Do you frontload kitty's meals?

[Doug N Libby]

Been lurking around today reading and noticed several of y'all feed a couple of mini-meals early in the cycle. While on ProZinc, we had been feeding at +6, but I'm wondering since nadir occurs at different time on Levemir, maybe meals should be different, too?

Thanks for your input!!!

Libby (and Hershey, too!)

 

[Marje and Gracie]

Hi Libby

Many of the Lantus users frontload meals to catch the early drop as lantus onsets for some cats at +2/+3. When Grace was on lantus, I fed those times as well.

On lev, it's a different story and you have to figure out what Hershey needs once you see how his lev curve patterns are. Be aware he may not need any scheduled feedings....some cats do fine free feeding on wet food without any food management per se and so feeding him as you currently are doing may just work fine.

Right now, it's hard to see Hershey's lev pattern clearly but he will develop a pattern. I know Jill feeds Alex two portions at PS and then another portion about +6 before Alex onsets. Gracie has a very atypical lev curve so I feed her a portion at PS, +2, +3 and then later in her cycle around +7 or +8 when she onsets. I have to feed her the early meals because she sometimes nadirs at +14/+15 from the morning shot after I give her the evening shot. Sometimes she nadirs at PS and then gets a second dip after the PS. When I have her dose right, she gets phenomenal overlap so telling where one cycle starts and the next one stops is difficult.

You'll have to study his SS closely when he really starts to settle into lev and see where his onset is. Nadirs can move but you should be able to see a range where he typically falls. We'll continue to look at his SS and see if we can help you figure out his pattern. But be aware that lev is going to onset and nadir later than PZI and later than lantus.

 

[Jill & Alex (GA)]

feeding plans are one of those ECID things. the only way to figure out what's best for the individual cat is through observation and experimentation. knowing how the individual cat responds to not only the insulin used, but food, too is important because food and insulin go hand in hand when managing feline diabetes.

since lev has a later onset, the nadir is usually later than with lantus. i divide alex's meals (also on levemir) up into 3 portions per cycle. two portions are fed at shot time and one portion is fed generally between +6 and +7. this is what works for her.

my reasoning is two portions at shot time leave her satisfied and any food spike should have dissipated by the time the insulin kicks in. her onset isn't until approximately +4 so i don't want to slow the action of the insulin down by feeding too close to onset. the single portion fed between +6 and +7 is to keep her from dropping too low at nadir. this is based on an onset at +4, duration lasting approximately 14 hours, and a late nadir. however, as with most kitties, nadirs and duration can and do change. her nadir has recently shifted. this has me re-thinking her current feeding schedule. i'm at the point where i have to consider what works best for BOTH our schedules.

whether kitty is on levemir or lantus, you want to try to avoid feeding after nadir. feeding post-nadir can oftentimes bring whatever insulin action is left to a grinding halt.


hershey is so new to levemir. i'd continue feeding him as you have been until you can begin to see patterns emerging.


just my thoughts...



edited to add:
take a look at alex's ss. i mark feedings on alex's spreadsheet with an asterisk in the corresponding cell. this method gives me a quick view to understanding how food may or may not have influenced her numbers that particular cycle. the method might help you, too. :mrgreen:

 

[Sienne and Gabby (GA)]

There are several issues to consider with using food to manage numbers. Before I go any further, if you want a good set of eyes on Hershey's SS and someone who is experienced with this strategy, I'd send Jill a PM.

I do agree with Marje. You need to have a sense of what your cat's pattern is and know when onset and nadir are. Changing a cat's usual pattern of eating is not necessary for every cat. If you have a cat that's prone to taking early dives, front loading can be a good strategy to try to offset that pattern. Be advised, though, that it can take several weeks for the strategy to yield results. I changed Gabby to feeding at pre-shot, +1, +2 and +3 on 4/30/2010. It took a while for the effects to be evident. I recently changed her food schedule to pre-shot, +1 and +2 when I'd found that when I doubled up the quantity of her meal at shot time because I would be gone early in the cycle, her numbers were flatter.

While it may not seem to be the case, much of the strategy is trial and error. In addition, there can be differences if a cat's pancreas is in the process of becoming active.

Some cats may do better with a different timing of their meals and others don't. We usually suggest to not feed after nadir. After nadir, there's less insulin available to counteract the effects for the food.

 

[Doug N Libby]

Okey dokey. I tried it different ways while on ProZinc and it didn't seem to change his numbers any, only increased/decreased his begging. That's why we stayed with the feeding at shot time and +6 (or sometimes as late as +7). Hershey usually inhales his food - which is good because Oreo would eat anything he left. So much for free feeding. ;-) But, at least with the scheduled feedings I know how much eat kitty ate and am sure they got their own food.

So for now, we'll just keep on keepin' on -

THANKS, again!

Libby (and Hershey, too!)