? Mochi - Low AMPS number (28) - should I hold off?

[Mochi & Me]

If you shoot the 2 units please be sure that you are able to test regularly for the next few days for sure to see what this dose will do. The higher numbers you are getting now are from bouncing from the hypo, as well as a skipped shot, but that will clear in the next day or two. Make sure you get a preshot reading and then ideally a +2 reading and a +4 reading and if possible even a +6 reading.

Testing shouldn't be a problem. Would it be reasonable to give him 1 unit tonight and then gradually increase over the weekend (1/4 at a time) until he's at 2 units if his numbers are okay? (Not that I even have any basis for what okay looks like with him....)

ETA: I don't think the vet meant regulated so much as recovered from the hypo bouncing when he said that.

 

[Tuxedo Mom]

Testing shouldn't be a problem. Would it be reasonable to give him 1 unit tonight and then gradually increase over the weekend (1/4 at a time) until he's at 2 units if his numbers are okay? (Not that I even have any basis for what okay looks like with him....)

There is no harm in trying 1 unit to start. You would have to give it a few days to settle the Lnatus depot though since the higher dose she was getting will take a day or two to "drain" and the next cycle or two could still be seeing results from the higher depot of 5 units.

But let's see what the actual preshot number is first before deciding what or if to shoot. With that hypo and the larger depot still in play you need to be cautious right now. Another thought would be to do a no shot for tonight to let the depot drain quicker and then start with the 1 unit tomorrow morning...depending on the numbers.

 

[Tuxedo Mom]

ETA: I don't think the vet meant regulated so much as recovered from the hypo bouncing when he said that.

It usually only takes a few days to recover from a hypo..as long as the dose has been readjusted to a proper range, which Mochi's is having done now. I had to wait 2 weeks for my first FD kitty to have a dental. He had some bad gingivitis so we put him on antibiotics prior to the dental to get the infection down as much as possible. It did help clear up most of the infection which was good, so it made it easier for the dental and extractions he needed.

 

[Mochi & Me]

And now he's at 425 BG.

 

[Tuxedo Mom]

And now he's at 425 BG.

Not really too surprising, although the number looks scary. First he had a hypo earlier and then the AM shot needed to be skipped.

You might try the 1 unit tonight...but be sure you are able to test a number of times through the first 6 hours. It is hard to say how quickly Mochi will recover from the bounce. Some kitties take a few days. other can recover much quicker.

If you can test and have adequate test strips and syrup/HC food (which you should always have on hand ) my thought would be to give 1 unit and see how he does with that. He may stay high for a day or two with the hypo and resulting bounce but that does not mean that a higher dose is in order at this point.

I will only be around for another couple of hours so I would like some others to be available to keep an eye on how things go.

Tagging @Bobbie And Bubba @Amy&TrixieCat @Wendy&Neko @Gill & George

 

[Bobbie And Bubba]

Mochi is bouncing from the super low numbers this AM cycle from the over dose. After a hypo that low they can be very sensitive to insulin. I was just about to say the same thing as Mary Ann to shoot 1 unit but, you would have to closely monitor tonight. I also, am not available to stay with you tonight. If you shoot, get a +2 to see if the number is the same or lower and if it is, it could be an active cycle.

 

[Tuxedo Mom]

Mochi is bouncing from the super low numbers this AM cycle from the over dose. After a hypo that low they can be very sensitive to insulin. I was just about to say the same thing as Mary Ann to shoot 1 unit but, you would have to closely monitor tonight. I also, am not available to stay with you tonight. If you shoot, get a +2 to see if the number is the same or lower and if it is, it could be an active cycle.

Thanks Bobbi. Hopefully some of the others I tagged will be around longer if need be.

 

[Mochi & Me]

You might try the 1 unit tonight...but be sure you are able to test a number of times through the first 6 hours. It is hard to say how quickly Mochi will recover from the bounce. Some kitties take a few days. other can recover much quicker.

I really can't stay awake that long, so I guess I'll hold off on the shot until tomorrow morning when I can keep a better eye on him. Unless that's a bad idea?

Thanks again, everyone.

 

[Tuxedo Mom]

I really can't stay awake that long, so I guess I'll hold off on the shot until tomorrow morning when I can keep a better eye on him.

Thanks again, everyone.

Sounds like a plan. Be prepared for a higher number in the morning, but after 2 skipped shots the 5 unit depot will be getting nicely reduced by then and you can start over with the lower dosing.

Have a good sleep

 

[Wendy&Neko]

Have you started testing for ketones yet? Mightn't be a bad idea with him high from bouncing.

We have seen one or two kitties take longer to get over bounces when they were really overdosed, so it may take a while to work out of the system. Good job today, sleep well.

 

[Tuxedo Mom]

Checking to see how Mochi is doing this morning. One thing I missed...you are feeding mostly Friskies Prime Fillets according to your signature and spreadsheet. These are a little higher in carbs than is suggested for a diabetic kitty. They average 14-15 carbs depending on the flavour. Ideally you would like the keep the food below 10 carbs. Would Mochi eat the Friskies pate types? Except for the Friskies Indoor Cat type the pates are all below 10 which is better for diabetic kitties and can help keep the glucose levels down.

 

[Mochi & Me]

Mochi seems much perkier this morning. His AMPS BG was 393. I gave him 1 unit using the correct syringe.

I know that the Friskies Prime Filets are higher in carbs than recommended, but that's what he is used to and I didn't want to make any changes right away. He won't eat pate. I've tired. I had some from a kitty we fostered before we decided that Mochi was meant for us, but he refused to touch it. Given the choice between dry food and pate he'll eat the kibble (and he doesn't much care for that either). I do have a few cans of the FF flaked for him to try as well as a couple others that are lower carbs and not pates. He likes the FF Purley, but those are a bit on the spendy side.

 

[Tuxedo Mom]

I didn't see a new post for today so I am commenting on this one.

I see that you shot 1 unit this morning. The nice thing is that Mochie was able to bring himself down from the higher testing last night. Especially after the hypo yesterday and not knowing how quickly he might break the bounce I would suggest some extra testing today. A test at +2 and then depending on where the numbers are another test at +4 would definitely be in order.

This post gives an idea how an active cycle with Lantus might look:

Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/

You posted as I was putting this comment together. If you could find another food type that is lower you could get better control. Here is a list of food with their carb content that was compiled by Dr Pierson.

http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

If you are having trouble getting Mochie to switch to a pate type food...which are usually lower carb, you could try mixing some of the Friskies Prime Filets with a lower carb food to see if that will help with switching. Many,many years ago my girlie kitty who was not diabetic at that time was a dry food addict..before I knew better, It took me a while to transition her to wet food but eventually she went along with it. If she had her choice I know she would choose dry over my home made but she eats the regular food with no problem.