02/08 Casper AMPS 356, +4 39, +4.5 232, +6 382, +9 246; PMPS HI, +2 452 | Feline Diabetes Message Board - FDMB

02/08 Casper AMPS 356, +4 39, +4.5 232, +6 382, +9 246; PMPS HI, +2 452

Yuling & Casper (GA)

Yuling & Casper (GA)

Member since 2020
Good morning everyone,

A new week, Casper's AMPS is 356 this morning before food and shot.
I am not sure if the Sub-Q and B12 injection made him extremely nervous that shot his BG way up, he didn't want to eat too much last night, so we syringe fed him; around 11 PM, he came out asking for chicken.
He's acting well this morning, jumping up and down, smacking the dog, ate almost a whole can of Beyond pate with supplements added by himself.
Previous thread
 
It’s really important to get a +2 or at least a +3 to avoid big drops like this and reductions. He’s too unpredictable as to when he will clear a bounce. I thought it might happen today with his amps.
 
tiffmaxee said:
It’s really important to get a +2 or at least a +3 to avoid big drops like this and reductions. He’s too unpredictable as to when he will clear a bounce. I thought it might happen today with his amps.
Click to expand...
Yup, my fault, meant to do +3 but I got into a meeting, it carried way longer than I expected. When I noticed the time, it was 1 PM already.
 
It’s ok. No symptoms right? He will likely bounce but at least you won’t need to reduce and you caught it before he was hypo. Wen you get busy can you just leave food out for him?
 
152 on contour, 232 on Alphatrak...I know this procedure is written around the human meter, but I really don't feel comfortable continuing with it. It's taking more blood each test, and it doesn't give an accurate reading. It's way too much difference in data...especially in the low.

tiffmaxee said:
No symptoms right? He will likely bounce but at least you won’t need to reduce and you caught it before he was hypo. Wen you get busy can you just leave food out for him?
Click to expand...
No, no symptoms, he was sleeping in his bed. I always leave him extra food and a chicken puree treat, he normally doesn't eat until he has his nap, unless we syringe feed him every 3 hours.
I will just have to set the alarm from now on. Nothing is more important than Casper right now.
 
Maybe get a Relion. Since the human meters read lower there’s a built in safety net. The two are closer in low numbers. There’s also the 20% meter variance.
 
tiffmaxee said:
Since the human meters read lower there’s a built in safety net.
Click to expand...
Well, in this case, on the low side, the human meter reads a lot higher than the pet one. According to the human one, he was safe, a little bit low side but good still; however, on the petmeter, he was super low. Luckily today I am running both meters for the vet's visit later this afternoon, otherwise, I would not think about running the petmeter. Symptom wise, you would not be able to tell when he is taking his nap, he acted normal, stretching and responded to us just well.

I am not so sure about the Relion, as it didn't pass the compliance tests in the blood glucose monitoring system surveillance program in response to the Department of HHS congressional diabetes caucus. I don't really see any updated product of Relion made since then to alter the test results, that's why I didn't get it when made the switch. I can always get one to give it a try, but for now, I really don't think I can trust the human one. On the high side, no problem, on the low, potential big issue, unless Relion is calibrated more like a petmeter rather than a human meter, maybe that's why they failed the compliance tests.
What makes me frustrated is how he could bounce so high and so low just in such a short period of time.
 
Last edited:
tiffmaxee said:
Here’s his ss. Cluck on 2020 first.
https://docs.google.com/spreadsheet...sYe47lHox5MN1VzhnyuGfM_U42fya2ftqCQn/pubhtml#
Click to expand...
Wow! It's amazing how those numbers can be... how did you manage to get 0.1U, or even 1 drop, less than 1 drop?

I did not test him twice with the contour at +4, if AT read at 39, the contour should be even lower, but it wasn't... this is so strange.
Taking the weight factor alone, my old vet doesn't feel comfortable giving Casper higher than 1U. I will talk to him more about this today. Now for the time being, especially when we are trying to understand his bg pattern or at least try to get it under control, I would feel more comfortable monitoring him with the AT if you don't mind. I am sorry it will create more work for you or whoever is helping us, it will be more of an inconvenience, but I just don't know if I could really trust the device with inaccurate data, specifically when we are determining his dosage based on that data. Of course, if you think Relion Prime would be different, we can give it try too.
 
It’s fine to use the AT. How much insulin a cat gets is based upon weight ONLY for the starting dose. After that it’s based upon how low it takes your cat. If you stick with a 1.0 unit limit and his numbers go up you risk adding glucose toxicity which will lead him to need more and more insulin. You will risk his kidneys getting worse too as he will be over renal threshold if his bg stays above about 250 too much of the time. A cat needs as much insulin as it needs to keep him in as normal bg as possible. You also risk ketones and DKA if left too high.
 
tiffmaxee said:
After that it’s based upon how low it takes your cat
Click to expand...
Agreed! I don't think Casper will ever need 1U, when the ER did 1U before, we had nothing but trouble and he couldn't get out of the hospital. I do feel the 0.75U is the correct dose.

tiffmaxee said:
Don’t reduce unless under 50 on contour.
Click to expand...
Really don't understand how could the human meter comes higher than AT today, should have tested more...I panic when I see a low number like that. Hold the dose at 0.75U or change it to 0.5U? I will also show the vet today how much I am giving him at 0.75U. SInce I don't have the fine, fine print of measurement, I do 0.75U with the top part of the plunger puts in the middle of the 1U line.
 
Yuling & Casper said:
Agreed! I don't think Casper will ever need 1U, when the ER did 1U before, we had nothing but trouble and he couldn't get out of the hospital. I do feel the 0.75U is the correct dose.

Dosing needs change. It goes up and down. Just because 1.0;was too much a few weeks or a month ago does not mean it might be too little next week.


Really don't understand how could the human meter comes higher than AT today, should have tested more...I panic when I see a low number like that. Hold the dose at 0.75U or change it to 0.5U? I will also show the vet today how much I am giving him at 0.75U. SInce I don't have the fine, fine print of measurement, I do 0.75U with the top part of the plunger puts in the middle of the 1U line.
Click to expand...

If he were my cat I would hold the dose. You hold the syringe and if you feel you want to reduce the dose that is fine. If it’s not enough insulin you can take him up again.
 
My message got mixed in with yours. So click on it and read the first part of what I said. Dosing needs change. Just because a dose was too much a few weeks ago does not mean it won’t be now and even could be too little.
 
Yuling & Casper said:
Agreed! I don't think Casper will ever need 1U, when the ER did 1U before, we had nothing but trouble and he couldn't get out of the hospital. I do feel the 0.75U is the correct dose.
Click to expand...
I know Elise said this but it bears repeating: try not to look back at what happened to Casper on a certain dose. What happened in the past is not indicative of what will happen in the future if he does end up back on 1u or more. Whether or not to increase is based on how low the dose takes the cat (nadir) currently.

Especially in the beginning when we are new to the sugar dance, it can be very difficult to hold onto a dose for kitty because we're trying to figure out the best times to test (looks like +2 for Casper to start) and what to feed to keep our cats' numbers steady. You're still figuring this out with Casper. The learning curve is steep.

Have you had a chance to look at other kitties' spreadsheets? Elise suggested Gideon's. Look at others. It can really give you a good sense of how insulin needs can change. Have a look at Butters' 2020 US spreadsheet : She started on 1.5u of lantus in early June, went down to .25u, up to 1.75u, and back down to 1u, all in four months.

Now look at her same spreadsheet from October - December. In two months, she went from .5u up to 4.25u. This is most likely because she developed some glucose toxicity after she wasn't given as much insulin as she needed to keep her numbers down. But once she hit that magical dose, she has been coming down the dosing ladder from December onwards (2021 spreadsheet). She is currently on 1.75u.

In the beginning, I also struggled to catch Butters' drops and feed her numbers properly. I leaned on Elise and others here hard for advice on how to feed and when to test. You can do the same. But please be open to Casper's insulin needs changing.

All that said, I still think you are doing a great job with Casper. But this is super tricky and it really does take a village to get these kitties better regulated.
 
tiffmaxee said:
If he were my cat I would hold the dose.
Click to expand...
Will hold the dose at 0.75U unless you suggest changing it.
I also set the alarm to test him at every +2 and will adjust the test time afterward based on the +2 number. I moved all the meeting schedules after 11:30 AM, so I don't miss out on his test time again. I apologize for the inconvenience, I tried to do everything and stay on top of it, now I realize I just simply can't and I need to choose the priority.

For his visit, the doctor was surprised to see how well he's been doing so far. His HCT comes up from 15.8 (01/29) to 23.4 today, still anemic, but he believes by giving Casper more time to recover, along with the B12-B9 treatment, we will slowly make it right. Kidney values are pretty much up to normal, his BG was 247 at 6 PM, +9. I also showed him the syringe on how much I did for 0.75U...just wanted to confirm I did it right since there is no half unit mak.
 
That’s is wonderful news! You must be so relieved. No apologies needed. You need to work to pay the vet bills, lol.

So going forward, if you are going to use the AT, you need to skip some lines on the ss. Do you want Bhooma to change the settings on the ss? If you are switching, change your signature as well. Is that the plan? It’s up to you.

I have couple other suggestion for you. Furst get some syringes with half unit markings. You can get them from ADW on line or even Walmart. Next get digital calipers as the lines on the syringes can be off by as much as .25 or more.

Here’s a video explaining dosing with calipers. Once I started using them I was lost without them. I used the ones in the video from harbor freight. At the time I just bought them on line.

https://www.felinediabetes.com/FDMB/threads/dosing-with-calipers-updated-w-videos.79851/#post-862835
 
Yes, let's change it back to AT please. His vet doesn't approve the human meter at all and and I found human meter does takes more blood, some times I needed to poke him three times to get a reading. I changed the ss, changed the formatting per conditions, revised signature. Ordered the half unit mark syringe, dug out the 3" digital caliper (need to change the battery), and I have a light tracer box.
:bookworm:
 
Butters & Lyla said:
In the beginning, I also struggled to catch Butters' drops and feed her numbers properly. I leaned on Elise and others here hard for advice on how to feed and when to test. You can do the same. But please be open to Casper's insulin needs changing.
Click to expand...
You are absolutely right! It's a huge learning curve for me and I am still trying to understand how's everything work in this sugar world. Believe or not, I do trust Elise more than my own vet. I really had to step away this afternoon with that 39 number, started reviewing what I've been doing so far...
 
He did ate a small serving of chicken puree treat, then we went to the vet. Came home, finished half can of FF beef pate at 7; had half FF chicken fillet at 8. Tested him at 8:55, HI. Gave him 0.75U.
I need a drink!!!!!
 
To sum it up for today.. Morning before shot, he had Fancy Feast Natural Beef pate, half can with supplements in; went to sleep until 1PM we found him at 39. Gave syrup, milk and only 1tbsp of FF gravy. Retested 30 mins, retested at 3PM. About 4:10, gave him a INABA churu chicken treat before the visit. Came home around 6:45, finished another half can of FF natural beef pate at 7. Tested at 8:55 for PMPS, HI.:woot: he is bouncing from the 39, right?
 
Yes, the 39 or 51depending on which you believe it was but either would cause a bounce.

So you can feed him whenever you want EXCEPT not 2 hours or less before preshots. His PMPS was also influenced by the food. Also, except when low it’s best to feed the majority of the food in the first half of the cycles as the insulin isn’t as effective toward the end of the cycle.

Now that you are using the AT, reductions going forward will be earned if he drops under 68. I still would shoot .75 tonight.

I understand your need of a drink. It’s been quite a roller coaster!
 
tiffmaxee said:
So you can feed him whenever you want EXCEPT not 2 hours or less before preshots.
Click to expand...
Got it! No feeding within 2 hours of preshots. Best to have him eat in the first 6-hour after shot.
In the day time it's easier to manage, for the night, I normally leave him the chicken and another can of food. He eats whenever he feels like. I gave him 0.75 tonight.
 
If he eats during the second half of the cycle it’s not so bad. It just might cause him to be high at preshot. The no food two hours before is t be sure he’s high enough to shoot.
 
tiffmaxee said:
If he eats during the second half of the cycle it’s not so bad. It just might cause him to be high at preshot. The no food two hours before is t be sure he’s high enough to shoot.
Click to expand...
That totally makes sense! I will make a protocol sheet and stick on the fridge tomorrow. Not just me but also the entire household needs to stick to these guidelines. We thought we were doing okay, apparently, we are far from it.
+2, he is at 452. He just finished one chicken fillet, had some water, now goes back to sleep.
 
You must log in or register to reply here.
Back
Top