? 02/03 Piper AMPS 329 Dosing Advice

Claire & Piper

Claire & Piper

Member Since 2022
Piper was diagnosed at the end of last year, so we are still learning.

She had her spleen removed Feb 2021 due to a mast cell tumor & seemed to recover well.
End of Nov 2021 she collapsed & had 5 days at the emergency vets with pancreatitis / DKA / UTI. Came home on Lantus with an Alphatrak2.

We are up to 3.5 units of Lantus twice a day. Vet is ready to increase to 4, and go up from there if still high.
Each time we increase her dose there seems to be a small reduction, but she is too high & not regulated.
Her appetite is ravenous, her weight is steady and her general health seems good. There was possibility of infection, so she had been on Azythromycin. Bloodwork done Jan 11 did not show any issues. Fructosamine test was at 505.

It feels like her dose is high & we need to go higher, but it doesn't feel like we are getting anywhere.
Would appreciate dosing advice.

Spreadsheet link:
https://docs.google.com/spreadsheets/d/1D8HI7bjtuiFLlT2gNLcaO_8j_Izn2ugIyhf3PMRnoW8/edit?usp=sharing
 
And poor Piper! And poor Claire. You've both been through a lot. I'm glad your baby has pulled through. This is the place to be for help. But we do need to be able to see your spreadsheet.

I can totally relate to what you are saying about insulin. My boy just kept getting more insulin and it seemed like it was doing absolutely nothing (look at my spreadsheet in 2020 for example.) It wasn't until I started following the advice of the people on this board that we had a prayer at getting into better numbers. Now, in my case, my baby had Acromegaly, which we found out about kind of late in the game. But he really needed a lot more insulin than he was getting and so we were making no progress. I was holding doses for way too long as well. Anyway, I hope you can change the permissions on your spreadsheet so that anyone with the link can view it.
 
Your beautiful girl has been through a lot.:bighug:

Part way down the spreadsheet instructions are the steps needed to publish to the web so others can see your spreadsheet. We are all rather data focussed here and will be able to help you better with actual numbers and dosing history.
 
As I hit enter, I see you fixed the permissions. Thank you. I see a couple things on the spreadsheet. First, we determine how to change the Lantus dose based on how low the dose is taking the cat. Those numbers are typically somewhere in the middle of the cycle, timing does vary by cat. Although you are great at getting preshot tests, there is very little data in the middle. Would it be possible to get more mid day data and a test just before you go to bed? That'll help us determine if Piper is going lower than what the current data shoes.

We have two dosing methods here, take a read and see if one of these would work for you. Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)
If you pick a dosing method, we can help you learn it so you get to the point of know when you should increase and decrease, and by how much. With Piper seeing some blue numbers (under 200), we would have had you increase by 0.25 units, not 0.5 units. Cats are sensitive to small changes in doses. Also, you are holding doses longer than we would.

While you are here, make sure you read all the yellow starred Sticky Notes at the top of this forum. And feel free to keep asking questions, we all know what it was like to be new.
 
That would be my recommendation too -- it's very important to get mid cycle tests in in order to know how low your kitty may be going on a particular dose. I see that sometimes you have been able to do it. Also the before bed test is important (and as they go lower it's critical to know if you can even safely go to be or need to set an alarm to test in the night! ... but you're not there yet). Do you think you can get a few more a.m. and p.m. (at least one for each cycle) tests in and get a little more data so you can see where you need to go from here?
 
Thank you.

I was dreading the answer of more testing, but was afraid that would be it. I'm a massive needle-phobe so this has been a bit of a challenge all round.
Now I'm had a brief cry, my stalwart husband has promised to push us doing more interim BG checks.

The next couple of weeks will complicate things - Piper is going to be staying with a very good (diabetic cat experienced) friend while we go back to England for a visit.

I think every time we got a yellow, we hoped the dose was beginning to work & held out making a change from 3.5.
We'll take her up to 3.75 and see where that (& extra testing) takes us.
 
I'm sorry! How is it that you've already done this well with beginning to test? You are overcoming your fear, I think! You can do it. I cried a lot in the beginning of testing. Best to keep at a really safe dose if your friend isn't up to testing. Hang in there. I can tell that you REALLY love Piper, so I know that you will want to help her in the best way that you can and to get her to a better dose that will make her feel better and spare her kidneys as well.
 
From someone who fainted at the sight of blood before hand, I can feel your pain. :bighug:Lots of crying at the beginning here too. I just kept telling myself I could do it to keep my girl safe. Sometimes I'd sing silly made up songs to both relax me and confuse the cat. They can sense if you are nervous.
 
Hi Claire,

I totally feel you! I can't even look when at the needle when I get shots, have to have some candy at the ready because I faint if I even know it's there! Somehow though for Ruby I have learned to rally. I still get queasy when I have to use a bigger needle for things like her arthritis shots and subQ fluids, but I put on my big girl pants and push on ahead because that's how much I love my girl. The testing does get easier. I never had much of a routine with my cats before diabetes, and now we are on such a regimented schedule of testing that Ruby comes over to remind me when it's time for her poke. :p I even got my partner who came into my life more recently than my cats to learn how to test and it's improved their bond immensely. Cats absolutely love routine and being on schedule. They will also sense any anxiety you have, so the more relaxed you are, the easier it is on everyone involved.

Also, I know you are working with your vet, but experience here has shown that .25 unit increases and decreases in dosage works best. Cats are really small, and respond to the tiniest doses. My Ruby was on a drop of insulin for a while and it made a big difference. There's more on it in the Dosing Methods link that Wendy sent to you.
 
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