1/10 Leo AMPS 334, PMPS 414

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Lacie

Lacie

Member Since 2010
Leo and I have been at this Lantus thing for just over three weeks. I'm still working with him to get detailed curve numbers without stressing him out. It's getting easier, but I don't like forcing the issue.

Could someone look at our SS and explain why are his BG numbers going up AFTER a shot? I know they're supposed go up +2 if he eats, but at +4 they should be going down. I've looked at a lot of SSs by other members, and I can't find anyone else who has had this problem. I've run control solution on this vial of strips.

I've been following the Lantus recommendations here and holding the dose for 3 [edit: 6] cycles before each increase, then increasing .25u each time. It's only been 1 cycle on the 2.25u, so I know I need to let the shed fill, but these BG increases after shots are upsetting me. I'm worried about acro and/or insulin resistance.

The Lantus immediately helped his coat, his energy level, and his excessive drinking. P/U is only somewhat reduced (though it's gotten better). He's gained weight but not enough considering how much he eats. He's still peeing outside the litter box, which wasn't a problem before the diabetes.

I free feed him because I want him to have a steady intake of food instead of a lot of highs and lows. I try to let him run out of food overnight before I take his AMPS the next morning, but that's hard to control, and I know some of his AMPS numbers aren't fasted. The one yellow AMPS on 1/7 was probably due to a spoiled strip (I was running low and awaiting a new shipment). His PMPS test results are always fasted. Leo eats canned food no higher than 7% carb.

I apologize that I don't have more frequent BG readings--Leo and I are new to this and still working things out together. But the way things are going, I don't think I have to worry about him going low anytime soon. I do test for ketones 1-2 times per day. The ketone issue worries me too - these pink numbers need to come down ASAP.

Most recent condo here (1/4)
viewtopic.php?f=9&t=33571

Edit: +6 is 348, nice smooth day. Now let's see those numbers come down!
 
Re: 1/10 Leo AMPS 334, +4 368, need eyes on SS ???

I am not an expert, but I'll take a look at your spreadsheet until someone smarter comes along! But even before I do that, I want to reassure you. Three weeks is MUCH MUCH too soon to worry about acro. You've barely gotten Leo started. Inverted curves - seeing a rise mid-cycle- happen. I think more often they indicate the need for a reduction in dose, which would not be the case here, but it's not a bizarre occurrence.

About feeding: A cat with diabetes is "starving," in the sense that its body is not able to take nourishment from the food. For this reason, it's usual to say that you should let a cat not regulated eat whatever he wants. You can leave him plenty of food overnight.

Back in a minute.
 
Re: 1/10 Leo AMPS 334, +4 368, need eyes on SS ???

Just took a look at your SS. Again, I'm not the world expert, but here are a couple of comments.

- I see that Leo had a nice drop on 1/8. I also think -- someone else will probably correct me -- that going from 334 to 368 is not that big a change. My GUESS is that he is just not really at his best dose yet, and you should continue the great work you're doing, gradually increasing.

- 7% food is not as low as you can go. It's great that Leo is eating soft food, but you can try for a lower carb content. See Janet & Binky's list for ideas: http://binkyspage.tripod.com/canfood.html

- Can you work towards trying to get at least a +2 after the evening shot? It's very important to see how Leo is doing at night. Many cats go lower at night. I realize his BG is fairly high, but he can have a nice breakthrough at some point and go lower. You want to see that.

Let's see what others say. I know you'll get great feedback today. Keep breathing! You're doing great.
 
Re: 1/10 Leo AMPS 334, +4 368, need eyes on SS ???

Thanks Kathy! Can you tell I'm stressing over this?! The past three weeks since Leo's dx have been a blur.

I'm still learning tricks for getting an easier BG test and am looking forward to posting more frequent numbers this week. I'd love to see some more of that nice yellow.

What was the stuff some folks here put on food to increase appetite? I much prefer to feed all of my cats the 0% carb EVO, but they like the 7% Friskies soooo much better. I read that cheap food has an artificial flavoring that makes cats scarf it up. I wouldn't be surprised if the 7% Friskies might be contributing to the mid-cycle bounce. Off to the pet supplies store today for another case of EVO.
 
Re: 1/10 Leo AMPS 334, +4 368, need eyes on SS ???

Hi Lacie,

Just took a peak at your SS. Again, still not an expert here but it appears pretty normal as far as response this early. Take a look at Atlas' SS. You'll see a lot or mid-cycle highs and very few lows until recently.

So take a deep breath, you're doing the right things and taking the right actions. As members here can tell you...patience...

If you care to flip back through my condos to the beginning of the year...I was pretty depressed and tired with Attie, diabetes, pokies and tests.

And then ....slowly the recent dose change, feeding schedule adjustments...started working.

So have hope, breath, and it will get better.
 
Re: 1/10 Leo AMPS 334, +4 368, need eyes on SS ???

There are a couple of "appetite incentive" tricks! You can sprinkle freeze-dried chicken dust (treats) on top. We use Halo brand, which we order by mail. I swear, Kitty eats the food only because it's attached to the treats! :lol:

Some people use bonita flakes. It's a fish flavor cats crave. Not sure where to get those, but someone here knows.

As for food: Kitties are -- surprise -- finicky! I have tried every possible food, and we ended up with Fancy Feast. If Leo wants Friskies, that is FINE. You can make a change later if you like, but there's nothing wrong with getting food into him however he will take it right now. Just look at the carbs and whether Leo will eat it.

Not all cats will eat Evo. It has a slightly higher fat content, and some kitty tummies don't like it.

The first few weeks are exhausting. There is so much to learn, and with the shots and tests and changes, it's a marathon. But you will find your groove soon. Promise. :mrgreen:

As for making testing easier, have you heard all the tricks about warming the ear with a rice sock, massaging the ear, etc.? I also used neosporin pain relief on the test site. People here have been ingenious.

And yes, look at Blue's SS for Attie, who is doing GREAT!
 
Re: 1/10 Leo AMPS 334, +4 368, +6 348

Wow, Atlas and Blue are amazing. There are so many great stories here.

I'm sniffling and wiping a few tears away while 8-month-old Osky darts around the house like a madman and Leo tries to get some sleep in spite of his idiot human poking his ear. :cool:
 
Re: 1/10 Leo AMPS 334, +4 368, need eyes on SS

Hi Lacie, nice to see you! First off, take a deep breath....it can be very frustrating, particularly in the beginning! It sounds like you are trying hard at everything, so good for you! Hang in there, it will get better!

Just a quick note about the cycles....each cycle is one shot, so there are two cycles per day. Not a big deal, just clarifying for you and others that might think you are increasing after 3 cycles...you are increasing after 6 cycles, or 3 days....per the protocol.

Many cats go higher right after a dose increase, while the shed is adjusting to the new dose...it's called NDW (new dose wonkiness) and is pretty common. As far as the increase from AMPS to +4 today, it also could be food related. I see on your SS that the +4 was after lots of food....it easily could be a food spike. In regards to the feeding, free feeding is fine, but it's best if you can pick up the food at least 2 hours before shot time so you get a clean test. Allowing him to eat any other time is ok.

A cautionary note about feeding as much as he wants....unregulated kitties are hungry kitties, that's because their bodies are not able to use the food efficiently. They will often eat everything you give them, and many people will tell you that it's fine to feed as much as they want...I used say the same thing! However, overfeeding contributes to high BG levels and makes it harder to regulate them, so I would not give him an unlimited food supply. Feeding a moderate amount above what he should need *may* be ok if he needs to gain weight, but I would keep it reasonable. How much does he eat per day? The profile says about 1 can...is that 5.5oz or 13oz? Is he underweight?

I'll preface my comments with the following: I know the testing is hard in the beginning, so please don't think I am being critical of you, that's not my intent! I'm just looking at the SS and giving you my thoughts about the data and how you could improve your monitoring. It would really help you if you could try to get a PS test before each shot (which you have been recently, good!), and at least one spot check in each cycle, AM and PM. Many people get a test right before they go to bed at night, around +3 or +4. Some of the spot checks need to be around his nadir so you can see how low he is getting. Since you don't know when his nadir normally is, a curve would be great because then you can see where his usual nadir is, so you know where to target the mid cycle tests. A curve is every 2 hours, a mini curve is every 3 hours through the cycle. Naturally, if you are having trouble getting spot checks, I understand that getting a curve is asking a lot right now...just food for thought because it will help you a LOT if you can do it. Also, many kitties go lower at night than they do during the day, so it is possible that Leo is going low at night and then bouncing during the day, giving you those higher numbers. You may be missing the data that would show you that he doesn't need an increase in dose. That's why it's so important to get tests in both cycles, so you can see patterns. Without the PM tests, you are missing half of your data, and that makes the other half of the data much less useful than it could be.

If any of this doesn't make sense, please ask questions!

You mentioned Acro and insulin resistance....those are always possiblities to be considered. However, 2.25u is not a very high dose, so I wouldn't start worrying about those issues at this point.
 
Re: 1/10 Leo AMPS 334, +4 368, +6 348

Thanks Laurie. I clarified my profile to say that Leo is eating about 1 cup of wet food per day and edited the cycles error. He's underweight by about 2-3 pounds, rear flanks sunken in and I can feel his spine, so I'm going to continue to let him graze. But I also need to measure what he's eating so I have a baseline. After all, I track my own calories (for a different reason :roll: ) and I don't just eat anything that lands in front of me, so why should my cat have the same privilege :lol:

Yeah, I figured the lack of numbers on our SS would come in for some gentle encouragement from the board. I was even a bit hesitant to post for that reason. I'm working on filling in more of those blanks but my first priority is to make sure Leo doesn't hate test time for the rest of his life. I'm home all day this week, so I can observe visually for hypo signs while we continue to negotiate more frequent test intervals. We're aiming for an every 2 hours curve for the daytime cycle today if he'll tolerate it.

I'm glad I now know that numbers in the 300s during the early weeks of treatment aren't unusual, and that 2.25 isn't a terribly high dose for Lantus. Again, thank you for the support.
 
Re: 1/10 Leo AMPS 334, +4 368, +6 348

Oh please don't hesitate to post! We are here to help, and we can't do that if you don't post! We do understand how hard it is in the beginning, we've all been there! I understand that you are doing the best you can. :smile:
 
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