05/06 Max AMPS 236 Dose Question

[critterlover]

Hi everyone

it's been awhile since I've posted although I have been reading your condos almost daily. Max has been holding his own and his numbers have been on the decline. However, I've reached a situation where I'm not sure what to do now.

Awhile back he was dropping too low on a .5u dose so I tried dropping him to .25 as per the protocol. I held it for a week but his numbers stayed too high so I brought him back up to .5 and the low cycles started again. I can't seem to find an in between dose.

I had one of my dogs in to the vet last week for her regular health check and mentioned what has been going on with Max. She said it seems as though the insulin is lasting about 15 hours instead of 12 and asked me to hold off on his PM shot for a few days just to see. That was last weekend and it does look that way. She mentioned that maybe he would benefit more from 15 hour interval injections instead of 12 but I can't always be here for those times. I've gone thru the cycles to see what the times would be and there would be 2 occassions during the cycle (it would take 4 days before it started the same times over) that would be during the day while I was working.

If anyone could give me some suggestions on where to go from here I would appreciate it.

Have a great Sunday

Dawn and Max

 

[julie & punkin (ga)]

hi dawn! nice to see you and max again.

i looked at his ss and went through all the .25u doses in early april. i think that actually was a good dose for him and am glad you're back to it now.

take a look at it again with me and i'll go through what i'm seeing.

4/8 night - he got down to 29 on the .25, but it was right after you'd decreased the dose from .5u that morning and that was likely a shed effect leftover from the higher dose.

you held the dose and he bounced from the 29. he was at 425 by the next morning, then it started to resolve and he was in greens again by that night.

4/10 morning - he's already resolving that bounce, hits the 85 midcycle and bounces to 446 by pmps. resolves that possibly by that night really late and the next day is a bounce again.

this pattern of hitting greens, bouncing and resolving repeated through the 16 cycles he was getting the .25u. i think if you had stayed with that dose, he would've settled into it and stopped bouncing. some cats take a while - but he will stop. it's like the bounces start getting half-hearted - not as high, don't last as long, resolve more and more quickly.

when you increased his dose to .5u on 4/16 he was in a bounce.

lantus does last about 16 hours, but we shoot at 12 hours because the overlap will ultimately help the cycle flatten out. if i were you, i'd hang in there longer at the .25u. as long as you are seeing greens at least every couple of days, i think it becomes a matter of patience while max gets used to being in lower numbers again. i'd also encourage you to give him a couple of teaspoons of low carb food as soon as he gets into greens to encourage him to surf a little bit. i can't tell from your comments last night if he got high carb or low carb food, but i can tell you that the dry may keep him high for another day. if i were you, i'd just hold that .25u and see if you can get him to flatten out on it.

when you see numbers under 50, use the high carb, but if he's just around 50, or close to it, try the lc to see if he'll just surf along. you want him to stay in green numbers as long as you can so that he gets used to it.

the yellow starred sticky on "how to handle low numbers" has been edited fairly recently - it has some good tips in there that might help you now.

anyway, that's my 2 cents worth - for what it's worth! hope it's helpful.

 

[critterlover]

thanks so much for the advice Julie, I will stick with the .25 dose longer to see how he does. I usually just give him his usual food when he gets low as he seems to be really food sensitive and in the past that was all he needed. Last night I was giving him Special Kitty, a Wal-Mart food that I have for one of my other cats and when that wasn't bringing him down, I gave him the dry Purina DM as a last resort

I do have a printout of the sticky "how to deal with low numbers" but I'll have a look at it again to what's changed.

Dawn

 

[Sienne and Gabby (GA)]

I would encourage you to not give dry food when you are trying to bring numbers back up. The dry stuff takes much longer to get into the system and can take just as long to work its way out. Stocking up on a gravy-based HC food is much more effective at raising numbers. If Max is carb sensitive, giving just a small amount of gravy will work well. You don't need to give a large quantity. Especially when you're seeing low numbers, like last night, I would not use LC to bring the numbers up. I'd also encourage you to test every 20 - 30 min. when you're seeing numbers that are below 40.