? Marshmellow AMPS 257 - Will do curve for increase? decrease?

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Marshmellow & Steve

Marshmellow & Steve

Member Since 2015
I will do a curve today and see where Marshy is at. I plan on a 0.25 increase tomorrow, is this correct. I will do every 2 hours as possible, but will get plenty of readings so we can see where she is going. Is this correct?

Also, I cleaned up my sheet, as I changed to the Relion meter just over 7 days ago, so I made a comparison sheet, and removed all the Alphatrak readings for the last 7 days so it was easier to see a better trend.
 
Although it's not necessary, tracking food amounts/feed times can also be helpful information when looking at the overall picture. It can help you and others see how your kitty responds to food and give you an idea of how to "feed the curve" when needed.
 
A curve will actually give you information regarding Lantus onset, nadir, and duration -- all of which are essential to know. When considering an increase, a curve can be useful but isn't essential. If Marshmellow's numbers aren't where you want them, with SLGS you increase after a week and with TR, you would increase after 3 days if numbers are generally above 200 and after 5 days if under 200.
 
Morning Steve :coffee::coffee::coffee:

Good luck with the curve! It should give you the data you need. I too used to chart what I fed when too, just to see how fuds given, and the % carbs, affected things.

Have a great day. I hope all goes well.
 
Blood glucose high at +2. Now I am wondering if 1 unit is actually too much???? I feed Marshmellow BID, usually 1 can of Friskies or 2 cans of Fancy Feast, always 7 carbs or less as per Dr Lisa's chart. This is still new to me, but will continue curve today except for when I go to PT. Thank you all.
 
Steve, since being here on this site, I've learned that some cats are more food sensitive than others. You've not really had a bunch of +2s to look at, but I suspect that feeding Marshmellow one full can at shot time is what has her kicked up that HI. I had to do the calorie breakdown from Dr. Lisa and for Zoey, that came out to a little less than two full cans a day. I only feed 1.5 ounces at shot time and then use the other 1.5 ounces (total of 3 ounces for Zoey, each cycle) to steer the numbers when needed, or to feed at the +6 mark while she still has some insulin in her. Not feeding it all at one time has helped her get into some lower numbers quicker and steering her with subsequent feedings can help her surf there a little longer.

I'm still new to all of this, but I wanted to share our experience with you in case you find that Marshmellow is very responsive to feedings, as well.

Good luck!
 
Thanks, have been feeding BID at shot time per vet, still new to this, and I don't want to change too much at 1 time. Will continue to see where she goes. Perhaps will try to start feeding 1/2 of what I give her and do it 4x daily. Still trying to decipher this all myself.
 
Still high but coming down. I'm not sure if it's the food or not. I keep reading about "bouncing" and am still thinking Marshy might still not be used to lower numbers, that is why I am thinking may need to reduce? It just doesn't make sense to me why this morning she was so high
 
Looking at the spreadsheet, I would say that it's a combination of the blues you saw yesterday and the food. Someone else will be on the thread at some point and will chime in, but I don't think it's the dose that's causing it. If you had a few more tests shortly after feeding, +1, +2, I think you would have a better understanding how she reacts to food. They have to eat but when you see the reactions with the BG it adds some clarity to everything and how this is not a one-size fits all issue. It was kind of my ah-ha moment. That, coupled with the bounce from the lows yesterday, and she's pretty much following the path of a lot of us newbies. Be patient (LOL ... Look @Wendy&Neko and @julie & punkin (ga) -- I'M advising someone to be patient! LOL) and it will start to flatten out and settle in.
 
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Steve, you don't want to decrease because of bouncing. You wait until they clear it to see what will happen next.

I too feed Max small portions up to +5-7 depending on his results that day. You are smart to not want to change more than one thing at a time. Max usually gets a good rise from food so I rarely know what he will do until +2.5. The more data you get the easier it will be to try and see Sheba's patterns.
 
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Marshmellow & Steve said:
I keep reading about "bouncing" and am still thinking Marshy might still not be used to lower numbers, that is why I am thinking may need to reduce?
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The only way that cats get used to lower numbers is to spend more time in lower numbers so that it becomes the new normal, instead of the higher numbers Marshy had gotten used to. It took me a while to change my thinking about bouncing (and Neko was a champion bouncer in the early days), but it helped me if I thought of the bounces as a reaction to successfully getting her into better numbers. I agree that today's ugly blacks were a short lived protest to yesterday's blue numbers.

Regarding food, more smaller meals in the first half of the cycle are easier on the healing pancreas, instead of having to process the food all at once. With the older insulins it was important to get food in early, but not so much with Lantus/Levemir.

I think you are following SLGS method for dosing? It would be helpful if you put that in your signature. If you are following SLGS, it would look like a .25U increase. Between the curve and your spot checks on this dose this last week, it looks like the lowest numbers are in the upper blues. From the SLGS Sticky:

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours
Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
 
I'd suggest you stop the curve for today because it's definitely a bounce day. Bounces don't tell you much because they override the normal Lantus curve. It looks like you had a normal day yesterday, though, and she got to the 100's. Don't sweat the bounces - they are just part of it until her body spends enough time in normal numbers to accept them as normal.

Also, with Lantus, dosing decisions are made by looking at how low the dose is taking the cat. So the blues yesterday are more important in making your decisions than the ugly blacks today. The high bounce numbers pass, but you don't want a cat too low when they do. That's why the focus is less on the highs and more on the lows.

I agree with increasing her dose by 0.25u.
 
Thank you, from reading posted, I thought an increase might still be in line. I am off until 7 tomorrow, but wife will be home all night. Will make the adjustment tomorrow. Still a little scary, but most of her nadirs are high enough that I thought we were just bouncing. I plan on changing her feeding schedule to 4x daily, should I wait until seeing how the dose change affects her?
 
I think you can increase and do the food change at the same time. Good luck with the new dose!
 
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