12/29 Chino AMPS 425, PMPS 568! First fur shot :(

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Adrian and Chino

Adrian and Chino

Member Since 2016
Brief intro (I'm new here): Chino is 10 years old, diagnosed with diabetes in mid-November. He was 17 lbs at one point. I got automated feeders to keep him from eating Fox's food (smaller cat that tended to graze instead of eating his breakfast all at once) but he managed to trick the machine by taking giant mouthfuls, then dropping them on the floor to eat away from the sensor that detected how long he was at the bowl.

About a week after a distemper vaccine, he became lethargic, dehydrated, stopped eating. I took him to the vet, who found that he had a fever and thought it was a delayed reaction to the vaccine. For 4 or 5 days, he hardly ate, and when he started eating again, he was also drinking a lot and peeing a lot. He is now down to 11.5 lbs.

I switched both cats to Fancy Feast classic after the diagnosis. 2 weeks later, the BG was still over 400 so on 12/03 he was started on Lantus. The vet said to give 1 unit BID for a week, then test after 7 days (see Relion Confirm SS). I started to do a curve with the AlphaTrak2, called to report the 6 hr value to the vet, and he increased it to 2 units with the same instruction not to test until 7 days out.

We moved from Naples to Tampa before the week was over, so I tested prior to the stress of the move to get a more typical value. On 12/20 (the day before an appointment with the new vet) I did a curve with the AlphaTrak2.

I brought the spreadsheet but the new vet didn't want to increase the dose. When I asked if I could increase by at least half a unit, he agreed, but he said I should only use the AlphaTrak2, so all testing from that point on is on that SS. I haven't been able to test as frequently because of how much the test strips cost.

Yesterday, he came down from the 600s to the 300s after a dose increase approved by the vet at an emergency clinic. I will be looking for a new vet. I've ordered 100 more strips, but I would rather keep those for curves and go back to using the Relion Confirm, if I can find a vet who will be OK with that...

TL;DR:

Chino was diagnosed in November. Switched to canned low-carb food, started Lantus at 1 unit BID on 12/03. Increased to 2 units a week later. Moved to another city. New vet didn't want to increase (though BG not anywhere near controlled) but agreed to go up to 2.5 units. Told me to use the AlphaTrak2 only. Less frequent testing now due to the expense. 1 week later (2 days ago), ended up at emergency clinic for BG > 600. No ketones but vet said OK to increase to 3 or 3.5. Increased to 3 and he came down from 600s to 300s yesterday, but this morning I gave my first fur shot! :( I hope this doesn't push him back into the danger zone. Gotta get the little guy off of this roller coaster.
 
Welcome! You've come to the best place for help. We've all been where you are now-one way or another.
I haven't got any dosing advise, but I do think you need to dump the alphatrak and go back to a human meter. Those alpa strips will bankrupt you. You've got a clever cat, Chino, outfoxing the feeder is no small feat! :cat:

I'm off and on the roller coaster for almost 3 years now. So, as everyone will advise you, be patient. There's a whole protocol for dose increases in our Health Links Forum:
http://www.felinediabetes.com/FDMB/forums/health-links-faqs-about-feline-diabetes.14/

More specifically go to this link:
http://www.felinediabetes.com/FDMB/threads/dont-go-too-fast-with-the-insulin.131184/

Chino will get better, so don't worry too much.:)
 
Welcome. I'm going to try to address a few things. Firstly though, good job home testing and switching to canned food. It's easier on the kitties pancrease if they eat small meals through out the day/ night.

We mostly use the Relion strips and meter one because of cost and we need to test as much as needed to keep out kitties safe. Secondly, the Tight Regulation protocol most of us follow here was written using a human meter. I think your idea of doing a curve to appease your vet with the AT is fine but know you don't need your vets permission to home test with the human meter. Honestly over time if you continue with this group you won't need your vet for dosing advise.

We also only increase in .25 unit increments unless nadirs are consistently over 300 then we might increase by .5 units until those nadirs drop. It's vitally important to test before each shot and to get one or two tests in mid cycle every day since Lantus is based on how low the dose takes them not the preshot or how high they might bounce. Sometimes high numbers are caused by low numbers or big drops and by testing mid cycle it helps you/us understand what is going on.

I'd encourage you to read the 2 protocols we use at the top of the page Tight Regulation Tight Regulation (TR) and Start Low Go Slow SLGS. Tight regulation gives kitties the best chance for remission but both work very well.

Do you have syringes with 1/2 unit markings? His levels will come down but needs to be done carefully.

Feel free to continue asking questions. It's hard for me to say if he's getting too much insulin or not enough because of the blank spots on the SS. At this point I think you are ok with sticking with 3 units. Hopefully some other experienced members will stop by today. Some are on later in the day so be patient...it will get better and we're glad you're here.
 
Welcome! You and Chino are so welcome here.

I would like you to know there are very few Vets that were taught to use human meters. Like you I spent a fortune on the alpha track and strips in the beginning.
I Decided in order to help Scooter I had to lower the cost and went to Walmart and got the relion brand meter for 10.00 and strips for 10.00. I listened to the folks here and followed the tight regulation protocol. I also put all my cats on fancy feast wet food feeding 5 times a day. Scooters numbers came down quick and in no time he was off insulin. Then came Jack using same meter and he is now off insulin. Junior was just diagnosed in Oct and he is on the road to be off insulin as well.
I know a Vet is important but Chino's blood glucose level is more Important. Invest 20.00 and some insulin. Read the TR protocol and start it with Chino. You won't regret it.
 
Thanks for all the replies! I do have syringes with half-unit markings.

He has rarely gone below 300 since I started testing. I'm going to have to follow the SLGS protocol for now. I would love for him to go into remission, but I can't test frequently enough during the overnight hours to try the TR protocol... I take medication for narcolepsy twice a night and each dose takes 4 hours to wear off. I'll skip one if I need to stay up and test hourly, but I've never been able to skip a dose without consequences.

My main concern with switching back to the Relion meter at this point is that his blood sugar will remain high, but I won't realize how high it really is because the readings will be lower. Is that a legitimate concern?
 
jcosmo said:
I can't test frequently enough during the overnight hours to try the TR protocol
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You don't have to test all night to do TR.....just getting a "before bed" test is enough......Whether you do TR or SLGS, you always want to get that "before bed" test in if at all possible. Most cats go lower at night so without getting that test in, it's possible he could go low at night and "bounce" high again by morning.....You'd think he needed more insulin when he really needed less!!

Yes, there may be some nights where you might need to test more, but that can happen on either TR or SLGS

jcosmo said:
Is that a legitimate concern?
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No....too high is too high.....whether it's over 150 on the AT or over 120 on the Confirm.....our goal is to keep them in normal numbers as much as possible (50-120 on human meter)

It's not a great analogy, but think of it like this.....Thermometers come in Fahrenheit and Celcius.....understanding the "scale" is what tells you if 32 degrees is cold or hot!! As you get more experience, you'll understand the "scale" of the meter you're using better
 
jcosmo said:
Is that a legitimate concern?
Click to expand...
I used the AT for months and still have it as my back up meter. I like Chris's analogy. One thing to keep in mind that the actual study is done with the human meter. Most important is to know normal numbers on a human meter are 50-120. Human meters are just as accurate but will rarely be close to an AT reading. The reason is the AT is calibrated for feline blood and the human meter is calibrated for human blood. It's more dangerous not to test because of the ridiculous cost of those AT strips than to use the human meter, cut some costs and test as needed.

SLGS is fine, it just may take a little longer to get Chino out of those numbers. Many start out with SLGS and you can switch to TR if and when you're ready. One thing for sure is FD is a marathon and not a sprint...we all have to wear patience pants.:rolleyes:
 
BTW, if you can add the food you're feeding and that you'll follow SLGS to your signature that would be great. Date of diagnosis, any meds or medical conditions too for Chino. This way we won't ask you those repeated questions. :)
 
I got the PMPS reading on both the Relion Confirm and AlphaTrak 2. AT = 568, RC = 429. I am kicking myself so hard right now for screwing up his morning dose.
 
jcosmo said:
I am kicking myself so hard right now for screwing up his morning dose
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Get a jar and put $1.00 in there and eventually buy something for yourself. I've managed to give FS to a shaved cat! A few times there were FS's a few cycles in a row. :banghead: We all do it, try not to beat yourself up.
 
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