After dx we switched to the lower carb FF and was feeding every 4 hours and over time we went to every 5 hours as well as a tablespoon of YAZC , these two were like clockwork on the 5th hour. Lately it seems we've gotten to anywhere from 5 to 7 hours between feeding sometimes as long as 8 hours....could this be anything? Could they need to be kept on a more frequent feeding schedule?
That's a definite possibility, and one that has very much been borne out in Saoirse's case. When her numbers started trending upwards after her insulin was withdrawn the only way that I could find to keep her in the normal range when I could not get another Lantus Rx for her was to control when and how much she was fed.
After monitoring Saoirse for so long I think despite her achieving a technical remission, the remission was never that solid. I think her pancreas never recovered sufficient function to secrete enough basal insulin between meals. I would often see a significant spike in her numbers if she fasted too long (impaired fasting glucose - a symptom of metabolic syndrome/pre-diabetes); a good feed and they would drop back into the normal range again.
The human pancreas produces pulses of insulin in response to inbound food and I assume that the feline pancreas works similarly. I leveraged that pulsing capacity to help keep Saoirse in the healthy BG range. I split her daily food allowance into mini meals and I fed her every 2-3 hours (timed feeder is vital). Also from what I have read my understanding is that the size of meals can influence how much insulin the pancreas stores ready for the next meal. Again I think that the feline pancreas may work similarly. Feeding Saoirse every 2-3 hours is better for her blood glucose levels than feeding her smaller meals more frequently.
The time of day when food is consumed can also affect BG levels. For example, if Saoirse doesn't each much in the hours around midnight but eats larger meals after about 4am her morning BG levels tend to be significantly lower (on or off insulin).
There is another phenomenon I've observed in Saoirse and have read here about other cats is that the actual carb content can influence BG regulation. Some cats do better at different carb levels and lower is not always better. For example, Saoirse does better with carbs at about 1.5-4% than she does at <1%.
Suggestions:
* Go back to the feeding schedule where Dasher and Blitzen had better numbers. Monitor how their BG responds before and after meals as suggested above. That should give you a better idea of what their pancreases are up to.
* Keep a daily log of meal times, food amounts and carb kilocalories. If you do feed products with different carb ratings you could again do the pre-meal and +1/+2/+3 postprandial tests to see whether different carb values make a difference to pancreatic response. (I record feeds using the 'Insert Note' function on Saoirse's spreadsheet so that I've got her food info easily accessible and in context with her BG data - it makes for easier identification of trends and anomalies. The log can be invaluable as a guide to optimising feeding schedules.)
* If you don't already have any, consider using timed feeders to optimise night time feeding schedule.
* If you find a schedule that works, stick to it until it no longer works.
* If you're getting any blood tests run for Dasher and Blitzen, perhaps ask the vet to include tests for liver function (precautionary).
Hope that gives you some ideas.
Mogs
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