? Baffled & could use advice

[Darnell & Sprocket (GA)]

I am helping my friend, a newbie, Christian.
Here is link to the first thread
https://felinediabetes.com/FDMB/threads/my-newbie-friend-needs-advice-on-dosing-food.286600/

My friend started testing Sunday. Cat (Sebastian) was diagnosed in October 2023. Cat is up to 5 units. First amps was 120. Gave half a dose. Cat stayed in blue then went to pink. Cat has neuropathy too & the b12 capsules ordered.
Gave 5 units next 2 cycles. Pm cycle cat was hiding, couldnt get tests. Next day cycle, Cat surfed in blue all day. Tonight cat was 127 for pmps. Advised to give 75% of dose of 3.25 units. Cat was given extra food mid cycle to get tummy used to wet food as he usually gets diarrhea when given in past then cat ate 1/4 cup of high carb (32-35%) dry food for pmps meal. Tested about hour & half later & he is 139.
I am baffled as to where the food spike is??

Finally after hour & half with no response, 279@+4.5. Is this the food spike?
Not sure if its the high carb food but never seen a cat with numbers all over at odd times. Amps & pmps should be higher & nadir lower in mid cycle but he doesn’t seem to be doing that.

I think if his cat could just able to switch food to wet right away without worrying about the diarrhea I would say it would be better to restart the insulin dose at a lower dose but since he has to transition slowly because of the diarrhea, I assume its not good. Plus his numbers are so good I wouldn’t want to screw that up.
I am not sure how to balance the dose with switching food slowly. ??

And now the food doesn’t seem to be spiking him makes me Think that dose is way too much & he is feeding the dose instead.

Not sure what to do??
Should I have him just switch & start with a lower dose?
Or I dont know how to balance the dose as he reduces the high carb to switch to low carb. ??
Also, cat is getting used to testing & afraid he will be hiding when he needs to get tested.
Dont want to risk hypo because cat is hiding.
And cat is also getting used to a new kitty brother. Been little over a week with a new kitty. One hissing & a swat situation but otherwise the two have been ok.

I am baffled.
Please advise.

here is his spreadsheet,
https://docs.google.com/spreadsheets/d/1j4BfEUCh8arOVSvmpbY04in_k2uXgQZirJ5jl4LzsjU/edit

 

[Chris & China (GA)]

It's looking a lot like he's been overdosed. Sure would be nice if the diet change could go faster but we don't want a cat that won't eat or has raging diarrhea either.

Has he started the probiotics yet? Even if he has, that can take some time to work.

There's probably still a lot of depot that is affecting his numbers too. My brain is fried tonight so maybe @Wendy&Neko has some advice to help your friend as to what dose to stick to for now. All these dose changes just make it harder.

 

[Darnell & Sprocket (GA)]

It's looking a lot like he's been overdosed. Sure would be nice if the diet change could go faster but we don't want a cat that won't eat or has raging diarrhea either.

Has he started the probiotics yet? Even if he has, that can take some time to work.

There's probably still a lot of depot that is affecting his numbers too. My brain is fried tonight so maybe @Wendy&Neko has some advice to help your friend as to what dose to stick to for now. All these dose changes just make it harder.

ordered probiotics, low carb dry & treats today, coming from chewy. & the b12 supplement ordered & coming monday.

and I think he went to
Sleep without testing again. He isn’t replying to me.
He doesn’t understand what this means so he just assumes he is fine.
while I know what they can mean & I am worrying!! Uggg!!!


Hour & half later he finally replied with 279 @+4.5.

 

[Diane Tyler's Mom GA]

Previous post
https://www.felinediabetes.com/FDMB...ds-advice-on-dosing-food.286600/#post-3152423

 

[Wendy&Neko]

I don't see indications that he's overdosed. But it's really hard to tell because the dose keeps on being changed. With the dosing methods we use here, consistent dosing is best. We don't change doses based on preshot values, but rather the nadirs, or how low the dose is taking the cat.

Finally after hour & half with no response, 279@+4.5. Is this the food spike?

Or a bounce response to that much blue, or a reaction to a lowered dose, or a mix of all three.

Amps & pmps should be higher & nadir lower in mid cycle but he doesn’t seem to be doing that.

With bounce breaking cycles, like yesterday, nadirs tend to be later. They could even be after the following shot.

Here's my suggestion for a plan. Pick a dose, one dose based on nadirs and not the preshots. If blue preshots make you uncomfortable, go down to 4.5 units. Stick with that dose for six cycles, get at least 2 tests per cycle for those six days. Once you have a better idea how that particular dose is working, then you can come up with a plan for a food switch.

 

[Darnell & Sprocket (GA)]

I don't see indications that he's overdosed. But it's really hard to tell because the dose keeps on being changed. With the dosing methods we use here, consistent dosing is best. We don't change doses based on preshot values, but rather the nadirs, or how low the dose is taking the cat.

Or a bounce response to that much blue, or a reaction to a lowered dose, or a mix of all three.

With bounce breaking cycles, like yesterday, nadirs tend to be later. They could even be after the following shot.

Here's my suggestion for a plan. Pick a dose, one dose based on nadirs and not the preshots. If blue preshots make you uncomfortable, go down to 4.5 units. Stick with that dose for six cycles, get at least 2 tests per cycle for those six days. Once you have a better idea how that particular dose is working, then you can come up with a plan for a food switch.

Yes I talked to my friend & explained more now. We made a food plan schedule & test schedule written on paper. Gave him some of the probiotic to get started until his order comes in & some low carb canned food. He is going to reduce the dry food too & add the canned food & start transitioning tonight.
I did explain the options when he gets a lower preshot bg.
He was 2 hrs late this morning so he needs to work back some to normal time he wants to stay with.
We will pick a dose tonight & stick to it for 6 cycles & by then the low carb dry food will be in & he can start the dry food transition to low carb dry with a little low carb wet.
Ultimate goal is to get off the dry food completely.
And he said that the vet mentioned that the cat wasn’t extreme in levels & she thought he would be able to go in remission easily yet this is the same vet that never mentioned to change to low carb food.