11/27/24 Tiger AMPS 252 +6 242 0.9 ketones

J9 Pearson

J9 Pearson

Member
Can someone please look at Tiger's spreadsheet numbers and provide your thoughts? He doesn't seem to be curving all that much and I'm wondering if I should hold at 1 unit of lantus and be patient or try adjusting his insulin? I've wanted to try the SLGL method but as you can see I have difficulty being patient with my furbaby! I'm concerned that maybe I should have stayed at .5 units or gone to .75 instead of 1. He is a big kitty (likely part mainecoon) and weighs 15 lbs. The past few days as his BGs have inched up I am really noticing a difference in his overall behavior. Much more lethargic and drinking a lot. TIA
 
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Heike & BInie said:
Hello,
your thread will get more attention if you put a "?" in your title. You can add it by using the thread tools on the top and right.

But let me tag some moderators for you:
@Wendy&Neko @tiffmaxee @Sienne and Gabby (GA)

I saw that you didn't mark in your ss which dosing method you want to use. Here you can read about the different methods:
https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

I hope someone can look at your ss soon!
Click to expand...

Thank you so much for the tips!
 
@J9 Pearson
About which dosing method you decide to follow you need to add it to your signature and your spreadsheet up top. If the Young Again Zero Mature is dry food you can only follow the SLGS method. Please read about the dosing link that Heike gave you above. The dosing method will tell you when you need to increase or decrease the dose
I also would advise to get some more tests in after the PMPS test


Here is your previous post for continuity , we like you to link your previous posts when you start a new post
https://felinediabetes.com/FDMB/threads/tiger-next-step-advice-request.295612/#post-3219566

Also your introduction post
Previous post introduction
https://felinediabetes.com/FDMB/thr...-create-a-plan-for-tiger.294761/#post-3213138

I read on your introduction post you said you were going to start the Savory Center's wet food

Chicken, Beef, Salmon and Tuna (I bought the Collection pack and he loves it!)



I can't thank you enough for all your help today. I will definately feed mostly canned wet food for all the reasons you described and supplement sparingly with the Young Again dry (which arrives tomorrow.

Did you start feeding the FF Savory Center's Yet ?
Are you still feeding the dry food also?

If you are feeding the wet you need to put in your signature LC Wet and Young Again Kibble

Also I noticed you are not getting some tests in after the AMPS tests

@J9 Pearson
 
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As Diane said with dry food in the mix, you’ll need to follow SLGS.

With SLGS you hold a dose for a week, (unless the cat goes under 90, in which case you would reduce the dose by 0.25u), then evaluate by running a curve, although getting random spot checks when you can during that week really helps to fill in the missing pieces.

From the SLGS dosing method sticky:

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments (emphasis mine).
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
The preshot numbers alone don’t give you the information. That said, looks like you’ve had 1u going for 14 days, and did have some extra testing 3-7 days into the 1u dose and had some am mid cycle tests more recently again which helps see a little bit more to see how the dose is working.

I’d also recommend you try and continue regularly with a before bed test since many kitties like to go lower at night, and with only some spot checks during the am part of the cycle, you are missing half the data.

It does appear that 1u isn’t enough, and since you’ve held it for 14 days, if you are able to monitor a bit more closely and get spot checks in both am and pm cycle, going up to 1.25u would be safe to do.
 
What Christie said. ;). I see some upper blues, which are nice. But I'd like to see more of them and a bit lower nadirs. Hopefully the increase will do good things. With Lantus and SLGS, you really don't want to hold a dose any longer than 7 days if you aren't seeing the nadirs you want to (between 90 and 149). Otherwise his body will get used to those higher numbers and require more insulin to break through.
 
Thank you Christie. I will give that a try and follow the SLGS and stick to it!!
Christie & Maverick said:
As Diane said with dry food in the mix, you’ll need to follow SLGS.

With SLGS you hold a dose for a week, (unless the cat goes under 90, in which case you would reduce the dose by 0.25u), then evaluate by running a curve, although getting random spot checks when you can during that week really helps to fill in the missing pieces.

From the SLGS dosing method sticky:

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments (emphasis mine).
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
The preshot numbers alone don’t give you the information. That said, looks like you’ve had 1u going for 14 days, and did have some extra testing 3-7 days into the 1u dose and had some am mid cycle tests more recently again which helps see a little bit more to see how the dose is working.

I’d also recommend you try and continue regularly with a before bed test since many kitties like to go lower at night, and with only some spot checks during the am part of the cycle, you are missing half the data.

It does appear that 1u isn’t enough, and since you’ve held it for 14 days, if you are able to monitor a bit more closely and get spot checks in both am and pm cycle, going up to 1.25u would be safe to do.
Click to expand...
Christie & Maverick said:
As Diane said with dry food in the mix, you’ll need to follow SLGS.

With SLGS you hold a dose for a week, (unless the cat goes under 90, in which case you would reduce the dose by 0.25u), then evaluate by running a curve, although getting random spot checks when you can during that week really helps to fill in the missing pieces.

From the SLGS dosing method sticky:

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments (emphasis mine).
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
The preshot numbers alone don’t give you the information. That said, looks like you’ve had 1u going for 14 days, and did have some extra testing 3-7 days into the 1u dose and had some am mid cycle tests more recently again which helps see a little bit more to see how the dose is working.

I’d also recommend you try and continue regularly with a before bed test since many kitties like to go lower at night, and with only some spot checks during the am part of the cycle, you are missing half the data.

It does appear that 1u isn’t enough, and since you’ve held it for 14 days, if you are able to monitor a bit more closely and get spot checks in both am and pm cycle, going up to 1.25u would be safe to do.
Click to expand...

THANK YOU. I've got it now and printed out the SLGS protocol so I can force myself to read it and not be tempted to adjust outside of the parameters. Appreciate your support and patience with me :)
 
@J9 Pearson

I read on your introduction post you said you were going to start the Savory Center's wet food

Chicken, Beef, Salmon and Tuna (I bought the Collection pack and he loves it!)



I can't thank you enough for all your help today. I will definately feed mostly canned wetfood for all the reasons you described and supplement sparingly with the Young Again dry (which arrives tomorrow.

Did you start feeding the FF Savory Center's Yet ?
Are you still feeding the dry food also?

If you are feeding the wet you need to put in your signature LC Wet and Young Again Kibble
Also can you please add SLGS to your signature also
Did you get an AMPS test today 11-22 ?
It's not filled in

Good luck with the increase
 
Diane Tyler's Mom GA said:
@J9 Pearson

I read on your introduction post you said you were going to start the Savory Center's wet food

Chicken, Beef, Salmon and Tuna (I bought the Collection pack and he loves it!)



I can't thank you enough for all your help today. I will definately feed mostly canned wetfood for all the reasons you described and supplement sparingly with the Young Again dry (which arrives tomorrow.

Did you start feeding the FF Savory Center's Yet ?
Are you still feeding the dry food also?

If you are feeding the wet you need to put in your signature LC Wet and Young Again Kibble
Also can you please add SLGS to your signature also
Did you get an AMPS test today 11-22 ?
It's not filled in

Good luck with the increase
Click to expand...

Thank you Diane. I updated my signature and today's AMPS (it was 283 so it looks like the 1.25 made a significant difference, at least today.) He just loves to be free fed so we made the decision for him to stick with the YA zero mature food without any wet food. The feeding is going OK and he has always been a great drinker (even pre diabetes) with a water fountain.
 
J9 Pearson said:
Thank you Diane. I updated my signature and today's AMPS (it was 283 so it looks like the 1.25 made a significant difference, at least today.) He just loves to be free fed so we made the decision for him to stick with the YA zero mature food without any wet food. The feeding is going OK and he has always been a great drinker (even pre diabetes) with a water fountain.
Click to expand...
Nice to see that blue already :bighug::cool:
 
Diane Tyler's Mom GA said:
Nice to see that blue already :bighug::cool:
Click to expand...
Unfortunately, Tiger ate some of his brother's dog food after that nice blue number and he has been yellow ever since. I got a ketone meter (KetoBM) (delivered this morning) and his number was 1.0 at 7:30am. He is more lethargic and eating a little less than typical but he is drinking a ton and still snuggly. His numbers were flat yesterday and higher this morning. My question is do I stay the course and complete the curve 7 days after his lantus increase? or is there something else I can do since I think the 1.0 ketone number indicates trace ketones? Is that correct? I had difficulty finding what the ketone numbers mean.
 
J9 Pearson said:
Unfortunately, Tiger ate some of his brother's dog food after that nice blue number and he has been yellow ever since. I got a ketone meter (KetoBM) (delivered this morning) and his number was 1.0 at 7:30am. He is more lethargic and eating a little less than typical but he is drinking a ton and still snuggly. His numbers were flat yesterday and higher this morning. My question is do I stay the course and complete the curve 7 days after his lantus increase? or is there something else I can do since I think the 1.0 ketone number indicates trace ketones? Is that correct? I had difficulty finding what the ketone numbers mean.
Click to expand...

Tagging some experienced members for you. I would start putting the numbers you get on the ketone meter in the remarks section on your spreadsheet
@Bandit's Mom
@Wendy&Neko
@Suzanne & Darcy
@Christie & Maverick
@Sienne and Gabby (GA)
@Bron and Sheba (GA)


@J9 Pearson
From what I just found that was posted by one of our members

You want them to be under 2.4 on the blood ketone meter. Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters

Let's see what the members I tagged have to say
 
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Although 2.4 is the point at which DKA is a concern, a rise in ketones numbers is something to watch. I'd get another test today to see if it's changing. Make sure Tiger is getting lots of liquids. Mix some into his wet food if you can.

Try to get those before bed BG tests too. If his ketones levels head up, and we have a better idea how low he's going on this dose, we can increase a bit sooner.
 
When you post on the Lantus Forum try and post everyday.
You could have left the AMPS there
Here is how we post
Date Tiger AMPS # and any additional tests after that, you can continue with Tigers PMPS # in the title and any additional tests after that.

We always link the previous days post to the new one. Did you see that I linked your previous days post above it was post #4
To do this



To link your previous posts
Your previous days post will always be in the URL all the way up top ignore where it says insert or cancel I'm just trying to show you where your previous days post will be
Just ignore where it says insert and cancel
Just copy your previous days post and then paste it when you do your new post





Like I said
your previous days post it will be the one all the way up top, above the pic of that cat and the picture of a bottle of insulin there, let me know if you understand it




austin-logo-240.jpg




So if you post tomorrow you will link your post which is 11-26-24 to your post for tomorrow.

Did you get anymore tests after Tigers AMPS today ?
The more tests you can get in the better .

Always try and get a test in before you go to bed
You're doing a great job :cat:
Tiger is a handsome dude :cat:
 
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I can't see a second ketones test results for today on the spreadsheet. If it was lower than 1.0, then you can wait at least another day at this dose.
 
A request - please start each day with a new post, with a link to the previous post. That way all of today's action in just the one post. Otherwise posts can get rather long to read if you are just starting to read about that kitty.

There can be some variation in ketones. I've seen one kitty go from trace to very high over the course of a day. Thankfully you aren't there yet. Just keep on top of testing. How is Tiger's appetite and activity level today?
 
Wendy&Neko said:
A request - please start each day with a new post, with a link to the previous post. That way all of today's action in just the one post. Otherwise posts can get rather long to read if you are just starting to read about that kitty.

There can be some variation in ketones. I've seen one kitty go from trace to very high over the course of a day. Thankfully you aren't there yet. Just keep on top of testing. How is Tiger's appetite and activity level today?
Click to expand...
@Wendy&Neko will do on the posts in the future. Tiger seems a little more active today. His appetite is less than usual overall. He seems to want to eat anything but his regular food but will eat some when I place him in front of it.
 
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