC gets her to raise to higher greens. If it's easy to bring her up, and there aren't a lot of limes, then I stuck with the dose. But you also don't want a lot of time in limes.

Just for an example of feeding if it helps - I eventually got to a plan where of Kit is above 150, I feed 7% at +1 and 9% at +1.5 - a tbsp each time. If I missed either, she would be more likely to have a steeper fast drop. Only to say - don't be afraid to try new things, but also make sure you're writing them down somewhere.
The other thing to try is maybe getting some +1.5 tests to see what she's doing?
I for sure wouldn't have the knowledge I have without the folks on here.
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Thanks! I'm going to try just the 8% at +1 for several days to see how that goes. I don't want to change a ton of things at once and not know what is or isn't helping. Hopefully this will do the trick but I will tinker more if need be.

I'll try to get more tests in tomorrow but I've been having a lot of trouble with her main meter (Contour Next One). It keeps giving me errors all of the sudden. I even bought another meter of the same kind and it's giving me errors too. I might try a new box of strips because I already tried a new vial from the same box and it gave errors too. I contacted Contour about it but after going through 20 minutes of really stupid questions like "did you insert the strip before putting blood on it?" they wanted to transfer me to someone else to troubleshoot the problem so I hung up and just bought a new one. So I'm using my backup meter and I only have about 40 strips left for that one right now but I'll do my best to get in some more tests so I can see what is going on.
 
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