Footfoot higher BG reading

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HelenR

HelenR

Member Since 2022
I just did a BG reading for Footfoot before giving her PM insulin shot and feeding her; I was surprised at the reading, 30.4. What could explain it's being so high? Previously the highest recorded is 27. Admittedly it's still early days with testing, so I don't know what to expect...
The link to the spreadsheet is in my sig.
 
We're still struggling to adjust to the timings. Her old meal regime was breakfast between 9-11am (usually), depending on who got up first and fed her; lunch at 3pm; dinner at 9pm.
I've now set her injection times at 10am and 10pm, feeding right afterwards, so a mid-point lunch is now 4pm. I'm wondering if I should split it into 2 lunches at maybe 3pm and 7pm?
 
Hi and welcome to the group. I love the name Footfoot!

as far as the seemingly super high number I wouldn't put much thought into it. You are just starting out on this journey, many cats have similar numbers in the beginning. Look at some of the other members' spreadsheets and you'll see the same. Like my cat Hendrick for example:

https://docs.google.com/spreadsheet...Y3bj6tt4NeAjfhJvVQb55bsyopXQHILbxlVKF/pubhtml

Regarding meals, yes many members spread the food out a bit, larger meals every 12 hours but also a few snacks worked in. If you're shooting at 10am I would probably avoid feeding at 7pm that is 9 hours after the insulin shot and at that point, the insulin has all but worn off so most members don't feed that late into the 12-hour insulin "cycle"
 
HelenR said:
What could explain it's being so high? Previously the highest recorded is 27.
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Some mid cycle testing will go a long way to help us answer this question. She could be bouncing or it could be too much insulin or not enough.

Prozinc expected nadir (the lowest point in the cycle) is around +6 but, sometimes a cat can nadir as early as +4 or as late as +8. This is where random mid cycle testing during both cycles really helps to catch when she's at her lowest and this is what will help tell us what's going on with those high numbers. Sprinkle those tests around at different times during each cycle to learn when to expect her nadir, then you can fine tune your testing to the most opportune times as you learn her patterns.
HelenR said:
We're still struggling to adjust to the timings
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Again, mid cycle tests will help out with this too. We'll be able to see what the food is doing to the numbers and it will help you determine the best times to feed her. It's usually better to feed the larger meals early in the cycle before the insulin reaches it's peak/before nadir. When you feed after nadir the insulin is wearing off and there's not as much insulin left in her system to offset the carb intake so the BG can really shoot up and the insulin looses duration.

As you collect more data you may find you need to adjust your feeding times - for now, I would feed the mid day meal around/before 2pm (+4) and maybe a small snack if she needs it around 6pm (+8) and the same for the PM cycle - if the late small snack isn't doable during the PM cycle, I'd make sure she gets a mini meal no later than PM+4.
 
@HelenR Since you just joined last week you may not know about so-called "bouncing"

BOUNCE: When a cat’s BG numbers drop into a low range, drop fast, or drop into a range the cat is no longer used to, the liver and pancreas may respond by releasing a stored form of glucose along with counterregulatory hormones. This causes numbers to spike back upward. It can take up to 3 days/6 cycles for a bounce to clear.

this is more often the case once kitty has been on insulin a while and finally sees some lower BG numbers. Unlikely to be happening at this point.
 
Thanks so much, Hendrick and Shelley! More testing definitely seems to be the way to go. I'll try it tomorrow. In fact, as we're approaching PM+4, I will attempt a test now, and a snack. Yes, we are a late-shifted household, which is why I've timed her morning injection for 10am - for me to get up every day earlier than that and be compos mentis and ready to test and shoot by 10am is, let's say, unrealistic. And I thought, if her evening injection is 10pm, I have *some* prospect of going out for an early evening event, at least. But it's all in flux - I may change those times as we go along. Apart from anything else, I'm starting a new job before the end of the month and I don't yet know precise hours for that. It's flexible but I don't know how much.
 
I just want to throw this out for your consideration.

The lowest point in the cycle (i.e., the nadir) is around the middle of the 12 hour cycle. You'll have a better sense of how your kitty is responding to insulin once you do a couple of curves -- testing every 2 hours over a 12-hour cycle from AMPS to PMPS. The curve gives you some idea of when insulin onset and the nadir occur. With your test times at 10:00, nadir would fall at around 4:00. That may be fine during the AM cycle. You may want to think about whether that will work for the PM cycle, though. It could mean your sleep could be fairly broken up if Footfoot's numbers are running low at night and you have to monitor. On the other hand, if you tend to be up late, the 10:00 shot time may work just fine.
 
Hmm, thanks for your thoughts, Sienne. I see the logic.
If I move the times to earlier slots, I'd also lose sleep - e.g. if I was getting up at 7am to do her test and shot... I'd have to hope to get another couple of hours sleep after that, which might or might not work. I rarely get to sleep before 2am, try as I might... but maybe I should consider that pattern.
Does a cat's nighttime curve tend to be similar to their daytime curve?
 
If you're up late, the time is fine. I adjusted Gabby's shot time around both my work schedule and to be sure I had time in the AM to grab tests before I left the house. You do what works for you.

There's some variability. The challenge is that nadirs can and do change. They may typically fall around a certain time but they can vary. Cats do not like to be predictable!!
 
Cats often do go lower at night during the evening insulin cycle. I used to shoot at 630am/pm and there were nights I was up until 2am because testing about 2 hours after the shot showed me he was dropping lower and I wanted to make sure I caught the low point. And indeed I did, at 12:30am one night when Hendrick threw me a 45, his first reduction.
 
not much data yet but my thoughts are: the low point (nadir) looks to be around +4

I was not a ProZinc user so hard for me to contribute on this subject but, have you read this write-up on PZ and dosing methods?

Dosing methods will help guide you on when to increase or decrease the dose and are a HUGE help in getting kitty regulated. I highly recommend you choose one ASAP.

I doubt the 1.0 U is enough, to be honest, but I also am not comfortable advising you to increase. I'm sure some of the PZ gurus will chime in here however.
 
FrostD said:
What are your thoughts on diet transition? I would start that before increasing the dose.
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I've had conflicting advice! Some people have said get her insulin dose sorted before changing her diet. I'm finding it all very confusing. I have changed her diet a bit, in that I'm giving her a bit less Hill's d/d kibble than before, with the addition of a bit of tuna in spring water - or a tuna-based cat food with minimal other ingredients (e.g. Blink). So her carbs are a bit less than before. I could phase out the Hill's altogether, over another week or two? I imagine I don't want to do it too quickly, since it's a change from all dry food to all wet food.
She's so damn hungry, I've also changed her feeding regime a bit. It was: breakfast between 9-11am, lunch 3pm, dinner 9pm. Now that she has a 10am-10pm insulin regime, her feeding regime is:
Breakfast 10am, first lunch at 2pm, second lunch at 6pm, dinner at 10pm. Lunches a bit smaller than before, in theory, but she lost so much weight last month that I don't worry about over-feeding her in terms of weight gain; I do worry about too much carbohydrate being a bad thing, diabetically speaking. But as I reduce the d/d kibble, and increase the tuna-based food, that would be less of an issue.

Does my thinking make sense or am I getting something badly wrong?
 
HelenR said:
I'm finding it all very confusing.
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It is confusing and you're doing an awesome job sorting it out! One step at a time - you'll get there. The best thing so far is home testing right from the start - no better way to help keep her safe.
HelenR said:
She's so damn hungry,
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This is normal for diabetic cats who are not regulated yet. Diabetic cats are unable to process nutrients properly and usually need extra food. Once her BG becomes better regulated she should feel less hungry.
HelenR said:
I do worry about too much carbohydrate being a bad thing, diabetically speaking. But as I reduce the d/d kibble, and increase the tuna-based food, that would be less of an issue.

Does my thinking make sense or am I getting something badly wrong?
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You truly are doing great! Getting rid of the dry food is the next best thing you can do. Reducing/eliminating the dry could have a significant impact helping to bring her BG down and home testing will help you keep an eye on what the food transition does for her numbers and will help you keep her safe.

ECID (every cat is different) but, here's an example of what a food transition helped do for one kitty recently:
https://docs.google.com/spreadsheets/d/1UFkUT_ALCNA0n0p-aJqfIhK0pOVfH97A-LM1W5vRZtM/edit?usp=sharing
 
The reason I am saying to do it now is her numbers give you good wiggle room for any drop in BG the diet change may cause. My hope is that diet change will get her more in the 100-300 range, but "results may vary" lol

If you spend weeks tweaking the dose and get her say in the 90-200 range, then do a diet change, that range could very easily turn into 30-100 and you'll be having a heck of a time monitoring her and trying to prevent hypos. Not to mention the wasted time tweaking dose. Additionally, that dry food tends to affect things over multiple cycles, and makes it much harder to regulate BG

Doing the change over a week or two is good. Like Shelley said what you're seeing is normal! It can take up to two weeks for the diet change to really show it's true effects, but we'll keep a close eye.

Of course monitor ketones in the meantime.
 
FrostD said:
If you spend weeks tweaking the dose and get her say in the 90-200 range, then do a diet change, that range could very easily turn into 30-100 and you'll be having a heck of a time monitoring her and trying to prevent hypos. Not to mention the wasted time tweaking dose.
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That makes perfect sense! Thank you. I'll aim to phase out the dry food over the next week or so, given that I've already reduced it by maybe a quarter to a third, per meal, reducing the dry food and adding some low-carb wet food; though, I *have* been giving her more meals.
Unless there is a good reason not to, I'd like to change her over to 'Blink!' brand tuna, which is a complete food, and about 1.7% Kcals from carbs. Or is that *too* low? (Or is there no such thing as too low?)
https://www.waitrose.com/ecom/products/blink-flaked-tuna-fillets-pouch/753827-750745-750746
 
I have the UK food list, it's really helpful. I'm wading through the options - I reckon I can find some low-carb options that she'll be able to eat which are from sources other than fish. Meanwhile, I can buy Blink or Lily's Kitchen locally, so they'll do for now.
I may be dropping the Hills d/d from today, as Footfoot has just tested 1.6 for ketones. :-/
 
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