Buddy Updates - AMPS 395 (and he's constipated)

lbeachstace

lbeachstace

Member Since 2022
So the update for today is that he's constipated. I do add Miralax to his meals. He tried to go this morning but he pushed and nothing happened. He's resting now.

Any advice on what I can do to help him? He got 1/4 tsp of Miralax with this his food this morning with 3/4 of a can of Weruva WX and some water - he ate all of it. He's been getting snacks and i will sprinkle some on that food to.

Anything else we can do??



Here's a link to the original post for him from a couple of days ago.
https://www.felinediabetes.com/FDMB/threads/need-help-with-lantus-dosage-reset.272245/#post-3028926
 
You could try more miralax? It is a dose to effect medication so sometimes you need to give more. Hydration is key so if he will drink more water that can help. I could sometimes massage Simon to help him have a bowel movement. It you haven’t checked out feline constipation dot org there is a lot of good information there.
Good luck! :bighug:
 
Dosing 1/4 tsp twice a day would be worth trying. Some cats just need it more than once a day.

You also might try psyllium and or pumpkin instead. Biggie gets 1/4 tsp psyllium (for bulking) and 2tsp of pumpkin (stool softener) twice a day. After many combinations of one or the other I found this to work best for him but you may be able to get away with just one or the other for Buddy. I have to mix the psyllium with a little water and food or it’s pasty also top it with fortiflora for palatability.
I use this psyllium that is sugar and additive free:
https://www.vitacost.com/yerba-prima-psyllium-husks-powder

Good luck!
 
Hi @Wendy&Neko - Buddy's numbers are not really moving from the mid-300-low 400 range. Today is day 4 of the 4.5 dose and is AMPS was 403.

Is there anything we should expect? Anything we should change? His numbers started to come down a bit in the 300s and we were hoping this would be the start of some regulation for this dose. He tends to take time for the numbers to come down, so do we just need to be patient for a few more days?
 
Did you dose this morning? The units column is blank for this AM. Also, I don't see any before bed tests last night. Did you do one?

With SLGS, you hold the dose for 7 days, unless you start seeing ketones show up. I hope you can get another ketones test in today. Is there a reason you are following SLGS instead of TR for dosing? Is he eating all low carb wet or raw food? We could move to TR and faster increases to get him into better numbers if eating the right diet and you can get at least a +2 or a before bed test every night. Some people will go to TR for faster increases, then slow down and switch to SLGS when regulation is closer.

I expect that the reason his numbers are high is that his dose is too low. Resets very seldom work out. Sienne did mention fast tracking, which is something we could help you do to get Buddy closer to a good dose faster, but it'll require those extra PM tests too.

Another thing that can cause higher numbers is constipation. How is progress going on that?
 
@Wendy&Neko - yes, i did dose this morning, i just entered it. i did not get a test last night before bed. I passed out before I was able to (I've been exhausted staying up late this week to test him, i apologize) :( I will get one tonight.

There is no reason we are following SLGS vs TR.

He eats Weruva WX (his phosphorus was a little high during his last blood test in Oct, so we switched to that).

If PM tests are required, i will do them. How many do you like to see? One before bed and/or +2 only or do you need more? (want to manage expectations)

He's not used to box since i've been up but i will get another Ketones test today.

He's still constipated and we've been giving him more miralax.
 
lbeachstace said:
So the update for today is that he's constipated. I do add Miralax to his meals. He tried to go this morning but he pushed and nothing happened. He's resting now.

Any advice on what I can do to help him? He got 1/4 tsp of Miralax with this his food this morning with 3/4 of a can of Weruva WX and some water - he ate all of it. He's been getting snacks and i will sprinkle some on that food to.

Anything else we can do??



Here's a link to the original post for him from a couple of days ago.
https://www.felinediabetes.com/FDMB/threads/need-help-with-lantus-dosage-reset.272245/#post-3028926
Click to expand...
You can do the Miralax twice a day. How much are you putting in the food? If it’s 1/4 tsp. then just do it morning and evening. Other things are plain psyllium husk added to his food (but a lot of cats don’t like the texture of their food after thos os added) or freeze dried pumpkin. I always order the freeze dried powder because it’s shelf stable for a long time, but in the short term you can use plain, unsweetened canned pumpkin and add a little bit to his food for extra fiber. Again, some cats don’t mind this and some don’t like it. These are some of the first line things that you can try. If it becomes worse then you can move to other things.
 
Okay, I see your sig says 1/8 tsp Miralax. I would give another 1/8 tonight or maybe you already did today. You don’t want to cause diarrhea. But if you do, you can back off the dose. Some cats need 1/4 tsp twice a day.

If you want to follow TR all you are required to do is to get both the morning and evening preshot tests PLUS at least one additional test per cycle. So the minimum requirement would be 4 Tests per day. I was just looking at Buddy’s spreadsheet and thinking he needs an increase. With these high numbers, after six cycles he would be ready if you decide to switch to TR. He has already had more than six at this dose. I’m happy there are no ketones present.
 
@Suzanne & Darcy - i have upped the miralax to 1/4 tsp but didn't update the signature for that.

We would like to get these numbers down, so going up .5 is okay. So we'd do that for 3 days to see where he is - with AMPS, PMPS and 2 other tests during day and night.

Small snacks are still okay, right?
 
lbeachstace said:
@Suzanne & Darcy - i have upped the miralax to 1/4 tsp but didn't update the signature for that.

We would like to get these numbers down, so going up .5 is okay. So we'd do that for 3 days to see where he is - with AMPS, PMPS and 2 other tests during day and night.

Small snacks are still okay, right?
Click to expand...
Yes to all. Keep up the small snacks. Let me link something for you to read. BRB
 
Okay. First just read this about how increases are done when following TR.

Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
 
Here’s the link to the full sticky note on this forum regarding dosing methods. You will see that it even discusses snacks. I remember finding all of this kind of overwhelming at first, that’s why I pulled out the excerpt for you. But you can read more as you are able.
 
Suzanne & Darcy said:
Okay. First just read this about how increases are done when following TR.

Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
Click to expand...

Thanks. We will start this in the morning. We are always nervous to change his dose at night, when we can't keep an eye on him. I know 6 units of Lantus is considered very high, when do we get concerned about his numbers and dosing?
 
lbeachstace said:
I know 6 units of Lantus is considered very high, when do we get concerned about his numbers and dosing?
Click to expand...
Have you ever looked at the Darcy's spreadsheet in Suzanne's signature? Cats can go much higher than 6 units, if that's what they need. We have a saying here, ECID, every cat is different. There is also a dose for every cat that will move them into better numbers. We just need to find out what that is for Buddy, and do it safely.
 
Wendy&Neko said:
Have you ever looked at the Darcy's spreadsheet in Suzanne's signature? Cats can go much higher than 6 units, if that's what they need. We have a saying here, ECID, every cat is different. There is also a dose for every cat that will move them into better numbers. We just need to find out what that is for Buddy, and do it safely.
Click to expand...

I can't say thank you enough times for helping us, being so caring and giving us hope that we can help him. I will look at Darcy's SS now :bighug:
 
lbeachstace said:
Thanks. We will start this in the morning. We are always nervous to change his dose at night, when we can't keep an eye on him. I know 6 units of Lantus is considered very high, when do we get concerned about his numbers and dosing?
Click to expand...
Yes! I like to do increases in the morning as well. I suppose people who are night owls may feel differently!
 
lbeachstace said:
Thanks. We will start this in the morning. We are always nervous to change his dose at night, when we can't keep an eye on him. I know 6 units of Lantus is considered very high, when do we get concerned about his numbers and dosing?
Click to expand...
Don’t put the cart before the horse. Let’s just see how he does first and see if we can get him into better numbers first. How about that? You are in a much better place than I was at the beginning… because you are here!
 
Buddy's other parent here ... we increased to 5 units with dinner, but I'm wondering how we know that we haven't overshot his dosage. If we had overshot, would the BG curve be erratic, or is it still possible that we may have overshot?

Thanks for everybody's help and guidance. Stace and I really appreciate it.
 
Yeah for negative ketones!
lbeachmike said:
Buddy's other parent here ... we increased to 5 units with dinner, but I'm wondering how we know that we haven't overshot his dosage. If we had overshot, would the BG curve be erratic, or is it still possible that we may have overshot?
Click to expand...
Hello Mike and other Buddy parent. For many cats, the +2 (or sometimes +3) is a good indicator of how the cycle will go with Lantus. If you see that second test is a lot lower than the preshot, then it's a very active cycle that needs more monitoring because he's going lower. Note, for most cats the +2 is a good test, but for Neko it had to be +3. Another of those ECID things, meaning you have to experiment and see what happens for Buddy. So during the day, get some +2 and some +3 tests and see at what point the numbers start to come down (insulin onset). That'd be a good time for that PM test. If lower, then you know you either need to keep monitoring, or feed higher carb food to keep him safe that night. Over time you will lean what works best.

If you have six cycles with two tests per cycle, that's enough time to see what he's been up to (or rather down to) in those cycles. It would have been good to get that before bed test last night, cause it looked like he's bouncing today and that always gets me asking "what caused that bounce?". But at this point, Buddy could even be bouncing from numbers under 300. Meaning he still needs an increase. If a cat is overdosed, you will see by the data that he will go into low numbers during one of those cycles.. He didn't do that for the six cycles at 4.5 units where you have enough data to see what the cycle was going to look like. Therefore, he's not overdosed.
 
One more thing, could you start a new post tomorrow. Because of the traffic volume on this forum, we request that people start a new post on each day that they post (not all do every day), with a link to the previous post for continuity.
 
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