? ? 07/30 Peter AMPS 115 +9=56 +10=97 after HC kibble 2iuBID DOSE ADVICE NEEDED RECENT DKA

Barbara and Peter

Barbara and Peter

Member Since 2019
My cat, Peter has been diagnosed three weeks ago and put on 2 iu of lantus 2x day. I am new to this and super busy with work and family, so it is hard to catch up with everything.

Peter is eating FF two cans daily. The vet never said to monitor daily, so I don't have a ton of numbers (see spread sheet) today his AMPS # was 115 and now+9 is 56.

I got scared and fed him about 1/4 cup of high carb dry kibble, just now. He seems OK, just sluggish and inhaled the food but I can't tell if it is more than normal.

What do I need to do? Any advice on tonight?
 
Hi Barbara, was just checking in and saw your new post here. 50 on a human meter is the take action point, so it's good you were alert. I would advise testing again in about 15 minutes, and see what the BG is. The dry higher carb takes a bit to be absorbed, then again to clear the system. But you did something and that's good. He was hungry because his blood sugar dropped. Let me check and see who else is around that can help out too. Be sure to post your test results on the spreadsheet so they can take a look at them. :)
 
Hi Barbara,

Welcome to the Lantus Basaglar and Levemir group! I'm sorry to hear about Peter's diagnosis, but you have found a really great place to start! You're pretty far along already since you have your signature and spreadsheet all set up and Peter is already on a wet / raw diet Awesome!

When it comes to dosing with Lantus we follow two methods here: Start Low Go Slow (SLGS), and Tight Regulation(TR). Have a look at the description of these methods Here and decide which one is best for you. Once you decide, add it to your signature so that members here can provide feedback for dosing as you move ahead. A quick summary of the two methods is that SLGS is a more cautious dosing method for members who can't test as much due to life obligations or for members who feed dry food, safety nets are built into this method such as less common dose changes and higher dose reduction points for BG levels because members who follow this method usually aren't able to watch their cats during the day. TR is a more aggressive dosing method which requires more testing. It has more frequent dose changes and lower BG value reduction points than SLGS. Many members who work are also able to follow TR. If you're more interested in the TR method than SLGS you can read THIS POST where members share how they manage to work and follow TR :)

In both TR and SLGS. We only increase or decrease by 0.25u at a time. How long you hold a dose depends also on whether you follow TR or SLGS

I think that 2u is a really high starting dosage for a newly diagnosed kitty, I believe 0.5u is a normal start dosage for a cat that is on a wet diet, but I don't have a lot of experience. @Sienne and Gabby (GA) @Wendy&Neko @Bobbie And Bubba and @Bron and Sheba are some members who have a lot of experience in this forum so they may be able to provide better feedback on what to do for tonight. If it were me, I think I would lower the dose by at least 0.25u... maybe more.

Because Peter has had an episode of DKA I would say it might be a better idea to wait for some input from some of our more experienced members as I don't have any experience with it :)

Don't sweat feeding the kibble, lower numbers are new to you so it is always better safe than sorry! Great job keeping Peter safe :bighug:

A lot of vets don't support the amount of testing we do around here but we all REALLY believe at the very minimum you should get BG readings before each shot so that you know if it is safe to shoot. Because Peter has had a recent DKA episode it's important for him to have insulin so when you get his BG level before the next shot (we call this the pre-shot) ask for some advice here before you shoot, you should get some good advice. A good way to ensure your post gets attention is to use strategic post titles. At the top right of your post there is some blue text that says "Edit Title" select that and then on the very left of that form there is a drop down where you can choose a blue question mark icon, use this when you have a question, and then write a title something like this:

? 07/30 Peter PMPS XXX DOSE ADVICE NEEDED RECENT DKA

PMPS just means evening pre-shot

Sorry if this is a lot of info, You're doing so great already, once you've settled in one of us will help you learn how to navigate the forum in the future :)

ETA: sorry about the double tags guys! I posted before I realized Lou had :oops:
 
First of all, good job at catching that 56! It's not a dangerously low number, but it's getting close to the "take action" number of under 50.

Next time, instead of using dry food, get some "Gravy Lovers" food. Most of us use Fancy Feast. If you pop the top, put it back down and squeeze the gravy into another bowl, you'll get quite a bit of gravy. Just a teaspoon or two is usually enough to nudge them back above 50, but any time you intervene with high carb anything, you need to continue to test for the next 2 hours to make sure they stay in safe numbers.

Dry food takes longer to break down and get into the bloodstream and then it takes longer to work it's way out, so the "Gravy" or corn syrup/honey/maple syrup is a better choice. It works faster but the simple sugars also wear off fast so it's important to continue testing

I think your vet started you at too high a dose to begin with. Do you know how much Peter weighs?

With the recent DKA, it's important that he always get his insulin, even if it means feeding a little higher carb food, but I still think I'd reduce down to 1.5 until you have a little more data on him so that hopefully you don't have to intervene with the high carb foods!

Usually we tell new people that if they get a PS under 150, you should stall, don't feed and post for help. Test again in 20-30 minutes to see if the number comes up without the influence of food. When you post, make sure your subject line says something clear like "STALLING...NEED HELP!" so you get some eyes on it quickly.

We have a tradition here...if someone replies to your plea for help, we either tell you up front that we can't stay to watch you, or we stay online as long as necessary to make sure everybody is OK (or find someone with experience who can take over)

What you shoot tonight will depend on where he's at then....He may zoom up very high by then or he may stay lower.....if you test at +11.5, you'll give us some time to think about it before it's time to shoot.
 
We will have to wait for one of the other more experienced members to look at the data on the spreadsheet, Barbara, but I am certain someone will respond. How long it is until shot time?

That 97 is fine, but you may see a higher PMPS because of the dry kibble. But don't worry, it clears the system in time. You haven't had a chance yet to get much testing data.

Oh, there's Chris with more input. :)
 
Barbara and Peter said:
Also do I still need to use Ketostix to test for ketones. I thougth ketones are only in the urine when the BG is high!
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Yes....for a little while anyway.....even a cat in normal numbers can go into DKA (although it's much less likely)

Anytime there's a recent history of DKA, it's important to continue testing for awhile....they can go from negative to large in less than 24 hours...catching them early is the key
 
I will be watching, Barbara. I am way over in Washington State, so it's no problem to be available to you, if no one else is. I only plan to watch some presidential wannabes debate on TV tonight anyway.

Since sweet Peter had DKA so recently, it wouldn't hurt to keep checking, for your peace of mind if nothing else. His BGs are looking good so far, and it's true when the BG is high, the danger is greater.
 
Hello from the west coast of Canada. There are better options that Fancy Feast for high carb. The wheat in FF gave my girl the runs. Some people feeding raw will add honey or maple syrup or rice or potato flour. The Honest Kitchen dehydrated raw has potato flour in it. In canned, First Mate has potato in it, I used some of the Weruva Cats in the Kitchen pouches that have potato.

Please test ketones daily, more if he gets to high numbers.

Are you able to test anytime after PMPS and before bed? Many cats go lower at night. We determine how to change the insulin dose based on how low the dose takes the cat.
 
Barbara and Peter said:
202 mg/dL at +11.5
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He may continue to go up tonight so don't worry if he does. When they drop low, or even just drop into numbers their body isn't used to, they can "bounce" high.

The liver releases stored sugars and hormones to bring them back up quickly. It can take up to 6 cycles to clear those sugars and hormones from the bloodstream.
 
Barbara and Peter said:
I am wondering if I should lower the dose to 1.5 permanently starting tomorrow.
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I think it wouldn't hurt to try 1.5 for six cycles...if you get enough tests in, if he needs more, we could discuss increasing at that point.

Can you get at least 1 mid-cycle test on the AM cycle and at least a "before bed" test on the PM cycle?
 
Ah, there's that spike from the dry food that I thought we would see earlier. He hit some what his body would consider "lows" and you gave the high carb food. It could be a combination of the high carb dry food plus a bounce, like Chris told you.

So, not to worry about that pink, it's only one number that might be influenced by a couple of factors.

See what the AMPS is in the morning. I most likely won't be online as early (relatively) as you, but there should be someone online to check with. I do believe that the 2 Units was too much to start with, usually a starting dose is 1 Unit and then it's evaluated when the depot has established. Always err on the side of caution, better one day too high than one hour too low. I am interested to see how he does on the 1.5 Unit. I don't see that entered on the ss, but I am thinking that was the dose tonight.

You are doing very well, learning fast and you are very vigilant. It does get easier, remember that first child? I was a mess with #1, and it was so much easier with #2, I had learned a few things and felt more confident. You will learn the "sugar dance" and will be able to help another new member out with encouragement and support.
 
Barbara and Peter said:
his +2 in the evening was in the pink
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I'm not surprised at the pink tonight....he dropped low today (not dangerously low) but if his body has been living at those higher numbers for awhile, it's not used to being in "normal" numbers anymore so he "bounced"

Hopefully, as he spends more time in normal numbers (50-120 on a human meter), his body will re-learn that it's OK to be there and won't react so much.

Usually, they do gradually learn that those good numbers are OK and the bounces won't be as high and won't last as long
 
Chris & China (GA) said:
I'm not surprised at the pink tonight....he dropped low today (not dangerously low) but if his body has been living at those higher numbers for awhile, it's not used to being in "normal" numbers anymore so he "bounced"

Hopefully, as he spends more time in normal numbers (50-120 on a human meter), his body will re-learn that it's OK to be there and won't react so much.

Usually, they do gradually learn that those good numbers are OK and the bounces won't be as high and won't last as long
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So you think it was a "natural" bounce not just me feeding him a big HC kibble overdose?
 
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