? 1/28 - Hendrick AMPS 512 / + 5@333 / +7@476 / PMPS 563 / +3@358

Hendrick Cuddleclaw

Hendrick Cuddleclaw

Very Active Member
https://felinediabetes.com/FDMB/threads/1-27-hendrick-amps-567-4-311-6-251-pmps-525.258453/


First time we've successfully tested for ketones with the Nova Max. Just as people here had mentioned, we were able to use the same blood droplet (first touched test strip on AlphaTrak to droplet, then touched test strip on Nova Max to droplet). It displayed .9 -- a quick google says under .6 would be good, .6 - 1.5 means slight risk of DKA??

He is 10.3 lbs and we've been feeding him about 300-350 calories a day I estimate (at least) and he is getting plenty of water as advised by folks here like @FrostD in order to keep DKA at bay. I think I remember that someone here at the FDMB said the slight presence of ketones in the blood of an unregulated diabetic feline is expected, and the important thing is that they stay on the low end. I hope that is correct.

Lab report from the vet from 1/18 says: Serum Ketones: Small 1+ A

I don't know what that translates into as far as comparing it to the .9 from today
 
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Here's info from posts on FDMB regarding Ketones:

Ketones, Ketoacidosis, and Diabetic Cats: A Primer on Ketones

Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters

The second link above has info about when ketones appear in felines on a blood meter (2.4-2.55). FWIW (I don't have personal experience with DKA), I'd check ketones regularly (at least daily) to keep an eye on the trend, especially since Hendrick is still showing higher glucose numbers.

I know I mentioned this yesterday but if you are wanting to follow TR, you'll still need to get one more test after PMPS - so TR requires the Preshot + another test each cycle. So, a minimum of four tests per day (2 each cycle...where the cycle is the 12-hour period from one insulin shot to the other). I know you all are working hard on testing :bighug: but we all also want to make sure Hendrick stays safe and testing per the protocol helps us do that :cat:
 
JaxBenji said:
Here's info from posts on FDMB regarding Ketones:

Ketones, Ketoacidosis, and Diabetic Cats: A Primer on Ketones

Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters

The second link above has info about when ketones appear in felines on a blood meter (2.4-2.55). FWIW (I don't have personal experience with DKA), I'd check ketones regularly (at least daily) to keep an eye on the trend, especially since Hendrick is still showing higher glucose numbers.

I know I mentioned this yesterday but if you are wanting to follow TR, you'll still need to get one more test after PMPS - so TR requires the Preshot + another test each cycle. So, a minimum of four tests per day (2 each cycle...where the cycle is the 12-hour period from one insulin shot to the other). I know you all are working hard on testing :bighug: but we all also want to make sure Hendrick stays safe and testing per the protocol helps us do that :cat:
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ohhhh somehow I misunderstood that as at least two tests per day, not per cycle. And yesterday it was mentioned that there is not a need to test a lot right now with his numbers so high so I wasn't as concerned with the PM +3. Oops.

I've been furiously reading those links about ketones ty. I will say I feel like he is still drinking a lot of water but otherwise appetite is generally fantastic, energy good, behavior normal. Honestly he seems very much himself this morning. Bright, alert, we had a good play session.

I am doing a +5 and +7 today, I will test for ketones again at +7 -- or at least try to as I am solo while wife is at work. If not at +7, PMPS
 
I would not worry about the .9 ketones. Keep an eye on it and just make sure it’s not going up too much. You will find that ketones vary throughout the day. I finally decided to test only once a day (for ketones.)
 
By the way, my boy had much higher ketones than that for a long time. He did not go into DKA again, but boy was I worried about it! And I did check his ketones daily (until he finally got down and stayed down.)

As I increased his insulin, his BG numbers did not come down (at first) but his ketones did start to come down before I saw reductions in blood glucose levels.
 
Suzanne & Darcy said:
I would not worry about the .9 ketones. Keep an eye on it and just make sure it’s not going up too much. You will find that ketones vary throughout the day. I finally decided to test only once a day (for ketones.)
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thank you!! I had pretty much already arrived at that conclusion based on his behavior, appetite etc all being normal, even a little better than what is "normal" as of late. More like, almost pre-dx normal.
 
I hate seeing those blacks on his SS. Now that you are getting so many good tests in, you should be able to increase his dose more quickly and get him into safer numbers. You are really learning so quickly.
 
Suzanne & Darcy said:
I hate seeing those blacks on his SS. Now that you are getting so many good tests in, you should be able to increase his dose more quickly and get him into safer numbers. You are really learning so quickly.
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thanks, I gotta get my wife on board. She hasn't poked him in a few days after a bad experience where she tried three times then I took over and got it in one try so...every time we go to do it, she now says she'll just hold him while I poke
 
You need to be testing more if you want to follow TR, especially after his PMPS , the more tests the better so we can see how the insulin is working for him. Vary the times so you will find his nadir and know when an increase or decrease is needed.
He will not hate you for this. I was able to test Tyler when he was as actually sleeping. He's been in remission since 1-24-21 with the help of all the members here. It took 2 years and 4 months to get him in remission :cat:
 
Re: ketones - 0.9 is a little higher than I like to see bit not immediately dangerous. For a regulated cat it's usually LO - 0.4, occasionally 0.6. So 0.9 not outside the realm of "normal" for unregulated cat. Just keep doing what you're doing with food and fluids, etc. Once they get to 2.4-2.5 it's guaranteed DKA (that's what @JaxBenji posted above - the forum post she linked is a little misleading, if you read the study in that link they looked at a bunch of cats and ketone levels and that was the conclusion).

I know the strips are expensive but I'd test daily or every other day if you can, just to make sure they're not trending up. Or alternate using urine strips and the meter. Once he's regulated it's usually just a weekly thing.
 
+5 ringing in with a 333, he had a snack about an hour ago of a TBSP or two of 10% carb food, also split morning meal as per usual with half at PS and half at +1


maybe I overdid it with snacks? If he is already on the way back up, gonna be high all day :(
 
At the expense of sounding like a broken record, whenever you are considering increasing a dose, you want to ask yourself, "how low is this dose taking kitty?" A few of us have noted the importance of pm cycle tests, particularly because you are missing half of the picture at the moment. Is he going lower at night and bouncing during the day? I don't know, because there aren't any night time tests for the last 3 days.

I do recognize that testing has been difficult, but I want to stress that it is super important to have enough data to support your decision of whether to increase.

Regardless of whether you are following TR or SLGS, I would suggest you get used to getting a before bed test to see whether there are any patterns at night that you may be missing. All data is good data, particularly when assessing whether you want to increase the dose. We make dose decisions based on nadirs, not preshots.

When first starting to collect data, I'm not overly fussed whether a CG has specifically chosen to follow TR or SLGS right away, unless it becomes a consideration when trying to offer dose advice, which is the point we've reached here. What I will also say is don't try and mix the two.

My 2 Canadian cents for what they are worth: be sure he's not up to anything in the pm cycles, so get a before bed test tonight and again tomorrow. If he's not showing you anything special, then you can consider an increase. And perhaps have a reread of the dosing methods again, and see which will fit you based on your current circumstances and comfort level.

Dosing Methods

That will help get consistent dosing suggestions going forward.
 
Yeah somehow I completely missed the fact that we need to be doing at least two tests per cycle, or 4/day. I thought we were ok to do just AMPS and PMPS some days. That changes immediately, we head for bed most nights right around +3 so we will start making that a routine test. Good thing I have got the hang of solo tests, as doing a 2nd test during the daytime cycle will require me to do it alone. But I have managed that pretty well lately.

just yesterday I was told that there is no need to test so much, when his numbers are so high, for example. Or at least that's what I thought I read, maybe I miss-interpreted
 
Hendrick's mom and dad said:
Yeah somehow I completely missed the fact that we need to be doing at least two tests per cycle, or 4/day. I thought we were ok to do just AMPS and PMPS some days. That changes immediately, we head for bed most nights right around +3 so we will start making that a routine test
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That would be fantastic, and no worries, you just started 10 days ago :), I would be amazed if you've been able to pick up every last little detail in all of our stickies in such a short period of time! So am I hearing you'd like to give TR a proper try? If you have any questions as you go, just ask, we are here to help.
 
I found those before bed tests invaluable. One year, for a period of 3 months in a row, my girl only went low at night, then bounced during the day, If I hadn't done night time tests I would have thought she needed an increase, when in fact she was earning reductions. After a while, Neko (and her partner in crime) came running when they heard me brushing my teeth. Tests and treats came next. :p

I see that Hendrick did get down to 118 on 1.25 units, so that's one data point that tells you he did get to a decent nadir a week ago. In between then, I note on AMPS where you say "fur?". Whenever you do a fur shot, otherwise skip a shot, the cycle count starts over. So even though there's been 9 days of 1.25 units, it was actually 4 days, a fur shot, restart the count after the fur shot, then another 4 days.

Did you dose last night? PMPS units is blank.
 
Hendrick's mom and dad said:
just yesterday I was told that there is no need to test so much, when his numbers are so high, for example. Or at least that's what I thought I read, maybe I miss-interpreted
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So the minimum is those 4 tests everyone has mentioned - the two preshots, and then one more in each cycle.

Most people tend to choose a +2 or +3, since that often gives you a clue what he's going to do the rest of the cycle. If that is flat or especially a drop, pretty good bet you'll need to test again later - when that test would be depends on the numbers/trends, we can help guide you.

Right now, just starting out, any data is helpful. But don't feel pressured to keep testing when it's obvious he won't go dangerously low - like yesterday, it was a reasonable assumption that 251 was pretty close to nadir, and he wasn't going to hit greens, so we said take a break if you need it. And today - that 476, well you know he's clearly on his way up, any further tests are just bonus data, but not critical.
 
Wendy&Neko said:
I found those before bed tests invaluable. One year, for a period of 3 months in a row, my girl only went low at night, then bounced during the day, If I hadn't done night time tests I would have thought she needed an increase, when in fact she was earning reductions. After a while, Neko (and her partner in crime) came running when they heard me brushing my teeth. Tests and treats came next. :p

I see that Hendrick did get down to 118 on 1.25 units, so that's one data point that tells you he did get to a decent nadir a week ago. In between then, I note on AMPS where you say "fur?". Whenever you do a fur shot, otherwise skip a shot, the cycle count starts over. So even though there's been 9 days of 1.25 units, it was actually 4 days, a fur shot, restart the count after the fur shot, then another 4 days.

Did you dose last night? PMPS units is blank.
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Ahh ok the fur shot resets things, got it thanks. And yes we shot last night, somehow missed filling that in ty!!
 
Sandy and Black Kitty said:
Hi there :cool:

I'm curious as to why you fed 13% and 15% food on 1/27...
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we screwed up. I thought it was 5% food. In fact, @FrostD you need to know, since you've been so tremendously helpful, that when I thought I was feeding him sub-5% food at meal time and then later, 10% at +1 as you recommended....it was actually more like 13-16% at meal time and 10% at +1. It is very unfortunate because he eats this food really really well and I was so happy we weren't having an issue transitioning to wet food from dry -- but we are now going to have to just keep it around for when we want to do a MC/HC meal.

My wife is actually at the store right now getting some weruva, tiki, and fussie cat all of them like 0, 2, highest is like 8% calories from carbs
 
FrostD said:
Gotcha, it happens! The 10% was specific to Rainbow and her cat Little Man as what works for them. I'd start by trying his regular LC as snacks, give it a few days, and if he's still diving hard increase carbs by 2-3%, repeat til the drops slow
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yeah...well 10% turned out to be the lowest carb we had anyway. /facepalm

I honestly have to wonder if his numbers are going to improve here in the next week as we actually start feeding him primarily sub-5-8% calories from carbs. Up until now, we have not been doing that. Thought we were, but we weren't
 
Hendrick's mom and dad said:
yeah...well 10% turned out to be the lowest carb we had anyway. /facepalm

I honestly have to wonder if his numbers are going to improve here in the next week as we actually start feeding him primarily sub-5-8% calories from carbs. Up until now, we have not been doing that. Thought we were, but we weren't
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It so happens...jist a couple weeks ago I had some canned duck that I had calculated awhile back at 1%. Bought again disnt bother to recalculate they changed recipe and it's a 5% now :banghead:....kept wondering why he wasnt coming down like normal. I'd bet you see some improvement in his numbers when he is on the LC food.

My guy is super carb sensitive so the 9% sends him way up nicely LOL
 
Hendrick's mom and dad said:
yeah...well 10% turned out to be the lowest carb we had anyway. /facepalm

I honestly have to wonder if his numbers are going to improve here in the next week as we actually start feeding him primarily sub-5-8% calories from carbs. Up until now, we have not been doing that. Thought we were, but we weren't
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Ok then yes definitely don't want to increase any time soon ha! See how he does with new food
 
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