8/20 Tink AMPS 320, +1=268 (stalled breakfast till +1)

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JenM

JenM

Member Since 2013
Yesterdays condo: viewtopic.php?f=9&t=123799

Making progress! We saw 202 last night at +4 and NO BOUNCE THIS MORNING!!!! flip_cat

I totally meant to test at +7 (1am) - set the alarm and everything... but it's a new phone and I apparently didn't set it right. ohmygod_smile

Here's hoping for a bounce-free rest of the week and hoping for a dose increase to 2.25u on Friday (though to not need one would be even better... but I think that's probably a bit unrealistic).

The last two mornings I've stalled his breakfast for an hour after giving his injection. Seems to help the insulin start working faster (he's been lower at +1 than at PS). I always feel bad loading him up with fuel at his highest points of the day.
 
it might be that what you're doing is postponing the typical food spike after eating. Lantus typically onsets about 2 hrs after the shot - which is why the +2 is helpful. What's your reasoning for delaying the breakfast? You might have said but i've looked back a couple of days and don't see it.

The way to get over the bouncing is to keep bringing Tink to green numbers and adjust the dose to try to keep him there.
 
The reason for stalling breakfast is because it seems counterproductive to give him extra fuel at his highest point in the day. It's going to spike him no matter what... but I'd rather it spike him once the insulin has started working than before. Unless there's a reason I shouldn't? I just dont like to feed him when I see a 300+ number, knowing the food will probably take him to 400 before the insulin starts to bring it back down.

The last two mornings I stalled, and his +1 was lower than his preshot, which I feel is a good sign.

I dont know... maybe there isn't any point. But it seems like it helps keep him from going super high early in his cycle.
 
i haven't seen anyone do that before.

in general, the rule of thumb here is to stick with the protocol until it's established that the normal routine isn't working for a particular cat. it's a pretty well proven protocol! it takes a while to decide that it's not working for a cat - i probably wouldn't stray off the protocol yet in Tink's case since you're really still new to Lantus. If I were you, I'd go ahead and feed him at preshot all the time. I wouldn't worry about food spikes (the spike in BGs from eating) and just concentrate on getting to the right dose.

Since you've got 10 cycles at this dose and the lowest point is a high blues, i'd go ahead and increase by 0.25u as soon as your schedule allows.
 
Hmm... I didn't realize that feeding times were part of the protocol since since I dont recall any suggestions about that in the protocol. I guess it's just implied that meals are at PS. Ok... I'll stick with that.

I can't be home to monitor beyond +1 (then +10 or 11) until the weekend so I'm planning to hold this dose until then. I'd like to see him stop bouncing from low 200's - hoping that'll happen with holding this dose a few more days.
 
On ProZinc, we used to feed a smaller meal at PS just because of the in-and-out nature of the insulin, there often wasn't any insulin left working at pre-shot time, and then we'd feed more at +2 when the ProZinc started to onset.

Coming from ProZinc, I think it was an adjustment to realize that the depot is still at work from the previous dose, so you're not thinking in terms of avoiding fueling a rise in the BG because the insulin has "worn off." Does that make sense?

Eventually, the depot and carryover from the last dose will help avoid some of those big food spikes. When that happens, a dropping number at +1 can signal a really big drop early in the cycle that can be hard to control if kitty doesn't have food on board. If those spikes are bounces, sometimes (for Eddie anyway), his bounces start the clear at the beginning of a cycle, and he might start with a spiky high pre-shot number, only to plummet within an hour or two after the shot.
 
Ahhh good point. Leftover ProZinc brain. :)

Ok. I'll not do the food stall anymore.

I'm currently feeding at preshot, +5, preshot & +4. Is that a reasonable schedule on Lantus? Or should I look at changing that? I was giving 5 meals on ProZinc, but that was largely because of the TID dosing. With the amount he gets, he is not satisfied with the serving size when broken up into 5 meals. Seems to be ok with the 4... but I'm not sure what the timing should be. I see a lot of folks give more food at the beginning of the cycle.
 
kinda depends on the cat. some cats seem to be able to successfully graze around the clock. cats getting near to OTJ often eat a bite at +9 to stimulate their pancreas to put out more insulin and bring down the preshot number.

cats that want to eat a larger quantity at once seem to do well with most of the carbs in the first half of the cycle, often before +4. the reason for that is that Lantus onsets about +2 in most cats, and that puts the food carbs in the time of the cycle when the Lantus is strongest. It begins to wane past the nadir and sometimes if you feed later in the cycle, you have the effect of putting the brakes on the Lantus. The result is higher preshot numbers.

I had a hoover cat and I fed him at preshot (3oz) and +3 (1.5oz). besides that i only gave boiled chicken breast cut into tiny (1/2") pieces for poking treats.

The cats you're seeing that have their meals broken up into mini-meals in the first 3 or 4 hours of each cycle - most of the time we suggest that when a cat drops too quickly between preshot and +2 or 3. If you can prevent a too-fast drop in blood sugar, you can often reduce the bounces caused by that.

I don't think any of that applies to Tink, because the large drop between preshot and +1 is because he hadn't been fed.

If I were you, I'd try giving all of his food in the first 4 hours of each cycle. I wouldn't worry about doing a bunch of mini-meals unless you see that plan a with the food doesn't work.
 
Ok... I'll try moving his AM+5 meal back to +4.

If I want to move to +3, I may have to start shooting at 7am rather than 6am. Their "bedtime" meal HAS to be at 10pm when I go to bed, or I wont get any sleep. They're SO used to eating when I go to bed that, even if they just ate an hour ago, they would loudly protest the lack of a 10pm meal.

Tink is definitely a "big meal" kinda guy. They have always been fed morning and night (pre-FD) as I've never been able to free-feed with at least half of my feline population being of the hoover variety. :lol:
 
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