? 9/3 Ivy AMPS 333, +3.25 155, Contour +6 133 Contour,+8 147, +10 368, pmps 400, +3 266,+5 244 Dose ?

Staci & Ivy

Staci & Ivy

Member Since 2022
https://www.felinediabetes.com/FDMB...-2-25-243-3-185-4-84-5-151-6-162-dose.281125/

Day 5 on 2.75u, SLGS.

Up until last night’s pm cycle, this dose had been mostly yellow and pink range.
Wondering if this increased dose was working as an increase.

Last night we finally got a blue stretch and dropped into green (Libre readings)
Ivy dropped 100 points in 1 hour, I fed 1/2 tsp 13% mc FF 1x.
Then fed regular diet food hourly small snacks to surf.

Follow up question: Should I be feeding less small snacks if she’s flat or higher bgs and not diving?
Is that schedule of feeding snacks (to feed the curve) only for when they are dropping lower and faster?

Lately (past few weeks) I have been feeding a 2 tsp snack hourly in the first few cycle hours (since she had been dropping low before onset) but past few days on this dose, she was not dropping fast on this dose.
(Note: no food is given after +6).

I assume if she doesn’t get more lower nadirs in the next few days she will get an increase?

@Gill & George
@Angela & Cleo
 
Morning Staci,
To determine how much to feed and when, you first need to ask How's Ivys weight? That will determine how many calories she needs a day. Then you take that and divide it up into mini meals or snacks.
To feed the curve, you need to be able to answer:
When does the insulin onset
When is nadir
How carb sensitive is kitty​
The purpose of feeding the curve is to keep kitty surfing in good numbers.

You fed the 13% at PM+4 BG 88? The next test at +5 was 151. That's a big food bump from just 13%.
 
Angela & Cleo said:
Morning Staci,
To determine how much to feed and when, you first need to ask How's Ivys weight? That will determine how many calories she needs a day. Then you take that and divide it up into mini meals or snacks.
To feed the curve, you need to be able to answer:
When does the insulin onset
When is nadir
How carb sensitive is kitty​
The purpose of feeding the curve is to keep kitty surfing in good numbers.

You fed the 13% at PM+4 BG 88? The next test at +5 was 151. That's a big food bump from just 13%.
Click to expand...
Good morning Angela, I’m not so worried about calories in this question. I’m not giving her more food, just using food from her daily allotment for these hourly mini snacks.

My question is: if she’s not dropping fast, in those high bg cycles, is it recommended to feed those snacks? Or is that not necessary?
I just didn’t know if giving her regular food at those intervals was continuing to bump up her BGs.

Also, yes I fed that 13% 1/2 tsp last night at +4, she bumped up a little, didn’t go above 133, then 15 minutes before that 151 +5 reading, she got an hourly (regular diet) 2 tsp snack (so the 151 was a slight bump from that recent food I believe, not the 13% from an hour prior.)
Does that make sense?
 
It seems to me that when you compare the results from the Libre to the Contour, the Libre numbers are considerably lower. You also seem to trust the results of the Contour when that happens. If you're not already aware, the Libre2 is being discontinued and you will not be able to get strips. There is a thread on Health about the Libre3 and several people are reporting problems. Perhaps it's time to consider a change to a human meter.

What I generally suggest is that if a cat has an early onset and/or nadir, to spread out the food like you've been doing. However, you may want to consider not feeding much past nadir.
 
Sienne and Gabby (GA) said:
It seems to me that when you compare the results from the Libre to the Contour, the Libre numbers are considerably lower. You also seem to trust the results of the Contour when that happens. If you're not already aware, the Libre2 is being discontinued and you will not be able to get strips. There is a thread on Health about the Libre3 and several people are reporting problems. Perhaps it's time to consider a change to a human meter.

What I generally suggest is that if a cat has an early onset and/or nadir, to spread out the food like you've been doing. However, you may want to consider not feeding much past nadir.
Click to expand...
Hi Sienne,
My question about feeding is this:
Is it a bad thing to give hourly snacks if they are in a high bg cycle? Does that contribute to higher bgs?
(I do think it’s helpful with her early onset drop cycles).

I am using a Libre 3 and generally find it a reliable and helpful tool to alert me to when Ivy is dropping and fast.
When she goes low I can then test manually with the Contour
.
She’s a very anxious and combative kitty, so I need to try to limit the pokes every day so she will also allow me to inject her insulin consistently and ear prick when needed for very low drops.

She’s a challenge and has always been. It’s her personality. We are doing the best we can to keep her as calm as possible to be able to manage her treatment.

Maybe someday she will allow constant poking, but not right now.
 
I think the feeding issue can be a trade off. Theoretically, if you're feeding when numbers are high, it's likely to keep numbers on the higher end. It also may mean that you're not getting a true representation of what Ivy's curve looks like if you're feeding every hour. However, cats are creatures of habit and many, if left to their own devices, would graze. If Ivy is used to you're giving her food throughout the cycle, she may get stressed if food isn't always available. Of course, the wild card is how carb sensitive Ivy is.

With many cats, the best way to sort out the food issues is to experiment. Make one change and be consistent with the change for a couple of weeks and evaluate the impact of the change.
 
Sienne and Gabby (GA) said:
I think the feeding issue can be a trade off. Theoretically, if you're feeding when numbers are high, it's likely to keep numbers on the higher end. It also may mean that you're not getting a true representation of what Ivy's curve looks like if you're feeding every hour. However, cats are creatures of habit and many, if left to their own devices, would graze. If Ivy is used to you're giving her food throughout the cycle, she may get stressed if food isn't always available. Of course, the wild card is how carb sensitive Ivy is.

With many cats, the best way to sort out the food issues is to experiment. Make one change and be consistent with the change for a couple of weeks and evaluate the impact of the change.
Click to expand...
So would it be reasonable to try to not give hourly snacks IF in a high bg cycle.
Maybe should I give a small (her regular diet 12.5% snack) at +2 and +6 then no more food until PS next cycle?
I have been giving +6 snack to try to keep her food and calories somewhat evenly spread (per the nutrition list recommendation) through her cycle to reduce end of cycle drastic drops. I think that has helped reduce that from happening.

Ivy is not carb sensitive in general. It usually takes a 13% or 15% mc food to stop a fast hard drop for her.
 
+4.25 74 Libre / 165 on Contour meter, cross checked.
Fed 1 tsp of her regular lamb diet food.
Active cycle now, the bgs have been dropping this morning.
 
I would encourage you to give some thought to why you're using a 12.5% snack on a routine basis. I would think that a low carb snack would be a better choice and only turn to higher carb if numbers are dropping into a considerably lower range (i.e., closer to 90). Even with the kind of cycle you're seeing today, I'd go with a low carb snack. If you feed high carb, you're bumping Ivy into higher numbers. You want her system to get used to being in closer to normal numbers.
 
Sienne and Gabby (GA) said:
I would encourage you to give some thought to why you're using a 12.5% snack on a routine basis. I would think that a low carb snack would be a better choice and only turn to higher carb if numbers are dropping into a considerably lower range (i.e., closer to 90). Even with the kind of cycle you're seeing today, I'd go with a low carb snack. If you feed high carb, you're bumping Ivy into higher numbers. You want her system to get used to being in closer to normal numbers.
Click to expand...
The only reason for the 12.5% snack is that it is the food that I’m feeding her on a regular basis. She’s not carb sensitive to low carb food at all.
she was originally on a 6% carb diet and was constantly dropping very low.
There was much discussion on FDMB and with my nutritionist and we thought that perhaps a higher carb recipe (which I make for her) would enable her to handle the insulin somewhat better.
So that’s how we ended up reformulating to a higher carb recipe.
I understand the lower carb theory, but she was dropping low and I couldn’t pull her back up easily.
So I’m not really sure what to do but I’m hearing you.
 
Sienne, I’m thinking about what you were saying, and feeding the lower carb recipe.
If I were to transition her back to her original 6% diet, how would you suggest I do that (over a few days?).
5 days ago I increased her insulin dose and am just starting to see some action on the dose.

Would I want to slowly add in the lower carb recipe over a few days to transition to it?
Or would I want to decrease her insulin to handle the lower carb recipe Content?
I would think decreasing the carbs and having a higher insulin dose would have the insulin dose over powering the carbs, at her current dose.
I know you’re only supposed to change one thing at a time, so my concern would be the current insulin would be too powerful for a lower carb content.

What are your thoughts?
 
Sienne and Gabby (GA) said:
I would encourage you to give some thought to why you're using a 12.5% snack on a routine basis. I would think that a low carb snack would be a better choice and only turn to higher carb if numbers are dropping into a considerably lower range (i.e., closer to 90). Even with the kind of cycle you're seeing today, I'd go with a low carb snack. If you feed high carb, you're bumping Ivy into higher numbers. You want her system to get used to being in closer to normal numbers.
Click to expand...
I just replied to your comments.
 
How about proceeding very slowly? Replace one of the snacks or meals with something close to 10%. See how Ivy does on lower carb. If what you see is good, switch out another of her snacks. Repeat the process until she's at around 10% for the majority (or all) of her meals. If she's stable at 10%, try the same process but at 8%. I would not do this over a period of a few days. I'd be thinking in terms of weeks or more. There's not a huge reason to rush given your concerns.

If you're concerned about her dropping too low or struggling to get her numbers up, doing this gradually may help. I'd also suggest using Karo (corn syrup) or honey if you need to get her numbers up quickly.
 
Sienne and Gabby (GA) said:
How about proceeding very slowly? Replace one of the snacks or meals with something close to 10%. See how Ivy does on lower carb. If what you see is good, switch out another of her snacks. Repeat the process until she's at around 10% for the majority (or all) of her meals. If she's stable at 10%, try the same process but at 8%. I would not do this over a period of a few days. I'd be thinking in terms of weeks or more. There's not a huge reason to rush given your concerns.

If you're concerned about her dropping too low or struggling to get her numbers up, doing this gradually may help. I'd also suggest using Karo (corn syrup) or honey if you need to get her numbers up quickly.
Click to expand...
I like your ideas, but….
I make her food because she has some IBD issues and what I feed her is homemade and formulated by a nutritionist. (Meals and her snacks, same lamb diet)
I only use some MC Fancy Feast when I need to, for a higher carb content and try to do that as limited as possible.
I only have a 6% and 12.5% recipe to feed her.
So given my constraints, how would I proceed? (Sorry for the complicated diet!)
 
Well, one option would be to combine 50% of each of the diets you have and the carbs would be 9.25% carbs. Would that work?

I'd hate to ask that you talk to the nutritionist, especially if it would cost for a consultation.
 
Ivy had a several hour run of lower for her numbers today. Several cross checks on the Contour Next meter in the mid 100s.
Then came the bounce up high after the better bgs. I guess she’s working this dose a bit finally after 4 days of high numbers.
I did have to feed small 1 tsp snacks if her regular lamb diet since she was dropping lower for her and I tried to keep her surfing for a long stretch.

Is that normal to take that long to get action out of a higher dose?
 
Sienne and Gabby (GA) said:
Well, one option would be to combine 50% of each of the diets you have and the carbs would be 9.25% carbs. Would that work?

I'd hate to ask that you talk to the nutritionist, especially if it would cost for a consultation.
Click to expand...
Yes, it would be another consultation fee.
Do you think that would be a safe way to combine the 2 recipes? That is creative.

What I do is break down her calorie allotment each day and feed that for meals and snacks.
So I guess I could replace one meal at a time of the combined 9.25% food and see what that does.
I guess the question is at what pace do you think I should go?
I know you said over several week period of time.
So how would you think I would schedule changes into her day while keeping her insulin the same?
And if she’s due for an increase in insulin this coming week, how would I handle that while safely reducing carbs at the same time?
 
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