1/6 Poppy PMPS 76 AMPS 285 +3 208, +6 58

Monica-Poppy

Monica-Poppy

Member Since 2020
Yesterday's thread: https://www.felinediabetes.com/FDMB/threads/1-5-poppy-amps-339-5-191-pmps-76-after-1u-amps.241050/

@Bandit's Mom About the <1u dose in Poppy's spreadsheet, because the smaller syringes haven't arrive yet (they are supposed to be delivered today), I used the 1ml/100u ones so it's kind of an approximation :confused: I tried to be with the plunger seal just above the first unit.

AMPS = 285 , +3 = 208 , +6 = 58 so still going pretty low
When do you suggest I should test again? +9 or earlier?
No dry food. She only ate low carb canned food and a few grams of boiled chicken between AMPS and +6

I also talked to the vet. Looking at the values and how things evolved, he said that it looks that her pancreas is really trying to help her. He suggested sticking to the 1u dose for consitency.

Regarding my experience, I had another cat with diabetes. He was diagnosed with diabetes when he was 12 years old, and died at 15, about 7 years ago. Never got into remission. Unfortunatelly he developed diabetic neuropathy and, at that time, the vet did not give him any treatment for that. The last month of his life was absolutely terrible. He was not on a strict diet because he also had kidney problems. No small syringes back then, so harder to dose right. And in Romania the vets had even less experience than they have now. It was very hard becuase it was my first cat, had him since he was 2-3 months old.

So regarding the dose and testing I am not necessarely unconfortable or unexperienced. I would just like to treat Poppy the best way I can.
 
I will answer you queries in detail later but I want to address that 58 at +6. Please test her again at +7. Did she eat anything at +6?
 
Monica-Poppy said:
@Bandit's Mom About the <1u dose in Poppy's spreadsheet, because the smaller syringes haven't arrive yet (they are supposed to be delivered today), I used the 1ml/100u ones so it's kind of an approximation :confused: I tried to be with the plunger seal just above the first unit.
Click to expand...

Can you get syringes of smaller capacity locally? 0.5ml or 0.3 ml? Even if they don't have 1/2 unit markings? Looks like 1U might be too much for her.
Do you have wet food with higher carbs - say 10 or 12% carbs?


Monica-Poppy said:
Regarding my experience, I had another cat with diabetes. He was diagnosed with diabetes when he was 12 years old, and died at 15, about 7 years ago. Never got into remission. Unfortunatelly he developed diabetic neuropathy and, at that time, the vet did not give him any treatment for that. The last month of his life was absolutely terrible. He was not on a strict diet because he also had kidney problems. No small syringes back then, so harder to dose right. And in Romania the vets had even less experience than they have now. It was very hard becuase it was my first cat, had him since he was 2-3 months old.

So regarding the dose and testing I am not necessarely unconfortable or unexperienced. I would just like to treat Poppy the best way I can.
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Is Poppy showing any signs of neuropathy? My cat Bandit had neuropathy in the first few months after diagnosis. I gave her methylcobalamin B12 that I found locally. I am India so the brands here are different from the ones available in the US.
https://www.felinediabetes.com/FDMB/threads/feline-diabetic-neuropathy-weak-back-legs.178252/
 
Bandit's Mom said:
Can you get syringes of smaller capacity locally? 0.5ml or 0.3 ml? Even if they don't have 1/2 unit markings? Looks like 1U might be too much for her.
Do you have wet food with higher carbs - say 10 or 12% carbs?

Is Poppy showing any signs of neuropathy? My cat Bandit had neuropathy in the first few months after diagnosis. I gave her methylcobalamin B12 that I found locally. I am India so the brands here are different from the ones available in the US.
https://www.felinediabetes.com/FDMB/threads/feline-diabetic-neuropathy-weak-back-legs.178252/
Click to expand...

I just received the BD Microfine Demi of 0.3 ml with 1/2 markings :cat:
I do have the "hypo kit" in case of emergency.

No she is not showing any signs of neuropathy so far. What signs did Bandit show?

Just gave her 2 teaspoons of lc canned food.
 
Monica-Poppy said:
I just received the BD Microfine Demi of 0.3 ml with 1/2 markings :cat:
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GREAT! Then you can shoot 0.5U at night! The idea is not to skip so many shots. If 0.5U is not enough, we can increase in 3 days per the TR protocol.

Monica-Poppy said:
What signs did Bandit show?
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Weakness in the hind legs. Began with a slight limp. Then she couldn't walk very long without needing to sit down. Completely stopped running and jumping to higher surfaces. It was awful. It got to a point where she would hold her pee in because she didn't want to walk to the litter box.

Monica-Poppy said:
Just gave her 2 teaspoons of lc canned food.
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Let's see what +7 has in store! :)
 
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Nice numbers for Poppy today, Monica :bighug: And Jax had mild neuropathy when he was unregulated - stumbled when he walked, stopped jumping to the counter and his cat tree. He is on the methyl-b12 Bhooma mentioned - he doesn't have symptoms any more (and is pretty much regulated with his diabetes). This video is really sweet and shows how the neuropathy can be reversed -

Hope you have a wonderful rest of your day :cat:
 
@JaxBenji Jax and his brother/sister are adorable. He made such big progress. Poppy seems fine for the moment, but I will keep an eye on her, she is very playfull, doesn't hesitate to jump.

Unfortunatelly she has some other health problems. One of them is the reason why I got her from the street. She was a stray until October 2020 and I got her with the intention to treat some skin problems that she seem to have, and foster her until we found a forever home. We've got 3 more cats and one of them is really not fond of Poppy. The stress and the tension between them don't help at all. Now that she has diabetes, we stopped promoting her for adoption. People here hardly adopt young healthy animals, no one will want an adult diabetic cat that also has some other health issues.

So she had a very ugly rash on the skin, compulsively licking herself to the point where she made wounds on her back. The vets suspected some sort of allergic reaction or eosinophilic syndrome. She was on prednisolone and hypoallergenic food (Hill's z/d) for a month (until we discovered the diabetes symptoms). The itching and licking stopped, the skin looked much better after the prednisolone. Unfortunatelly, I recently noticed the she started the licking again :( and she has a small wound on her back (I attached a photo). I found out the Kattovit Sensitive, which is reccomended for food allergies, is also low carb and good for diabetes, so I ordered her some cans to see how it goes.

Besides this, she has some coughing episodes, so she had an Rx where they found out some problems at her lungs :( She needs more investigations that should be done under anesthesia. The vet reccomended that we first try to regulate her diabetes and then we continue the lungs investigations.
 

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@JaxBenji I took a look at Jax's spreadsheet. His values look so good. I have a question though: so when his AMPS / PMPS is 56 or 82 (I am looking at 01.04 - 05 for example) you still give him his regular dose of Lantus, 1.25u?
For the moment I am affraid to give Poppy the dose when her BG is under 100. I am affraid she will go into hypo, especially overnight when I can't supervise her that much. If you look at her spreadsheet, you will see that I skipped the insulin @PMPS in the last 3 days.
 
Monica-Poppy said:
Jax and his brother/sister are adorable. He made such big progress. Poppy seems fine for the moment, but I will keep an eye on her, she is very playfull, doesn't hesitate to jump.
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I just love that video because it's so hard to see cats with neuropathy and to know it can be largely reversed gives hope - and that's not Jax in the video (he's the black kitty in my profile pic).

Monica-Poppy said:
@JaxBenji I took a look at Jax's spreadsheet. His values look so good. I have a question though: so when his AMPS / PMPS is 56 or 82 (I am looking at 01.04 - 05 for example) you still give him his regular dose of Lantus, 1.25u?
For the moment I am affraid to give Poppy the dose when her BG is under 100. I am affraid she will go into hypo, especially overnight when I can't supervise her that much. If you look at her spreadsheet, you will see that I skipped the insulin @PMPS in the last 3 days.
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Yes I do shoot the full dose - I follow TR and shoot anything over 50. I also have lots of data and am confident in handling low numbers (I know what to feed and when) - I was mentored by Elise (@tiffmaxee) when I was starting out. A lot of shooting low numbers hinges on the caregiver building confidence - it will come with time - and it helps when the more experienced folks guide you. When I first shot low, Elise would stay online with me & tell me when to test/feed. Now, I can manage it myself.

Sorry about Poppy's other health issues - she sure is lucky to have you :bighug: I'm sure some of those folks Bhooma tagged will chime in with thoughts :cat:
 
@Monica-Poppy The next time you get a lower PS number that you are not comfortable shooting post here and tag any of us and someone will help you with it.
Use the "?" prefix in the title and say something like "NEED HELP SHOOTING LOW AMPS/PMPS" in the title.
 
Hi monica and poppy.

Monica-Poppy said:
For the moment I am affraid to give Poppy the dose when her BG is under 100. I am affraid she will go into hypo, especially overnight when I can't supervise her that much. If you look at her spreadsheet, you will see that I skipped the insulin @PMPS in the last 3 days.
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So would I.
The reason you will see many of us shoot low, is because we have taken the dose up gradually and we know that the cat is not on too much insulin, so the dose, is about right, how much they respond to a given dose does change depending on absorption, healing of the beta cells, and sometimes which way the wind is blowing. It's a moving target. That's why we reassess dose and make adjustments regularly based on how low the dose is taking the cat.
You haven't got to this dose in a way that makes me confident that it isn't too much for her, and you are reducing the dry.(the hills diabetic dry is high carb, crazy I know but there you go)......so I would expect her insulin needs to be reducing.

I think you need to take the dose down.
But you with lantus you need to be dosing (if safe) twice a day 12hours apart, the dosing strategies we follow here are based on shooting regular doses, we do not shoot different doses in the morning and evening.
Shooting 1u once a day is not giving you 24hrs duration so you see her climb back up by the next morning and you get into this roller coaster cycle.

I might be tempted to try, 0.5u twice a day.
Even that may prove too much once the dry has worked its way out of her system. You will need to be vigilant over the next few days, while we try to help you figure out what is a good dose and get you to a point where you are shooting regularly the same dose twice a day.

Now to the reason why @Bandit's Mom tagged me
Monica-Poppy said:
Unfortunatelly, I recently noticed the she started the licking again :( and she has a small wound on her back (I attached a photo).
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I think getting rid of the dry may help, a lot of additives in that diabetic food.

If she is allergic to something then it's trying to figure out what it might be that's the trick. Some folk do it by process of elimination, it takes time.
I use the Katovit Sensitive, my guy seems to love it, I use it because it's relatively low in phosphorus, and he has CKD. Animonda do some single protein, no additives flavours that are LC you can find them on the UK food list. There are other single protein foods on that list, I would look for stuff that's simple no added gunk.

the picture you posted looks like something George got a while back, he's never been allergic to anything, but I suspect it was a bite, we too have other cats, and he's a 21yr old grumpy kitty at times, he picks on the others and I think he may have gotten bitten for his troubles, and it was an abscess that I didn't notice.
Perhaps one of the other cats got her???

I've been trying to look for a picture of his wound in my photo album, but I think I may have deleted it. Keep it clean, and hopefully it will heal up.
 
@Gill & George
I see. I imagine it takes a lot of time and close observation to feel confortable to shooting at low values. I know that Lantus is supposed to be shot twice a day, 12 hours appart and that is all about consistency.
It looks like +9 is still low, 68. I doubt that PMPS will be over 100 (for me to feel confortable to shoot). What do you suggest?

It is definitely not a bite from the other cats. I work from home so I constantly supervise them, and for the time being, at night or when we leave home, Poppy stays in a separate room form the other cats (fortunately she is a sweetheart and doesn't object too much). The spots where she had wounds when I got her from the street, were shaved by the vet so the skin could heal so I checked them constantly. The itching and excessive liking is in the exact same spots and started againg a couple of weekes ago. I see her licking and "scratching" with her teeth, pulling out hair sometimes :( It's obvious that she feels itchyness disconfort in that place. I thought it might also be due to stress. But she got the same problem on the street and at home, so I don't know. Today I got her flea treatment, maybe she got infested at one of our latest visits at the vet. I read that flea bites can cause serious skin problems for some cats, something in their saliva. Hopefully, the Katovit Sensitive will help.
 
Hi. I saw the picture of her back. Does she have any of those anywhere else? I think it looks like what my Mocha has had on her lips. It is called EGC, eosinophilic granuloma complex if it is. I had to switch her diet to a protein she had never eaten before. I feed her a raw diet so there are several single proteins to choose from. Here’s one article on it.
https://icatcare.org/advice/eosinophilic-granuloma-complex/
I also would take poppy down to .75
 
Monica-Poppy said:
It looks like +9 is still low, 68. I doubt that PMPS will be over 100 (for me to feel confortable to shoot). What do you suggest?
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If you are not comfortable, skip and shoot 0.5U twice a day from tomorrow. @Gill & George

It could be flea allergy dermatitis, but do you see fleas? Is she scratching anywhere else? Bandit had a fungal infection last year - bald patch, excessive licking...My vet recommended an antifungal ointment (clotrimazole) mixed with aloe vera gel.
 

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tiffmaxee said:
Hi. I saw the picture of her back. Does she have any of those anywhere else? I think it looks like what my Mocha has had on her lips. It is called EGC, eosinophilic granuloma complex if it is. I had to switch her diet to a protein she had never eaten before. I feed her a raw diet so there are several single proteins to choose from. Here’s one article on it.
https://icatcare.org/advice/eosinophilic-granuloma-complex/
I also would take poppy down to .75
Click to expand...

This is what the vets suspect she has - EGC, eosinophilic granuloma complex. The treatment was: corticosteroids pills (Prednisolone) + Hill's z/d diet food. She was ok with those (the skin got well and the itching dissapeared) until we discovered the diabetes, so we had to stop both the food and the pills. When I got her from the street she also had it on the back of her tail and one of her hind legs. For now it just reappeared on the back.

I checked and Kattovit Sensitive (Hypoallergenic Food) is a special feed with one single source of protein and it's also on the recommended food lists for diabetes. And I know that she likes it.

Did Mocha got rid of it when you changed his diet?

I agree with 0.75, but in 2 hours is her PMPS. What value do you think it would be safe to shoot? +9 she had 68.
 
Monica-Poppy said:
It looks like +9 is still low, 68. I doubt that PMPS will be over 100 (for me to feel confortable to shoot). What do you suggest?
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See where she is, if she's rising and above blue. Then I would shoot 0.5u, monitor her at +2 +4 (and a just before) ( you want to catch when she onsets) if you find her dropping at +2, then you may need to monitor more closely than that.
If she is too low for you to feel comfortable shooting, as long as she hasn't had a problem with ketones/DKA then I would skip and start the new dose tomorrow, at 0.5u. Shoot that even if she is pink/red or black, don't try to shoot down the PS number, remember you ignore those and we look to the lows to help us decide on dose.
I'm hoping that the 0.5u will allow you to shoot am and pm, but as I said with the food change....her insulin needs may well be shifting as the dry food works it way out of her system.

How often are you giving her her integra wet? Are you spreading that out?
I would recommend that you give her a main meal, at shot time, then several small meals or snacks especially in the early part of the cycle, maybe at +1 +3 +5??? The boiled chicken is good for treats but probably won't influence her BG so if she is dropping as she onsets the LC food will sustain and flatten her curve better. You want to avoid feeding the integra in the latter half of the cycle as this can inflate numbers, and of course no food at all 2 hours before shot time.
 
Monica-Poppy said:
This is what the vets suspect she has - EGC, eosinophilic granuloma complex. The treatment was: corticosteroids pills (Prednisolone) + Hill's z/d diet food. She was ok with those (the skin got well and the itching dissapeared) until we discovered the diabetes, so we had to stop both the food and the pills. When I got her from the street she also had it on the back of her tail and one of her hind legs. For now it just reappeared on the back.

Mocha was just a kitten when it started. I ruined 4 proteins trying to figure it out. You have to switch to one they have never had before. Hers came and then went away. I suspect it started from chicken and turkey. Since it would disappear I didn’t take her to the vet right away and when I did it was gone. I figured it out with Google and eventually got it confirmed by my vet. She then had to add another food intolerance, dermatitis, which I thought might have come from the rabbit she was eating. Currently she’s on venison but my vet sad she might react to it too in a couple years. Fingers and paws crossed she won’t. She now has been on lots of proteins and I am afraid she will run out of foods to eat. We don’t want to put her in medication that might cause diabetes or other bad side effects. She’s just 4 years old.

I checked and Kattovit Sensitive (Hypoallergenic Food) is a special feed with one single source of protein and it's also on the recommended food lists for diabetes. And I know that she likes it.

As long as it’s a protein never eaten before try that.
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Got it.

@Gill & George Yes, the integra wet is spread out in several meals just as you said. More consistent imediately after shot and a few more small meals, generally at +2 or +3 and +5 or +6, or if i I see that she drops too much at some point during the day. Of course, no food several hours before the shot.

Do you also feed at night? Poppy is very greedy, so no matter how much wet food I give her, she will eat it all at that meal. So far her last meal in the evening was at PMP +5, which is approximately 12 PM for us.
 
Monica-Poppy said:
Poppy is very greedy, so no matter how much wet food I give her, she will eat it all at that meal. So far her last meal in the evening was at PMP +5, which is approximately 12 PM for us.
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I have the same problem with George, when he was on insulin his normal last meal in the evening was at midnight too, usually +5, sometimes I had to stay up later because his numbers warranted it.
It's handy that she is greedy, as Elise said you can use an autofeeder to give her more snacks in the night if you feel like she may need food to sustain her numbers, it's a blessing to have a diabetic cat with a good appetite on who you can count will eat on demand. Having one that rotates and hides any uneaten meals works well so you know she won't have eaten after +10.

Did you shoot?
or are you skipping?
If you skipped, it's recorded as PMBG (pm Blood glucose) as opposed to pmps (pm Pre Shot)
 
She is rising, when you feed she is likely to rise even further with the food, so it is probably safe to shoot. On TR this would be a very shootable number, but I guess you are still undecided on which method to follow (You are testing enough for TR).



But will you be able to get a +1. and monitor if you have to? at least until +5 till you go to bed
 
@Gill & George thank you for your support!

I think for the moment I feel more confortable with the other method, going more slowly, since I don't know how she will react. I will shoot tomorrow morning 0.5 no matter how high the value, and see how it goes tomorrow. Hopefully get to a value where I can shoot at PMPS too.
 
Shooting your first green is scary. Doing your first at night sometimes is even more so. You will soon get used to it. Then it becomes addictive. Just know that when you do you will have guidance through the cycle.
 
Monica-Poppy said:
@Gill & George thank you for your support!

I think for the moment I feel more confortable with the other method, going more slowly, since I don't know how she will react. I will shoot tomorrow morning 0.5 no matter how high the value, and see how it goes tomorrow. Hopefully get to a value where I can shoot at PMPS too.
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that's ok, :) especially as you are nervous.
even though you haven't shot, it might be interesting to see how fast she rises and by how much after she has had her dinner. Knowing where her BG is at +3 say, without the influence of an insulin shot.

With lantus it's hard to get your head around shooting a low number, but since most cats will onset after a couple of hours, and the food will also push their BG up, and the BG is usually rising at the end of the cycle, you have to try to remember that you are shooting the number they will be in two or three hours, the above exercise may help you visualize that and help you get more comfortable with shooting lower.
 
Gill & George said:
that's ok, :) especially as you are nervous.
even though you haven't shot, it might be interesting to see how fast she rises and by how much after she has had her dinner. Knowing where her BG is at +3 say, without the influence of an insulin shot.

With lantus it's hard to get your head around shooting a low number, but since most cats will onset after a couple of hours, and the food will also push their BG up, and the BG is usually rising at the end of the cycle, you have to try to remember that you are shooting the number they will be in two or three hours, the above exercise may help you visualize that and help you get more comfortable with shooting lower.
Click to expand...

I will get her BG at +3 and I think I'll manage to get it at +5 also.
 
Tbat will give you valuable information. The more tests at times you have not tested the better. Data builds confidence to shoot those lower numbers.
 
PMBG +9 126 She ate lc at +4.5 and now at +9 I gave her a spoon of integra.

the rise today, compared to yesterday was much slower, and the trend in general over the last few days, even if I skipped the shot in the evening.

If AMPS (in 2 hours) is still low, not sure if I still need to give her the 0.5u. Affraid I will get her into hypo if this trend continues.

She seems to be regulating with food.
 
I think you will need to give less insulin and agree the diet change is making a big difference. She’s barely over normal range. Unless she goes up a lot I’m thinking .25 might be a better dose. Get the amps and post it. She might even be lower for all we know.
 
Will you be home to monitor? I am on the west coast so will only be on line for a couple hours. I would shoot .25 but if you are comfortable shooting I need to see if someone can stay with you as long as needed. What do you think?
 
Given how low she was yesterday I think you need to skip unless you expect to only be gone an hour or two at the most.
 
Wait, I missread. Sorry just woke up. I won’t be gone for long. Max 2 hours. Will be leaving in about 2-2.5 hours from home.

I gave her 0.25 and she ate well. Will be monitoring her over the next couple of hours. In case she seems to drop too much, I will see if I can postpone the appointment for later.

Will post new thread with the next value.
 
Monica-Poppy said:
Wait, I missread. Sorry just woke up. I won’t be gone for long. Max 2 hours. Will be leaving in about 2-2.5 hours from home.

I gave her 0.25 and she ate well. Will be monitoring her over the next couple of hours. In case she seems to drop too much, I will see if I can postpone the appointment for later.

Will post new thread with the next value.
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Have just seen the +2.
It is lower than her amps, so looks like it will be an active cycle, that means that we expect to see her drop through to nadir before she rises again, (probably nadiring around +6)
If you are going out, feed her some LC now. Is there anyone in the house that could give her another snack in and hour and then in two hours, even if they are not able to test?
 
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