Thomas pre AMPS

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Jenn ~ Thomas

Jenn ~ Thomas

Member Since 2023
@Sienne and Gabby (GA)
Last night I was waiting for the amount of insulin to give Thomas and was 2 hours late giving it to him. Therefore I need to wait longer this morning to give insulin. I cannot wait until the correct time because I have to leave for work. I was asked to do a pretest as soon as I wake up to make sure I can give him insulin.

Thomas had a reading of 372 at 6am (35 minutes ago). I need to do his AMPS at 7 so I can give insulin at 730.

Should I take away his food from now until I do another glucose test or do I let him eat? I am so confused.
 
My cat is staring at me wanting to eat. I don't want to mess up his numbers so I don't know what to do.

I will be doing his AMPS in 5 minutes so I guess he will eat then. I will need to know it its ok to give insulin as well as how many units to give him in 30 minutes.

I have been taking my vets advice for almost a year, he was on 12 units as of Saturday and feeding dry rx food. I feel like I am doing better for my cat by taking this boards advice but I waiting for answers yesterday on how many units to give him and ended up being 2 hours late, which in turn changes my routine for this morning. My only saving grace is that my son isn't in school this week so I have a bit more time this morning. Now I am sitting here again waiting for answers on what to do. I just want to do what is best for my cat and I am clueless on this whole feeding and insulin thing.
 
His AMPS was 372, the same as the pre test from earlier. I gave him food after doing the test. I will need to give insulin in 15 minutes. How many units?
 
@Snickers and Chrissy I see you were online and have interacted with my previous post. Can you tell me how many units I need to give Thomas? I am already late leaving for work. Sorry to be nagging I just don't want to do the wrong thing
 
Thank you for your reply. I am already late with my day, so unless I can catch up in between appointments or during an appointment I’m going to be running late all day I waited till I cannot wait any longer and went ahead and gave him three units and I left food out for him. Hopefully that is the right thing to do now I’m gonna worry about him all day on top of being late for my client appointments.
 
Hopefully your clients will all understand being animal lovers.
Is there anyone at home that you can talk to during your day, so they can relay to you how Thomas is doing? That may put you more at ease.
Please remember to get the ketostix.
 
My clients are usually very understanding but I hate being late. The traffic around here is stressful enough!! No one at home during the day. What should I look for and do to f I can get a chance to stop by.

Also, I looked up the keto stik and they do not have any at Walmart. They do have keto test kit five rely on. Is that the same thing?
 
RelyOn makes ketone test strips.
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If you get a chance to stop by around noon, I would try to get a test, and of course give him a freeze dried treat or a piece of meat as a reward.
 
Jenn, I’m sorry I’m 3 hours behind so can only answer now.

You are going to hold the same 3 units dose if he’s over 200 at preshot tests for a week. You’d only change the dose or skip if he’s under 200 or if he follows below 90 at any given time, so you don’t need to wait for a response when you get a number above 200. Does that make sense? Did you get a chance to review the dose info on the Vetsulin forum I linked for you on Sunday? I’m copying and pasting below:

Changing the Dose

Hold the dose for at least a week UNLESS
  • your cat won’t eat or you suspect hypoglycemia
  • your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12-hour curve (i.e., testing every 2 hours) OR perform an 18 hour curve (i.e., testing every 3 hours). Note: Random spot checks are essential in order to "fill in the blanks" on your kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.

The general guidelines for making dose changes are:
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
  • HOWEVER, there are some situations which signal that a larger than usual dose reduction is needed. If you are unsure, please post on this forum or in the Health forum and ask for input about your dose.
As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], lengthen the waiting time between dose increases. If you decide to change another factor (e.g. diet or other medications), don't increase the insulin dose until the other change is complete but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change.

Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may race past the right dose for your cat.
 
Jenn…I’m sorry it was a bit of a stuff up for you this morning Re finding the dose from someone. @Ale & Bobo & Minnie (GA)
When you reduce the dose as we did yesterday pm dose down to 2 units, because the BGs dropped so low (47)…you stay with that dose unless the BGs drop under 90 again. I mentioned in post 116 in the previous thread that the dose was 2 units but you needed to find out from someone if it was safe to give that dose (ie was the preshot high enough)
3 units is too much for Thomas as that dose dropped the BGs to 47.
Can you please go back to 2 units and stay with that dose unless Thomas drops under 90 again.
 
Hi! Thank you!
ok I will start giving him 2 units. I dread getting the blood. He is a really good cat and pretty much lets me do anything. I poke him and nothing comes out then I poke him and it feels like it goes completely through to my finger on the other side of his ear. He loves temptations cat treats however I quit giving them to him because the vet said no treats, only the rx food.

This whole diabetic issue started when I tried to change him to wet food a year ago. He was so mad and stressed out but I was determined to change him to wet food. I tried every brand and consistency. Every kind of meat and he has no interest. He went from 25 pounds to 18 pounds and looked so scrawny and unhappy. He also had a UTi so when they did bloodwork his glucose was high.
 
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What size lancet are you using. In the beginning until the ear learns to bleed size 26 and 28 is best.
Also are you warming the ear first with some rice in a sock? And milking the ear towards the top
always Give a treat even if it is a failure
 
Hi! I use 26 gauge lancet. Yes I warm the ear with the rice sock. I guess it will take time to get the pressure right on my end. Am I ok to give him Temptation treats?

No one has the ketostix (Walmart, cvs, Walgreens, Publix) so I ordered them off amazon. hopefully they will be here today.

His numbers were high 404 but I called my boyfriend and he said he has been feeding him when he gets up. (this is Thomas's ritual) he eats at 430ish and right before he leaves at 515. So I get up at 6 and do his AMPS. should we not allow him to eat in the morning?

Am I ok to give him the Temptation treats?
 
Thank you! I will try it. I tried to switch him to a freeze dried raw food diet before the diabetic diagnosis and he wouldn't have anything to do with it. He wouldn't even eat wet food.
 
The issue is what we explained before about the no food 2 hours before the preshot tests. Today he had food less than 2 hours before you do his amps so you’re not getting a true bg. You’re getting a higher bg that is influenced by food. Any way your boyfriend can feed him earlier like as soon as he gets up and leave you a note with the time he fed him? That way you can calculate 2 hours and do the test after the 2 hour mark. The 404 you got today was because he had food in his system.
 
The AMPS 404 could have been a bounce from lower BGs last night, we don't know what happened overnight with the BGs.. .Is there any way you can get a test in during the PM cycle? even a before bed test is helpful. Just getting preshot BGs is not telling us how well the insulin is working...is it dropping the BGs too low? or is it not dropping them enough. The only way to tell is to get those all important tests in during the cycles.
 
yes, he ate before I got home as well so again with the high number. I am thinking that my boyfriend needs to not feed him. Thomas just needs to eat after I do his test. We will have to get on a different schedule. Should he only eat after the doing the test? I thought he needs food out during the day incase his glucose gets too low so he can eat correct? Everyone gets home about 530 6 and I do his insulin, so how do I know if he ate just before I got home.

I wil do a test later as well.

Thankfully (:)) I will be home tomorrow so I can test more to get good numbers.
 
If you buy an automatic timed feeder you can set it to turn at the hours you want it to and at +10 hours (that will be the 2 hours pre shot, you can get it to turn to an empty space. Then when you come home, he has not eaten for 2 hours.
Those red BGs could be bouncing, not from food eaten before the preshot BG is taken. The only way to find out is to keep testing.
Yes he needs to be eating during the cycles...that is important.
So you test first, then feed if the BG is high enough to give the shot, wait 30 minutes, then give the shot.
If you have to give him a little bit so you can test him, that is OK as well.
Keep asking questions
 
Bron and Sheba (GA) said:
If you buy an automatic timed feeder you can set it to turn at the hours you want it to and at +10 hours (that will be the 2 hours pre shot, you can get it to turn to an empty space. Then when you come home, he has not eaten for 2 hours.
Those red BGs could be bouncing, not from food eaten before the preshot BG is taken. The only way to find out is to keep testing.
Yes he needs to be eating during the cycles...that is important.
So you test first, then feed if the BG is high enough to give the shot, wait 30 minutes, then give the shot.
If you have to give him a little bit so you can test him, that is OK as well.
Keep asking questions
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feed if the BG is high enough to give the shot, I feed at that time no matter what the number is correct? if its over 200 then give shot, if under 200 do not give shot.... am I thinking correct?
 
Jenn Slade said:
feed if the BG is high enough to give the shot, I feed at that time no matter what the number is correct? if its over 200 then give shot, if under 200 do not give shot.... am I thinking correct?
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If the preshot is under 200 we suggest you stall, don't feed and test again in 20 minutes to see if the BG is rising. And post and ask for guidance.
If the preshot is still under 200 after that I would skip the dose as you are using vetsulin.
 
Jenn Slade said:
I did find a vet that will prescribe any insulin that I want. They use vetsulin as well but said that it is up to the pet parent as to which kind. I am still looking for a vet that only uses Lantus for cats. it would make me feel like they know what they are talking about.
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If you have found a vet who will prescribe lantus that is good. You don't need to find a vet who only prescribes Lantus though.
We can help you with the dosing of the lantus.
 
Jenn Slade said:
True. Should I do that ASAP or wait until numbers are correct?
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I would organise to get the Lantus insulin and then we can have a look at starting you.

Jenn Slade said:
When do I start introducing fancy feast classic wet food to get rid of the vet rx food Hill's Multi Benefit w/d?
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We don't want to be doing 2 things at once. So we need to decide whether to swap the food or the insulin first.
Can you tell me what you are feeding at the moment? Each meal and snack please?
 
He is eating Hill's Multi Benefit w/d dry food. it is prescribed from the vet. The vet said no treats or other food.
 
Jenn Slade said:
I just tested again and it was 416.
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When was the 416? +?

Jenn Slade said:
He is eating Hill's Multi Benefit w/d dry food. it is prescribed from the vet. The vet said no treats or other food.
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The high carb dry food was probably saving him when he was on 12 Units of insulin!
The dry WD is very high carb and is totally unsuitable for diabetic cats.
Do you think Thomas will eat a low carb canned food diet?
Have you been giving any snacks to Thomas during the cycles up until now?
When you start to change over to a low carb diet, you will need to be able to monitor the cycles fairly closely. Is this going to be doable for you?
 
He gets no treats per the vet. Maybe I could give a tiny bit of the fancy feast as a treat? Plus then I could see if he will eat it.
 
Bron and Sheba (GA) said:
I would organise to get the Lantus insulin and then we can have a look at starting you.
Click to expand...
Hi Bron I can give @Jenn Slade some information about generic lantus

Rather than me type the whole thing out just tap on this blue link below
that I gave to another member about it and also some med and high carb foods for you hypo kit. Look at the post number 4 and number 5, they are to the right of each post
Tap on this link
https://felinediabetes.com/FDMB/threads/new-member-11-8-and-i-am-tired.283363/#post-3121360

Also some info on auto feeders
Here is an auto feeder that hold 5 slots and comes with 2 ice packs for wet food
https://www.amazon.com/Cat-Mate-C500-Digital-Automatic/dp/B01AUYLVU8/ref=sr_1_6?gclid=EAIaIQobChMIuM_y2p79_AIVDvrICh1_xAy6EAAYASAAEgJBDfD_BwE&hvadid=178540036693&hvdev=t&hvlocphy=9003521&hvnetw=g&hvqmt=e&hvrand=6990619631848479728&hvtargid=kwd-12652445711&hydadcr=10635_9894649&keywords=petsafe 5-meal automatic pet feeder&qid=1675560889&sr=8-6

Extra ice packs so you can keep them in the freezer ready to go
https://www.amazon.com/Cat-Mate-Rep...5c-bd5c-e23f6094563c&pd_rd_i=B091HTXNHR&psc=1

This one has 3 slots with one ice pack
https://www.amazon.com/Cat-Mate-Automatic-Feeder-Digital/dp/B01MXDFB28

Extra ice pack
https://www.amazon.com/Mate-Replace...cb-974a-deec2fb8a80c&pd_rd_i=B07KFP7PRG&psc=1

You can even order the stainless steel inserts for the 5 slot if you don't like your kitty eating out of plastic, from what I have heard plastic could cause acne on some cats
https://www.amazon.com/Cat-Mate-Sta...36-830d-6cc20f385409&pd_rd_i=B0B3MS1MWR&psc=1

Jenn is there anyway you can get another test in before you leave for work and on weekends do more.Also during the night cycle I would get another test in maybe @+2 and one before you go to bed
 
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Jenn Slade said:
He gets no treats per the vet. Maybe I could give a tiny bit of the fancy feast as a treat? Plus then I could see if he will eat it.
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If you are not giving any snacks at all, I would try giving him a small snack at +3 and +5 each cycle (just a teaspoon of the fancy feast) to see how he goes.
 
it is Thomas AMPS time and it is 446. He did not eat since midnight which was just over 6 hours ago. totally confused.
 
I would give him the 2 units and can you get any tests in during the cycles? We need to be able to see what is happening during the cycles, so we can see what is the best dose to give.
Did you get the bottle of Ketostix so you could test the urine for ketones? It’s important you do this. Is he eating ok for you?
 
Bron and Sheba (GA) said:
I would give him the 2 units and can you get any tests in during the cycles? We need to be able to see what is happening during the cycles, so we can see what is the best dose to give.
Did you get the bottle of Ketostix so you could test the urine for ketones? It’s important you do this. Is he eating ok for you?
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You are awake! Yay!! Yes I will be home pretty much all day today. He is eating now and has an appetite. I just did a ketone test and it is negative.
 
Jenn Slade said:
You are awake! Yay!! Yes I will be home pretty much all day today. He is eating now and has an appetite. I just did a ketone test and it is negative.
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I am so glad the ketone test was negative. Can you do a ketone test each day please?
Also make sure Thomas eats well. Snacks as well.
What we need to see is how low this 2 unit dose is taking Thomas. So if you could get a test at +2 + 4 and +6 that will give us valuable information. If at any time the BG is low, always feed and test again to see the numbers are going back up.
 
Arrrgh! I just did his test and it was 465, then I realized I didn't give his insulin 30 minutes after his AMPS and eating. So I guess we have a pre pre test of 446 at 630 and the AMPS of 465 at 830 so now I will do the 2 hours curve. Too many high priority issues going on at the same time for me. I already have to write everything down, now I guess I need to set alarms for everything!
 
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