? ?? 6/9 Muffin AMPS 187 - HELP = First day to start insulin - dose??

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Julie + Muffin

Julie + Muffin

Member Since 2013
Hi
This is the first day, after 6 days of low carb food, we were going to start Muffin on insulin since her numbers weren't great. This morning her AMPS was 187 and not expected. We were going to start with .75 unit. Not sure if we should proceed. Any advice would be appreciated.
 
You may get more help from the Elders if you put a ? in front of your thread title. Go to thread tools above your post and edit your title. Good luck. I know low carb helps a lot but I am not sure how long to be on it before starting insulin. 187 is not horrible. What was your BS at diagnosis? Awesome that you are with an animal rescue! I just saw that in your signature.
 
Supurrkitten said:
You may get more help from the Elders if you put a ? in front of your thread title. Go to thread tools above your post and edit your title. Good luck. I know low carb helps a lot but I am not sure how long to be on it before starting insulin. 187 is not horrible. What was your BS at diagnosis? Awesome that you are with an animal rescue! I just saw that in your signature.
Click to expand...

Her BS at vet about 7 days ago was 475. 6 days all lc canned food. Today was a surprise. I still charted her on the SS even though wasn't giving insulin. thanks for your advice. I changed the subject.
 
I'm sorry no one was around to help you this morning. Days when the forum loses an old friend can be hard.
Did you shoot?

Here is some information taken from the Start Low, Go Slow stickie at the top of the Lantus page:

Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing; b.) give a token dose (10-25% of the usual dose); c.) feed as usual, test in a couple of hours, and make a decision based on that value.
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.

With experience, you may find that lowering these thresholds may work well for your cat. When you have reached that stage, the following guidelines are suggested for Lantus and Levemir users following the Start Low Go Slow approach:

If the preshot number is far below usual preshot numbers:
  • Do you need to stay on schedule? Then skip the shot.
  • Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable.
  • Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary.
 
Sorry there wasn't anyone about.

Why do cats always do that! Fancy throwing a blue ambg!!

Looks like you postponed the lantus, can't say I blame you. It'll be interesting to see what her BG's do today. Was she on high carb dry before you made the switch?? Maybe it's just taking her little longer to get it out of her system.

See what she does with the rest of today before deciding on the dose.
 
If I were you I would be tempted to give her a day or two more on the LC food. As long as she is staying blue. You can always start insulin in the morning.
Since you are slgs, you can just follow that but check back here for advice on a starting dose.

Have an awesome day!
 
Gill & George said:
Sorry there wasn't anyone about.

Why do cats always do that! Fancy throwing a blue ambg!!

Looks like you postponed the lantus, can't say I blame you. It'll be interesting to see what her BG's do today. Was she on high carb dry before you made the switch?? Maybe it's just taking her little longer to get it out of her system.

See what she does with the rest of today before deciding on the dose.
Click to expand...

Hi George
I decided to postpone rather than make a hasty decision. Was really surprised with her BG. Before the diagnosis she was on canned and Whole Earth dry which is no grain but I assume is high carb. The canned was already low carb but she really liked the dry. When we got the diagnosis I immediately stopped all dry and wet to all low carb canned. The SS chart gives a good idea of how all over the place she was. Today I decided to start insulin and she pulled a blue from the get go. We will monitor throughout the day and see how it goes. I will keep the SS up to date. Thanks so much for responding.
 
Red & Rover (GA) said:
I'm sorry no one was around to help you this morning. Days when the forum loses an old friend can be hard.
Did you shoot?

Here is some information taken from the Start Low, Go Slow stickie at the top of the Lantus page:

Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing; b.) give a token dose (10-25% of the usual dose); c.) feed as usual, test in a couple of hours, and make a decision based on that value.
  • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
  • In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine.
  • Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher.
Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then personal experience should be your guide.

With experience, you may find that lowering these thresholds may work well for your cat. When you have reached that stage, the following guidelines are suggested for Lantus and Levemir users following the Start Low Go Slow approach:

If the preshot number is far below usual preshot numbers:
  • Do you need to stay on schedule? Then skip the shot.
  • Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable.
  • Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary.
Click to expand...
 

I decided to postpone rather than make a hasty decision. Was really surprised with her BG. Before the diagnosis she was on canned and Whole Earth dry which is no grain but I assume is high carb. The canned was already low carb but she really liked the dry. When we got the diagnosis I immediately stopped all dry and wet to all low carb canned. The SS chart gives a good idea of how all over the place she was. Today I decided to start insulin and she pulled a blue from the get go. We will monitor throughout the day and see how it goes. I will keep the SS up to date. Thanks so much for responding.
 
Supurrkitten said:
If I were you I would be tempted to give her a day or two more on the LC food. As long as she is staying blue. You can always start insulin in the morning.
Since you are slgs, you can just follow that but check back here for advice on a starting dose.

Have an awesome day!
Click to expand...
Thanks!! I postponed.
 
Wow see she shot right up into pinks 3 hrs later.

Just a thought for future reference, if you get a number that surprises you, high or low, it can be worth double checking the test straight away. I had a couple of dodgy tests where either strip was dodgy, got too much, or not enough blood on strip leading to an erroneous result.
 
Gill & George said:
Wow see she shot right up into pinks 3 hrs later.

Just a thought for future reference, if you get a number that surprises you, high or low, it can be worth double checking the test straight away. I had a couple of dodgy tests where either strip was dodgy, got too much, or not enough blood on strip leading to an erroneous result.
Click to expand...

That is a good point! Next time for sure. We will start over tomorrow and see what happens. Don't want to postpone too long in case it puts her at risk of getting worse. George is a cutie! Thanks!
 
Julie + Muffin said:
That is a good point! Next time for sure. We will start over tomorrow and see what happens. Don't want to postpone too long in case it puts her at risk of getting worse. George is a cutie! Thanks!
Click to expand...
In the scheme of things a day won't make a difference.

Paws crossed for tomorrow.

Tanks Julie dat muffin iz soopa cute
Deputy BFG:cat::cat::cat:
 
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