05/03 Mister AMPS 360 +2 377

[Elizabeth & Mister]

Link to prev. condo

Hi everyone. Mister is on his 5th cycle of Lantus. I plan on keeping him at 2.5u this evening and upping his dose tomorrow morning, as recommended.

I guess I’m looking for a little bit of encouragement. I don’t really know what is considered “normal” (for lack of better word as I know every cat is different) but seeing so many red and pink after each increase worries me. I’ve also not been able to pinpoint a nadir or even really any type of pattern so far.

I do have a question regarding his diet and would love some insight or suggestions. Right now he eats 1 can of FF pate for breakfast and dinner (pre-shot meals) and since he has ketones and I’m increasing his calories, he eats every few hours, usually about 1/4 of a can. I try to keep track of the calories as best I can to have an idea of where he’s at every day, and aim for ~400. He also usually gets a small amount around +7PM. Do I need to be more concerned about the times I am feeding him as it relates to his shots and BG tests, as in should I be testing before he eats and should I be offering zero carb treats instead of meals after +6 hours?

Also second question- in reading about TR protocol, I’ve seen where higher doses increase by .5u, so I would be going to 3u tomorrow morning (assuming his BG continues how it’s been)?

His ketones are down to 0.6 again (as of yesterday, haven’t checked yet today) so that is good, and I’m still trying to continue his Sub-Q fluids even though he’s let me know he’s fed up with it.

Thank you all for all of your support, I say that in every post and I truly mean it. I’d be drowning without this place right now.

 

[Elizabeth & Mister]

@Marje and Gracie I wanted to reply to your comment from yesterday and would love to hear from you on this.

 

[Marje and Gracie]

@Marje and Gracie I wanted to reply to your comment from yesterday and would love to hear from you on this.

Good morning

I looked at his SS last night and was glad to see his ketones were down. Yes, tomorrow morning you will raise his dose to 3u bid. Are you back on your regular shot schedule?

Right now, he looks pretty normal as he’s filling his depot. He’s just high and flat and it’s a pattern we often see.

Lantus is different than Vetsulin with feeding. Because it does not onset until +2, you don’t have to have food on board before his shot; however, we always suggest you test, feed, shoot (TFS) within 15 mins pretty much in that order.

You also want to avoid feeding two hours before his shot so no food after +10 until the TFS unless he’s dropping quickly in green numbers or he’s below 50 at +10. That doesn’t mean you need to test him every cycle at +10 but if he’s trending down after nadir (which they will do if clearing a bounce), you’ll want to be sure you get a BG around +10 so you will be able to tell if he needs a tiny bit of LC food.

When you say around “+7 PM” I don’t know where you mean in his cycle. At +7? We didn’t use clock hours here as we are all on different time zones so we just speak in terms of hours after the last shot. Ideally, you wouldn’t feed him at +7 (see below).

You will learn that managing a Lantus curve with food is an art more than a science and, as we often say here “every cat is different” (ECID). Some cats need very specified feeding at certain times and others don’t.

Typically, and again unless he’s dropping, you’ll want to try and not feed after nadir as that slows down the effect of the insulin and he will lose duration. It’s important, once you get more data, you be able to spot his onset, nadir, and duration. We can help with that as you gather more data.

Keep asking questions and it will help if you can post every day and if you can read a few other cats’ condos because there is alot of teaching that goes on. I know it’s tons of reading and I’d prioritize the Stickys.

 

[Elizabeth & Mister]

Good morning

I looked at his SS last night and was glad to see his ketones were down. Yes, tomorrow morning you will raise his dose to 3u bid. Are you back on your regular shot schedule?

Right now, he looks pretty normal as he’s filling his depot. He’s just high and flat and it’s a pattern we often see.

Lantus is different than Vetsulin with feeding. Because it does not onset until +2, you don’t have to have food on board before his shot; however, we always suggest you test, feed, shoot (TFS) within 15 mins pretty much in that order.

You also want to avoid feeding two hours before his shot so no food after +10 until the TFS unless he’s dropping quickly in green numbers or he’s below 50 at +10. That doesn’t mean you need to test him every cycle at +10 but if he’s trending down after nadir (which they will do if clearing a bounce), you’ll want to be sure you get a BG around +10 so you will be able to tell if he needs a tiny bit of LC food.

When you say around “+7 PM” I don’t know where you mean in his cycle. At +7? We didn’t use clock hours here as we are all on different time zones so we just speak in terms of hours after the last shot. Ideally, you wouldn’t feed him at +7 (see below).

You will learn that managing a Lantus curve with food is an art more than a science and, as we often say here “every cat is different” (ECID). Some cats need very specified feeding at certain times and others don’t.

Typically, and again unless he’s dropping, you’ll want to try and not feed after nadir as that slows down the effect of the insulin and he will lose duration. It’s important, once you get more data, you be able to spot his onset, nadir, and duration. We can help with that as you gather more data.

Keep asking questions and it will help if you can post every day and if you can read a few other cats’ condos because there is alot of teaching that goes on. I know it’s tons of reading and I’d prioritize the Stickys.

Okay this is very helpful and answered my question about the feeding, by +7 PM I meant his PM cycle +7 which for me is 3am, I’ve been worried about his ketones if he goes all night without eating but I started to be concerned about feeding during the time the insulin is wearing down. Is something like plain boiled chicken breast and lamb (he loves these) okay to give after nadir? I do fast him for the two hours before his shots. I also didn’t know BG can trend down after nadir while clearing a bounce so I will keep that in mind. So much to learn and remember! I feel much better about information I’m absorbing now than I did two weeks ago and am hopeful I will be able to say the same again two weeks from now

He is back on his 7am/7pm times

I was thinking about the depot filling while seeing his flat curve, so that is good to know that’s what I’m looking at. I guess I was also used to seeing his numbers drop by ~100 or so after just a couple hours while being on Vetsulin and I’m not sure what to expect now that he’s on Lantus. I’m not the best with numbers but I will take the time to learn his behaviors and keep gathering the data so having extra sets of eyes to help me determine his nadir will be so helpful.
I’ll go ahead and remove my “?” And update later with his fluids and ketones. Thank you!

 

[Staci & Ivy]

Hi Elizabeth, great job posting and asking questions. I’m glad Marje has been here to explain so much.
I think a piece of chicken or lamb that Mister enjoys should be fine as a snack. Or even a treat after you give him a poke for a blood test. Many cats enjoy a reward after they’ve gotten a blood test and then they look forward to the routine.

It’s great if you can keep the fluids up while he’s recovering. I hope he continues to be a good boy. I know the other day he got a little antsy with you.

The reason they want you to withhold food in the two hours prior to the pre-shot is because they don’t want the glucose to be influenced by food. So we want to try to see what the BG is on its own without food involved.

Of course, as Marje mentioned if he were dropping lower, then you were comfortable with, you could always use a teaspoon of low-carb food if needed.

Hopefully very soon as you get to a better dose, you will start to see his numbers coming down, and of course, once his depot is more full.

I’m glad to hear he doesn’t sound like he’s constipated and everything seems to be going OK in that direction.

Good luck with the increase tomorrow morning and keep us posted on how you’re both doing

 

[Elizabeth & Mister]

Hi Elizabeth, great job posting and asking questions. I’m glad Marje has been here to explain so much.
I think a piece of chicken or lamb that Mister enjoys should be fine as a snack. Or even a treat after you give him a poke for a blood test. Many cats enjoy a reward after they’ve gotten a blood test and then they look forward to the routine.

It’s great if you can keep the fluids up while he’s recovering. I hope he continues to be a good boy. I know the other day he got a little antsy with you.

The reason they want you to withhold food in the two hours prior to the pre-shot is because they don’t want the glucose to be influenced by food. So we want to try to see what the BG is on its own without food involved.

Of course, as Marje mentioned if he were dropping lower, then you were comfortable with, you could always use a teaspoon of low-carb food if needed.

Hopefully very soon as you get to a better dose, you will start to see his numbers coming down, and of course, once his depot is more full.

I’m glad to hear he doesn’t sound like he’s constipated and everything seems to be going OK in that direction.

Good luck with the increase tomorrow morning and keep us posted on how you’re both doing

Thank you! Your input and advice has helped ease my mind so much too. I wish every aspect of life had a community like this one

He definitely let me know he was not trying to get his fluids that day, LOL. He is my sour patch boy, one minute he’s a sweet little angel making biscuits on my lap, and the next he is grabbing my arm to bite me. Cats are so funny.

I have found that switching up his treats while giving fluids helps, he can get tired of things pretty quickly. Once I get it started, he’s pretty good about letting me finish.

I’m going to read up on tips on how to freehand the lancet for his glucose tests, because I’m starting to have some trouble getting enough blood. Keep getting errors. His left ear bleeds better than his right, but it’s getting irritated and I don’t want to keep using the same one. I try to use his right ear and almost nothing comes out. I think I’ll have better luck without the lancet device. If you or anyone reading has any advice on this I’d love to hear it. I did start applying Ledum 30c to the irritated ear, I read that somewhere on here.

 

[Marje and Gracie]

Thank you! Your input and advice has helped ease my mind so much too. I wish every aspect of life had a community like this one

He definitely let me know he was not trying to get his fluids that day, LOL. He is my sour patch boy, one minute he’s a sweet little angel making biscuits on my lap, and the next he is grabbing my arm to bite me. Cats are so funny.

I have found that switching up his treats while giving fluids helps, he can get tired of things pretty quickly. Once I get it started, he’s pretty good about letting me finish.

I’m going to read up on tips on how to freehand the lancet for his glucose tests, because I’m starting to have some trouble getting enough blood. Keep getting errors. His left ear bleeds better than his right, but it’s getting irritated and I don’t want to keep using the same one. I try to use his right ear and almost nothing comes out. I think I’ll have better luck without the lancet device. If you or anyone reading has any advice on this I’d love to hear it. I did start applying Ledum 30c to the irritated ear, I read that somewhere on here.

Maybe something in this post will help with testing.

I agree with Staci that a little boiled chicken breast or freeze dried treat later in the cycle shouldn’t affect his BG.

 

[Staci & Ivy]

Thank you! Your input and advice has helped ease my mind so much too. I wish every aspect of life had a community like this one

He definitely let me know he was not trying to get his fluids that day, LOL. He is my sour patch boy, one minute he’s a sweet little angel making biscuits on my lap, and the next he is grabbing my arm to bite me. Cats are so funny.

I have found that switching up his treats while giving fluids helps, he can get tired of things pretty quickly. Once I get it started, he’s pretty good about letting me finish.

I’m going to read up on tips on how to freehand the lancet for his glucose tests, because I’m starting to have some trouble getting enough blood. Keep getting errors. His left ear bleeds better than his right, but it’s getting irritated and I don’t want to keep using the same one. I try to use his right ear and almost nothing comes out. I think I’ll have better luck without the lancet device. If you or anyone reading has any advice on this I’d love to hear it. I did start applying Ledum 30c to the irritated ear, I read that somewhere on here.

I totally understand about how he’s loving one minute and then spicy the next.

My Ivy is just like that as well

Definitely read the link Marje sent. It’s very helpful with ideas for testing.
I find using a rice sock or a pill bottle with water warmed up really helps.
Then I massage her ear and poke.
The tip of a dab of Vaseline is a good one too. It helps hold the blood in one spot and not disperse in the ear fur.

Good luck with the tricks and keep on with all your hard work!

 

[Mary & Jude]

Hi Elizabeth!

One thing that helped me so much when I first started treating Jude was looking at others' spreadsheets. And I had some of the same questions (e.g. what is normal?) when we started, too. Look at Jude's ss back in 2024--in the fall (he came out of remission in the fall). It seemed like it took forever for us to get to that 'goldilocks' dose that began to bring him down into lower numbers, which finally happened around the beginning of 2025. There is a saying here frequently that we have to put on our patience pants, which I had to be reminded of a lot because I worried so about those pinks/reds/blacks. Be encouraged--Mister will get 'there.' The good news is that you are getting very good guidance on the forum about dose increases, etc., from Marje. I don't know what I would have done without this forum either.

 

[Elizabeth & Mister]

My first fur shot…I’m just in tears. Giving tests/shots/fluids was relatively easy at first, he tolerated them. Lately he isn’t, and he swats at my legs when I walk past him, even if I’m not poking him. I feel like he’s becoming scared of me. I keep reminding myself it’s helping him, but it hurts me. His BG was high at PMPS and I feel like I failed him tonight. I don’t mean to sound so dramatic, it’s just been very heavy lately.

 

[Staci & Ivy]

My first fur shot…I’m just in tears. Giving tests/shots/fluids was relatively easy at first, he tolerated them. Lately he isn’t, and he swats at my legs when I walk past him, even if I’m not poking him. I feel like he’s becoming scared of me. I keep reminding myself it’s helping him, but it hurts me. His BG was high at PMPS and I feel like I failed him tonight. I don’t mean to sound so dramatic, it’s just been very heavy lately.

Awww you can vent here any time
We totally understand.
We’ve all done it (me last week).
Be kind to yourself and know you’ll get back on track tomorrow.

And you are helping him, so don’t forget that. It’s very hard some days

I can’t tell you how many tears I’ve shed since traveling this journey.

Use tonight to get some rest since he’ll most likely bounce higher. Take care of yourself too, Elizabeth

 

[Mary & Jude]

My first fur shot…I’m just in tears. Giving tests/shots/fluids was relatively easy at first, he tolerated them. Lately he isn’t, and he swats at my legs when I walk past him, even if I’m not poking him. I feel like he’s becoming scared of me. I keep reminding myself it’s helping him, but it hurts me. His BG was high at PMPS and I feel like I failed him tonight. I don’t mean to sound so dramatic, it’s just been very heavy lately.

We've ALL been there--it's unnerving and annoying and all the other adjectives!! He will recover. I had to withhold a shot from Jude last night because I had to go out of town--it is what it is. He's bouncing, but he'll recover, and so will Mister. Please try not to be so hard on yourself--FD is a very challenging disease to treat, and you're doing your very best.

Have you read about CGMs? Or has someone discussed them with you? They are a great option if you find you have trouble with or cannot poke. Are you using a lancet device? One of the things I eventually learned with Jude (I freehand poke him) is to make sure the bevel is up, hold the cotton pad underneath, and just ever so lightly poke the edge of his ear with the lancet's sharpest edge. It takes a minute with such a light poke for it to bleed, but I gently 'milk' the ear and the blood comes. And then, LC treats, treats, treats! Before, during, and after. Hang in there. Let us know if you need info about CGMS. Staci is a pro!

 

[Elizabeth & Mister]

Hi Elizabeth!

One thing that helped me so much when I first started treating Jude was looking at others' spreadsheets. And I had some of the same questions (e.g. what is normal?) when we started, too. Look at Jude's ss back in 2024--in the fall (he came out of remission in the fall). It seemed like it took forever for us to get to that 'goldilocks' dose that began to bring him down into lower numbers, which finally happened around the beginning of 2025. There is a saying here frequently that we have to put on our patience pants, which I had to be reminded of a lot because I worried so about those pinks/reds/blacks. Be encouraged--Mister will get 'there.' The good news is that you are getting very good guidance on the forum about dose increases, etc., from Marje. I don't know what I would have done without this forum either.

Oh thank you so much for this, this really brought ease to my mind. I began by looking at others spreadsheets but I felt like I needed to take a break from that because I started to compare them rather than use them as a learning tool, but this was so helpful. And made me realize I can take a learning approach rather than “comparison”. I’m still learning about patterns, nadirs, bounces, everything that goes into the data I’m collecting. My first few days I was like “I’m testing and testing but what do these numbers mean?” i appreciate your kind words so much. I don’t feel so alone and scared when I read comments like yours so I truly appreciate it. I don’t know a lot about CGMs, my vet mentioned it at our first appointment but dismissed it and said most cats rip them off (he also dismissed a lot of other things, but at the time I didn’t know any better) so I will do some reading. I am using a lancet device at the moment and i believe that is part of my problem. Also I wasn’t warming up the ear. He won’t stay still for very long, he can get a bit aggressive when he really wants to, so I try to be quick. But I may have to re-evaluate the way I’ve been doing things. I won’t be giving up!

 

[Elizabeth & Mister]

Awww you can vent here any time
We totally understand.
We’ve all done it (me last week).
Be kind to yourself and know you’ll get back on track tomorrow.

And you are helping him, so don’t forget that. It’s very hard some days

I can’t tell you how many tears I’ve shed since traveling this journey.

Use tonight to get some rest since he’ll most likely bounce higher. Take care of yourself too, Elizabeth

Thank you so so much. I broke down for a few minutes but trying to take it as a lesson learned, I should have given myself more time this evening knowing he was a bit stressed from the tests and fluids. Oh the tears I’ve shed too! I think I cried the entire first 3 days. It just breaks my heart to think he might have a bad night now, not feeling good, etc. the ketones really worry me. Thankfully they are still below 1 today. I appreciate you so much Staci!

 

[Elizabeth & Mister]

@Marje and Gracie do you think I should still up the dose to 3u tomorrow morning even though I missed his shot this evening? I know it’s impossible to say how much got in them with fur shots, but I do know it couldn’t have been much (if any) as I felt and saw the syringe was not in his skin it was my fault for trying to move too quickly, he gets really upset at shot time.

 

[Marje and Gracie]

@Marje and Gracie do you think I should still up the dose to 3u tomorrow morning even though I missed his shot this evening? I know it’s impossible to say how much got in them with fur shots, but I do know it couldn’t have been much (if any) as I felt and saw the syringe was not in his skin it was my fault for trying to move too quickly, he gets really upset at shot time.

(((Elizabeth))). As the others have said, we’ve all given fur shots and we’d all be wealthy if we had a done die all the tears shed. We don’t want our babies to spend one extra minute in high numbers but it happens and they do come back down.

Did you smell the insulin (smells like bandaids)? Was his skin wet? Let’s see what he does at +2. Can you grab that test?

Under the TR protocol, we are looking at consecutive cycles and if he did get a fur shot, then it’s like starting over with the cycle count. But with his history, I don’t want to do that. If he starts to come down a bit, then we know he got “some” insulin and we can increase tomorrow.

If he goes high so it looks like he didn’t get insulin, I want to think about it and I’ll post. Normally, I would tell someone to hold off on the increase but I don’t want his ketones coming back.

I’m sorry he’s unhappy. You might have to burrito him to do his tests. Let me know if if you need a video but a CGM might be the ticket for him.

Hang in there….it’s just one shot.

 

[Elizabeth & Mister]

(((Elizabeth))). As the others have said, we’ve all given fur shots and we’d all be wealthy if we had a done die all the tears shed. We don’t want our babies to spend one extra minute in high numbers but it happens and they do come back down.

Did you smell the insulin (smells like bandaids)? Was his skin wet? Let’s see what he does at +2. Can you grab that test?

Under the TR protocol, we are looking at consecutive cycles and if he did get a fur shot, then it’s like starting over with the cycle count. But with his history, I don’t want to do that. If he starts to come down a bit, then we know he got “some” insulin and we can increase tomorrow.

If he goes high so it looks like he didn’t get insulin, I want to think about it and I’ll post. Normally, I would tell someone to hold off on the increase but I don’t want his ketones coming back.

I’m sorry he’s unhappy. You might have to burrito him to do his tests. Let me know if if you need a video but a CGM might be the ticket for him.

Hang in there….it’s just one shot.

Thank you for the encouragement, “it’s just one shot” that’s what I will remind myself tonight when my mind starts to go crazy. And oh yeah, I even said “it smells like melting bandaids”, that was it. +2 is right now, so I’ll get a test in. I saw a comment somewhere on here earlier about burritoing them, I’ll look into that. Is it just how it sounds, like a swaddle? Adding CGMs to my nightly reading tonight also. I think where I’ve seen posts about them malfunctioning, I never gave them much thought, but I’ll take all the help I can get! Will update in a few with his BG.

 

[Elizabeth & Mister]

@Marje and Gracie PMPS 411 +2 336

 

[Mary & Jude]

Oh thank you so much for this, this really brought ease to my mind. I began by looking at others spreadsheets but I felt like I needed to take a break from that because I started to compare them rather than use them as a learning tool, but this was so helpful. And made me realize I can take a learning approach rather than “comparison”. I’m still learning about patterns, nadirs, bounces, everything that goes into the data I’m collecting. My first few days I was like “I’m testing and testing but what do these numbers mean?” i appreciate your kind words so much. I don’t feel so alone and scared when I read comments like yours so I truly appreciate it. I don’t know a lot about CGMs, my vet mentioned it at our first appointment but dismissed it and said most cats rip them off (he also dismissed a lot of other things, but at the time I didn’t know any better) so I will do some reading. I am using a lancet device at the moment and i believe that is part of my problem. Also I wasn’t warming up the ear. He won’t stay still for very long, he can get a bit aggressive when he really wants to, so I try to be quick. But I may have to re-evaluate the way I’ve been doing things. I won’t be giving up!

Jude doesn't like the *click* of the lancet, so we handpoke. Definitely warm up the ear with a little rice sock nuked for a few seconds. What size lancets are you using?

 

[Elizabeth & Mister]

Jude doesn't like the *click* of the lancet, so we handpoke. Definitely warm up the ear with a little rice sock nuked for a few seconds. What size lancets are you using?

I tried the rice sock the very first few times I started testing him, but it scared him so I let it go. But now that he’s used to the tests (used to them, not accepting of them haha) I wonder if I could use them now. I do rub the ear between my fingers to try to warm up the blood flow. I also found the middle part of his left ear to be the easiest place to draw enough blood, but maybe with the added heat I could get the “sweet spot” to work. I’ll try the rice sock again next time.

I use 28g lancets, the Freestyle brand. I’ve been a little afraid of doing it by hand of puncturing too deep, but I think if/when I get the hang of it, it would actually be more gentle and not have the scary clicking sound

 

[Marje and Gracie]

@Marje and Gracie PMPS 411 +2 336

Hmmmm looks like he got “some” insulin. The TR protocol allows for increasing the dose after six cycles in cats newly started on Lantus who have high, flat numbers and/or are ketone-prone.

I’m going to recommend you increase to 3u bid in the morning. He’s had a few little dips below 300 but he’s been pretty flat.

Here’s the video on testing fractious cats. I always thought free hand testing was easier than using a device. Definitely helps to warm the ear.

Good luck with the increase.

 

[Elizabeth & Mister]

Hmmmm looks like he got “some” insulin. The TR protocol allows for increasing the dose after six cycles in cats newly started on Lantus who have high, flat numbers and/or are ketone-prone.

I’m going to recommend you increase to 3u bid in the morning. He’s had a few little dips below 300 but he’s been pretty flat.

Here’s the video on testing fractious cats. I always thought free hand testing was easier than using a device. Definitely helps to warm the ear.

Good luck with the increase.

Okay that sounds good to me. I’ll be with him all day tomorrow. I plan on returning to work soon (part-time) but for now I’m always available to monitor him. I was happy to see a lower number rather than a higher one. I appreciate you checking in, I hope you have a goodnight

 

[Marje and Gracie]

Okay that sounds good to me. I’ll be with him all day tomorrow. I plan on returning to work soon (part-time) but for now I’m always available to monitor him. I was happy to see a lower number rather than a higher one. I appreciate you checking in, I hope you have a goodnight

You’re welcome. You have a great night, too.

 

[Staci & Ivy]

Good luck with the increase!
I like freehand poking too.
I found the lancet device clunky and the click scared Ivy.
And I could never really know exactly where I was poking with that device.

When you poke, bevel up on a warmed ear, and try to poke a bit at a sideways angle 45% (not a straight up and down 90 degrees).
That seemed to help me.

I think it’s trial and error to get your technique down.
And of course, we always have the added factor of a squirmy pissed off cat

You’ll get there! Keep at it