04/15 Jasmine AMPS 167.4, +4 167.4 dosing advice?

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Jodi & Jasmine

Jodi & Jasmine

Member Since 2010
Hi all,

'Tis the weekend .... sweet :smile: I have had Jasmine back on insulin going on day #3 now. She has been receiving 0.5 units and her numbers seem to remain either the same or are increasing a bit. Last night I shot closer to 0.75 and her numbers dropped quickly over 3 hours PMPS 201.6, +2 156.6, +3 118.8, gave her a teaspoon of food, +4 120.6 and +5 151.2. When I give her 0.5 units it doesn't seem to be enough but when she had 0.75 units, it was too much too quick. Any suggestions?

Have a great weekend everyone!!!!!!
 
Take a look at what Sienne does with feeding - she tries to spread it out carefully in the first half of the cycle so that it works smoothly with the insulin pattern. And she may have some ideas for you.
 
Thanks guys. Jasmine has been on the same eating pattern for nearly 2 years now. She gets fed AMPS, +6, PMPS and +6. Basically every 6 hours. When she was in remmission, I kept the same eating pattern for her. She does not get snacks, only last night I snuck her a tad of food when her numbers dropped so quickly. I will check out what Sienne does.
 
Jasmine's PMPS was 176.4, she received 0.50 units and +2 190.8 The 0.50 units is not working for her, but 0.75 seems like too much :? :? :?
 
can you hit in-between? like draw .75 and squeeze out one drop before you give it to her? i was playing with the syringe last night and thinking that it might be easier for me to do that than using the .5u lines and trying to hit in-between.
 
Maybe try splitting the +6 food into 2 portions, 1 for +3 and the 2nd for +6.
Or split the food into thirds @ 0, +3 and +6.

The first half of the curve is when the glucose is dropping; the second half is when it is rising, so as Sienne says "feed the curve", ie, put more food toward the beginning when it is going to drop and less towards the end when it is starting to raise.

And the last 2 hours before a shot, it is recommended not to feed, so your test is most accurate (barring any adverse symptoms of hypo!)
 
Jodi, it's important to shoot a consistent dose with Lantus, you don't want to jump around. The shed is still filling, you need to hold the initial dose for 5-7 days before adjusting. I would stick with 0.5u and to give it a few more days. Please take a look at the Tight Regulation Protocol sticky, as well as the other stickies, there is a lot of good info there.

"General" Guidelines:

Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).
Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Click to expand...

And some other important information...

WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR...


Kitty should be monitored closely the first three days when starting Lantus or Levemir.
Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
More monitoring may be needed.
It will be necessary to test kitty's blood glucose levels multiple times per day.
Learn the signs of and how to treat HYPOGLYCEMIA and prepare a HYPO TOOLBOX.
Test regularly for ketones and know about DIABETIC KETOACIDOSIS (DKA).
Use U-100 3/10cc syringes with half units marked on the barrel for fine dosing.
Feed a high quality low carb canned or raw food diet.
Feed small meals throughout the day. Some kitties adapt well to free feeding.
Click to expand...

You will notice that it suggests feeding small meals throughout the day...many of us split up the food into several mini-meals that we feed over the first part of the cycle, before nadir. Small meals are easier on the pancreas, and work better with Lantus' gentle action.

I would also suggest that you consider switching to a different food. Purina DM is really junk, if you look at the label you will see that it is mostly by products. It is also expensive. There are far better options that are better quality and less expensive. Take a look at Janet & Binky's list.
 
Hi Jodi: we also feed the minimeals: PS, +1, +2, +3 and a very small snack at +5 before nadir. There are easily doses between a .75 and .50 unit....not so much fun to draw but you can. I dial in the .75u and then take one small drop off and call it a sk .75u. Many folks are shooting skinny or fat doses. Some cats can't take full reductions of .25u and can only be "shaved" by a drop. Get out your magnifying glasses :lol: :lol: :lol: Good luck!
 
Hi Jodi,

I know it is frustrating - Zoe is back on Insulin after being OTJ for a little over 2 years and it is frustrating when starting back on insulin. I have no real dosing advice - just letting you know, I understand your frustration and am cherring you and Jasmine on.
 
@ Marjorie - thanks for the tips :smile:
@ Sherry - thanks for the support and good luck with Zoe. It is very frustrating, it is like starting all over again!
 
First, these are great numbers. Like Laurie pointed out, the first 5 - 7 days the dose needs to be consistent so the insulin depot (aka "shed") forms. Because the shed is forming, you are not going to get a big response from Lantus. Please be patient. The keys to working with Lantus are patience and consistency.

How you feed depends on your cat and your cat's response to both insulin and food. The reason I front load the cycle (food at pre-shot, +1, +2, and +3) is because Gabby is prone to early, fast drops in her numbers. BJ's suggestion to feed at pre-shot, +3 and +6 may work for Jasmine. At this point, you still need to find out when Jasmine's nadir is.

I'd also urge you to find a better quality food than Purina DM. It is primarily animal by-products. It's also about 7% carb. While this is still low carb, most of us feed below 5%. To be honest, Fancy Feast is a better quality food and far less expensive than DM. You could be feeding a lower carb, premium, human grade food for what you are spending on a poor quality, expensive, prescription food.
 
Thanks Sienne for this valuable info. I have also been thinking about changing her diet and have heard many people talking of Fancy Feast classic. I will keep her at 0.5 units for a few more days and then increase her dose slightly and see what her nadir is. Then determine what feeding schedule is good for her. Her AMPS today was 145.8 and + 4 1/2 @ 169.2. Have a good weekend and thanks again :smile:
 
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