9/9 Woody AMPS 457; +4 326 - New Member

[chitra80]

Hello all,

I am a new member to this message board. My sweet boy Woody was diagnosed as diabetic at the end of July and started on Lantus 2 units twice daily on August 4th. I was traveling a lot for work at the time and did not have much time to do a lot of research and was following my vet's instructions to test only before AM and PM meals. His AMPS and PMPS were very high over those weeks and I was instructed to increase his dose to 3 units BID. At that point, I was home from work travel and becoming increasingly stressed and depressed about his diagnosis and found this forum. I have been reading your posts and excellent advice and want to thank you in advance, as I have felt some relief because of this site. I have adopted some of the methodologies and started taking more readings during the day. Woody was having some readings in the 200s on the 3 unit dose, so following the TR protocol, I increased his dose to 3.25 units. Looking at his spreadsheet, I feel like he is either not responding well to the insulin dose or is bouncing quite a lot because his AMPS and PMPS readings still remain quite high, and I have still yet to see a nadir less than 200. I increased his dose to 3.5 units this week and am increasingly feeling frustrated about his progress (or maybe I'm just impatient ). My vet is happy with his response so far and is recommending that he remains on the 3.5 unit dose for another week, do a curve, and reevaluate at that time.

Some questions I have:

1. I realize that I increased his dose by 1 whole unit early on and am fearful that maybe I am overdosing him on insulin, though I still have not witnessed any readings below 200. When deciding whether to increase a dose, should I wait until he clears his bounce (if that's indeed what is happening)? Also, there are days when he has lower AMPS and PMPS in the 300s, but his spot checks over the course of the day stay relatively stable and don't decrease much; what does this mean?
   
2. How long does it typically take to see the effects of Lantus? He's been on it for almost 5 weeks now, and his numbers are still high, without much change with dose increases. I've been reading that it may take some time for the pancreas to adjust to insulin, especially if he has been diabetic for awhile.
3. In regards to feeding, Woody is always hungry and ravenous. I'm pretty sure he'd eat 2 or 3 cans of FF in one sitting! How much and how often should he be fed? Initially, I was only feeding him twice a day, but I've started giving him small portions of FF throughout the day and he always licks his bowl clean and begs for food often. He has lost about 1.5 pounds in the past few months.
   
4. Generally speaking, at what point should one consider testing for insulin auto antibodies and acromegaly?

I apologize for the long-winded post and for all of the questions. Thank you in advance for your advice and for listening.

 

[thebigfuzz]

Hey! Welcome!

Some great questions Would you be able to make your SS shareable so others with the link can view it? It should be in your settings

 

[thebigfuzz]

Woody is adorable! Love the hat!

 

[chitra80]

Hey! Welcome!

Some great questions Would you be able to make your SS shareable so others with the link can view it? It should be in your settings

Sorry about that! I’m not the most tech-savvy!! Hopefully it works now.

 

[thebigfuzz]

I can see it now! Thanks!

I will leave some of the specific questions you have for more experienced eyes, but will say that I think we can all empathize with how you are feeling. It can be stressful and frustrating having a sugar kitty. They are just so darn cute I’m glad you found the forum!

Have you been checking out the stickies on the forum for information? Looks like you have since you’ve got your signature and SS all set up I re read them all the time, and every time I do, I absorb something new!

One thing I might mention is in regards to testing as you learn his patterns (or as patterned as living creatures can be LOL). Many kitties can go lower at night, so it is always good to grab a +2 to get an idea of what is in store for that cycle and determine if you need to set an alarm or monitor more closely that cycle. If a +2 is the same or lower than the preshot number, you could have an active cycle. Not always, but often. It looks like you are grabbing some during the day and the last couple nights, which is good. I’d keep doing that.

It may be hard to tell what is happening because of some data gaps and not knowing what is happening overnight.
8/23 he went from 326 to a +3 of 200 which is a decent drop. It is possible he went lower overnight and came back up to a AMPS of 453 - which is likely a bounce (when the liver panics from numbers he isn’t used to yet, and dumps glycogen into the blood stream as a protective measure)
9/7 is another interesting day where he had a big drop into the yellows during the day and then another large drop after PMPS. A +4 or +6 would have been interesting to see?

Just a couple observations for now, and I am sure more people will come by to help answer some questions

 

[thebigfuzz]

Bump

 

[Red & Rover (GA)]

In regards to feeding, Woody is always hungry and ravenous. I'm pretty sure he'd eat 2 or 3 cans of FF in one sitting! How much and how often should he be fed? Initially, I was only feeding him twice a day, but I've started giving him small portions of FF throughout the day and he always licks his bowl clean and begs for food often. He has lost about 1.5 pounds in the past few months.

I don't give dosing advice but this one I can answer.
Non-regulated cats cannot process their food properly. Give a good sized meal at shot times and snacks through the day but pick up any food at +10 (two hours before the next shot) so that the test number at shot time is not food influenced.

Generally speaking, at what point should one consider testing for insulin auto antibodies and acromegaly?

I believe it is above 5 units.

If you could start getting some PM cycle tests in, that will help fill in the bigger picture. Perhaps a test before you go to bed and if you get up during the night.

 

[Wendy&Neko]

Hello and welcome to you and your sweet boy Woody.

To decide how much food you need to give, you need to have an idea of what his ideal weight is. Then you can decide if he needs to gain back the weight he lost or loose some more. Then use the scale to determine if what you are feeding is right or needs to be modified. Age and activity level also play a part in how much food a cat needs. Several smaller meals can help get rid of the hunger. I also loved my investment in an autofeeder. One I had that, Neko stopped focusing on me as the primary food giver.

Generally speaking, at what point should one consider testing for insulin auto antibodies and acromegaly?

My girl had both those conditions. When a member gets to six units, we suggest it's time to test for both of them. However, if you see symptoms and think it's a possibility, it's fine to test earlier. We've seen cats with both those conditions on less than six units. At one point my girl was down to 0.25 units though she peaked at 8.75 units. The reason for the 6 units is that we've seen cats get close to that, then hit that magic dose and turn it around. Over 6 there is a good chance a secondary condition is present.

How long does it typically take to see the effects of Lantus? He's been on it for almost 5 weeks now, and his numbers are still high, without much change with dose increases.

Five weeks is still relatively early. How long it takes to see results depends on how long it takes to get to the dose that moves the cat. Each cat is different (ECID) and needs differing amounts of insulin. I'm glad you've decided on Tight Regulation. As long as you are feeding all low carb wet or raw, it's your best chance to get him into better numbers quickly and safely. By the way, nothing screams secondary conditions in Woody's spreadsheet to me yet. Nor a cat that is overdose. Just a cat who needs more insulin. The others have stressed the night time tests, and I'll third that. We determine how to change the dose based on how low it takes the cat, so we really do need see what happens at night. Those before bed tests are good to get.

or maybe I'm just impatient

We get that a lot here. Lantus will teach you patience. Not my strong suit either.

 

[chitra80]

I can see it now! Thanks!

I will leave some of the specific questions you have for more experienced eyes, but will say that I think we can all empathize with how you are feeling. It can be stressful and frustrating having a sugar kitty. They are just so darn cute I’m glad you found the forum!

Have you been checking out the stickies on the forum for information? Looks like you have since you’ve got your signature and SS all set up I re read them all the time, and every time I do, I absorb something new!

One thing I might mention is in regards to testing as you learn his patterns (or as patterned as living creatures can be LOL). Many kitties can go lower at night, so it is always good to grab a +2 to get an idea of what is in store for that cycle and determine if you need to set an alarm or monitor more closely that cycle. If a +2 is the same or lower than the preshot number, you could have an active cycle. Not always, but often. It looks like you are grabbing some during the day and the last couple nights, which is good. I’d keep doing that.

It may be hard to tell what is happening because of some data gaps and not knowing what is happening overnight.
8/23 he went from 326 to a +3 of 200 which is a decent drop. It is possible he went lower overnight and came back up to a AMPS of 453 - which is likely a bounce (when the liver panics from numbers he isn’t used to yet, and dumps glycogen into the blood stream as a protective measure)
9/7 is another interesting day where he had a big drop into the yellows during the day and then another large drop after PMPS. A +4 or +6 would have been interesting to see?

Just a couple observations for now, and I am sure more people will come by to help answer some questions

Thanks so much for your thoughts! I've definitely been thinking about getting more night time readings and will do so moving forward! And definitely, I feel a bit obsessive about Woody's diagnosis and have been spending a lot of time reading and re-reading posts and stickies; definitely learning more and more each time!

 

[chitra80]

I don't give dosing advice but this one I can answer.
Non-regulated cats cannot process their food properly. Give a good sized meal at shot times and snacks through the day but pick up any food at +10 (two hours before the next shot) so that the test number at shot time is not food influenced.

I believe it is above 5 units.

If you could start getting some PM cycle tests in, that will help fill in the bigger picture. Perhaps a test before you go to bed and if you get up during the night.

Thanks for the advice on the food. Woody has always been super food motivated, but now is acting straight up loony about his food! It's been helping to give a few smaller meals between his large breakfast and dinner, at least for my sanity! LOL! And will definitely start getting more PM cycle tests; I will admit that I am a horror if I don't get 7-8 hours of rest each night, so have to find the right nights to do this!

 

[chitra80]

Hello and welcome to you and your sweet boy Woody.

To decide how much food you need to give, you need to have an idea of what his ideal weight is. Then you can decide if he needs to gain back the weight he lost or loose some more. Then use the scale to determine if what you are feeding is right or needs to be modified. Age and activity level also play a part in how much food a cat needs. Several smaller meals can help get rid of the hunger. I also loved my investment in an autofeeder. One I had that, Neko stopped focusing on me as the primary food giver.


My girl had both those conditions. When a member gets to six units, we suggest it's time to test for both of them. However, if you see symptoms and think it's a possibility, it's fine to test earlier. We've seen cats with both those conditions on less than six units. At one point my girl was down to 0.25 units though she peaked at 8.75 units. The reason for the 6 units is that we've seen cats get close to that, then hit that magic dose and turn it around. Over 6 there is a good chance a secondary condition is present.

Five weeks is still relatively early. How long it takes to see results depends on how long it takes to get to the dose that moves the cat. Each cat is different (ECID) and needs differing amounts of insulin. I'm glad you've decided on Tight Regulation. As long as you are feeding all low carb wet or raw, it's your best chance to get him into better numbers quickly and safely. By the way, nothing screams secondary conditions in Woody's spreadsheet to me yet. Nor a cat that is overdose. Just a cat who needs more insulin. The others have stressed the night time tests, and I'll third that. We determine how to change the dose based on how low it takes the cat, so we really do need see what happens at night. Those before bed tests are good to get.

We get that a lot here. Lantus will teach you patience. Not my strong suit either.

Hi Wendy and thank you so much for your responses. Woody has typically been around 13-14 lbs and is currently around 11.5; he feels so bony now and it makes me sad. An autofeeder sounds great, but I have other cats, so not sure it'll work well for my situation. Also, appreciate your advice on the dosage; I feel a bit better now about his dosage and will definitely work on being more patient and getting in some night time tests!