? Need some advice, thoughts as to whats going on

Sisu

Sisu

Member
Hello hope you are well.

Mumu has unfortunately become diabetic again after 2ish years of remission but I have hope he has another chance for remission and am working hard and caught the creeping levels early.

I have a dilemma in which I don't know if I should up his AM dose or lower it, I won't have time to create a new chart but will give you enough information below about his food, BG values (as they are very similar day to day) and insulin dosage (Lantus).

I am currently feeding him 3.5 oz tiki cat chicken in the AM and 3 oz tiki cat chicken in the PM as that seems to be the sweet spot for what he will eat and be satisfied. His weight has remained 11~ lbs for quite awhile now 1+ year.

I have worked him up to 1.25 U AMPS/PMPS and his BG values are as follows:

Day 1 : 8:00am AMPS 250.2 Shot 1.25U, 10:00am +2 268.2, 8:00PM PMPS 356.4 Shot 1.25U, 11:29PM 136.8

Day 2 : 8:00am AMPS 156.6 Shot 1.25U, 1:00PM 91.8, 8:00PM PMPS 149.4 Shot 1.25U, 12:17am 138.6

Day 3 : 8:00am AMPS 207 Shot 1.25U, 11:45am 273.6, 8:00pm PMPS 324 Shot 1.25U, 12:05am 91.8

I can sort of see a pattern in these three days where Day 2 he seems normal with the insulin dose during the day but then Day 1 and Day 3 he doesn't seem to be responding to the insulin during the day but is during the night, today is the same he was 160.2 amps I shot 1.25U then at 2:37pm he was at 304.2 so I know he will be around 342 come 8:00 pm and i will shoot 1.25U in which he will respond and drop to a healthy BG.

I am just not sure what I should do for the AMPS, am I giving him too much insulin and just not catching the bounce or am I giving him too little? Because he is responding well to the PM dose, any insight would be appreciated, thank you.
 
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I'm afraid we can't really give you dosing suggestions without seeing an up to date spreadsheet. Do you need some help doing this?

If he's just starting insulin again, it can take 5-7 days for the depot to rebuild and give you a good idea how he's doing on this dose. Plus if he's been in higher numbers for a while, there's a good chance he's bouncing, which is causing higher numbers.

With our dosing methods, we find it best to give the same dose AM and PM. If you are following SLGS again for dosing, you reduce the point when you see him go below 90.
 
Have you been testing at all since you stopped insulin?
Are you going to follow SLGS or TR

When did you restart insulin?
 
@tiffmaxee
Yes I had been monitoring him throughout the whole remission period, and caught the diabetes coming back, started insulin about a month ago. I will update my SS.

I started him with SLGS, and have worked my way up to 1.25U both at AM and PM.
 
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@Wendy&Neko

Just finished, I am worried about what those higher numbers mean now that I have finally got to 1.25U.

I have fluctuated some PM doses as he tends to go lower at night and I was worried.

Any advice is appreciated, thank you.
 
With SLGS you reduce when the BG drops under 90 but you did not reduce on 6/22. With SLGS you hold doses for 7 days.

How are her teeth? Has she seen the vet to see if a dental is needed? That’s often why cats come out of remission.
 
tiffmaxee said:
With SLGS you reduce when the BG drops under 90 but you did not reduce on 6/22. With SLGS you hold doses for 7 days.

How are her teeth? Has she seen the vet to see if a dental is needed? That’s often why cats come out of remission.
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I have not followed the protocol exactly I was doing what I thought was best and am now seeking advice.

As for his teeth he does have some build up on the back teeth but have been nervous to bring him in as he is extremely intolerant and can become very aggressive at the vets. When the vets discovered he had diabetes they had to put him under to check all his vitals as he would not work with them and am nervous about bringing him in again for something bad to happen. I have been using Proden Plaque off and I know that is not enough but will probably phone the vet soon then and see what the options are.
 
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One of the main reasons cats come out of remission is because they need a dental. I’d get his mouth checked.
 
Maybe the vet can give you some gabapentin to give before the appointment, to calm him down. If you want to give something more natural, I give Rescue Remedy for Pets drops before vet visits. And spray the carrier with Feliway.
 
Going below 68 on a pet meter means the dose is too much insulin. You should have reduced the dose instead of increasing it.
 
Wendy&Neko said:
Going below 68 on a pet meter means the dose is too much insulin. You should have reduced the dose instead of increasing it.
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Yes but is it actually a good decision to do that for both doses going forward or just the PM dose as he is higher during the day and tends to drop lower at night. For me it is not as easy as seeing a lower number and referring to a SLGS method only to see his BG levels start to rise and second guess myself if i should've left it.

That is more the question I was asking if I should raise his AM dose and lower his PM dose.

@tiffmaxee

I checked his mouth/teeth really good and it looks fairly clean and in good condition, nonetheless I phoned the vet and she knows Mumu so I will talk with her this week she said, thank you for the information about the dental correlation to relapse that had not crossed my mind.
 
With our dosing methods, we find it best to shoot the same dose AM and PM. Otherwise the depot gets messed up and you can get wonky numbers.

Sisu said:
I checked his mouth really good and it looks fairly clean and in good condition
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Neko's dental vet examined her mouth visually and found no problems. But when he did x-rays, he found something under the gum that needed to come out. Sometimes you'll see some red gums indicating a problem lower down, but sometimes not.
 
Wendy&Neko said:
With our dosing methods, we find it best to shoot the same dose AM and PM. Otherwise the depot gets messed up and you can get wonky numbers.


Neko's dental vet examined her mouth visually and found no problems. But when he did x-rays, he found something under the gum that needed to come out. Sometimes you'll see some red gums indicating a problem lower down, but sometimes not.
Click to expand...

Thank you for the information and advice, If I see another low number I will reduce then and see what happens, maybe since both of my doses have been varied sometimes I am getting those higher numbers or maybe there is something in his teeth, will get that sorted out. Take care.
 
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