8/25 Ivy AMPS 195, +1 276, +2 283, +5 317, PMpS 319, +2 362, +4.75 198, +5.75 149

[Staci & Ivy]

https://felinediabetes.com/FDMB/thr...-345-pmps-337-1-294-3-165-4-122-5-103.280822/
AMPS 194
Last night PM breaking bounce cycle till around PM +5.25.
Fed mc lamb regular food or 15% FF MC 1/2 tsp snacks every 30-40 minutes, as needed, when began to drop fast again.
Trying to get her to surf into lower BG, without steep drops.

Graph below for clarity to show the drops (her SS looks like it was a flat blue night). I think the SS is a bit deceptive just based on the #s.

The reality was it took carbs to keep her from diving hard into a possible dose reduction.

 

[Alicia & Kit cat (GA)]

Those fast drops are rough - Kit is super fond of them.

 

[Staci & Ivy]

Those fast drops are rough - Kit is super fond of them.

You bet. Any good tips to share with me that work for you?

 

[Alicia & Kit cat (GA)]

Kit mostly drops early in her cycle, so I've added in tests at +1 and +2, and when I see the signs for her drop, I try to supplement with some 6 or 7% carb food. Depending on where her AMPS was, I've even used MC to try to head it off. I'm still trying to work out a consistent solution. She likes to keepe on my toes. It's her nortie tortie side.

 

[Staci & Ivy]

Kit mostly drops early in her cycle, so I've added in tests at +1 and +2, and when I see the signs for her drop, I try to supplement with some 6 or 7% carb food. Depending on where her AMPS was, I've even used MC to try to head it off. I'm still trying to work out a consistent solution. She likes to keepe on my toes. It's her nortie tortie side.

I have a similar issue. Ivy usually drops early in her cycle also. But sometimes it lasts 3-4 hours till she levels out. Very labor intensive with the feedings.

You’re lucky Kit can get a bump from 6/7 %. That % does nothing for Ivy. I need 15% to slow her down for about 30 minutes. Then repeat if necessary.
Thanks for sharing what works for you guys. I hope Kit surfs safely for you

 

[Angela & Cleo]

Stacy, Let me start with I truly think that you are feeling overwhelmed and for that ((hugs)).
I think that you may benefit from (re)reading The Basics: New to the Group? Start here! and the explanation of Typical Lantus cycle.
The following is not a criticism by any means, it's merely my opinion based on reading your condos and Ivy’s SS and in response to what I know is your willingness to learn more.

You say that Ivy has “deep dives”. I do not see this. I do see fluctuations in BGs. We want that! We want to see the insulin take the cat into blues and greens.
Meter readings have a variance of 20-25% including the Libre 3 (see the last couple of pages of the manual, screenshot below)

What I have personally seen in my cat and my understanding:

DIVE - the difference in BG readings greater than approx 40-45% and an hour apart from one another.
ACTIVE CYCLE - for an active cycle I personally consider it something like 25-30% by +2/+3 (- so about 5-10% beyond meter variance).​

Now looking at your SS-
8/21 AM (cycle 1 dose increase) - All these readings are within meter variance, no diving, no bouncing, just fluctuations within meter variance.

8/21 PM (cycle 2 dose increase) - PMPS 400 and stayed high for hours - Bouncing

8/22 AM (cycle 3 dose increase) AMPS 353 +2 189 [46% DIVE and early in the cycle, feed higher carbs] +3-+9 GREAT JOB!!! at keeping her surfing . I personally would have fed LC at/after +5. Feeding later in the cycle can shorten the duration of the insulin.

8/22 PM (You shot a reduced dose) PMPS 241 - Bounce. I would have shot the full dose.

8/23 AMPS 374 +2.75 247 (34% ACTIVE CYCLE) AM+10-PMPS: you said that ‘Ivy’s diving and fast’. I see that she was flat and coasting. Even with the AM+11.25 green 88 BG, I still consider Ivy flat and coasting. That 88BG is 26% of the 122BG reading (within meter variance).

8/23 PM (You shot a reduced dose) PMPS 122 +1 207 Food bump (you may want to examine what you fed at PMPS because that is a big food bump) +2 155 higher than PMPS but within meter variance, by PM+5 all the carbs you fed shortened the duration and any action of the insulin and she climbed through the end of the cycle into the reds.

8/24 AMPS 389 Bouncing- take the cycle off from FD

8/24 PMPS 327 +2 221 (32% ACTIVE CYCLE)

8/25 AMPS 194 Bouncing - take the cycle off from FD

I feel that you are confusing Diving with Active Cycles. In the last 10 cycles, there was only 1 instance of a dive.
You are correct that Ivy clears bounces quickly. That is fantastic (and personally wish my Cleo wouldn't take the full 6 cycles to clear a bounce ).
I also feel that you are overusing 15% Carbs. It should be saved for Dives, Low BGs, and/or right before Onset if for personal reasons you need to abort they cycle.
I want to reiterate that I think you are feeling overwhelmed as we all have felt and that you are doing a good job.
This is just my two cents for what its worth.

 

[Staci & Ivy]

Stacy, Let me start with I truly think that you are feeling overwhelmed and for that ((hugs)).
I think that you may benefit from (re)reading The Basics: New to the Group? Start here! and the explanation of Typical Lantus cycle.
The following is not a criticism by any means, it's merely my opinion based on reading your condos and Ivy’s SS and in response to what I know is your willingness to learn more.

You say that Ivy has “deep dives”. I do not see this. I do see fluctuations in BGs. We want that! We want to see the insulin take the cat into blues and greens.
Meter readings have a variance of 20-25% including the Libre 3 (see the last couple of pages of the manual, screenshot below)

What I have personally seen in my cat and my understanding:

DIVE - the difference in BG readings greater than approx 40-45% and an hour apart from one another.
ACTIVE CYCLE - for an active cycle I personally consider it something like 25-30% by +2/+3 (- so about 5-10% beyond meter variance).​

Now looking at your SS-
8/21 AM (cycle 1 dose increase) - All these readings are within meter variance, no diving, no bouncing, just fluctuations within meter variance.

8/21 PM (cycle 2 dose increase) - PMPS 400 and stayed high for hours - Bouncing

8/22 AM (cycle 3 dose increase) AMPS 353 +2 189 [46% DIVE and early in the cycle, feed higher carbs] +3-+9 GREAT JOB!!! at keeping her surfing . I personally would have fed LC at/after +5. Feeding later in the cycle can shorten the duration of the insulin.

8/22 PM (You shot a reduced dose) PMPS 241 - Bounce. I would have shot the full dose.

8/23 AMPS 374 +2.75 247 (34% ACTIVE CYCLE) AM+10-PMPS: you said that ‘Ivy’s diving and fast’. I see that she was flat and coasting. Even with the AM+11.25 green 88 BG, I still consider Ivy flat and coasting. That 88BG is 26% of the 122BG reading (within meter variance).

8/23 PM (You shot a reduced dose) PMPS 122 +1 207 Food bump (you may want to examine what you fed at PMPS because that is a big food bump) +2 155 higher than PMPS but within meter variance, by PM+5 all the carbs you fed shortened the duration and any action of the insulin and she climbed through the end of the cycle into the reds.

8/24 AMPS 389 Bouncing- take the cycle off from FD

8/24 PMPS 327 +2 221 (32% ACTIVE CYCLE)

8/25 AMPS 194 Bouncing - take the cycle off from FD

I feel that you are confusing Diving with Active Cycles. In the last 10 cycles, there was only 1 instance of a dive.
You are correct that Ivy clears bounces quickly. That is fantastic (and personally wish my Cleo wouldn't take the full 6 cycles to clear a bounce ).
I also feel that you are overusing 15% Carbs. It should be saved for Dives, Low BGs, and/or right before Onset if for personal reasons you need to abort they cycle.
I want to reiterate that I think you are feeling overwhelmed as we all have felt and that you are doing a good job.
This is just my two cents for what its worth.

Hi Angela. Huge hugs back to you!!
First of all I really want to thank you for the incredibly thorough analysis of the SS. Wow! I’m just blown away at how good you are at analyzing all that data!!

I definitely will re-read this link you sent. Very good information to again scour.

I am most definitely overwhelmed and confused about how to manage this bouncing and active cycles over and over. Plus I’m exhausted from very little sleep.

I think the SS is a bit deceptive though. What it doesn’t show are the very fast drops Ivy takes from one hour to the next and if I’ve fed her carbs to reduce the drop, you aren’t seeing that reflected. You just see the end result in the number on the SS for that hour.
So it looks like she’s coasting along, not that I’ve fed her carbs to keep her aloft for that hour.

On 8/22 that pm reduced dose was a decrease in dose, since she went under 90 in the am cycle.

The other instance, on 8/23, you note that at pm + 5 she went to reds (the red cycle wasn’t until the next day when she bounced from the very active mostly all day). Maybe I misunderstood you here.

On 8/23 The reason I fed, then eventually stalled at pm shot time and gave a reduced pm dose was that at +11 she was dropping under 100 on the Libre and I didn’t want her to go so low that I couldn’t give her shot when it was time.
Here is what the graph looked like at that time when she was dropping:

I’m not sure the SS shows how steep the actual drops are, which is what I see. To my eyes, this is not coasting, but sharp drops. (Am I still misinterpreting the data?)

As for using the 15% carbs, it’s been the only way I’ve found to slow her drops. It only lasts about half hour then she resumes the drop again.
Her regular food doesn’t stop her from dropping at all when she’s headed down fast.

Is there anything else I could do to slow her down?

Once she gets later in the cycle, I can usually go back to her regular food to get her to surf.
And I try not to feed late in the cycle, if possible.

I can’t thank you enough for putting your eyes on all the days and trying to help me. It means so much to have you help me and Ivy like that. You’re a gem

If I think of another question, I will let you know. I hope you and Cleo have a wonderful weekend!

After today’s bounces, I expect another round of action maybe even tonight.

 

[tiffmaxee]

Stacy we all feed (usually 10-13% carbs) to keep them from going too low. That’s what is meant by feeding the curve. The only time I take that into account when deciding if the ss is deceptive as you call it is if having to feed over really high carbs to prevent a drop into lime.
The more time spent 90 to low 100’s regardless with whether you are feeding to keep her there the sooner Ivy will likely get used to normal BG.

 

[Staci & Ivy]

Stacy we all feed (usually 10-13% carbs) to keep them from going too low. That’s what is meant by feeding the curve. The only time I take that into account when deciding if the ss is deceptive as you call it is if having to feed over really high carbs to prevent a drop into lime.
The more time spent 90 to low 100’s regardless with whether you are feeding to keep her there the sooner Ivy will likely get used to normal BG.

I’ve experimented with LC, which does nothing for Ivy. I’ve tried 13% mc, which didn’t slow her down.
The only thing I’ve found to slow her down is 15%, and that’s temporary.
Usually when she’s dropping really fast if I don’t give carbs, I’ve had her drop where she earns a reduction.
I’m trying to hang into her doses, if possible.
I know we want to get her used to lower green numbers, just not while dropping more than 100 points or more in a short time.

Am I missing something else I should do?
Thank you for checking in today.

 

[tiffmaxee]

How long in between feedings? BTW she was flat blue last night which is good. I dint care what you fed her and the lowest I see is 103 and it’s the Libre.

 

[Angela & Cleo]

I definitely will re-read this link you sent.

Cleo was diagnosed on 1/3/2022. I joined FDMB at the end of 2/2022 early 3/2022. I read the The Basics: New to the Group? Start here! every day since joining including today!

I am most definitely overwhelmed and confused

I understand, truly I do!

On 8/22 that pm reduced dose was a decrease in dose, since she went under 90 in the am cycle.

Yes I see that now. I stand corrected.

8/23, you note that at pm + 5 she went to reds

What I said/meant was that by feeding higher carbs through and after +5 Ivy ended up in the reds. Its actually pink on your ss and red the next cycle. TBH, High is High - pink or red doesn't matter - its all above renal threshold.

(Am I still misinterpreting the data?)

I think that you are. If we're talking about the pic of the graph posted above -the 8/23 AM cycle - and assuming your shot times are 6am/pm, its seems to me:
AMPS over 350,
+3 (9am) was ~250, 28% lower than amps
+6 (12PM) ~200, 20% lower than +3
+9 (3pm) ~175, 13% lower than +6
+10 (4pm) ~150, 15% lower than +9
+11 (5pm) ~120 20% lower than +10
+12 ~90. 25% lower than +11 - you stalled 1/2 hour
PMPS (630pm) ~ 120 rising BG
When looking at this particular cycle, BG was fluctuating and Ivy was coming down from a bounce resulting in a late nadir. I agree that stalling was the right thing to do, however, I think Ivy would have been just fine with LC. However, we don't know because we don't have that LC data. The SS has MC and HC in every cycle.
I do think that your intention is to feed higher carbs in order to "slow" the drop. But from the Using Food to Manipulate the Curve emphasis is added to #2.

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".​

Please note that it says *may*.
A cat's insulin needs change and the human adjusts. I NOW (and now is over a year) know Cleo's carb sensitivity but after months of experimenting and re-experimenting, because it changed. 10% carbs used to do nothing and now 10% cannot be used after +5 in any cycle.

I think the SS is a bit deceptive though. What it doesn’t show are the very fast drops Ivy takes from one hour to the next and if I’ve fed her carbs to reduce the drop,

There's such a thing as too much information and if its "deceptive" than how do you know what's true or how can any of us help you?

May I suggest that the SS reflect the BGs at certain intervals - PS and every two hours one cycle, the PS and every three hours the next. Even with humans, after we eat our hormones (insulin being one) and blood pressure fluctuate for an hour or two or three. If you decline, I will NOT be offended. Ivy is your cat!

The goal with managing FD is to get our cats in the greens and blues for LONG stretches of time in a cycle. While there are longer stretches of blues there are still a lot of pinks and reds.

I thank you for taking the time to hear me out.

 

[Staci & Ivy]

How long in between feedings? BTW she was flat blue last night which is good. I dint care what you fed her and the lowest I see is 103 and it’s the Libre.

I fed her about every 30 minutes for most of the first 5 hours of the pm cycle last night when she would drop.
I alternated her regular food 1-2 tsp and the 15%, about 1/2 tsp.
This is what it looked like as she went along :

 

[Staci & Ivy]

Yes I see that now. I stand corrected.

I totally wasn’t trying to correct you. I just wanted to let you know where she landed. However, you are completely correct, red or pink no matter, both colors we don’t want to see!

 

[Staci & Ivy]

Cleo was diagnosed on 1/3/2022. I joined FDMB at the end of 2/2022 early 3/2022. I read the The Basics: New to the Group? Start here! every day since joining including today!


I understand, truly I do!

Yes I see that now. I stand corrected.

What I said/meant was that by feeding higher carbs through and after +5 Ivy ended up in the reds. Its actually pink on your ss and red the next cycle. TBH, High is High - pink or red doesn't matter - its all above renal threshold.


I think that you are. If we're talking about the pic of the graph posted above -the 8/23 AM cycle - and assuming your shot times are 6am/pm, its seems to me:
AMPS over 350,
+3 (9am) was ~250, 28% lower than amps
+6 (12PM) ~200, 20% lower than +3
+9 (3pm) ~175, 13% lower than +6
+10 (4pm) ~150, 15% lower than +9
+11 (5pm) ~120 20% lower than +10
+12 ~90. 25% lower than +11 - you stalled 1/2 hour
PMPS (630pm) ~ 120 rising BG
When looking at this particular cycle, BG was fluctuating and Ivy was coming down from a bounce resulting in a late nadir. I agree that stalling was the right thing to do, however, I think Ivy would have been just fine with LC. However, we don't know because we don't have that LC data. The SS has MC and HC in every cycle.
I do think that your intention is to feed higher carbs in order to "slow" the drop. But from the Using Food to Manipulate the Curve emphasis is added to #2.

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".​

Please note that it says *may*.
A cat's insulin needs change and the human adjusts. I NOW (and now is over a year) know Cleo's carb sensitivity but after months of experimenting and re-experimenting, because it changed. 10% carbs used to do nothing and now 10% cannot be used after +5 in any cycle.


There's such a thing as too much information and if its "deceptive" than how do you know what's true or how can any of us help you?

May I suggest that the SS reflect the BGs at certain intervals - PS and every two hours one cycle, the PS and every three hours the next. Even with humans, after we eat our hormones (insulin being one) and blood pressure fluctuate for an hour or two or three. If you decline, I will NOT be offended. Ivy is your cat!

The goal with managing FD is to get our cats in the greens and blues for LONG stretches of time in a cycle. While there are longer stretches of blues there are still a lot of pinks and reds.

I thank you for taking the time to hear me out.

I do think that your intention is to feed higher carbs in order to "slow" the drop.

Yes, correct. I’m just trying to slow her down to get to blue and green and coast. But she just drops fast if I don’t slow her down. And the SS only shows so much details. (I can’t expect you to read all my detailed notes).

Part of the problem is that Ivy isn’t carb sensitive. So that’s how we landed on a higher carb for help. But if that’s sending her up to high then that’s not a good answer.
I just don’t really know what else to do.
And you don’t have to thank me for listening to you. I truly appreciate your very thoughtful ideas and response.
I respect your knowledge and your time.
I’m just trying to learn here. You all have so much more experience and understanding. I’m just in awe of the knowledge base here and appreciate the help!

I have so much to learn and really need help with all of this. It’s so overwhelming and hard to navigate on my own. I really feel so lost most of the time. Trying hard to study and “get it”.

Thank you again for everything

 

[tiffmaxee]

I can’t go by the Libre. I never tested 24/7. I suspect many cats would look similar. I also did not feed anything but l unless in the low 50’s and usually if below 50 only.