10/11 Big Kitty AMPS 392- HELP with dosing needed

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evakot

Member Since 2010
Hi All,

Could you please look at Big Kitty's spread sheet and help me figure out what is going on? He's been getting shots for close to a month now and there is NO IMPROVEMENT whatsoever, and maybe even some worsening. He seems to follow no pattern, or, as it seems to me (but I may be wrong) the more insuline he has in his system, the higher his numbers.

I dropped off the spread sheet at my vet this morning and she just called. She said to crank up the dose to 2 units BID tomorrow morning. My question to you all is- does this seem reasonable, given my spread sheet? Should I raise it first to 1.75u (a half unit from the 1.25u he is on right now) and then in a few days to 2 units, or go to 2 units directly?

Any help will be appreaciated,

Frustrated and disappointed Big Kitty's Mom.
 
Hi....I tried to find your last condo and this is what I came up with: viewtopic.php?f=9&t=25662&start=0&hilit=Big+Kitty+eva
We link the previous condo to our first post of the day so people can easily see what transpired the day before.

Is there a way that you might be able to post daily so we can keep an eye on what is happening with Big Kitty?
Just a few questions: what are you feeding Big Kitty and at what times?
Have you had blood work or a dental done in the recent past?
How is he acting? Litter box action is normal and everything seems fine with him?

At the top of the page are tome starred stickies. Please read them and come back here with any questions that you might have.

We usually increase in increments of .25u. That way, we are going slow and there is a better change on finding the right dose instead of bypassing it. It looks as if Big Kitty should have an increase at this point. the above stickies will give you an idea of how long we hold the dose etc. I would like to see you each day if you can.
We post the header this way:
Date, Kitty's Name, AMPS+__________ and then we update the header with new BG numbers as we get them.

This is a frustrating dance ....but with following the protocol and posting each day, things do get better. I am so glad to see you here today! :mrgreen:
 
Pat+Raja+Shadow said:
At the top of the page are tome starred stickies. Please read them and come back here with any questions that you might have.
Hi....I tried to find your last condo and this is what I came up with: http://felinediabetes.com/FDMB/viewtopi ... +Kitty+eva
We link the previous condo to our first post of the day so people can easily see what transpired the day before.

Is there a way that you might be able to post daily so we can keep an eye on what is happening with Big Kitty?
Just a few questions: what are you feeding Big Kitty and at what times?
Have you had blood work or a dental done in the recent past?
How is he acting? Litter box action is normal and everything seems fine with him?
Click to expand...
Click to expand...

Hi and thank you for your answer. I still didn't figure out how to post a link to a previous condo....Sorry...

To answer your questions, Big Kitty is on a low carb diet. He was diet-controlled for 8 months, before his recent relapse. I am trying to stay under 5 carbs now. He eats about 1/2 can for breakfast (before AM shot) and less than 1/2 can for dinner (before PM shot). But other than that he LOVES SNACKING and asks for something to eat every 2-3 hours. A snack would consist of a teaspoon of food or some boiled chicken. So, he eats about every 2-3 hours, but small amounts.

As far as blood work- yes- he had it done before staring Lantus, as well as urinalysis. Everything was fine except for the high BG. He did have inlflammed gums but this is a point of disagreement between my vet and I. She does not believe gums could be the reason his BG is up, and she does not want to do a dental until he is somewhat regulated. I know that it could be a viscious cycle and I explained it to her, but she won't agree to doing a dental right now.

As far as his behavior- he is drinking a lot and peeing a lot ever since his numbers went up. The insuline shots made no difference so far. He is eating, but he is not as voraciously hungry as he was before we started Lantus. He seems much more lethargic than when he was in his remission.

You said increase by .25u. So should I not go to 2 units as my vet suggested and only go up to 1.5unit tomorrow? My vet said that .25 would not make much difference for such a big cat (Big Kitty is 17lb now, his ideal weight is 15.5-16lb).

Any feedback regarding by how much to increase the dose tomorrow will be greatly appreciated,

Thank you,
Eva
 
start again.
if you look at top of page-url where there is a blue pawprint and http etc.left click to highlight and then right click. then click on copy.
when you open your condo, right click and click paste-hey presto day befores condo. I don't know the posh way of posting it under a title.

Have looked at your numbers (slow typing only have one hand free).
Because of nadir pretty much consistently being above 300 it is o.k to increase by .5u

read this: viewtopic.php?f=9&t=1581

It takes time for you to find breakthrough dose-so concentrate on this for now remebering the sugar dance is a marathon not a sprint.
Read the -increasing the dose bit, good guide for you.
As stated above posting daily can be really helpful to you as well as giving info to others that may offer support and advice.

As for vet not doing dental-bad move from everything I've heard. No end of beans on here have had kitties where thelack of a dental has been the reason for raised bg's. I really would get them done. The only thing would be if there was some danger (asI have no direct experience of this).

Good luck
 
kate and lucky said:
start again.
if you look at top of page-url where there is a blue pawprint and http etc.left click to highlight and then right click. then click on copy.
when you open your condo, right click and click paste-hey presto day befores condo.
Click to expand...


Thanks, I will try that.


Because of nadir pretty much consistently being above 300 it is o.k to increase by .5u

read this: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581
Click to expand...
Click to expand...

OK, I read the guide, thank you. Seems like the best thing to do is to go to 1.75u tomorrow- and increase by half a unit.

I will try to post condos daily. Life at times gets in a way...:( but will do my best.

THANK YOU AGAIN!

Eva
 
Just a quick follow-up question-

I read somewhere that a flat curve at high numbers could signify the Somogyi effect (sp?). Is there any chance that Big Kitty is experiencing that? Please note that his numbers do seem higher ever since I increased the dose from 1u to 1.25u. Or are these doses way too low to cause the rebound?

Thank you,
Eva
 
sorry for delay

There is a general consensus here that you don't/can't get somygi rebound with Lantus/levemir.
can see on shorter acting insulins (vetsulin)

I have noted your flat/higher numbers which is why in the first instance i have said your looking for a breakthrough dose.
there are 2 other possibilities that i don't want you to consider jut yet as early days. these are high dose conditions-IAA and Acromegaly. but i urge you to wait a bit and get some more data before we look at these.
have a look at some of the other ss's and see how they got on.look at ours too (lev almost identical action to lantus)
can have a positive reaction initially and then numbers seem to rise-all normal with lantus.

if nadirs stay above 300 next rise would be .5u again (yes your right to go to 1.75u)

good luck and that's ok to try and post each day, not a drama if you can't just try as much as you can.
 
kate and lucky said:
have a look at some of the other ss's and see how they got on.look at ours too (lev almost identical action to lantus)
can have a positive reaction initially and then numbers seem to rise-all normal with lantus..
Click to expand...

I looked at your SS and realized that you had lost your kitty. I am so very sorry...It looked like you were doing such an awesome job regulating him...

Thank you for your advice. I will be raising to 1.75 in the AM.

Best,
Eva
 
i'm a newbie too...so no advice, but just wanted to tell you i think you've come to the right place...the folks here can help you out immensely, and are knowledgeable and more than willing!

good luck!

celi & binks
 
thankyou.

yes it's been just over a year now.
I've just thought of something - do you have any numbers from jan? and did you use lantus then?
 
kate and lucky said:
thankyou.
yes it's been just over a year now.
I've just thought of something - do you have any numbers from jan? and did you use lantus then?
Click to expand...

Very few numbers from January. He was diagnosed at the vet at 400 and was given 4 u of Humulin N by the vet. She told me to do the same dose BID at home. I only gave him 2 more shots at this dose (I didn't home test yet then!) and then I found this forum. I realized he was on the wrong diet and wrong insuline. I stopped the insuline and switched to low carb diet, thinking that my next step will be to get him on Lantus. However, within 1 week of LC diet Big Kitty was in the low 200s and in the second week he was around 110-130 every day, and in the thrid week he started to be consistently between 50-70 and stayed that way for 8 months. My current vet (not the one who gave N) is astounded that this drop happened on diet only, but it really did. So, now it is upsetting that he is 1 month on inuline an no progress. But I know I must be patient. And I am thankful for the 8 months OTJ we had.
 
Gingers Mommy (Lori) said:
My cat was put on Lantus about a week after yours.

You think your cats numbers are bad, you should look at my cats.....

Gingers Spreadsheet
Click to expand...

Lori,

I am sorry your kitty is having such bad numbers. That must be frustrating. With all the effort and time and $ we go to regulate them, it's hard not to see them feel better. Hope Ginger's numbers go down really soon.

E
 
E,
Thank you.
Yes, its a bit stressful and frustrating because she feels just awful and there is nothing I can do to help her.
 
hi,
sorry, being in europe i'm on a different timezone.

that's interesting about the numbers.that also in my book means you may still have a shot at remission (no guarantees mind).

As long as your staying on lc food.
please try again about the dental-I think this may be having some influence.
paws crossed on the dosecrease.

-keep a note of peeing, pooping, preening, playful (rubbish-there's one more p and i can't remeber it.mummy mush brain :lol: ).good to get as much info as possible, then your looking for patterns (i love them and big reason why i like ss's as patterns jump out at me in colours)

your doing great-just remind yourself of that :-D
 
I agree with the others who have noted the importance of a dental. Any inflammation or infection can raise BG numbers. If your vet will not do the dental, this is a link to http://www.avdonline.org/avdmembers.html]board certified veterinary dentists[/url]. You can always go to a specialist.

FWIW, most of us here have cats who are in various stages of regulation and have dental work done. And in some cases, it was fairly extensive dental work.
 
Eva,

I'm still new at this, but be patient here and listen to the advise of the wise ones. I don't want to persuade you to change any dose any which way as I am not qualified to do so, just trying to show you some of the same reactions with Lantus. Check out Buddy's SS. After being sick, he was moved to LC wet food only. 0.5 Units Lantus was doing nothing, in fact it was going up (not that this is exactly like your cats response), so I upped it to 1unit as per the chart. After only 1.5 cycles he dropped to 50 at PMPS, so close, a little scary even, after 30min it was on the rise again and 4hrs out up to 200 range - hypo averted. But I had to skip a dose and bring it back to 0.75 this morning, hoping it doesn't take too long again to see any effect. So take it easy, take a breath, and stay consistent with dosing times, BG checks and food. You're doing great and have a lot of data to work with.
Good luck,

Tony and Buddy
 
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