Why are BG levels so much higher than AMPS

PatJ

PatJ

Member
Would someone with an expert eye know why my cat's BG levels have gone so high when his AMPS is in the blues and then he shoots right up? He hasn't had any high carbs. I just can't make it out. Would be grateful for any advice. Thanks.
 
Any chance your AMPS test is done at less than the full 12 hours? Cats can easily rise over 100 points during that last hour, so testing even 10 minutes early or late can sometimes make the numbers out of balance like this. It's okay to be off a little, you just have to know you're doing it and adjust the way you think about it.

If that's not the cause, there are other ideas too... :) But figured I'd start with the easiest one.
 
Hi Djamila, I usually do between 8.15 and 8.30 but even when I've gone a bit earlier or later either way it's never made his PS numbers lower than his cycle before but it's possible it's happening now.:banghead: I thought that there was a bit of 'wiggle' room with Prozinc, that you could go a bit before or after? perhaps I got the wrong end of the stick? but I'll try being dead on the dot and see if it makes any difference. It just seems so strange that he's much lower in the morning than he is for the rest of the day.:confused:

If it's not that do you think that it could be because his Prozinc has nearly finished? I've only had it for about three months and I bought a new one last week which I haven't used yet, but maybe it's affecting his levels?

Thanks for replying and thanks for the advice:)
 
PatJ said:
I thought that there was a bit of 'wiggle' room with Prozinc,
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There is wiggle room in terms of safety. But that last hour can be pretty active for some kitties, so it can impact the numbers you see. For example with Sam, his AM numbers are always higher than his PM numbers. If I test him at 4:15am, I can get a blue. If I test him at 4:30, it's more often yellow. Or if he's still blue at 4:30, by 4:45, he'll be up to yellow. So sometimes he takes a little longer than 12 hours, and other times it takes a little less. If I test him and get a blue, I know I can still give the full dose though because he's on his way up and it takes a couple of hours for the insulin to kick in.

It's unlikely to be the insulin unless it's been "abused" - left out of the fridge, shaken too much, stored in the door of the fridge (more vibration), etc. But as long as you've been taking care of it, it would be unlikely to be less effective at this point.

So the next most likely cause is simply that he has a large food spike. Some cats are more impacted by food than others. Even if it's low carb food If his insulin is lasting a little longer than 12 hours (which is what's giving you the lower PS numbers), and then wears off right after that, just as the food is really kicking in but before the new dose is starting to work, you'll see a spike in numbers.

It also looks like onset for William is rather later than most cats. Are you shooting in the scruff? That can impact absorption of the insulin, so if you are, try injecting lower on his shoulders, or on his sides instead and see if that moves onset up a little earlier in the cycle.

Looks like he had a good cycle this morning! Hooray for green!
 
Do you think that there is too fast a drop in numbers because he's gone from 12.0 to 3.5 in just over two and a half hours, so because it was so quick I didn't want him dropping quickly to a 2 number so I gave him low carb food but he still went down so qave him high carb, he went up a bit, but then went down again:arghh:

I never shoot in his scruff. I did it a few times when I first started but the vet showed me an easier way and I shoot in his shoulders and sides. The insulin is kept in the salad drawer at the bottom of the fridge so it's not jostled about.

Should I drop the insulin a bit for tonight because the high carbs don't seem to have done much good and he's been up and down like a yo-yo in the last couple of hours. I really dread a night time hypo. His numbers are much steadier when they're high, so why doesn't it happen when his numbers are low? I really can't make it out at all.:banghead:

Thanks so much for all your trouble. Much appreciated:)
 
I found it! The injection site images :bookworm:. We typically use Scruff and Side of chest here. Very nice cycle last night! :cool::D

One question, do you rub the injection site after giving a shot? If so, don't as it impacts the absorption rate of the insulin regardless of location ;).
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Thanks, Yong for that information.

I didn't know that you shouldn't rub the injection site and I always do! I don't put the needle into the scruff, just shoulders and sides. I thought that it wouldn't be sore if I gave it a quick massage. Well you live and learn!

Thanks again:)
 
I don't know what is going on with my cat but his levels are going crazy. He started off at 6.2mmom/L yesterday morning and at PMPS was 21.5. In the night he was 23.7 and I hadn't fed him, and this morning at AMPS he was3.8. I don't know how much to give him now. I'm waiting for him to go up, so far he's at 5.1 after 35 minutes. Should I keep to the same dose or give him less? I don't know what to do. Would be grateful for some thoughts. I've given him different food (low carb) because he's getting so finicky lately. Could that be why? But he's had it before and it hasn't done anything.
Thanks.
 
Sorry for the panic. I've dosed him. I was more worried about the big drop to 3.8 but perhaps I've answered my own question maybe it's the change in food. Hope so. Sorry to have made a fuss.
 
Hi Pat- I'm looking at your spreadsheet, and I don't see the numbers you are listing in your post. I don't see a 3.8 or a 5.1....?

So I'll speak to yesterday's numbers where you had the 6.2 to 21.5 (although I don't see the 23.7 either). On the 6.2, you lowered the dose (which I probably would have done too). However, we can see that his nadir stayed blue, and the duration was shorter. Both of those together indicate that he probably would have been just fine if you had kept the full dose instead of lowering. So you just keep that in mind for the next time he gets a number like that. It really helps too that you are able to monitor him so well - you are able to be a little more aggressive than folks who are out of the house all day.

So I think what you're seeing is that the AM numbers are lower because the insulin hasn't quite worn out yet - you're getting some nice overlap in the morning. But then you're seeing him jump back up for a few hours - so it's looking like William's onset is a little slower. The insulin isn't kicking in at +2 or +3, but maybe more in the +4 range. What that means for dosing is that you'll need to kind of ignore his AMPS numbers and just go ahead and give the regular dose, trusting that the insulin isn't going to act on the number you see at AMPS, instead it's going to act on the number he's at around +2-3 which you know will be a much higher number.

If that idea gives you anxiety - another option would be to move his AMPS routine so it's a little later than it is now. That would slightly lengthen the PM cycle, and give him a little more time to rise. And it would slightly shorten the AM cycle which would likely give you nicer PMPS numbers.

Let me know what questions you have about either of those options. My coffee hasn't quite kicked in yet so I'm not sure if that's clear or muddled ;)
 
Hi Djamila,

I didn't put the 3.8 and 5.1 in because I waited for him to go up before his AMPS and the 23.7 was in the early hours (haven't put it in yet!) He tested at 8.7 this afternoon and 2 hours later it was 2.6. I am so stressed with his BG levels dropping to near hypo numbers every time he gets nice low numbers :arghh: that I almost dread him getting them!

I think that both of the options that you've suggested make a lot of sense and I think I'll do the first one.Thank you so much. So just to double check (I know I'm paranoid about these hypos:banghead:) is it all right to ignore even a 3 number and shoot the full dose?

Your explanation was very clear and not at all muddled!!!:) but a low PS still makes me nervous!!!

I'm really grateful:) Thank you!
 
It’s really hard to know what to do at night since it’s so much harder to monitor. Did you shoot yet? I would not give the full dose on that green right now. But I also would try not to skip completely. Can you stall an hour and then shoot? See where he’s at, and reduce the dose a little if he’s in the low blues.

Regardless, the lime green number says to reduce anyway. Looks like 2.25 is too much right now.
 
Hope I haven't done the wrong thing. I waited till he was 5.6 then gave him a very skinny 2.00. I was already an hour overdue because I waited this morning for his levels to rise so he was late this evening. I'll have to keep setting the alarm through the night but do you think he's had too much?
 
I would say odds are good that he’ll be just fine. :) Give him a check at +2, and one more at +4 if you can stay awake that late. But given the low number today, he’ll most likely run a little high tonight and keep himself out of trouble.
 
I love seeing William getting some better numbers again after that long stretch of reds and pinks. It does make everything a little more stressful though!
 
Hi Djamila,

It's great that his numbers are better, but it seems that going to hypo numbers is obligatory with William. He seems to fall so quickly and I always worry when he gets to about 4 because his nadir is nearly always some hours away and then he'll reach 3 and he's got plenty of time to go even lower:banghead:. He's had that happen this afternoon -again!! - and I've tried to steer him away with low carb and he went up slightly and then went back down again this happened a couple of times then I gave him high carb biscuits and he still went down again to 2.6 so gave him honey and more high carb biscuits and he finally went up.This went on for three hours. I just wonder if I'm giving him too much insulin? I just hope that it will sort itself out when he gets more used to being lower.

Thanks for all your patience and good advice:)
 
I think your decision to reduce the dose was absolutely the right one. So I think we should revisit option #2 from above if your schedule allows it. Try doing the test/feed/shoot routine later if you can. So you would be shooting on a 11/13 cycle - 11 hours from AMPS to PMPS, and 13 hours from PMPS to AMPS. And yes, stick with the reduction.

There are two main possibilities right now - one is that he simply uses the insulin quite differently during the two cycles, so he needs the time to be different.

The other option is that he's getting ready to take a little slide down the dosing scale. If that's the case, then things might be a little crazy for awhile as he gives you a lime green, you reduce, he gives another lime, you reduce again, repeat as needed. ;)

Sam does this every once in awhile too. Not that long ago he was on 2.6u. Then he started giving me a bunch of lime greens and ended up at 1.8u. Then he flattened out, and now we're heading back up again. They like to keep us on our toes. In Sam's case, my hunch is that it's connected to the flea meds because it always seems to happen right around the same time. But it could also be the cycle of the moon, or a squirrel, or the mood he's in, or how sunny it is, or....:cat::cat::cat:

So you'll just have to take it one cycle at a time right now, use your mama sense, and I'm happy to give a second opinion whenever I can. :bighug::bighug::bighug: You're really doing great with all of this. William isn't making it easy, but you seem to be taking it in stride and making really sound decisions, getting data, and taking great care of him!
 
Well a fly landed near William the day before yesterday, so that could explain it!!!

I'll start that cycle tonight and see what happens. It might just work!!:) I'll keep everything crossed.

Flea medication can cause problems. I had to stop using one that I put on one of my cats because it made him walk round crying and he was sick. Don't remember the name of it because it was ten years ago but he's fine with Stronghold, so I use it for all of them. Plus, although the vets try to tell you they need it every month, it lasts at least 6 months and sometimes longer.

Thank you so much for your support and all the trouble you've taken. It's really appreciated.:bighug:
 
PatJ said:
Well a fly landed near William the day before yesterday, so that could explain it!!!
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LOL! :smuggrin::joyful::D

PatJ said:
Plus, although the vets try to tell you they need it every month, it lasts at least 6 months and sometimes longer.
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Really??? I would love to not give it every month! First, it's expensive. Second, they hate it. And third, I worry about putting chemicals on them like that. I lived in a condo for the past decade, so they were very much indoor only and I never used it. But back in August I moved into a house and Sam walks outside now so I've been worried about him bringing fleas in with him. I live in a temperate climate, so the little critters are year-round here - they don't die off in winter like in colder places. Maybe I'll try going to every-other-month anyway and see if that works.
 
I definitely would! I can only speak as I find, and I've been using it for years, but I live in rural France, surrounded by forest (therefore plenty of foxes, badgers etc all probably covered in fleas) and it gets in the very high 30's centigrade in summer. So good breeding weather. (Aren't you lucky to have mild winters?) I've got four cats and three dogs and they don't have a flea between them. The cats go out during the day and foxes come in the garden at night so one of them should have caught a flea by now. I have to say though that Stronghold is the best one I've ever used.

It might depend on the flea medication. Do you spray Sam and Atticus, or is it a pipette on the neck? Stronghold is a pipette on the neck but it really does keep fleas off for literally months and they've had no ill effects at all. It also kills intestinal worms. It won't stop ticks, but I just twist them off with a tick remover.I hate putting chemicals on them too. It has been known for cats to die as though poisoned with nerve
gas using those medications. Not now, but when they first appeared, but they're still being absorbed by the body. As soon as the first one starts scratching again then I buy more Stronghold,and it works almost at once but you're right, it's so expensive - about 10 euros for a teaspoonful! Outrageous!!

I never need to buy Stronghold for at least six months. (Whatever the vet might tell you!)
 
I use a pipette on their neck. The one we use says it stops ticks, but thankfully we don't have those around here anyway. I would love to live somewhere with foxes! They are the cutest things! We have coyotes here, but they are not nearly as cute. And I did find a bunny in the yard this morning. Thanks so much for sharing your experience.
 
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