10/16 Carol & Rico AMPS 403, +24 >600 NEW UPDATE - EMERGENCY!

Hi Carol and Rico,
Is this your first post?
When choosing which dosing method to follow, it will depend if you are feeding any dry food at all…if you are you can only do the SLGS method. Also with TR you will need to be available to test at least 4 times a day.
It looks as if Rico is bouncing from the blue BGs and this is causing him to bounce up into the red and black numbers. This is pretty normal in newly diagnosed cats. Here is an explanation about bouncing.
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
I would hold the dose for 7 days (stay with the 0.5 units) and in the meantime think about which dosing method would suit you.
 
If I only feed him on wet food, as I currently do, and choose the TR until he is (hopefully) regulated, could I then go back to a mix of both dry and wet food in a 1:4 ratio?? Wet food seems insufficient for him. He eats every two hours!!!
 
Hi and welcome to LLB. Yanna asked me to look for you. If you ever decide to go back to giving dry food you would need to switch back to SLGS. I’m hoping you find wet foods he loves. Freeze dried all protein treats might help take the place of dry. In the US they make sine that look just like dry.
 
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tiffmaxee said:
Hi and welcome to LLB. Yanna asked me to look for you. If you eve4 decide to go back to giving dry food you would need to switch back to SLGS. I’m hoping you find wet foods he loves. Freeze dried all protein treats might help take the place of dry. In the US they make sine that look just like dry.
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Thanks ❤Elise!
 
Bron and Sheba (GA) said:
Hi Carol and Rico,
Is this your first post?
When choosing which dosing method to follow, it will depend if you are feeding any dry food at all…if you are you can only do the SLGS method. Also with TR you will need to be available to test at least 4 times a day.
It looks as if Rico is bouncing from the blue BGs and this is causing him to bounce up into the red and black numbers. This is pretty normal in newly diagnosed cats. Here is an explanation about bouncing.
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
I would hold the dose for 7 days (stay with the 0.5 units) and in the meantime think about which dosing method would suit you.
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UNFORTUNATELY, CHRIS AND I JUST FOUND OUT THAT THE VET HAD MIXED UP MLS AND UNITS SO RICO HAD ACTUALLY STARTED (AND CARRIED ON) WITH 5U PER SHOT! TONIGHT, WE LOWERED IT TO 2U AND WAIT TO SEE WHAT WILL HAPPEN...[/QUOTE]
 
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Bron and Sheba (GA) said:
I would hold the dose for 7 days (stay with the 0.5 units) and in the meantime think about which dosing method would suit you.
Click to expand...
tiffmaxee said:
If you eve4 decide to go back to giving dry food you would need to switch back to SLGS. I’m hoping you find wet he loves. Freeze dried all protein treats might help take the place of dry. In the US they make sine that look just like dry.
Click to expand...

Carol is also in the FD group on Facebook and she asked me to look at her spreadsheet and give my opinion and the first thing I asked her was to take a picture of the syringes she was using. When I see numbers drop that much and then bounce up so high, my first thought is "are we sure we're shooting what we think we are?" All this time, she's been giving 5.0 units (which is where her vet told her .5 was).
The plunger is where she's been pulling to and I put a line at where 0.5 actually is.
393059687_1364983397733765_3699009678564559361_n.png


She is starting over at 2U for at least the next 3 days. (and she has better syringes on the way)
 
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That he is a huge starting dose. I’m glad he hasn’t had a symptomatic hypo. Fortunately it takes 5-7 days for the depot to build.

Hi Chris. Do you know what dose she was giving before the switch?
 
I think going back 1.0 would not be enough. Do 2 and if it turns out it’s not enough we can go up following whichever method you use and fast track if needed. I’m not knowledgeable about converting from caninsulin to Lantus but I think this is a safe starting point. @Bron and Sheba (GA)
 
How did you arrive at the 5 units of Caninsulin? Start at 1 unit and increase? I'm just wondering if 5 units was a safe dose of Caninsulin. If it was, then 5 units would be the starting dose of Lantus. Note, my Neko started out at 1 unit of Caninsulin, and increased up to 5 units, at which point I switched to Lantus. Unfortunately, we started at 1 unit of Lantus per the vet and it took me three months of slow increases to get back to 5 units of Lantus, which turned out still not to be enough insulin. Typically when someone switches from one other non depot insulins to Lantus, we take the existing dose into consideration and how kitty is doing on it. Did you have any blood sugar data from 5 units on Caninsulin?

Reading the spreadsheet, it sounds like he really needs a dental and is on antibiotics for now. If your vet can refer you to a dental vet specialist, they may be willing to do a dental on an unregulated cat. Actually, my regular vet was comfortable doing that too, but not all general practice vets are. Getting a dental can make a huge difference. In fact, cats with bad teeth often cannot get regulated, hence the difficulty in waiting until the cat is regulated before getting the dental done.
 
Wendy&Neko said:
How did you arrive at the 5 units of Caninsulin? Start at 1 unit and increase? I'm just wondering if 5 units was a safe dose of Caninsulin. If it was, then 5 units would be the starting dose of Lantus. Note, my Neko started out at 1 unit of Caninsulin, and increased up to 5 units, at which point I switched to Lantus. Unfortunately, we started at 1 unit of Lantus per the vet and it took me three months of slow increases to get back to 5 units of Lantus, which turned out still not to be enough insulin. Typically when someone switches from one other non depot insulins to Lantus, we take the existing dose into consideration and how kitty is doing on it. Did you have any blood sugar data from 5 units on Caninsulin?

Reading the spreadsheet, it sounds like he really needs a dental and is on antibiotics for now. If your vet can refer you to a dental vet specialist, they may be willing to do a dental on an unregulated cat. Actually, my regular vet was comfortable doing that too, but not all general practice vets are. Getting a dental can make a huge difference. In fact, cats with bad teeth often cannot get regulated, hence the difficulty in waiting until the cat is regulated before getting the dental done.
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He started at 5U of Caninsulin and during that month he lost a lot of weight and his BG went from 468 to >700. I was not hometesting then. The vet was against Lantus, so I made the switch myself, following the posts of the FD group and kept the dose as it was for Caninsulin. He started gaining weight again and seems happier except for those bounces in the last two days... That's why we reduced his dose from 5U to 2U. There is no dental vet specialist in Greece - at least not where I live - and general vets, mine included, all have the same method: Convenia shots every 15-20 days until the BG is "somehow" regulated. It's a vicious circle though, isn't it?
 
Carol & Rico said:
There is no dental vet specialist in Greece - at least not where I live
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Sometimes there are general practice vets who specialize in dentals. But it would take some investigation to find one. If there is a vet school anywhere nearby, that is also a possibility for finding a dental vet.
 
@Wendy&Neko @Yanna @Chris & China (GA) @tiffmaxee @Bron and Sheba (GA) @Bandit's Mom

Rico has >600 for the past 3 hours!!! I think I should go back to 5U, as he was used to!!! I don't know what to do - give him 1 more U now or wait until 9:30 am (that is in 1 1/2 hours) for the normal shot??? Will the next shot be 2U again or should I go back to 5 (or 2.5 at least)??? Kind of emergency here!
 
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@Carol & Rico

Considering how high he's been on the 2U dose when he was on 5U of Caninsulin before, I think you could go ahead and go back to the 5U (as long as you can test)

If he was on that high of a dose on Caninsulin, it's totally reasonable to start at 5U, or if you're concerned, maybe try 4.0 units of Lantus instead.

If @Wendy&Neko are still up, maybe she'll chime in. She's been here for what seems like forever and wouldn't steer you wrong.
Others that are usually up this time of night (or day depending on where you are) would be @Bron and Sheba (GA) and @Bandit's Mom

Oh and @tiffmaxee too
 
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I know you said no home testing was done while on Caninsulin, but did he ever get any blood testing or curves done at the vet? Just wondering if we have any clues how that dose was working for him.
Carol & Rico said:
He started gaining weight again and seems happier except for those bounces in the last two days... That's why we reduced his dose from 5U to 2U.
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Bounces aren't a reason to reduce the dose. Bounces are the result of the insulin working and taking his blood sugar into lower numbers than he's used to. The other reason a bounce can happen is if the blood sugar drops down quickly. Today he went down to 103 at +6, and we don't know how much lower he went before +10 went he was 125. It's possible he stayed around 103, but regardless, 103 is lower than he's used to going. He also did some fast drops. Hence the bounce, which as Bron posted in post #3, is a temporary condition that results in higher numbers. What you saw in the PM cycle of the 16th could have been a bounce from what he did in the AM cycle. We don't react to a bounce, other than to wait for the bounce's high numbers to clear, and test for ketones.
 
Also, numbers over 600 are not an emergency. They are unfortunate, but hopefully temporary and the result of the bounce. The first year, Neko had lots of times her meter read "Hi", meaning the blood sugar was too high to measure.
 
Wendy&Neko said:
I know you said no home testing was done while on Caninsulin, but did he ever get any blood testing or curves done at the vet? Just wondering if we have any clues how that dose was working for him.

Bounces aren't a reason to reduce the dose. Bounces are the result of the insulin working and taking his blood sugar into lower numbers than he's used to. The other reason a bounce can happen is if the blood sugar drops down quickly. Today he went down to 103 at +6, and we don't know how much lower he went before +10 went he was 125. It's possible he stayed around 103, but regardless, 103 is lower than he's used to going. He also did some fast drops. Hence the bounce, which as Bron posted in post #3, is a temporary condition that results in higher numbers. What you saw in the PM cycle of the 16th could have been a bounce from what he did in the AM cycle. We don't react to a bounce, other than to wait for the bounce's high numbers to clear, and test for ketones.
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I have added his Lab results in his SS. New Test is to take place this Friday.
 
Wendy&Neko said:
Also, numbers over 600 are not an emergency. They are unfortunate, but hopefully temporary and the result of the bounce. The first year, Neko had lots of times her meter read "Hi", meaning the blood sugar was too high to measure.
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When I write 600, the indication was actually HI.
 
Carol & Rico said:
I have added his Lab results in his SS. New Test is to take place this Friday.
Click to expand...

I don't know what kind of relationship you have with your vet, but if Rico has been on Convenia and his WBC is still high, then I'd suggest trying a different antibiotic (AB). Different AB's work in different ways and on different types of bacteria.

Convenia was originally developed for skin infections which are caused mostly by aerobic bacteria which means they require oxygen to survive. Dental infections are mostly caused by anaerobic bacteria that do not require oxygen to survive and some can even die from exposure to oxygen.

Convenia has been used a LOT since it came out because it's convenient (thus the name). It's used a lot in cats for all kinds of infections because vets know that most cat caretakers would rather not try to give their cat pills every day for 7-10 days.

Clindamycin has been an effective AB for dental infections but there are several more. Hopefully some others will chime in with other options for you to consider along with your vet.
 
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