1/15 AMPS HI

Giomax

Giomax

Member Since 2018
Here we go again with this "HI" business. Max just got his 5 units...hoping to see some dramatic (but not too dramatic) drop in numbers!! Will be testing every 4 hours.
 
Morning Giomax! First off, can you tell us your name? Unfortunately, I'm not familiar with your Max's situation. Can you give us some background information? Did Max start off at 3.0u? What are you feeding him? Looks like your signature indicates you fed a dry food, but have switched. Are you all low carb foods now? That can effect the insulin needs.
 
Amanda and a Loudogg said:
Morning Giomax! First off, can you tell us your name? Unfortunately, I'm not familiar with your Max's situation. Can you give us some background information? Did Max start off at 3.0u? What are you feeding him? Looks like your signature indicates you fed a dry food, but have switched. Are you all low carb foods now? That can effect the insulin needs.
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Thanks Amanda
 
We got a pink at +4! :)

Hi, Amanda. My name is Sarah (Gio is Max's kitty brother). We started Max off at 1 unit in October and when we weren't seeing results with fructosamine testing we increased about 1 unit a month. He was at 4 units up until a couple days ago, but was not getting better, home testing numbers were crazy high, neuropathy starting to set in. So I upped him to 5 units and it's some of the best numbers I've seen since we started this journey.

I switched the boys from Purina Naturals (high carb!) to a dry food called Instinct that is much lower in carbs and much higher in protein. They get a scoops of that in the morning to nibble on throughout the day and they share a can of Friskies paté in the evening. I'm not totally set on Instinct...it's just the lowest carb/highest protein food I could find at the pet store. I would like to keep with dry throughout the day though, so any suggestions on a good dry food are welcome!
 
I think I saw on Bella's thread a discussion on the dry food. I think you will find that the dry food will influence the number. There are options for low carb dry food if that is what Max is absolutely convinced he needs. Dr Elsey's or Young Again. That said, with diabetes I would think getting extra moisture into the diet is important. Those kidneys are working hard on getting that extra sugar out of the system. Have you checked out Dr. Lisa cat food list with all the carbs listed?

I just saw the yellow #, congrats! Be prepared for a possible bounce!
 
I will definitely be looking at dry food options. Max doesn't insist on the dry food, I do. At least for now! Might switch to all canned at some point. Thanks you guys for all the advice!

I think he was bouncing yesterday. Gonna test him again right before his PM shot and then again at +4
 
An automatic feeder would help while your out all day. You can put wet food in it using different ways. Freeze the food, use ice packs under trays, or my go to is just putting an ice cube in middle of food. The cube or frozen food also gives them extra fluid. All those methods will keep it fresh.
 
Hi there and Welcome to the best place you never wanted to be.

Looking at the SS one thing that popped out was that you have shot insulin without getting Pre shot test AM and PM. Since the first of the year, you have only gotten pre shot numbers 5 times out of a possible 30 times. Please always get a pre shot number so that you know that it is safe to shoot. I can't stress that enough.

With looking at Max's numbers that you got, he does look high but that said, sometimes too much insulin can look like not enough. I'll explain: On the PM cycle of 1/13, you got a blue number. Seeing a number in the blues was just enough to cause Max to bounce. The next AM you did not get a test before you shot and you increased the dose to 4.5 and then one cycle later you increase it again. What you want to do when they go lower and bounce is to let the bounce clear and that can take up to 6 cycles to clear before raising the dose again. I would hold this dose for at least 6 cycles unless he goes under a 50 and earns a reduction. But , that said, that is only if you can test pre, mid cycle and before you go to bed. The depot takes about 6 cycles to fill so it's important to not take the dose up and down without giving the necessary time for it to get stable. Try to get different test in at different times to help fill in the SS. Most cats nadir ( that is the lowest point in the cycle) somewhere around +4 - +7 so mix up those times to try to catch it. Since we are basing the dose on the lowest they go, it's an important number to get.

We are here to help you. So ask questions and read all the stickies at the top of the Lantus forum to help you help Max.

Also, we raise the insulin in increments of .25 unit so we don't shoot over a good dose. (That goes back to sometimes too much insulin looks like not enough)
 
Bobbie And Bubba said:
With looking at Max's numbers that you got, he does look high but that said, sometimes too much insulin can look like not enough. I'll explain: On the PM cycle of 1/13, you got a blue number. Seeing a number in the blues was just enough to cause Max to bounce. The next AM you did not get a test before you shot and you increased the dose to 4.5 and then one cycle later you increase it again.
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Actually, if you look again you'll see that I got the blue number when I upped his PM dose from 4 to 5. The next morning I actually went down to 4.5, not up. I was concerned I had jumped too high with the 5 units, but then didn't see nicer results with 4.5, so I tried 5 again and his numbers were a lot better and we seem to actually be making some progress.
 
A couple small corrections, we raise the insulin dose by 0.5 units if nadirs are all over 300, or if the cat’s total dose is 5 units and above. If you have to increase again, it would be by 0.5 units. But let’s gather some more data on this dose before deciding what to do next. With your first blue, you would hold the dose longer, at least 8 cycles with good data.

Speaking of data, I noticed your spreadsheet has “...” in the AMOs spot, but your post says “Hi”, so you did test this morning. Could you change the spreadsheet to say Hi”. Then we know you did a test then.

We dose based on how low the insulin takes the cat, try not to react to the high numbers you are seeing. Those are just bounces, which are signs the insulin is working and taking the cat to numbers he’s not used to yet.
 
I tried writing HI but couldn't get any text in the slots, only numbers. Hmm. Will try again! I just did another reading at +10...another blue number! I've read the procedures for insulin increases, but I just want to ask. If his PMPS is in the yellow or blue, should I still give the full 5 units?
 
Giomax said:
Actually, if you look again you'll see that I got the blue number when I upped his PM dose from 4 to 5. The next morning I actually went down to 4.5, not up. I was concerned I had jumped too high with the 5 units, but then didn't see nicer results with 4.5, so I tried 5 again and his numbers were a lot better and we seem to actually be making some progress.
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My bad, I thought the dose that PM was also 4 like the AM dose. Please excuse my mistake.
 
Giomax said:
I tried writing HI but couldn't get any text in the slots, only numbers. Hmm. Will try again! I just did another reading at +10...another blue number! I've read the procedures for insulin increases, but I just want to ask. If his PMPS is in the yellow or blue, should I still give the full 5 units?
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Yes, you are going to hold this dose unless he earns a reduction.
 
Thanks so much for your help! I appreciate you looking over my spreadsheet. I did read the protocols, but it's a lot of information to retain in one go. When exactly does he earn a reduction?
 
Giomax said:
Thanks so much for your help! I appreciate you looking over my spreadsheet. I did read the protocols, but it's a lot of information to retain in one go. When exactly does he earn a reduction?
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Since you are using a human meter, the reduction is giving when they go under 50.

It is a lot of information and I still learn each day. What helped me was to read other's post and I learned what I didn't know and could ask questions and I asked a lot of questions. :rolleyes:
 
Thanks!

The reason I didn't always test before shots was that his numbers were always so consistently high I didn't think there was any way he'd be low enough to not need a shot. Now that I'm getting better numbers though, I'll definitely be pre-testing!
 
Giomax said:
I didn't think there was any way he'd be low enough to not need a shot.
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Oh, it happens :D Kitties are full of surprises!

I also encourage you to look at other cat's SS and learn from them. Even a little bit of insulin has large effects. You might not see the effects right now because maybe Max has some glucose toxicity in him that needs to be cleared or another factor that's going on. Be prepared to reduce and monitor lows when needed. Those are quite nerve wracking to deal with.
 
I work full time, five days a week during his first cycle. That's what scares me! If he goes low I won't be here to help.
 
Giomax said:
I work full time, five days a week during his first cycle. That's what scares me! If he goes low I won't be here to help.
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What time in the AM do you shoot? Is it possible for you to get at least a +1 before leaving the house? The +2 is more ideal as if it is the same or lower than the pre shot test it could indicate an active cycle. Then you could be prepared to leave out some higher carb food according to the numbers you get. But if a +1 is all you can get, it's better than nothing.

Some peeps that work full time change the shot time up so that they can get a +2 before leaving or some come home at their lunch time that live close enough to work. It does present challenges working away all day but there are those that do it and I am sure some will offer some suggestions for you. I realize a lot of this is determined by how early you have to be at work.
 
I usually have to be to work at 6am. ^.^;

His AM shot is around 5:00-5:30, so no time for another good check. I live about 10 minutes away so could come home around 11am, but would be sacrificing my whole lunch as I only get 30 minutes. Worth it for him though! I can pretty much take my lunch anywhere from 10am-noon. Which would be the best time to check in?
 
Giomax said:
I usually have to be to work at 6am. ^.^;

His AM shot is around 5:00-5:30, so no time for another good check. I live about 10 minutes away so could come home around 11am, but would be sacrificing my whole lunch as I only get 30 minutes. Worth it for him though! I can pretty much take my lunch anywhere from 10am-noon. Which would be the best time to check in?
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Since you have that flexibility, I would shake up the test times between +4–+7 since most cats nadir between those time. Now, some cats nadir earlier and some late. But those times are a good starting place.
 
Correction on the reduction point. Since you are feeding dry food, that means Start Low Go Slow method is your dosing methid, and reductions are earned if he goes below 90. If you do manage to switch to all wet, then you could switch to TR if you want to.

Could you get a +11 test in the morning as well as AMPS? That might tell you if he is going down into preshot and an indicator to leave higher carnpb food out for snacks.

Not all cats nadir at +6. Now that you are seeing lower numbers, you will get an better picture of Max’s nadir. Today you are seeing a bounce breaking cycle. Tonight might be more active.
 
It sounds like you are using your phone to enter his data. To enter letters into a "number" cell, look for an area near your data entry that says Aa or something similar. You can toggle between letters and numbers that way. See mid right of my screenshot
 

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majandra said:
It sounds like you are using your phone to enter his data. To enter letters into a "number" cell, look for an area near your data entry that says Aa or something similar. You can toggle between letters and numbers that way. See mid right of my screenshot
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Hey, thanks! Fixed!
 
Wendy&Neko said:
Correction on the reduction point. Since you are feeding dry food, that means Start Low Go Slow method is your dosing methid, and reductions are earned if he goes below 90.
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Thanks Wendy, we overlooked the dry food. :oops: It sounds like her kitties are taking nicely to wet so hopefully they can kick the dry and she can follow TR.
 
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Hi Sarah. I am so glad Max BG's are improving. I know your mind is probably a bit frenzied with all the new information you are trying to cram in there.:) I want to add just a little more.
I looked at your last thread and didn't see ketones mentioned. Ketones are naturally made and are peed out daily.
When Kitties have high BG their body makes more of them, sometimes so many of them that they can't get rid of enough of the ketones in their urine.
An overabundance of ketones causes people and Kitties blood poisoning, their blood becomes acidic, at that point it is called Diabetic Ketoacidosis and is life threatening.
Here is a link: http://www.felinediabetes.com/ketones.htm

When I was new to the forum another member advised me to check Bear for ketones and he did have them.
They saved Bear's life.

I got the Relion ketone test urine strips at Walmart or Walgreens. They can be used for kitties or people.They aren't that expensive around $7 at Walmart.
I just put them under Bear as he pees but there are multiple ways to collect urine if Max is skittish when he pees. I now test Bear frequently.
 
Thanks! Will definitely be getting some of those! If his pee has already touched the litter (not fully absorbed, but pooled in the litter) will it still be accurate?
 
Giomax said:
Thanks! Will definitely be getting some of those! If his pee has already touched the litter (not fully absorbed, but pooled in the litter) will it still be accurate?
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Yes, it will. Some use saran wrap and put it in kitties favorite pee spot and some use a large spoon and collect as they pee. ;)
 
I have two cats and Gio is a scratcher/digger...I don't think Saran wrap will work! It would drive him nuts, lol. I also have a covered box because they like to fling litter, but I think Max is still peeing enough at this point that I can stick a strip in there before it all gets absorbed.
 
I'm so glad some of the experts stopped by to give you advice. I got busy at work and couldn't respond back this morning. :oops: My buddy Lou is what we call a high-dose kitty, even though his dose isn't crazy high right now (he has insulin autoantibodies - IAA). We've been working on getting him back into good numbers after a flare-up, so I can understand the frustration. I used to drive myself crazy worrying about the high numbers, and sometimes I still do if I'm being honest. Probably the best advice you'll get here is feline diabetes is a marathon, not a sprint. These depot insulins are not fast-acting, so you'll have to learn patience with getting Max into better numbers. It's early days yet. Just remember you're doing the best you can to help him, and you really are in the best place you never wanted to be for when you need assistance. Also remember that Max is more than his numbers and try to focus more on how he's feeling (I know, easier said than done sometimes). We're here to help! :bighug::bighug:
 
Giomax said:
I just ordered some. Sad I have to wait for shipping. I really hope it helps him!
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I think it will. A lot of peeps here have great results with it. I have used it for my civvie with other issues and having hind leg issues and it really helped him.
 
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