01/16 Casper AMPS 439 Starts 0.75U

[Yuling & Casper (GA)]

Good morning/day/afternoon almighty forum,

Thanks for sticking around yesterday and all night provided support and your knowledge. The 0.5U last night worked fine for Casper, it didn't bring his BG down dramatically but helps to keep the number going above 600.
(Previous post: https://felinediabetes.com/FDMB/thr...464-7-57-discharged-from-er-yesterday.241514/)

This morning AMPS is 439 mg/dl, Casper acts better than yesterday, walks around, commanding for warm water. Appetite is not so well, shows no interest in the food.

+3 reading is 553 mg/dl (half can of FF was given at +2), will test again at +6. Thank you!

Yuling

 

[tiffmaxee]

You want to hopefully stick with the same dose both cycles. So I’m hoping you can give .75 tonight. If he goes to low then you try .50 all cycles. Make sense?

 

[Yuling & Casper (GA)]

you can give .75 tonight. If he goes to low then you try .50 all cycles.

Will do! His +6 reading is at 500 mg/l. Was hoping the number could even go lower in the 300s. I guess it takes few days for the insulin to start working on it's magic.
Any suggestions how I can improve his anemia?
Thanks!

 

[Bron and Sheba (GA)]

I agree with @tiffmaxee, try and stay with the 0.75 units if you can as chopping and changing the dose doesn’t let the depot settle.
At the moment he’s still bouncing.

 

[Yuling & Casper (GA)]

I will stick to 0.75 U, give it a week, and then we can make any adjustments from that point.

 

[tiffmaxee]

Will do! His +6 reading is at 500 mg/l. Was hoping the number could even go lower in the 300s. I guess it takes few days for the insulin to start working on it's magic.
Any suggestions how I can improve his anemia?
Thanks!

it depends on what is causing the anemia. If nonregenerative due to CKD, you can give Aranesp or epogen injections. He had transfusions which is the only other way I know of and if temporary his anemia should improve. If the HCT stays above 20% B vitamins and B complex can help. See what your vet says at the recheck.

 

[Yuling & Casper (GA)]

Hi, just tested, his PMPS reads 215. Should I continue with 0.75 or safer to go at 0.5 for the night? Pls advise, thanks!

 

[Yuling & Casper (GA)]

it depends on what is causing the anemia. If nonregenerative due to CKD, you can give Aranesp or epogen injections. He had transfusions which is the only other way I know of and if temporary his anemia should improve. If the HCT stays above 20% B vitamins and B complex can help. See what your vet says at the recheck.

Will do, thanks!

 

[Bandit's Mom]

Hi, just tested, his PMPS reads 215. Should I continue with 0.75 or safer to go at 0.5 for the night? Pls advise, thanks!

That is quite a drop. Let me tag @tiffmaxee and @Bron and Sheba (GA)

 

[Yuling & Casper (GA)]

Talked to my husband, we went ahead and gave Casper 0.5U based off his PMPS reading at 215 mg/dl. Sounds like the morning dose is still working. I am afraid 0.75U will make the BG dropped way low in the night. I will do my best to monitoring him in the night. Depends on his sleeping mode, I may test him again at +4, +6 and +8 for more data.
Boy! He is mad at me tonight

 

[Bandit's Mom]

You want to hopefully stick with the same dose both cycles. So I’m hoping you can give .75 tonight. If he goes to low then you try .50 all cycles. Make sense?

Like Elise said here, you want to stick to 0.5U then. Do not go back up to 0.75U. Lantus doesn't work like that. You need to shoot a dose you can shoot comfortably AM and PM. Let's hold the 0.5U for a few cycles and see how he fares.

 

[tiffmaxee]

I understand why you went with .5. Let’s stick with it now for at least 6 cycles unless the numbers require a reduction. Can you get clarification from the vet as to whether there was DKA because it said no ketones so it’s confusing. With DKA you don’t want to skip and need to make sure enough insulin is given.

 

[Yuling & Casper (GA)]

Let’s stick with it now for at least 6 cycles unless the numbers require a reduction.

Will do!
I don't understand how his number bounced back higher in the first 6 hours, then drop lower by the end of the 12- hour period. But tonight, clearly, 0.75 U could be too risky for him. I will start with 0.5U tomorrow morning.
I tested ketones again tonight at 8, still negative.

 

[Yuling & Casper (GA)]

You need to shoot a dose you can shoot comfortably AM and PM

I like this strategy. Start low, add if needed.

 

[tiffmaxee]

Will do!
I don't understand how his number bounced back higher in the first 6 hours, then drop lower by the end of the 12- hour period. But tonight, clearly, 0.75 U could be too risky for him. I will start with 0.5U tomorrow morning.
I tested ketones again tonight at 8, still negative.

It’s lower now because the bounce cleared.

 

[Bron and Sheba (GA)]

I agree you need to stick with one dose for at least 6 cycles, otherwise the depot can’t settle and you will get wonky numbers.
Definitely find out about the DKA...if he had it or not.....as it is important information for us to know as it can change our thinking.
Looks like he might be coming off the bounce so I’d get some early tests in during this cycle to see what he has in mind.

 

[Yuling & Casper (GA)]

Definitely find out about the DKA...if he had it or not.....

Will do. I will call the vet on Monday and see if I may get an answer. If not, I can ask him at the follow-up appointment.
I think only the assessment on the treatment plan mentioned "DKA", I really don't see it anywhere else with proven data. His lab results came back all negative on ketones and I've been checking everyday with the test strip. I will update everyone once I have an answer, meanwhile, keep checking everyday.