?Dosing Suggestions Low AMPS

thaurermellon

thaurermellon

Member Since 2025
I just started Paco on a new dose. This last week has been awful for numbers and he is going to urgent care tomorrow due to high ketones.

my question: I increased Paco’s dose by 0.25U this am. He has gone from pmps of over 600 to 300s and hasn’t hit his nadir yet at +5. Is this too much of a drop? What should I do if his ps number isn’t ridiculously high? I’m mostly worried for when I’m at work during the day.

*correction, I meant yesterday am (4/13)
 
Last edited:
Sorry Paco is having such a difficult time. It's tough I know seeing so much black.

How is he this morning? Did you say he was going to vet today for ketones?

I have limited experience and expertise to offer I'm sorry but I know how stressful it is when you don't know what to do for the best.
 
His ketones are actually down to 1.2 and he has a amps of 272. So now I'm really unsure of how to proceed. He dropped a bit last night on the 1.75 dose so I don't think it's safe to give that dose. Unfortunately his normal time is going to come in about 30 minutes so I'm not sure if anyone will be able to advise on his shot dose
 
It would have been safe to give him the full dose, I believe, look how his BG was rising already within 15 minutes. You did the right thing to retest him, although I would have waited 30 minutes (but maybe your schedule would not allow for that.)
 
The lowest he has ever been has been in the 200s. If we are going to get rid of ketones then we must get his numbers down into a least the 100s. So anyway, he’s never dropped low on this dose and I don’t know why today would be any different.
 
Suzanne & Darcy said:
It would have been safe to give him the full dose, I believe, look how his BG was rising already within 15 minutes. You did the right thing to retest him, although I would have waited 30 minutes (but maybe your schedule would not allow for that.)
Click to expand...

Normally I can't really delay the am dose because I have to leave right away for work. What would you say is too low for a amps dose to give him his full dose of 1.75U? I just worry because he just started this dose, and I work 30 minutes away. I try to check his numbers while I'm gone, but I'd be worried about him during the day.
 
You will be able to monitor his BG today with the Libre while you are at work, so that is good. I do understand how seeing a yellow preshot at first is new territory! It’s a good sign though.
 
I'm also guessing he has dropped a little lower during the day, but the Libre seems to read a bit higher than when I do a blood glucose check. He isn't a huge fan of that, so I try to limit it to a few times a day.
 
thaurermellon said:
Normally I can't really delay the am dose because I have to leave right away for work. What would you say is too low for a amps dose to give him his full dose of 1.75U? I just worry because he just started this dose, and I work 30 minutes away. I try to check his numbers while I'm gone, but I'd be worried about him during the day.
Click to expand...
It’s okay. We will learn from today’s numbers and will have a better idea at the end of today, i.e. what to do the next time.
 
I called and they still want him to go in, so he will be going in. I just am not as concerned about him going into ketoacidosis since his ketones did at least drop.
 
It actually looks like he needs that dose increase.
I hope you have a good day, Jessica. It really is scary when you can’t be right there with them. I don’t see anything alarming on hospice spreadsheet in terms of drops. I think you were worried about last night? It looks fine. Thank goodness he got out of black. He had a late nadir probably due to breaking a bounce. A yellow preshot is a good sign of progress.
 
thaurermellon said:
I called and they still want him to go in, so he will be going in. I just am not as concerned about him going into ketoacidosis since his ketones did at least drop.
Click to expand...
Ketones fluctuate a lot — it’s all the black BG. One higher reading does not mean DKA. As long as he is eating well, not lethargic, not vomiting, seems normal then it’s just high ketones and not DKA.
 
Suzanne & Darcy said:
Ketones fluctuate a lot — it’s all the black BG. One higher reading does not mean DKA. As long as he is eating well, not lethargic, not vomiting, seems normal then it’s just high ketones and not DKA.
Click to expand...

He was vomiting on Saturday which is why I took him to emergency. He didn't yesterday though so I take that as a good sign.
 
I agree he needs the 1.75U, I am mostly concerned about when I'm not here but I'll have to take the plunge. I'm a teacher, so I can't wait until I have summer off and can give him any dose he needs without concern.
 
thaurermellon said:
I will try to go through today and mark them. I've mostly only done the glucometer if the Libre reads HIGH but I've also started doing his ps checks with it because the Libre seems to be off.
Click to expand...
Yes. If you can put a letter next to it (not sure what kind of meter you have - like C for Contour or R for ReliOn) or something like that. Or even an asterisk it would be helpful. Later on is fine.
 
He has never had a DKA before has he? If he has, then we really should be more aggressive with his dosing. Either way, these high numbers are very hard on his kidneys, in particular, but other organs as well.
 
Suzanne & Darcy said:
He has never had a DKA before has he? If he has, then we really should be more aggressive with his dosing. Either way, these high numbers are very hard on his kidneys, in particular, but other organs as well.
Click to expand...

He has unfortunately from his pancreatitis. I will start doing the 1.75 units more consistently after this morning because yea with his kidney disease and previous episode I am worried about him.
 
thaurermellon said:
He has unfortunately from his pancreatitis. I will start doing the 1.75 units more consistently after this morning because yea with his kidney disease and previous episode I am worried about him.
Click to expand...
Please add DKA and the date of the DKA to your signature. That’s very important information to have on the signature (even though it’s already on your spreadsheet. )
 
Suzanne & Darcy said:
Wow. You did the right thing. Did they do bloodwork to check his electrolytes and a CBC?
Click to expand...

I ended up having the hospital keep him yesterday and they will keep him one more day since his kidney values were elevated even from a month ago.

They said they only gave him 1U of insulin and got him down to 127. I am going to see if I can get a print out of the values when I go to visit him tonight. If he is getting that low on 1U what dose should I start him on when he gets home? He obviously needs to be much lower than he was the last few weeks so he doesn't end up having to go back in to the hospital for his kidneys. Would you recommend sticking with 1.75U? I'll upload their values once I get home tonight. Thanks again.
 
I think you are seeing that the dry food is really not helping him. Dry food (as you noted) is not a good choice for trying to bring up low numbers. It also takes a longer time to wear off. Usually it will keep them high for a long time. Although, having said that, I don’t see anything on that day which needed bringing up of his numbers. He’s been so high. You should ditch the dry food unless he won’t eat anything else. And if he is given dry then it should only be 1) Dr. Elsey’s Clean Protein chicken kibble or (2) Young Again Zero Mature. Those are the only low carb dry foods suitable for diabetic cats. I would opt for the Young Again since it’s lower in phosphorus and that will be easier on his kidneys.
 
Are really back to feeding him only twice a day? That is such out-dated thinking regarding the treatment of feline diabetes. I do not think it will help Paco
 
I hate these high numbers. As long as you can monitor him, I would increase to 2 units tomorrow morning unless he drops into lower blues tonight.
 
Suzanne & Darcy said:
I think you are seeing that the dry food is really not helping him. Dry food (as you noted) is not a good choice for trying to bring up low numbers. It also takes a longer time to wear off. Usually it will keep them high for a long time. Although, having said that, I don’t see anything on that day which needed bringing up of his numbers. He’s been so high. You should ditch the dry food unless he won’t eat anything else. And if he is given dry then it should only be 1) Dr. Elsey’s Clean Protein chicken kibble or (2) Young Again Zero Mature. Those are the only low carb dry foods suitable for diabetic cats. I would opt for the Young Again since it’s lower in phosphorus and that will be easier on his kidneys.
Click to expand...

yes I’m trying to find an emergency food he could have when I’m at work but obviously the dry isn’t going to be an option. He wasn’t low I just wanted to see how it would help him. I now know it takes about 30 mins for the dry to kick in and obviously lasts way too long.
 
thaurermellon said:
he was having dr elseys when given dry. But again it spikes him too high.
Click to expand...
I have had a few people say that Dr. Elsey’s spiked their cats. Is it the chicken variety? I have heard some say that Young Again didn’t spike their cats, but then again some people have said that it gave their cats diarrhea. I am not sure if they still send out free samples of the food anymore.
 
I was trying to check Pack’s spreadsheet, but it’s not current. I hope everything is all right and you are having a good day.
 
Suzanne & Darcy said:
I was trying to check Pack’s spreadsheet, but it’s not current. I hope everything is all right and you are having a good day.
Click to expand...
I've appreciated all your help. This week is pretty crazy for me so I am keeping track of Paco's patterns on the libre but I haven't been able to enter them on the computer. I'm also really struggling with my vet so I plan to get in to a specialist. It's hard to hear so many different opinions, so I'm trying to get a specialist. I'll have an appointment with them in May. Luckily Paco is acting much more like his normal self though even though he still has highs. I've been giving him fluids again at home and that really seems to make a difference for him (he hadn't needed them for a long time).

I have noticed though that when he gets fluids his numbers are much better (though the drop is very fast). Have you ever heard of insulin going through their systems faster when they also get subq fluids?
 
Can you point me to the days/times when he had fluids and the numbers (hours?) when you get a chance. I just wanted to see how he was doing on this dose this week.

I have seen fluids positively affect numbers. If the fluids make him feel better then that’s one reason. His hydration status no doubt helps him put the insulin to better use as well.
 
@Suzanne & Darcy I'm still super busy, but I'm hoping to upload today's numbers because they were wonderful yet a bit terrifying. He did get down to 97. My only question for you once I get today's sheet up, he did start dropping towards 80 but levels off luckily right around +5 - +6. I leave food for him, but he is insanely lazy and won't eat most of the time during the day. Should I keep his dose at 2.0U and hope he doesn't have an emergency when I'm gone for 10 hours? It would be not great for me to have to leave work if he starts dropping under 80, and he doesn't hit his nadir until I'm only about halfway through my day. I'm fine doing 2U at night since I am home the whole time.

I also work 30 minutes from home, so I'd essentially have to take a half day which I really can't do unless I thought he was going to have severe damage.
 
I will look for his numbers in the SS later. You haven’t had time to put them in yet, I see.

It sounds like fantastic numbers. Remember that 80 — or 70 or 60 … all the way down to 50 — are extremely safe numbers. The normal BG for a cat is 50 to a max of 120 (occasionally or perhaps right after food) with most of the time spent in green. Also remember that these are Libre numbers and Libre numbers below 100 are not that reliable— meaning that if you tested them with a human handheld glucometer you would most likely get a higher reading. The lower the Libre reads the difference usually becomes greater between the two meters. So I have no worries about him approaching 80 near nadir.
 
Ok great. I just get nervous.‘I’ll continue his 2units then.

my other question. He is still in the green. I’m about 3 hours out from his shot. He normally is between 400-600+ for his pmps even before food. I’m wondering what dose I should give tonight if he continued to be in the greens or even low 200s?

Suzanne & Darcy said:
I will look for his numbers in the SS later. You haven’t had time to put them in yet, I see.

It sounds like fantastic numbers. Remember that 80 — or 70 or 60 … all the way down to 50 — are extremely safe numbers. The normal BG for a cat is 50 to a max of 120 (occasionally or perhaps right after food) with most of the time spent in green. Also remember that these are Libre numbers and Libre numbers below 100 are not that reliable— meaning that if you tested them with a human handheld glucometer you would most likely get a higher reading. The lower the Libre reads the difference usually becomes greater between the two meters. So I have no worries about him approaching 80 near nadir.
Click to expand...
 
You must log in or register to reply here.
Back
Top