Chnoudi-dose advice

I think you are good to shoot provided you can monitor as long as needed and have plenty of test strips, high carb and middle carb. I can’t stay with you know.
 
Get a +2. If it’s lower than the pretest you will need more tests. If it’s higher then you can then test +4. I should be able to check in with you around +4. If not sure what to do, add the question mark prefix to your subject and change to say need help. Put your +2 in the box and the rest of your numbers if in doubt.
 
tiffmaxee said:
Get a +2. If it’s lower than the pretest you will need more tests. If it’s higher then you can then test +4. I should be able to check in with you around +4. If not sure what to do, add the question mark prefix to your subject and change to say need help. Put your +2 in the box and the rest of your numbers if in doubt.
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Thank you so much! :bighug:
 
I’m glad you shot. You are seeing a bounce from the lower BG today. It will be interesting to see how long it takes to clear. It’s to be expected. I hope it clears soon.
 
I had already set an alarm clock, so there is also a +6: 356.
It's may be expected, as you said, but after a cycle of blues, this really makes me sad :(
 
That's a big drop this morning, looks like the bounce is clearing you may well see her drop back into blues and green. I would get at least another test midcycle today just to see what she's up to.
 
Yes I am going to get another one at +6, and after PMPS of course!
I don' t know what happens at night... Despite the yesterday's bounce, I've noticed that night cycles are very different from morning cycles...
 
He seems to be in a pattern 'at the moment' of having an active cycle during the day, bouncing at night.
The patterns can change, and often do, that's why the before bed test is useful, it can give you the heads up if she's going to change it up and have an active evening cycle.
He saw that green number 6 cycles ago, he seemed to bounce of that, though she seems to have been trying to get back down there, she's not quite managed it yet, bounces can last upto 6 cycles so you may see her make it back to green today.

Does he get the same amount of food at the same time at night and in the day?
What time are your usual feeding times?
 
Oh I understand! Well, she eats 1/2 of the can at 10:30 (11:00 is the shooting time), then at 17:00 (after the +6 test) she eats another 1/4 of the can and at 22:30 (before the 23:00 shot) she eats again 1/2 of the can.
 
You don’t want to be feeding half an hour before the shot that just makes sure you’re shooting a higher number. The feeding and shooting should take place in the same few mins. Test-feed (to make sure she will)-shoot all within about 5 mins.

A lot of people shoot while the kitty has it’s head in the food bowl.
 
Hi. Just to clarity, I know you fed a half hour before shooting, but are you testing when you feed or right before you shoot?
 
I' ve just thought of something... Before the night dose, along with food I give her a food supplement for the liver. "Hepatiele Forte"
The vet told me so... Is there a possibility to cause all these bounces at night?
Its ingredients are phospholupidium and ornithinum. The paper included says: Contents: soybean oil, soy lecithin, L-aspartate L-ornithine.
Analytical constituents:crude protein 23.6%,crude fat 57.92%, crude ash 10.68%, moisture 1.71% (I m sorry for this, I don't know how to post a picture)
As I see from the contents it can cause an increase to BG, right? Soy is full of carbs!
 
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Melita said:
As I see from the contents it can cause an increase to BG, right? Soy is full of carbs!
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Soya beans do have a significant amount of carb, but the ingredients state soy oil and soy lecithin, so I don't know if that would be high in carb.
Are you giving her the liquid, tablet or is it in a capsule?? (the capsules can be full of carbs)

As it's just a food supplement maybe you could not give it for a couple of nights and see if it makes a difference. The problem with a lot of supplements is that they don't tell you if there are sugars in them. I had a problem with some arthritis supplements, tablet form, they had sugars and they seemed to affect Georges BG.

So supplements may cause sime higher BGs, if it turns out they have carbs in them, but they would not be responsible for a bounce.
FWIW the numbers in the evening don't look like bounces to me, it looks more like she has more carbs on board in the evening meal. With a bounce you would expect the numbers to remain high and flat for more than just that one cycle.

If there are some hidden carbs in those supplements they could, at least in part, be contributing to those higher numbers at night. One thing I would like to clarify for you is that not all high numbers are bounces,

From the Basics Sticky
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

Melita said:
Well, she eats 1/2 of the can at 10:30 (11:00 is the shooting time)
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Melita said:
I test first, then feed and then shoot. But between feeding and shooting there is a gap of 20-30minuts, while she's eating.
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The reason your vet would have recomended you feed 30minutes before you shoot is that with the faster acting insulins you want to have time for that food to start to be digested before the insulin onsets since it onsets so fast. With Lantus onset is around +2 for most cats, so there is no need to wait the 30minutes after feeding. It may just be that your vet is more used to using the faster acting insulins and didn't make the distinction.


As @Vyktors Mum said I was one of those who would shoot while kitty had his head in the bowl.:)

I'm glad that you are testing before you feed, since you then do know that the number you are shooting is not food influenced, I wonder though if feeding 30min before shooting might be contributing to the sharp drop that you see in the early part of those morning cycles. If kitty is digesting and metabolizing the food well before the onset, with little food on board it may cause her BG to drop more sharply.

Melita said:
Oh I understand! Well, she eats 1/2 of the can at 10:30 (11:00 is the shooting time), then at 17:00 (after the +6 test) she eats another 1/4 of the can and at 22:30 (before the 23:00 shot) she eats again 1/2 of the can.
Click to expand...

That's how I used to feed in the beginning, after some trial and error and to try and flatten the curve and avoid the sharp drops George experienced at onset I ended up feeding at main meal at shooting time then snack at +2 +4 and +6. This worked better for us. But every cat is different, and it's early days for you both, just bear in mind that you can use food to avoid sharp drops, which in turn can mitigate the bounces.

Tonight is cycle 10 on the 1.25 units, looking at the nadirs, though you have seen green, they have both been in the 90's so there is room to take the dose up. Unless you see some lower green tonight if it were me I would be considering taking the dose up to 1.5u.
Some cats take a little longer to settle in to a dose, but I wouldn't recommend holding on to this dose for too long, she's spending a little bit too long in those pinks.

**If you are going to experiment with removing the supplement you might want to try that first before taking the dose up, just in case it's influencing her BG more significantly than you might expect.
 
Gill & George said:
Soya beans do have a significant amount of carb, but the ingredients state soy oil and soy lecithin, so I don't know if that would be high in carb.
Are you giving her the liquid, tablet or is it in a capsule?? (the capsules can be full of carbs)

As it's just a food supplement maybe you could not give it for a couple of nights and see if it makes a difference. The problem with a lot of supplements is that they don't tell you if there are sugars in them. I had a problem with some arthritis supplements, tablet form, they had sugars and they seemed to affect Georges BG.

So supplements may cause sime higher BGs, if it turns out they have carbs in them, but they would not be responsible for a bounce.
FWIW the numbers in the evening don't look like bounces to me, it looks more like she has more carbs on board in the evening meal. With a bounce you would expect the numbers to remain high and flat for more than just that one cycle.

If there are some hidden carbs in those supplements they could, at least in part, be contributing to those higher numbers at night. One thing I would like to clarify for you is that not all high numbers are bounces,

From the Basics Sticky
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).



The reason your vet would have recomended you feed 30minutes before you shoot is that with the faster acting insulins you want to have time for that food to start to be digested before the insulin onsets since it onsets so fast. With Lantus onset is around +2 for most cats, so there is no need to wait the 30minutes after feeding. It may just be that your vet is more used to using the faster acting insulins and didn't make the distinction.


As @Vyktors Mum said I was one of those who would shoot while kitty had his head in the bowl.:)

I'm glad that you are testing before you feed, since you then do know that the number you are shooting is not food influenced, I wonder though if feeding 30min before shooting might be contributing to the sharp drop that you see in the early part of those morning cycles. If kitty is digesting and metabolizing the food well before the onset, with little food on board it may cause her BG to drop more sharply.



That's how I used to feed in the beginning, after some trial and error and to try and flatten the curve and avoid the sharp drops George experienced at onset I ended up feeding at main meal at shooting time then snack at +2 +4 and +6. This worked better for us. But every cat is different, and it's early days for you both, just bear in mind that you can use food to avoid sharp drops, which in turn can mitigate the bounces.

Tonight is cycle 10 on the 1.25 units, looking at the nadirs, though you have seen green, they have both been in the 90's so there is room to take the dose up. Unless you see some lower green tonight if it were me I would be considering taking the dose up to 1.5u.
Some cats take a little longer to settle in to a dose, but I wouldn't recommend holding on to this dose for too long, she's spending a little bit too long in those pinks.

**If you are going to experiment with removing the supplement you might want to try that first before taking the dose up, just in case it's influencing her BG more significantly than you might expect.
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Thank you so much I ve read everything very carefully!! I ll try to reply, though my English don't help me very much..
So, the supplement I give her is capsule. However, I cut the plastic and I give her only the interior. (it's a kind of pate..)
Yes, I don't know why the morning drop is so harsh in comparison to the evening, when the insulin looks like it doesn't affect her at all... Though, its worth mentioning that she is sleeping almost all of the night! I don't know... Maybe this plays some part..
Today's PMPS was really high, at 372...and I am very sad.. . I didn't gave her the supplement in order to see if this influenced her BG. In a while I ll test +2 and I'll make the first conclusions.
Nevertheless, tomorrow I will increase the dose to 1.5 unit as you said!
Thank you so much for your help!!!
 
It might be good, if you recorded on the comments section, when you feed, how much, what you feed and if she has had any supplements,

It helps to know these things when anyone is looking at her numbers and trying to help you. It will also help you to learn and make decisions for her as you move forward with this journey.

Did/ does she have some liver problems? Is that why the vet recommended the supplement?

I remember well how hard it's to see those pink numbers. George was a sea of red and pink for the first 8 weeks, god it was hard to look at!:bighug:

I think that dropping back to 1u was probably more than was needed, though I understand why you came to that decision, it would not surprise me if takes a few more increases before you start to feel like you are moving forward. Hang in there.

As you are doing TR, just let the numbers continue to guide you and take those dose increases following the guidelines.

It can take a few cycles for them to settle into a new dose, up to 6. So let's see what the 1.5u does for her. Fingers crossed the new dose will bring the whole range down.

How is she feeling/acting?
How are the 5p's?
  • Purring
  • Peeing
  • Pooping
  • Playing
  • Preening
Remember she is more than just her BG numbers.:bighug:

(Your English excellent)
:kiss:
 
Yes, you re right! Ι intend to write all the details about the food from now on!
AS far as the liver is concerned, the transaminase in her blood test were really high.. The vet told me that maybe it's due to her diabetes, but in any case she recommended that supplement.
Well, I know that dropping back to 1u was a big drop and I am sure that we have a big journey in front of us. At least, I m happy I' ve saw some blues and greens..! I dont know how to cope with TR guidance yet, but i feel safe in that MB... i have stopped talking to my vet about diabetes.!
The only thing that really concernes me is why there is no decrease of BG at night... Ι feel like I m dealing with a different cat at evening cycles... :(:(
However, the good part is that she looks great!! She plays and purrs almost all day, she's going to toilet (having excellent results :p ) and grooming herself more than ever! I would not understand that she has diabetes if I didn't know it. Before her diagnosis she was in a very bad condition, but almost after the first week of insulin , she transformed to the kiity i had! Maybe her young age led to it, cause she's 6.
Thank you for all the support, it means a lot to me !!:bighug::rb_icon:
 
Hi, I just took a look at Chnoudi's numbers,
How long ago was that 64?

It's great that you fed, but it would be good to check she's not dropped any further.
I would get another test no later than +7, just to make sure that she's not going to drop any further.
 
If you shot at 11am, taking into account the time zone, you must have just got that +6, if you are able to get a +6.5 test even better.
 
Οh and i thought so! I just wanted to make an effort from today to feed small meals often .. how stupid I am.
I shot at 10:30, the +6 was half an hour ago! And after that i fed her. Ok, so I test again now, after the food intake?
 
How long after the food was that? 30minutes?

Grab a +8 just to make sure that she doesn't dip. With any luck she is 'surfing' (when you get a nice steady run of green numbers)

At this stage as we are in the second half of the cycle, don't feed too much (you can give a teaspoon if it helps with the testing), unless of course you were to see her dip near the 50 mark, in that case you might give a little more food. If we feed too much in the second half of the cycle, what can happen is that the numbers spike as this this mornings shot wears off (reaches end of duration) in an ideal world we would have her surf into PMPS in a nice green or low blue number.
 
It was actually 45m after the food. ok ok!!
No, I m not going to feed her anymore. She will eat again after the PMPS test. Luckily she is really patient , she tolerates the tasting!!
I hope PMPS is blue and green! And then, the big deal is the evening cycle...It' s always in high numbers....
 
In case we get a lower PMPS

have a read of this info post (sticky)
https://www.felinediabetes.com/FDMB...y-to-shoot-handle-lower-pre-shot-numbers.147/

I would suggest that you start a new thread today for Chnoudi.

11/24 Chnoudi amps 334 +3 144 +6 62 new to green this is standard format for the threads, it gives the important BG and you can ask a question at the end of the numbers if you need help with anything. We usually do a new thread every day. When the threads get too long it's difficult to look through them, it also means that when you have a new incident people can see quickly if you have had some help or if you are in need of it.


Melita said:
No, I m not going to feed her anymore.
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that's fine, but if she drops below 50 you will need to feed. 50 is the take action point.

Melita said:
I hope PMPS is blue and green! And then, the big deal is the evening cycle...It' s always in high numbers..
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I hope so too, there's a saying here, 'shoot low to stay low' I hope you get the opportunity to shoot a lower number tonight. She will probably bounce, she dropped fast, and down into a lower green than she is used to, so I would not be surprised if she bounces. We just want to see how long she can spend in green. It's a process, the more she is in green, the more she get's used to it, the less likely we will be to see the physiological reaction. Try not to worry about the bounces, they are part of the process, until she becomes regulated.


I have to go out in a bit to walk dogs, then feed cats, but I will pop back in to see you.
 
Gill & George said:
In case we get a lower PMPS

have a read of this info post (sticky)
https://www.felinediabetes.com/FDMB...y-to-shoot-handle-lower-pre-shot-numbers.147/

I would suggest that you start a new thread today for Chnoudi.

11/24 Chnoudi amps 334 +3 144 +6 62 new to green this is standard format for the threads, it gives the important BG and you can ask a question at the end of the numbers if you need help with anything. We usually do a new thread every day. When the threads get too long it's difficult to look through them, it also means that when you have a new incident people can see quickly if you have had some help or if you are in need of it.



that's fine, but if she drops below 50 you will need to feed. 50 is the take action point.


I hope so too, there's a saying here, 'shoot low to stay low' I hope you get the opportunity to shoot a lower number tonight. She will probably bounce, she dropped fast, and down into a lower green than she is used to, so I would not be surprised if she bounces. We just want to see how long she can spend in green. It's a process, the more she is in green, the more she get's used to it, the less likely we will be to see the physiological reaction. Try not to worry about the bounces, they are part of the process, until she becomes regulated.


I have to go out in a bit to walk dogs, then feed cats, but I will pop back in to see you.
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I am incredibly moved by your help... Yes, I will make the new thread later with the new numbers. Thank you soooo much! :bighug::kiss:
 
like that 78
images

:D:D:D
 
Very nice cycle, lots of time spent in healthy green numbers.

I think you're OK to not check at +10 if you both want a break.
Grab a +11, so you can see which way the numbers are heading at pmps, it also gives you some time to make a plan should he still be surfing in those green numbers.
No food till PMPS.

Do you have enough supplies on hand, test strips, food, higher carb wet food (over 10%), honey....
Are you able to monitor this evening?
Does Chnoudi have a good appetite? I could always rely on my boy to eat if I needed him to because his BG was low.

Whenever you are shooting lower than usual important to have supplies ready in case you need them, and important to monitor until you know she is going to be safe.
 
Have no fear, supplies are always here! :cat:
Yes, due to lockdown I am always at home, I can test whenever I want.
I ll set alarm clocks !
She is hungry all the time, no problem with her appetite! :)
 
Melita said:
She is hungry all the time, no problem with her appetite! :)
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That makes life easier when they have a good appetite.
Melita said:
Yes, due to lockdown I am always at home, I can test whenever I want.
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We have to look on the bright side, I'm sure Chnoudi is loving you being home.:)

Melita said:
Have no fear, supplies are always here! :cat:
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Excellent
Melita said:
I ll set alarm clocks !
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Sounds like you are ready for a PJ party.
Keeping fingers crossed she keeps steady in blue for PMPS. The rise may be the start of a bounce or just that she is reaching the end of the cycle.

Time will tell.
 
Not bad for a pmps, are you happy to shoot?
Melita said:
PMPS :178
Shall I start a new thread now? It was up to you all day long, you should rest :)
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Yes you should.
Every day start a new thread. I used to link the daily threads in the comments on the Spread sheet, so I could look back at advice given and refresh my memory of how a particular cycle/day went.
 
Melita said:
It was up to you all day long, you should rest
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That's no problem. I've got one hour till bedtime.

The numbers are rising at pmps, so the theory goes that Lantus will onset around +2. If it's going to be an active cycle that +2 will be either lower or about the same as your pmps. If it's way higher, then that would confirm the bounce.
We still do not know if the rise to 178 at pmps is a normal end of cycle rise or if it is the start of the bounce. She's not made it too clear yet.
 
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