Kelley and Merlin - Lower AMPS Numbers

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Kelley and Merlin

Kelley and Merlin

Member Since 2020
Good morning,

Here is the new thread. Here is a link to the old one.

https://felinediabetes.com/FDMB/threads/11-28-24-new-member-kinda.296102/#post-3225055

This morning Merlin's AMPS numbers are the lowest yet - 190 (Alpha Trak) and 184 (Reli On).

I'm really nervous about giving him 2 units since the vet said to hold the prescribed 1 unit if he's under 280. We see the vet tomorrow. I have a busy workday and will be gone for a while to pick up my son from the airport. I'm not sure how to handle this. If he goes low, what do I do? I have dark Karo syrup and honey.
 
Can you re-test in 20 - 30 minutes? If numbers are rising, it's likely fine to shoot. Alternatively, you can shoot a reduced dose.
 
I wasn't able to retest until 9:40am. His numbers then were 460 AT, 476 RO. I gave 2 units at 9:45am. Yes, I will set up the signature today.
 
Just a thought...
I'm not sure what time zone you're in. Your first post was at around 9:00 my time. I posted at around 9:40. When you're giving times, the actual time (the time on the clock) is meaningless since our members are spread out all over the world. If you use the shot time designations, we have a common language. Someone like Bron is in Australia so I have no clue what time it is there when it's 9:00 here!! (I'm on EST.)

Also, I found it helpful to retest if I got a number that seemed out of sync. It's always possible it was a bad test or a bad strip.

From your spreadsheet, it looks like you were about 1.75 hours off of your usual shot time. This means your PM shot is due 12 hours from when you shot this morning. You have 3 options if you need to get back on schedule.
  • Shoot 30 min early once a day until you are back on schedule
  • Shoot 15 min early twice a day until you are back on schedule
  • Skip one shot and the next shot would be at your preferred shot time.
 
Please record those lovely 190/184 numbers on your spreadsheet. You can put them in the +11 cell from last night, just label it as 190@+12 so we know when it happened.
 
Sienne and Gabby (GA) said:
Just a thought...
I'm not sure what time zone you're in. Your first post was at around 9:00 my time. I posted at around 9:40. When you're giving times, the actual time (the time on the clock) is meaningless since our members are spread out all over the world. If you use the shot time designations, we have a common language. Someone like Bron is in Australia so I have no clue what time it is there when it's 9:00 here!! (I'm on EST.)

Also, I found it helpful to retest if I got a number that seemed out of sync. It's always possible it was a bad test or a bad strip.

From your spreadsheet, it looks like you were about 1.75 hours off of your usual shot time. This means your PM shot is due 12 hours from when you shot this morning. You have 3 options if you need to get back on schedule.
  • Shoot 30 min early once a day until you are back on schedule
  • Shoot 15 min early twice a day until you are back on schedule
  • Skip one shot and the next shot would be at your preferred shot time.
Click to expand...
I'm in the Central time zone. It is now in my signature. Thank you for this info! I will shoot 30 minutes early until back on schedule.
 
Ahh, I set up my signature and guess I did something wrong with the link. I'll reset it.

Merlin's BG at 9:20pm was 479 (Alpha Trak) and 414 (Reli On). I gave 2 units at 9:30pm. Tomorrow I will start going back 30 minutes until we get back on an 8a/8p schedule.
 
Good morning, Merlin's numbers at 8:45am were 270 (Alpha Trak) and 262 (Reli On). I'm holding insulin this morning bc the vet said to hold under 280 and we see her at 11:30 this morning. I'm sure his numbers will go up before we get to the appt, but maybe that will help her determine whether we really should be holding at this level. This is not helping us get back on schedule, but we will get there eventually. I will take his insulin to the vet so we can give it there. I will get a blood ketone reading at the vet too. Merlin continues to pee around my collection devices in the litter box.

I saw a thread somewhere on here about homemade food and the necessary supplements to add to it. I think I would like to try that for Merlin to help save money. Could someone provide a link to that thread?
 
If faced with a situation like this again, wait 15 minutes. He's probably be above 280 and you could shoot. Here we tell new people to shoot above 200.

For home made food, there are a couple ways to go. One is on the catinfo website: https://catinfo.org/making-cat-food/
The other options are to buy a meal completer like FoodFurLife's EZComplete or Alnutrin where you mostly just add meat and water.
 
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Thank you, Wendy! I've updated Merlin's spreadsheet with the info from the vet visit this morning.

For ease, here are the SS notes from the visit:

11:45am AMPS was 642 AT at vet, vet gave 2 units at 12:00pm, blood ketones at 3.2 - vet's instructions are to give PM 2 units at 10:00pm if over 150 and he ate, followed by 2 units at 8:00am tomorrow if over 150 and he ate - general instructions for next week are to give 2 units if over 150 and 1 unit if between 80-150, hold if between 50-80 and retest at 2 hours, follow up visit scheduled for 12:30 on 12/10/24, purchase Laxatone for helping with BMs, continue baby food (3 meals a day + snacks) until we stabilize then we will try some glycobalance (but I am considering homemade food for cost reasons), I'm going to test at injection time and once mid-cycle for each injection unless I'm unavailable for some reason at mid-cycle.
 
You'll need to make some changes to the spreadsheet to show the delay this morning. Since his shot time was 9:30 last night, his shot this morning was at +14.5 (or 2.5 hours late). Put the 270 from this morning in the +11 cell from last night, and write it as 270@+12. Then put the 642 in the AMPS cell today as 642@+14.5. And put the 2 units as normal in the Units cell.

Commenting on the vet visit. Where to start? First "Glycobalance" is great if you want to keep him in high numbers. It is not low carb food suitable for diabetics. We've seen cats switch from Glycobalance to low carb food and go into remission.

I'm glad the vet agrees with 2.0 units as the dose. And I'm happy to see the vet suggest shooting full dose above 150, though if you see an AMPS almost that low when you are about to head out the door for the day, post here for help. The rest, well - sigh! Shooting early with Lantus can act like a dose increase. We recommend not shooting more than 1/2 hourly once per day, or 15 minutes early per cycle. In some cases, and with help from an experienced member, you can shoot once earlier than 1/2 hour, if in very high numbers. Definitely much higher than 150.:eek:

A minor modification to the instructions above if you see a preshot in the 50-80 range. First, anything below 68 on the AT (or 50 on the Relion) means the dose is too high and needs to go down to 1.75 units. Second, I wouldn't wait two hours to test again. If below 68, he'll need some food to bring him up right away, we don't want him lingering down there. I'd also test sooner, not waiting the full 2 hours. Some cats cat really zoom up fast. You want to get insulin into him as soon as you safely can. And you want to make sure, if you gave food cause he was below 68, that it got him higher. Again, post for help if this happens.
 
Wendy&Neko said:
You'll need to make some changes to the spreadsheet to show the delay this morning. Since his shot time was 9:30 last night, his shot this morning was at +14.5 (or 2.5 hours late). Put the 270 from this morning in the +11 cell from last night, and write it as 270@+12. Then put the 642 in the AMPS cell today as 642@+14.5. And put the 2 units as normal in the Units cell.
Click to expand...

I made the SS updates. :)

Wendy&Neko said:
Commenting on the vet visit. Where to start? First "Glycobalance" is great if you want to keep him in high numbers. It is not low carb food suitable for diabetics. We've seen cats switch from Glycobalance to low carb food and go into remission.
Click to expand...

I'm concerned about dry food in general, and also I would prefer to find something more affordable. Thank you for the info you shared above on homemade food. I will do some reading tonight.

Wendy&Neko said:
I'm glad the vet agrees with 2.0 units as the dose. And I'm happy to see the vet suggest shooting full dose above 150, though if you see an AMPS almost that low when you are about to head out the door for the day, post here for help. The rest, well - sigh! Shooting early with Lantus can act like a dose increase. We recommend not shooting more than 1/2 hourly once per day, or 15 minutes early per cycle. In some cases, and with help from an experienced member, you can shoot once earlier than 1/2 hour, if in very high numbers. Definitely much higher than 150.:eek:
Click to expand...

I'm very ok with taking the schedule adjustment slower. I work from home so I'm usually here to be able to give his injections at any time of day.

Wendy&Neko said:
A minor modification to the instructions above if you see a preshot in the 50-80 range. First, anything below 68 on the AT (or 50 on the Relion) means the dose is too high and needs to go down to 1.75 units. Second, I wouldn't wait two hours to test again. If below 68, he'll need some food to bring him up right away, we don't want him lingering down there. I'd also test sooner, not waiting the full 2 hours. Some cats cat really zoom up fast. You want to get insulin into him as soon as you safely can. And you want to make sure, if you gave food cause he was below 68, that it got him higher. Again, post for help if this happens.
Click to expand...

This is great information to have. Thank you.
 
Merlin's PMPS was 195 (Alpha Trak) and 173 (Reli On). I gave 2 units at 11:30pm and will plan to give 2 units in the morning at 11:30, then tomorrow night move up to 11:00pm.
 
Can you get another test in a couple hours? We want to make sure he's not planning to dive tonight.

A lot of the colours seem to have gone missing from the BG data in the spreadsheet. After so many years looking at spreadsheets, I see patterns in colour.
 
Hi Wendy, sorry, I didn't see your response last night. Both Merlin and I fell asleep. I just tested him at +7 and his numbers are 77 (Alpha Trak) and 80 (Reli On). I just fed him. How should I proceed this morning? He is due for insulin at 11:30am. Also, check the SS again and see if the colors are there.
 
I'm glad you fed him. One of the things you should do soon is get some proper cat food he can eat. Something without fish this time. What type of protein (meat) is in the baby food you are feeding?

Can you test again in an hour or so to make sure he's not dropping any lower? With blood ketones of 3.2 yesterday I wouldn't want to lower his dose, but I also don't want him going below 68 on that AT.
 
The baby food is either beef, turkey, or chicken. I have all three, mostly beef and turkey though. I have so much cat food. :facepalm: I have a little of the dry Hill's sensitive stomach that started this chaos, a cheaper replacement (dry Purina One Plus sensitive skin and stomach) that I was going to transition him too before this happened, I've got his old FF gravy lovers grilled collection (what he ate prior to the sensitive stomach food), I've got both wet Glycobalance and wet prescription Purina diabetic food (can't remember the name the case is still in the car), and a few cans of the more recent FF low carb I bought the other day then one made him vomit.

I could open a cat food store. And he's eating baby food... :banghead:

Yes, I am actually about to test his BG now and then will again just prior to the 11:30 dosing time.
 
Ok, his BG at 10:10am was 452 (Alpha Trak) and 450 (Reli On). Plus he got about a Tbsp of baby food while I took it so he would sit still. With these numbers I should plan to give 2 units unless something in the numbers drastically changes in the next hour, correct?
 
Looks like he's bouncing from those greens overnight. 2 units is probably good.

Back to cat food, I was thinking something canned (or raw or freeze dried) not dry food. And I'm wary of Fancy Feast cause it sounds like a fish allergy and so many of their products have fish somewhere in the ingredients. There are plenty of low carb products out there that are called limited ingredient, or only have the meats you list that seem to be OK for him. Turkey and chicken are a common combination, or with duck. If he'll eat the Purina DM canned (not the Selects), you can try that. It's not the greatest ingredients and many cats grow tired of it but some like it.

The FF grilled tend to be medium carb. Check through the ingredients list and see if you can find some that don't list fish. You can save those for when his numbers need a little boost.

You should be able to return the Glycobalance food to the vet and get your money back - and room in the car.
 
At 10:45pm, Merlin's BG was 405 (Alpha Trak) and 387 (Reli On). He had 1 jar of baby food. I gave 2 units of insulin at 11:00pm.
 
Merlin's BG at 10:45am was 391 (Alpha Trak) and 348 (Reli On). He had 1 jar of baby food. I gave 2 units at 10:50am (10 min early) bc I had to log into an 11:00 work mtg.
 
Merlin's AM +5.75 was 546 on the AT today. I don't understand why it varies so much. Yesterday his AM +6.75 was 112 AT and the day before his AM +5.75 was 346.
 
Merlin's PMPS was 692 (Alpha Trak) and Hi (Reli On). I gave him 2 units after he ate. Does anyone have any idea why he's going so high after being at 236 this morning? This morning was his lowest AMPS so far and tonight was his highest PMPS. Is this a bounce?
 
Kelley and Merlin said:
Merlin's PMPS was 692 (Alpha Trak) and Hi (Reli On). I gave him 2 units after he ate. Does anyone have any idea why he's going so high after being at 236 this morning? This morning was his lowest AMPS so far and tonight was his highest PMPS. Is this a bounce?
Click to expand...
Kelley he is bouncing from the lovely low numbers that are starting to creep into the SS. Bounces are frustrating but a lot of diabetic cats bounce, especially newly diagnosed ones. My Sheba was a champion bouncer.
We know that the 2 units can take Merlin down to 77 so it is a good dose for now. And then 112 yesterday.
Just keep feeding him lots of food and adding water to the food and testing during the cycles.
Have you managed to get any more ketone tests done?
 
He had a big snack when I took the 321 reading. But then he and I fell asleep hard (him in my lap). He looks really good right now so I'm going to wait to test him before his next scheduled dose (about an hour).
 
Mer's BG this morning was 581 (Alpha Trak) and 587 (Reli On). He ate well and got 2 units at 10:15am CT. How many cycles does a bounce usually last?
 
Merlin's BG @ +9.5 was 337 AT. I just let him lick the inside of the baby food jar lid while I took it. I think I read somewhere not to let them eat too close to insulin time so their PS number isn't skewed. Is that correct, or does it not matter since I've taken a few readings and know where his numbers have been this afternoon?
 
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