Raymond James AMPS 137

Lee cuzz

Member Since 2020
Finally starting to trend downward!! After three years of diabetes, acromegaly and cabergoline, better BG numbers. I know I'm using a sliding scale, not good. Can't shoot 70 units when he is low. I know I need more data, I work 12 hour shifts. Question: what dose I continuously shoot when he is under 100 and how many cycles? Feel like I'm playing with hypo? When is he in remission? Should I quit giving insulin? Thanks, Had Raymond James shaved down. He was heavily matted, awful...
 
Let's see if I can tackle those questions one by one.
I know I'm using a sliding scale, not good. Can't shoot 70 units when he is low. I know I need more data, I work 12 hour shifts. Question: what dose I continuously shoot when he is under 100 and how many cycles?
You are correct, we cannot help you with whatever dosing method you are currently using as we have no familiarity with it. In addition, there are almost no night time tests. Cat usually go lower at night and we dose based on lows (not preshots), so we'd be just guessing how low he's going and where his dose should go. You say you cannot shoot 70 units when he is low, what do you define as "low"? Assuming you start with a lower dose than 70, how low would you feel comfortable shooting him his full dose? Remember, with the Levemir depot, the cycle will play out a lot like if you had shot the full dose, unless you do a greatly reduced dose.
Feel like I'm playing with hypo?
What makes you say that? What signs are you seeing? Does he always have food available to stay safe?
When is he in remission?
When a cat's dose is reduced down to zero units, following reduction guidelines in a dosing methodology, and then goes 14 days in normal numbers, then we consider it to be in remission. Raymond James looks like he's a long ways away yet.
Should I quit giving insulin?
Why would you stop insulin? It looks like he still needs a large dose, though it's really hard to say what that dose is.

Is there any way you could follow a dosing methodology we use here? Such as the Start Low Go Slow dosing method? That would mean keeping the same dose, regardless of preshot value, unless you see him go below 90, in which case you'd reduce the dose. If so, I'd pick a dose and stick with it, until you see him earn a dose reduction by going under 90. I'd be guessing what that starting dose is, but I think it's lower than 60. Maybe 50? I'd just have to try it and see how it goes.
 
Let's see if I can tackle those questions one by one.

You are correct, we cannot help you with whatever dosing method you are currently using as we have no familiarity with it. In addition, there are almost no night time tests. Cat usually go lower at night and we dose based on lows (not preshots), so we'd be just guessing how low he's going and where his dose should go. You say you cannot shoot 70 units when he is low, what do you define as "low"? Assuming you start with a lower dose than 70, how low would you feel comfortable shooting him his full dose? Remember, with the Levemir depot, the cycle will play out a lot like if you had shot the full dose, unless you do a greatly reduced dose.

What makes you say that? What signs are you seeing? Does he always have food available to stay safe?

When a cat's dose is reduced down to zero units, following reduction guidelines in a dosing methodology, and then goes 14 days in normal numbers, then we consider it to be in remission. Raymond James looks like he's a long ways away yet.

Why would you stop insulin? It looks like he still needs a large dose, though it's really hard to say what that dose is.

Is there any way you could follow a dosing methodology we use here? Such as the Start Low Go Slow dosing method? That would mean keeping the same dose, regardless of preshot value, unless you see him go below 90, in which case you'd reduce the dose. If so, I'd pick a dose and stick with it, until you see him earn a dose reduction by going under 90. I'd be guessing what that starting dose is, but I think it's lower than 60. Maybe 50? I'd just have to try it and see how it goes.

Thanks, you're so knowledgeable. I don't want to shoot 60 units when he reads AMPS, 90 and leave for work. Raymond James does not have access to food when I'm not home due to other furkids will get there first. I'll try 40 units, I guess regardless of what the BG is. I'll figure it out!!!!
 
Is there any way you can leave Raymond James in a separate room by himself with food when you see lower numbers before going to work? Or you can get microchipped feeders so that only he can get access to the food.
 
Is there any way you can leave Raymond James in a separate room by himself with food when you see lower numbers before going to work? Or you can get microchipped feeders so that only he can get access to the food.
Thank you for responding. I can isolate him when I work 12 hours. Not sure how that microfeeder works. Just can't regulate him, he is high again. With all I have learned here, I still can't get it. I have no dosing method, as he has been high forever. I know I need to do a curve and get PMPS reading. Is it true with levemir, the lowest is after 12 hours?? Seems like he is lower in AMPS.
I am jealous when pet parents say they are giving one unit. I'm spending $550 on insulin every seven weeks.. UGG...
 
Is it true with levemir, the lowest is after 12 hours??
It depends on the cat and the cycle. On Levemir, Neko's I spotted her low points anywhere from +5 to +15, though +9 to +12 was the most common time.

It'll really help us to help you with dosing if you could stick with the same dose for at least three days and nights in a row. We dose based on how low the dose takes the cat, not the high or preshot values. Can you try shooting 45 units the next six times? And get some other tests mid cycle or before bed, when you can?
 
It depends on the cat and the cycle. On Levemir, Neko's I spotted her low points anywhere from +5 to +15, though +9 to +12 was the most common time.

It'll really help us to help you with dosing if you could stick with the same dose for at least three days and nights in a row. We dose based on how low the dose takes the cat, not the high or preshot values. Can you try shooting 45 units the next six times? And get some other tests mid cycle or before bed, when you can?
I will stick with 45 units for three days. I do understand I am dosing on the nadir not preshot. Just get nervous when his AMPS is 94 and I shoot 45. I will get more data, I understand that's the only way to tell. Wish you lived closer, you would correct his diabetes. Neko was so fortunate to have you, they should all have a wendy to take care of their serious health problems. Thanks again for everything!!!!
 
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