2/24 AMPS 85 +2 52 +6 70 - lower dosage or skip?

Called the vet at the 52 just to see if I should be doing more than encouraging food since she had a few hours before bottom, she said drop to 2 units tonite or skip if under 100. I have heard skipping is not good.

I am just starting out home testing these past couple of weeks because she been getting such low numbers at the vet. Smokey has been on the insulin since Dec 28. started at 1 unit, raised to 2 @ 2 weeks, @3 units for the past month. We've removed very high card hard food from the diet and they now get wet 2X a day right after the shot with hard Purina DM available free feed.

Any opinions on the evening dosage? Follow vet instructions? Give at least a small dose even if she is still relatively low? I see varying recommendation of keep between 50-80, keep between 70-120, don't dose if under 150 @-)


http://spreadsheets.google.com/ccc?key= ... vRWc&hl=en

 

Hi Melanie,
I read your post on health. Congratulations on learning to home test and these are great numbers! I don't have enough experience to suggest what you should do about tonight's dose (although 3 U sounds like a lot to me and I wouldn't be surprised if what you were told on the other board is what you'll be told here) but I'm sure someone will see this soon.

Welcome to LL and I wanted to reply so I could bump you up ad also suggest that you read the "stickies" on the top of this page IF you haven't already.
Might help if you put an exclamation icon in your subject line (then remove it after you've received help)

Hang in there!

Caryl

 

Hi Melanie and welcome.

Congrats on getting started with home testing! It looks like it was a good thing you got this under way.

Sorry if you have posted this information on the Health board, but I'm curious as to what data your vet was using to advise you to raise Smokey's dose? (If you could link your post from Health to this thread it would be helpful.) We use a particular dosing protocol that raises doses in much smaller increments -- typically in 0.25 to 0.50 units -- than what you've been doing. Smokey is showing some wonderful numbers but it may be that the doses were raised fairly quickly and you didn't mention what the vet was using to base those increases on (e.g., a fructosamine level, curves).

Generally, for someone new to this process, we suggest skipping the dose if the pre-shot value is less than 150. There is obviously not enough data on your spreadsheet to know how to best advise you. One immediate thought is that since you have removed the high carb (HC) food, you are already seeing a dramatic improvement. These are normal blood glucose numbers. How would you feel about ditching the D/M as well? (Take a look at the ingredients before you answer. It may be relatively low carb but it's really a poor quality food.) If the folks over in Health haven't suggested this already, we can certainly help you to brainstorm some ideas about how to keep canned food available (e.g., timed feeders, "catsickles").

 

Hi Melanie!

Link to Health thread for those who need to catch up: viewtopic.php?f=3&t=7320&view=unread#unread

You mention that you have been hometesting some recently, do you have any other numbers before today that we can take a look at?

Based on just these three numbers, I would say that Smokey looks to be very well regulated. Of course, any one cycle looked at out of context can be extremely misleading, so I would love to see more information. How long would you say that Smokey has been running in numbers under 100 most of the time?

 

Melanie, if you see this in time, can you get a test at +8 and one at +10?

 

Thank you all for your support and answers. Sorry, I did not come back sooner. Husband came home and I had to get to work. I am an accountant and tax season is a bad time to miss a whole day. I won't be able to get home to test again until +12 right before the shot. Some more background on her numbers, she has been tested very sporatically because we were just testing at the vets.

these are what I can remember, my sheets are at home so I may be a little off of dates:
12/21 first testing well over 400, I think it was 486? (Science Diet Lite Hairball freefeeding at this point, mixed with DM and started to feed soft 2X, but with holiday travel held off on complete conversion)
12/28 began Lantus at 1unit (food soft DM 2X per day, diluted hard to more DM, less SD)
12/30 +6 225
1/4 +6 325 increased to 2units (removed SD hard, straight DM hard freefeed, but limited amount put out, soft 2X)
1/18 +6 269 uncreased to 3units
1/25 +6 cannot remember exact number, I think it was 107 (food - mixing some of the OTC soft foods like Nature Care (??) and Whiskas because she is tired of the food and not eating it and getting aggresive with the other cats for theirs)
2/1 +6 83
2/15 +6 66
2/20 +12 77 first home test on human meter
? AMPS 82 home testing
2/24 todays numbers as listed in the spreadsheet

As you can see, she hasn't shown very high numbers in a while, she came down really fast and has stuck there. I don't think the vet even thinks about partial units. Nothing showing over 100 in a month.

I have tried to remove the hard DM, but they are ravenous come feeding time when they don't have it (Smokey is in the kitchen crying 2 hours before shot time). My other two are becoming quite portly and they all get diarhea and vomit more when we tried to increase the soft and reduce the hard. Smokey has become pretty aggresive towards the other two if they get different food than her. The vets recommended leaving the hard DM because of the stomach issues and the aggresiveness. I only leave about 1/2-2/3 cup a day for all three.

 

good information, thanks!

Will you post your PMPS number before you shoot? And (because we're all in different time zones), about when will that be? How many hours from now?

 

It's looking like Smokey may be pretty well regulated. If you can get home to test before shot time, please post that number (unless it's 5 min. before!) and/or post your PM pre-shot number. We'll be keeping an eye out for your post. Please put the numbers in the first subject line of the day so can quickly spot the numbers.

A couple of thoughts re. food. The dry DM is 13% carb. (Sorry if you know all of this.) We generally look for less than 10% carb for a food to be considered truly LC. What you're feeding is a medium carb (MC) dry food. I suspect that if you can transition all of the cats over to a LC wet diet, you will see a further improvement in Smokey's numbers.

If you've not seen Lisa Pierson, DVM's website on feline nutrition, she discusses how to transition over from dry to wet foods. Many of us use timed feeders to make sure food is available throughout the day. I also freeze watered down cat food in an ice cube tray and leave "catsickles" out overnight or when I'm out of the house. It's advisable to have food available. No doubt if Smokey's numbers drop, she's hungry. We try to make sure there is food around so the cat's can feed themselves if numbers are running low.

 

I am heading home to test now. Her next shot is due in half an hour.

 

Our 8:49 test (just shy of +12) is 79.

We have opted to not does her tonite. I am more scared on running her too low than a blip up. Hopefully my assumption that having maintained a low number for a good period would indicate we won't shoot up to 300 overnight isn't off.

 

If nothing else, it will be data! Just mark the "dose" on you SS as a skip. Will you be able to get in any spot checks tonight and tomorrow?

 

your numbers are indicating that Smokey probably didn't go lower than the 52 today, so probably he has been surfing in this range of numbers for a long time. 52 isn't too low at all, it's a number that means you should test again and see which way he is going, but for most cats it is not a dangerous number.

Skipping a shot should not hurt much at this point. Please do come back and post each day. With numbers like these, there is a chance that Smokey could become diet controlled and we would like to try to help you get there.

 

Thank you all so much. Getting to diet controlled would be a dream come true!

I am hoping that this will give us some good information on how her body is reacting to food changes.

Thanks for reminding me to update the chart too.