05/18 Scout, NEW, AMPS 300, shot or no shot?

Scout's mom

Scout's mom

Member Since 2021
Hello. Scout is newly diagnosed as of 04/28/2021. https://felinediabetes.com/FDMB/thr...ng-from-hepatic-lipidosis-and-ketones.247477/
Scout may be coming to lower and steadier numbers after a recent bounce. On 05/14, the hospital internal medicine vet advised me that he may be heading into remission and to give him no more shots unless his numbers move to the 300-400 range. She said that if he did move into that range, I should restart him at .5 units rather that the 1 unit he had been getting for each shot. Of course, his numbers moved to that range later the same day so I gave his PM shot after giving him no shot that AM.

He moved into the 200-250 range and stayed steady within it during the night. It is now coming time for his shot and his AMPS is 300. Should I give him his shot or not?
 
Link to your previous condo:
https://www.felinediabetes.com/FDMB/threads/05-13-2021-new-member-newly-diagnosed-cat.247331/

Firstly, with ketones in the picture, skipping a shot is not advised. We ask new members who do not have enough data to skip the shot below 150. But for cats with a history of ketones/DKA, insulin is essential. So whenever you get a number you are uncomfortable shooting, please stall without feeding and post here for advice.

On the dosing front, your spreadsheet says that you have decided to follow the TR dosing protocol. In case you haven't had the chance to look at our dosing protocols, I am linking them below. If you could take a look and pick a dosing method, we could advise you accordingly. Since you are feeding low carb canned and test quite a bit, you could follow TR. It is a more aggressive protocol but designed to get Scout to his optimal dose quickly but safely.
https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

1.5U was too high a dose for Scout and we don't have enough test data on 1U to know how he was going on that dose. You have been on 0.5U for 7 cycles now and it looks like Scout needs more insulin than that. Here we increase and decrease in increments of 0.25U. If you decide to follow TR, you can increase his dose to 0.75U.

Lastly the normal range for a cat is 50-100 mg/dl on a human meter. Spending time in those numbers helps his pancreas heal and gives a better chance for remission. Vets prefer to let cats stay in higher number because they do not advocate home testing and they would rather the cat be just below the renal threshold which is around 250-280 (differs from cat to cat).

Since you are home testing, there is no reason why you should not take Scout to a dose where he sees normal numbers and give him the best chance for remission.
 
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Welcome to you Mary and Scout. We find here that a reset almost never works. You waste precious time trying to catch up and end up on a much higher dose due to glucose toxicity. With ketones and hepatic lipidosis in his history we don’t even want you skipping doses. Post asking for dosing advice if ever a preshot is lower than 150.

Does he still have the Freestyle Libre? Do you have high carb food and Karo or honey in case we need to prop him up? I think the is DM is middle carb so some low carb pate would be good to have as well.

Bhooma has given you lots of good info as well. Keep asking questions.
 
Thank you so much, @Bandit's Mom and @tiffmaxee ! This is all very helpful. I wouldn't have questioned whether to give him his shot while in the 200-250 range but for the advice I had been given on 05/14 by the hospital internist who said to forego it unless he got back into the 300's. I was unclear when I set up my spreadsheet whether I was following the TR or SLGS dosing protocol because it was confusing to me. The link you sent me looks helpful and I will have time later today after work to review it more carefully to determine what it is I'm doing.

He does still have the Freestyle Libre. A friend of mine with diabetes gave me her spare Bayer Contour to begin testing with after his Libre stops working. I have Karo and honey. I will be going out today to get him some wet high carb food in the event of a hypo. Based on your information, I will also get him lower carb food for his regular meals, too. I had intended to switch from the Purina DM to one of the low carb Fancy Feast wet foods as soon as I use up the Purina DM that I have.

It sounds like I should also increase his dose to .75.
 
The Purina DM canned is 6% carbs and the DM Selects is 10%. But no reason to spend a ton of money on prescription food when any low carb food will do. Fancy Feast, Friskies, Tiki Cat.

This list gives a list of wet cat foods and their carb%. There are several newer variants that are missing from it though:
https://catinfo.org/chart/index.php

This is our food classification in terms of carb%:
Low carb: <10%
Medium carb: 10-15%
High carb: >15%
 
If you follow TR you can increase but with SLGS you hold the dose for 7 days. TR gives the best chance of remission. Also you did the reset dropping the dose too much.
 
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Scout's mom said:
I will be going out today to get him some wet high carb food in the event of a hypo. Based on your information, I will also get him lower carb food for his regular meals, too. I had intended to switch from the Purina DM to one of the low carb Fancy Feast wet foods as soon as I use up the Purina DM that I have.
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Welcome!

FYI the Fancy Feast beef gravy lovers is HC and pretty easy to find. I was feeding DM Selects before I knew better - if that's what you've got, instead of finishing it that would be good to keep on hand as a MC (low-end since it is just over 10%). I keep some of the DM pate on hand because Minnie will randomly decide she doesn't like what I'm feeding her, so it's a good LC 6% backup.

Good luck! You are in great hands here, @Bandit's Mom is my savior (night-time for me is daytime for her which is always when I need help!!)
 
Hi Mary, I’m glad you made it over to this page. You will get lots of help here. I’m glad you have a magnifying glass. It makes it easier to see the doses such as 0.75 units. I agree that TR would be the better option and you could increase to 0.75 units at the next Preshot.
 
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Liz & Minnie said:
Welcome!

FYI the Fancy Feast beef gravy lovers is HC and pretty easy to find. I was feeding DM Selects before I knew better - if that's what you've got, instead of finishing it that would be good to keep on hand as a MC (low-end since it is just over 10%). I keep some of the DM pate on hand because Minnie will randomly decide she doesn't like what I'm feeding her, so it's a good LC 6% backup.

Good luck! You are in great hands here, @Bandit's Mom is my savior (night-time for me is daytime for her which is always when I need help!!)
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Thank you! I have so much gratitude for this site and the people on it. I have gotten my best information yet in just the few days that I've been connected here.

I have the Purina DM pate (not the Selects) so I'll keep the small number of cans I have left as an LC alternative if Scout snubs his nose at another one. Thank you for that particular Fancy Feast food for a HC option to have on hand.
 
Bron and Sheba (GA) said:
Hi Mary, I’m glad you made it over to this page. You will get lots of help here. I’m glad you have a magnifying glass. It makes it easier to see the doses such as 0.75 units. I agree that TR would be the better option and you could increase to 0.75 units at the next Preshot.
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I'm getting the sense that TR is the best option for Scout. I gave him a 0.75 dose this evening.
 
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