1/23 Sammy AMPS 413- Need advice on dosing.

[Sarah and Sammy]

Long story short (ish) Sammy was on 1 unit of Lantus BID then we had a hypo moment out of the blue (43) not sure what may have been different about this day, i took him to the vet because i'm still new to this and have very high anxiety about it due to when he was first diagnosed his BG dropped to 22 and he had a seizure.. The Vet suggested that we change his dose to 1 unit 1x a day ( I didn't feel confident with this decision so I started SLGS) after a week of super high numbers, I went back to 1 unit BID last week Thursday We recently transitioned the rest of our cats to the FF pate diet as well because i wasn't positive if he was or was not getting to some of their food since then Sammy has been starting off his days in the 400's I test, feed then give insulin but by the time I go to test him at 6 pm hes been in the 100's so I haven't been giving insulin and i feel like its creating a cycle. Does this mean his dose is too high?! i plan to do a full curve on Saturday. is it too soon to say without that curve?

 

[Mimis mom]

Let me get some experts to help you

The thing I found alarming was stopping an insulin shot. You risk them going DKA (diabetic Ketoacidosis) which is deadly- I was skipping shots when Mimi first got diagnosed because I was afraid of her going hypo- but that’s not what you do... read “how to handle low numbers” on the sticky in this forum.
It’s not as scary as it sounds- you can get them up pretty easily. And then adjust the dose the next cycle. The hundreds are good to be in. I’ll read the stickies on this forum over and over again- it’s really helpful.
See this is why I like Tight regulation because you’re supposed to test more throughout the day. (If your schedule allows it)



@carfurby
@Marje and Gracie
@Sienne and Gabby (GA)
@MrWorfMen's Mom

 

[Si am cat mom]

Hi there !

I know it can be overwhelming caring for a pet with diabetes- you are already doing so well by home testing and seeking advice.

I did notice that on the 12th it looks like you got a reading of (74) on the 0.5 unit dose. With SLGS, that would have called for a reduction since it was less than 90. It looks like you doubled the dose to 1 unit. They usually recommend 1/4 unit (0.25) increases and decreases here, so that you can catch a good dose or gradually see if an increase is too much. I would try the 0.5 units again if it were me, to see if you get flat numbers that you can shoot consistently... but someone with more experience should be by in a few !
Are you able to grab test before bedtime...maybe a +4 or something ?

 

[Wendy&Neko]

Hello and welcome from me. Is there any way of getting rid of the green in the spreadsheet cells? We reserve that lime green for low numbers so it's alarming to see it if you didn't actually get a value below 68.

I think I would start by going back to 0.5 units twice a day. If you are having to skip multiple times, it's better to give a lower dose twice a day. It's possible that the high numbers you are seeing at preshot are because he's bouncing, because he's getting some lower numbers in the middle of the cycle than his body is used to. You also saw some higher numbers at 0.5 units due to the skipped dose. The Lantus depot has to rebuild before you can see what the dose can do. I would hold the 0.5 unit dose for a week now, then perform a curve and we can decide what to do next. Unless of course he goes below 90, in which case you would further reduce down to 0.25 units.

Are you testing for urinary ketones? Not all cats get ketones, but it's a good thing to test for when their numbers are high as a safety precaution.

Here is the link to your last post here, for a little history. http://www.felinediabetes.com/FDMB/threads/im-new-and-need-help.223987/
We include those links to make it easier for those helping you.

 

[Marje and Gracie]

Since Wendy has answered your question, I’ll just offer to fix the spreadsheet for you if you send me a private message. To do that, click on “Marje and Gracie” to the left and then “start a conversation”.

 

[Sarah and Sammy]

Let me get some experts to help you

The thing I found alarming was stopping an insulin shot. You risk them going DKA (diabetic Ketoacidosis) which is deadly- I was skipping shots when Mimi first got diagnosed because I was afraid of her going hypo- but that’s not what you do... read “how to handle low numbers” on the sticky in this forum.
It’s not as scary as it sounds- you can get them up pretty easily. And then adjust the dose the next cycle. The hundreds are good to be in. I’ll read the stickies on this forum over and over again- it’s really helpful.
See this is why I like Tight regulation because you’re supposed to test more throughout the day. (If your schedule allows it)



@carfurby
@Marje and Gracie
@Sienne and Gabby (GA)
@MrWorfMen's Mom

I did not ever stop giving insulin. i missed one dose.. Also i noticed whenever he has bottomed out it has been during the times that i am typically at work. I am not able to leave my job nor would i know if something was to happen.

 

[Sarah and Sammy]

Hello and welcome from me. Is there any way of getting rid of the green in the spreadsheet cells? We reserve that lime green for low numbers so it's alarming to see it if you didn't actually get a value below 68.

I think I would start by going back to 0.5 units twice a day. If you are having to skip multiple times, it's better to give a lower dose twice a day. It's possible that the high numbers you are seeing at preshot are because he's bouncing, because he's getting some lower numbers in the middle of the cycle than his body is used to. You also saw some higher numbers at 0.5 units due to the skipped dose. The Lantus depot has to rebuild before you can see what the dose can do. I would hold the 0.5 unit dose for a week now, then perform a curve and we can decide what to do next. Unless of course he goes below 90, in which case you would further reduce down to 0.25 units.

Are you testing for urinary ketones? Not all cats get ketones, but it's a good thing to test for when their numbers are high as a safety precaution.

Here is the link to your last post here, for a little history. http://www.felinediabetes.com/FDMB/threads/im-new-and-need-help.223987/
We include those links to make it easier for those helping you.

the green is gone! ( still getting used to the spreadsheet).. i see what you are saying however i noticed that when he was on the .5 BID his numbers ( which i wasnt able to get written down consistently to put on the spreadsheet) were super high. the highest i saw was 557, he was sleeping much more and much deeper. if i was to go back to .5 BID do i just start doing that tomorrow or should i wait to do a curve ( i planned to do one on Sat) ?

 

[Mimis mom]

I did not ever stop giving insulin. i missed one dose.. Also i noticed whenever he has bottomed out it has been during the times that i am typically at work. I am not able to leave my job nor would i know if something was to happen.

All it took was skipping one dose for Mimi to go DKA- but the recipe is also not eating and infection. So not to be alarmed. I just know you shouldn’t skip if it’s low- there are other protocols that are more effective and safe too.

 

[Wendy&Neko]

Thanks for fixing the green!

Without seeing those high numbers you saw on 0.5 units, it's hard for me to comment. Other than to speculate he was bouncing. That 22 he got would definitely cause a bounce.

Since you have had to skip dosing a couple night, the 1.0 unit depot will be depleted, and a Saturday curve will not give you a good picture of what the 1.0 unit dose can do.

 

[Sarah and Sammy]

Thanks for fixing the green!

Without seeing those high numbers you saw on 0.5 units, it's hard for me to comment. Other than to speculate he was bouncing. That 22 he got would definitely cause a bounce.

Since you have had to skip dosing a couple night, the 1.0 unit depot will be depleted, and a Saturday curve will not give you a good picture of what the 1.0 unit dose can do.

sure i understand i will try to see if i can go back in the history of my meter to get accurate numbers if that helps some.. it is safe for me to start the .5 BID tomorrow and continue to do so for a week then do a curve? is changing his doses too much going to mess with his system?? Also to answer your question i have not tested for Ketones. i'm not sure how to do so. We have 4 cats total is there any tricks/tips?

 

[Wendy&Neko]

People following TR for dosing change doses as often as every three days, depending on nadirs.

Here are tips on testing ketones. I used to follow Neko when she went to the litter box. Some people get blood ketone meters if they cannot catch a urine sample.

 

[Sarah and Sammy]

People following TR for dosing change doses as often as every three days, depending on nadirs.

Here are tips on testing ketones. I used to follow Neko when she went to the litter box. Some people get blood ketone meters if they cannot catch a urine sample.

if i was to get a blood Ketone Meter is there one that you could suggest? all the ones i see on Amazon for the "Keto Diet" is that the same thing? Today i will start .5 BID his AMPS for today was 250.

 

[Wendy&Neko]

I don't see a post for Sammy for today, so am replying here. Just below the picture on this post, you will find links to the Precision Xtra and Nova Max Plus ketone meters. Shop around, the strips are pricy but you can get them cheaper some places.

 

[Mimis mom]

if i was to get a blood Ketone Meter is there one that you could suggest? all the ones i see on Amazon for the "Keto Diet" is that the same thing? Today i will start .5 BID his AMPS for today was 250.

ADW has a free meter with the purchase of 20 test strips for the Presicion ketone meter. One thing to consider- the test strips are about 2$ a strip- and they require .9u of blood where as the glucose meters are .5 and .3, do you have to get a good amount of blood. Sometimes I don’t get enough and it starts reading anyway and says an error message, and I near want to throw the machine across the room. Anyway, I have even placed Mimi in the litter box after she’s eaten or if I noticed she’s been in the same spot for a while- to see if she has to pee, and as soon as she does- I just stick a Ketostick into the urine stream. Some people collect it in a ladle, but I’m more impatient than that. Lol.

 

[Sarah and Sammy]

I don't see a post for Sammy for today, so am replying here. Just below the picture on this post, you will find links to the Precision Xtra and Nova Max Plus ketone meters. Shop around, the strips are pricy but you can get them cheaper some places.

am i suppose to post daily? Today we started .5 BID--- his numbers are posted on his spreadsheet.

 

[Mimis mom]

am i suppose to post daily? Today we started .5 BID--- his numbers are posted on his spreadsheet.

You should post every day. It’s a second job. In the beginning I was like “are you kidding me” with all of the things I needed to do (or was encouraged highly to do) now I feel in so much control with Mimi. People told me I’ll get used to it, and now I’m here telling you, you will as well! The more info you can share, or gather, the higher the chances of a possible remission!!

 

[Mimis mom]

I don't see a post for Sammy for today, so am replying here. Just below the picture on this post, you will find links to the Precision Xtra and Nova Max Plus ketone meters. Shop around, the strips are pricy but you can get them cheaper some places.

I haven’t yet found a place to get them cheaper- I’ve found around 20$ for 10.
The ones from amazon don’t seem to work all the time- constant errors- and others have commented to amazon as well with the same complaint. Amazon was good in refunding me for what could have been a “bad batch”

 

[Sarah and Sammy]

You should post every day. It’s a second job. In the beginning I was like “are you kidding me” with all of the things I needed to do (or was encouraged highly to do) now I feel in so much control with Mimi. People told me I’ll get used to it, and now I’m here telling you, you will as well! The more info you can share, or gather, the higher the chances of a possible remission!!

I posted for today hope I gave some useful inf.