? AMPS 124, +12.5 117 - ate after +12.5- +1 75 , +1.5 68 , +2 70 +3.25 54 +4 90, +5 68, +6 135

I have a question about testing her ear.. Ive seen how to do it and where to, but as Im pricking her over and over, trying to do different spots, but some I know work better than others, I notice she's getting scars where Im poking her. is that what Im feeling?
 
Do you treat the spot after you have poked? If you are not doing so it's important not to leave this out as you can get some scaring. I tried to swap ears.

To treat after the poke.
I would use a cotton pad I had a cold wet pad, that I would hold firmly over the poked spot applying firm gentle pressure and count slowly to 10 (if George let me there).

This will minimise scaring. George has no scars, and I tested tonnnnnnnnes,
 
Gill & George said:
Do you treat the spot after you have poked? If you are not doing so it's important not to leave this out as you can get some scaring. I tried to swap ears.

To treat after the poke.
I would use a cotton pad I had a cold wet pad, that I would hold firmly over the poked spot applying firm gentle pressure and count slowly to 10 (if George let me there).

This will minimise scaring. George has no scars, and I tested tonnnnnnnnes,
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I try and hold pressure, but I guess I could clean it out a little with something wet. I have these saline wipes, but I just ran out.
 
what percentage of carbs in a food is considered LC, MC, or HC.. so I know when I check it out on my own
 
well ok.. I fed Mimi some of that canned CD diet I had "gifted" to me after her Cystotomy figuring it was MC, but I just looked it up and its fricken 30 percent carbs, and the gravy lovers is 15... WTF IS WRONG WITH THIS COMPANY.. and their one for GLUCOSUPPORT is 15 %, so thats just like the stupid GRAVY LOVERS.
 
Mimis mom said:
ut I guess I could clean it out a little with something wet
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It's not about cleaning it it's more about it being cool to reduce inflammation.
Mimis mom said:
+5 is 68 is it because its close to nadir?
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Interesting question.
Nadir so far was that 54, nadir is the point at which the BG is lowest. We won't know till the cycle is over.
+5 is approaching midcycle, so we should be entering a point where insulin action is greatest, and from now on the amount of insulin action should slowly start to decrease.

Because +5/+6 is when we have peak insulin, in a typical, lantus cycle we would expect the nadir to coincide with that. But until a cat is well regulated we don't always get this, other factors affect when they may nadir, not just the insulin.
So this morning Mimi nadired early, because she was just clearing a bounce as you shot, when they drop like that they often nadir early, that's why we suggest the +1 (which you did and you continued monitoring closely and caught that 54)

Last nights cycle she probably nadired late, maybe even after the amps.

Mimis mom said:
well ok.. I fed Mimi some of that canned CD diet I had "gifted" to me after her Cystotomy figuring it was MC, but I just looked it up and its fricken 30 percent carbs, and the gravy lovers is 15... WTF IS WRONG WITH THIS COMPANY.. and their one for GLUCOSUPPORT is 15 %, so thats just like the stupid GRAVY LOVERS.
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oops. Well save it if she ever gets into very deep water, I used 28% for george when he dropped into the 30's.

When did you give her it? was it just now?
Don't worry about it, at least it's canned it'll be out of her system soon enough consider it a food experiment. Note when you gave it (and any other food) on the SS, it will be interesting to see how it all affects Mimi.

I was just writing to say, give her some regular food sorry, not typing fast enough.
 
Mimis mom said:
what percentage of carbs in a food is considered LC, MC, or HC.. so I know when I check it out on my own
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LC below 10 %
MC 10 to 15%
HC over 15%

FWIW I had to use over 20% to get Georges numbers to move when he was diving(I used 28% or he would not budge especially if he was dropping early in the cycle), he wasn't very carb sensitive, so it's important to learn what works for your cat as much as what is 'classed' as LC/MC/HC
That's why I would encourage everyone to take meticulous notes and keep that on the SS, somewhere everyone can see, so folk can use that info to help you more efficiently, but where you can at a glance see what worked and what didn't work for your cat.
I used to keep a note book and write down everything I did when I was steering an episode of lower than usual numbers, then I would transfer that info onto the SS, just so I wouldn't miss anything out in the excitement.
 
Gill & George said:
LC below 10 %
MC 10 to 15%
HC over 15%

FWIW I had to use over 20% to get Georges numbers to move when he was diving(I used 28% or he would not budge especially if he was dropping early in the cycle), he wasn't very carb sensitive, so it's important to learn what works for your cat as much as what is 'classed' as LC/MC/HC
That's why I would encourage everyone to take meticulous notes and keep that on the SS, somewhere everyone can see, so folk can use that info to help you more efficiently, but where you can at a glance see what worked and what didn't work for your cat.
I used to keep a note book and write down everything I did when I was steering an episode of lower than usual numbers, then I would transfer that info onto the SS, just so I wouldn't miss anything out in the excitement.
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well almost everything Hills makes is 20% and above, so....oh- their Glucosupport is 15%.. :banghead:
 
Mimis mom said:
at +4.5 so that might be why her +5 spiked
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OK you may have stalled the cycle with that.
Grab a +6.5 to make sure she is still up, after 2hrs the carbs (she probably will be/but you never know with cats)
If you managed to stall the cycle you may find she is fairly high at PMPS, a high PMPS could be a bounce but it could equally be a shortened duration from to many carbs.
You will not know which it is.
If its a bounce she will stay high in the pm cycle.
If its shortened duration what you will see is she will start to come down significantly tonight once she onsets. So even if she is high I would advise you at least get a before bed test to see which it is.

Mimis mom said:
is 30% too high you think? Or should I grab a few cans of Hills brand because they have such high carb content o_O
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I used 28% so very similar, I found it useful when George was dropping steeply.
 
I didn’t want to get in the midst of Gill helping you but want to be sure your first question of the day is answered.

To get the link to any condos you have previously done, click on your user ID in the upper right hand corner and then click on “your content” in the right column. It will list all of the condos you’ve posted or the ones you’ve posted on. Find the one you want, open it, copy the browser address, and then paste it in your current condo.
 
Bobbie And Bubba said:
Add a little of the gravy to her regular food. You don’t want to give a lot of the gravy as it can fill them up and you might need her to eat some more through this cycle. Adding it to her raw food will help hold her up longer.
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When using LC food and adding HC gravy, it’s really important to look at three things:
  • How carb sensitive is the cat?
  • What is the BG and where is it in the cycle
  • Is the cat flat or dropping in consideration of the above.
If you get a 53 early in the cycle and it was a big drop from the previous test, it might be necessary to alternate HC food with HC gravy to slow the drop down.

If the 53 is +4 or after and is flat, a couple of large tsp of LC alone might do the trick. Or in a cat that is not very carb sensitive, a drop of gravy added to that might help.

This is where knowing your cat comes in.
  • What is kitty’s onset, nadir, and duration?
  • How carb sensitive is kitty and how responsive if numbers are dropping fast or if they are flat?
  • Where in the cycle does that lower number come in in relation to onset, nadir, and duration?
As in many things with FD, there is no one size fits all. Rosa is likely still gathering data on Mimi’s responses so it’s really important to write down when she was fed, how much, what % carbs, so that info can be used the next time around.

It’s always been my thought that one should use the lowest carbs that gets the job done. That might mean 10% on a regular basis for some cats. For others, it might be 3%. For some with fast dropping numbers early in the cycle might be 20%. It is correct to alternate gravy with food when working lower numbers to be sure kitty doesn’t get too full early in the cycle.
 
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just did her at +8.. her ears are thickening by the site I prick so I wanted to give them a rest for a second. now its high- 354.

Should i keep her at 1.5 seeing she had such a drop with it today? or lower it to 1.25
 
Gill & George said:
OK you may have stalled the cycle with that.
Grab a +6.5 to make sure she is still up, after 2hrs the carbs (she probably will be/but you never know with cats)
If you managed to stall the cycle you may find she is fairly high at PMPS, high PMPS could be a bounce but it could equally be a shortened duration from to many carbs.a
You will not know which it is.
If its a bounce she will stay high in the pm cycle.
If its shortened duration what you will see is she will start to come down significantly tonight once she onsets. So even if she is high I would advise you at least get a before bed test to see which it is.


I used 28% so very similar, I found it useful when George was dropping steeply.
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when you say "onsets" do you mean at the +6 mark or earlier. "high PMPS could be a bounce but it could equally be a shortened duration from to many carbs" what does that mean?
 
Mimis mom said:
when you say "onsets" do you mean at the +6 mark or earlier. "high PMPS could be a bounce but it could equally be a shortened duration from to many carbs" what does that mean?
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Have you read through this post? It explains onset, nadir, and duration. Since it varies by cat, it’s something to important for each caregiver to know about their cat. After you read it, if you have questions, please tag me and I’ll be happy to explain what you don’t understand.:)

On the latter comment about PMPS being higher, if you feed a lot of HC food and/or gravy and karo during the cycle, it slams the breaks on the action of the insulin so the duration can be less than 12 hours. If it’s less, then numbers shoot up quickly at the end of the cycle because there isn’t enough insulin action to carry over until the next shot. After a low cycle, a higher preshot can also mean a bounce is starting. Sometimes it’s both. If it is solely duration, the BG comes back down once the next shot onsets.
 
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Marje and Gracie said:
When using LC food and adding HC gravy, it’s really important to look at three things:
  • How carb sensitive is the cat?
  • What is the BG and where is it in the cycle
  • Is the cat flat or dropping in consideration of the above.
If you get a 53 early in the cycle and it was a big drop from the previous test, it might be necessary to alternate HC food with HC gravy to slow the drop down.

If the 53 is +4 or after and is flat, a couple of large tsp of LC alone might do the trick. Or in a cat that is not very carb sensitive, a drop of gravy added to that might help.

This is where knowing your cat comes in.
  • What is kitty’s onset, nadir, and duration?
  • How carb sensitive is kitty and how responsive if numbers are dropping fast or if they are flat?
  • Where in the cycle does that lower number come in in relation to onset, nadir, and duration?
As in many things with FD, there is no one size fits all. Rosa is likely still gathering data on Tina’s responses so it’s really important to write down when she was fed, how much, what % carbs, so that info can be used the next time around.

It’s always been my thought that one should use the lowest carbs that gets the job done. That might mean 10% on a regular basis for some cats. For others, it might be 3%. For some with fast dropping numbers early in the cycle might be 20%. It is correct to alternate gravy with food when working lower numbers to be sure kitty doesn’t get too full early in the cycle.
Click to expand...


it seems like something I should easily understand but for some reason I am a little confused. So lets say Mimi for example.
Based on her numbers, she was low AMPS, which could mean because I didn't get any findings during the night, could mean this dose is getting too high for her? The last few days she's had a lot of blue and yellow, which some green, so does that mean her dose is regulating her or eventually going to be too high according to the TR protocol?

today she dropped consistently at +1 and +2 and then at +3 when it dropped to 50 something I gave there the HC 15 % FF which spiked her a little bit but then dropped again at +5. I figured it was getting close to the nadir so I didn't want to spike her with HC again, so I found a can of the CD diet from Hills they gave her after her surgery, figuring it has to be lower than 15% carbs, and I couldn't find it on Dr. Piersons food chart. But then after finding out it has 30%??? so the +6 mark I got 135- i think thats why she spiked. not we are at +8-9 and her BS has spiked even more to 354.

what do you think is happening in her little body based on those numbers?

Also, can someone confirm I am right about the carb percentage in the CD diet- I went to their website and it said 30% carbs- but maybe the chart Dr P made is a different calculation?
 
Marje and Gracie said:
Have you read through this post? It explains onset, nadir, and duration. Since it varies by cat, it’s something to important for each caregiver to know about their cat. After you read it, if you have questions, please tag me and I’ll be happy to explain what you don’t understand.:)

On the latter comment about PMPS being higher, if you feed a lot of HC food and/or gravy and karo during the cycle, it slams the breaks on the action of the insulin so the duration can be less than 12 hours. If it’s less, then numbers shoot up quickly at the end of the cycle because there isn’t enough insulin action to carry over until the next shot. After a low cycle, a higher preshot can also mean a bounce is starting. Sometimes it’s both. If it is solely duration, the BG comes back down once the next shot onsets.
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I probably did read through it, but forgot. I think I need to actually learn what diabetes is- I know what everyone says it is- but I should find a youtube video explaining it in detail so some of this makes more sense.
 
Mimis mom said:
it seems like something I should easily understand but for some reason I am a little confused. So lets say Mimi for example.
Based on her numbers, she was low AMPS, which could mean because I didn't get any findings during the night, could mean this dose is getting too high for her? The last few days she's had a lot of blue and yellow, which some green, so does that mean her dose is regulating her or eventually going to be too high according to the TR protocol?

today she dropped consistently at +1 and +2 and then at +3 when it dropped to 50 something I gave there the HC 15 % FF which spiked her a little bit but then dropped again at +5. I figured it was getting close to the nadir so I didn't want to spike her with HC again, so I found a can of the CD diet from Hills they gave her after her surgery, figuring it has to be lower than 15% carbs, and I couldn't find it on Dr. Piersons food chart. But then after finding out it has 30%??? so the +6 mark I got 135- i think thats why she spiked. not we are at +8-9 and her BS has spiked even more to 354.

what do you think is happening in her little body based on those numbers?

Also, can someone confirm I am right about the carb percentage in the CD diet- I went to their website and it said 30% carbs- but maybe the chart Dr P made is a different calculation?
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It looks to me like she started a bounce the night of 11/4 and she bounced all day yesterday. The yellow at PMPS last night might have been the high before the break or she could have gone a bit higher or stayed in flat yellow before clearing the bounce today.

By AMPS today, she was definitely clearing the bounce and bounce clearing cycles are always very active ones. She had a very characteristic bounce-clearing cycle.

At this point, her dose is not too high. She’s just doing the typical bouncing we see until the liver gets used to seeing normal numbers.

From Dr. Lisa’s charts, it looks like tense different c/d formulas ranging in 23-28% of calories from carbs on an as Fed basis. You might want to read this post I did that explains where all the numbers come from on a website or can and how they differ from what the actual %calories from carbs is.

It’s also been my experience that vets ae not typically aware of the %calories from carbs in cat food. Meaning that I wouldn’t have taken for granted that by giving her c/d, that it would be under 15% calories from carbs.
 
oh so the percentage of carbs might not be 30% based on how Dr. Lisa listed it carbs to calories?


ok, what is a bounce? Also what do you mean the high before the break.
"she could have gone a bit higher or stayed in flat yellow before clearing the bounce today."- explain this to me like I am 5... lol
 
Marje and Gracie said:
At this point, her dose is not too high. She’s just doing the typical bouncing we see until the liver gets used to seeing normal numbers.
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so what do I do while I am at work tomorrow and can't test her like I did today. should i assume shell drop and leave her higher carb meals to snack on? what would have happened today if I didn't feed her some HC food, would she have dropped to hypo?
 
Sienne and Gabby (GA) said:
You asked what a bounce is? You're seeing a bounce!
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what do those jumps do to her little body though- does it put stress on it? are these bounces part of her getting used to the medicine? is this all common in the process of her getting regulated? Im just thinking what if I had to work today and couldn't do tests every 30 minutes, and feed her high carb.. I have been home all day monitoring her, which is fine because she's my baby, but what if I couldn't?

Im trying to see based on her numbers why she could have dipped so much, unless thats just part of the process, or should I reduce the shot next time.
 
Mimis mom said:
what do those jumps do to her little body though- does it put stress on it? are these bounces part of her getting used to the medicine? is this all common in the process of her getting regulated? Im just thinking what if I had to work today and couldn't do tests every 30 minutes, and feed her high carb.. I have been home all day monitoring her, which is fine because she's my baby, but what if I couldn't?

Im trying to see based on her numbers why she could have dipped so much, unless thats just part of the process, or should I reduce the shot next time.
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Mimis mom said:
+10 is 504 :arghh::(
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does this jump mean the insulin isn't working anymore and its time to shoot her sooner than later? Or can I get back to shooting her at 9:25 , like today I did 9:50
 
Mimis mom said:
does this jump mean the insulin isn't working anymore and its time to shoot her sooner than later? Or can I get back to shooting her at 9:25 , like today I did 9:50
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is her being above 500 going to put her back at risk for DKA?
 
You should be giving shots as close to 12 hours apart as possible. Not shooting on schedule has an impact on the depot.

A bounce is the result of either low numbers, a cat dropping into numbers that may be in a lower range than what's she's used to, or a fast drop. The kitty's liver and pancreas release a stored form of glucose along with counter-regulatory hormones and it can take up to 6 cycles for a bounce to clear. This is what causes the numbers to spike upward. A bounce is fundamentally a protective mechanism. Your kitty's system interprets the lower numbers as "dangerous" which is why the big jump to high numbers happens. This is a normal response -- it's annoying but normal. A bounce does not mean that the insulin stopped working.

High numbers do not by themselves cause DKA. DKA is the result of an infection/inflammation + not enough insulin + not enough calories. FWIW, numbers can be pretty much anywhere and ketones can develop.

Rosa -- you've got to take a few deep breaths and not keep scaring the cr*p out of yourself! If there were something truly amiss, there are enough people here with experience that we would let you know. This place is is where we put the welfare of the cats first.
 
I just found the explanation of "bouncing" so I guess what @Marje and Gracie was saying is i can predict a bounce based on how her numbers looked in the days previous? My question is if she's AMPS lower than 150, do I have enough data to shoot her, or do I need to call out of work to monitor, or should I just give her some extra carbs in her food to be on the safe side.

Today was hard to get a response from anyone for a long time, so I didn't know what to do. Was shooting her the right thing to do, and just counteract the dips with HC food?
 
Mimis mom said:
Ya, she’s had the runny eye before. I know when I first adopted her they said she had URI (this was 2009)
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HI! So a cat that has had a history of runny eyes from kittenhood which waxes and wanes is usually virally based. The shelters usually use the catch all phrase URI. However, with a true URI, the discharge is usually green or yellow indicative of an infection whereas a virus has a clear discharge which sometimes can take on a brownish color as well. Check the whites of her eyes and make sure they are not blood shot as this does not occur with a viral infection. Sometimes a course of Azithromycin can help expedite the runny eyes and or nose. Hope this helps! Hope she feels better soon!
 
Mimis mom said:
oh so the percentage of carbs might not be 30% based on how Dr. Lisa listed it carbs to calories?

ok, what is a bounce? Also what do you mean the high before the break.
"she could have gone a bit higher or stayed in flat yellow before clearing the bounce today."- explain this to me like I am 5... lol
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Dr. Lisa’s charts are accurate unless the companies have changed their food composition.

The high before the break is when a kitty bounces, it looks like the bounce will clear by lower numbers (usually blue) being seen, and then a rise in the BG before the bounce clears.

Mimis mom said:
so what do I do while I am at work tomorrow and can't test her like I did today. should i assume shell drop and leave her higher carb meals to snack on? what would have happened today if I didn't feed her some HC food, would she have dropped to hypo?
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If the +2 before you leave is the same as or less than the AMPS, I would leave food out. I don’t know if she would have dropped to dangerously low numbers today if you hadn’t been there.

Mimis mom said:
also, what bounce was she speaking of starting 11/4- the PMPS number?
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The 304 at +10.5 in the PM cycle is indicative of a bounce starting.
Mimis mom said:
what do those jumps do to her little body though- does it put stress on it? are these bounces part of her getting used to the medicine? is this all common in the process of her getting regulated? Im just thinking what if I had to work today and couldn't do tests every 30 minutes, and feed her high carb.. I have been home all day monitoring her, which is fine because she's my baby, but what if I couldn't?

Im trying to see based on her numbers why she could have dipped so much, unless thats just part of the process, or should I reduce the shot next time.
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Bouncing is normal. All cats do it until they don’t. The liver of some cats adjust fairly quickly and they don’t bounce long but many cats bounce and then go to normal numbers then bounce, etc. Again, bounce clearing cycles are very active cycles managing numbers can drop lower. We don’t change doses based on bouncing alone. Remember we base dosing primarily on the nadirs. If you need to leave for work and it appears a dose is clearing, you can “carb her up” and leave carbs out.
Mimis mom said:
is her being above 500 going to put her back at risk for DKA?
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DKA is not caused solely by bounces but by not enough insulin + infection + not enough food/hydration. I’ve seen cats in pretty well regulated numbers get DKA so the infection, inappetance, and dehydration are also part of it. Keep checking ketones; if she shows less appetite, then it’s critical that you make sure you know what her ketones are.

Mimis mom said:
I just found the explanation of "bouncing" so I guess what @Marje and Gracie was saying is i can predict a bounce based on how her numbers looked in the days previous? My question is if she's AMPS lower than 150, do I have enough data to shoot her, or do I need to call out of work to monitor, or should I just give her some extra carbs in her food to be on the safe side.

Today was hard to get a response from anyone for a long time, so I didn't know what to do. Was shooting her the right thing to do, and just counteract the dips with HC food?
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Yes...with a post DKA cat, as long as it’s safe to shoot, you should not skip shots.

Bounces are not preventable.
 
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