? 12-01 Muffin AMPS 120 SOS

[Skatkat]

Hey guys,


I need some dosing help. I just read a lot of the information posted here, but wanted to check in with some questions. I have a 15 yo male recently diagnosed with diabetes. He was on Vetsulin for over two weeks with little to no changes in his BG. I decided to switch him to Semglee (found a good deal with a coupon). After only one day his BG started coming down. I want to note a few things. Vet said to do 1.5 units and I felt nervous switching the insulin at that high of a rate so I tried 1 unit. Then I got nervous he pretty quickly came down to the 100s pre-shot so I held some doses. After reading the information here, I realized that my changes in doses were not appropriate.

I contacted my vet and she said do half the dose on days he is in the 100s preshot. I decided to start testing him every 2 hours as I was able and he has stayed in the 100s for the last 24 hours (gave half the dose this morning of .5 units instead of 1 unit). What do I do? If I’m reading correctly, I have messed up the dosing by decreasing by more than .25 and also I didn’t wait the week.

With that said, his PM shot is coming due in an hour after testing. If he’s in the 100s, do I give the full 1 unit for a week and just watching him? Do I do half the dose?
For the days I skipped the insulin he immediately spiked so I know that’s not the answer. Can anyone help? It won’t let me attach my numbers so I am trying a link to the Google Drive. I just want to do what’s best for him and I was scared of making him hypo. He had a steroid shot on 09/28/2022 and that’s what sent him into diabetes.

Any help is appreciated. Sorry if the questions are stupid, I’m still new. Thank you!
https://docs.google.com/spreadsheets/d/1Gmm7fyA9JZLAgGbgI5bDJRCwIt8EEvQ6sKRgU7Fkawg/edit

 

[Bandit's Mom]

Welcome to FDMB and the LBL forum! Sorry that no one responded earlier. I see that you gave 0.5U tonight?

It's good that you switched Muffin to Semglee. Glargine is a much better insulin than Vetsulin for cats. I would stay with 0.5U going forward. It's possible that 1U may be too much. Rather than give 1U once a day, you want to find a dose that you can shoot comfortably twice a day. Is this the 6th day on Semglee? The initial depot takes a week to build.

Dosing is based on nadirs - how low a dose takes the cat - and not the preshots. However, for caregivers with newly diagnosed cats who do not have enough data on how their cats behave on insulin, we ask that you not shoot below 150. As you collect data you can shoot lower preshots. As low as 50, if you are following the Tight Regulation (TR) protocol.

If you can take a look at our doing methods and pick one, we can advise on dosing accordingly:
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

In addition to updating your Spreadsheet, it would be a big help to us if you can set-up your signature? It's basically a summary of the information we need about your cat to give you advice. The spreadsheet and signature are the things we look at when asked for advice. It saves us asking you the same questions again and again especially when the question is time critical like stalling or low numbers. It also saves you the effort of giving us the information every time you post!

Here's how you can set-up your Signature:

• In the Menu, under your user name, click on Signature.
• Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
• Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
• There is a limit of two lines. You may separate info with commas, dashes, | etc.
• Be sure to click the 'Save Changes' button at the bottom.

 

[Skatkat]

Thank you so much for answering! I’m a bit desperate for help. I will continue the 0.5 unit, but do I continue on this dose for a week before I do another glucose curve? And should I give his shot as long as he is at 150 or more preshot?

The day he was diagnosed I switched him to Fancy Feast/Weruva/Tiki Cat (he’s picky so I switch it up) - he really misses his dry food). Could it be possible that the diet is starting to work and also the new insulin is helping? I am confused because on the Vetsulin he never got out of the 300s and he’s been on Semglee for 5 days and immediately went down (even before the seven days).

I will make sure to set up my signature, but can I keep y’all posted with the spread sheet if things change? I’m feeling nervous since things changed so rapidly and want to make sure that’s a good thing.

 

[Bandit's Mom]

I will continue the 0.5 unit, but do I continue on this dose for a week before I do another glucose curve? And should I give his shot as long as he is at 150 or more preshot?

Yes, stay with 0.5U for now. However, whether you reduce the dose or not depends on which dosing protocol you follow. If you choose SLGS, you would reduce to 0.25U if her BG drops below 90. With TR, you would reduce only if she drops below 50 (on a human meter).

The day he was diagnosed I switched him to Fancy Feast/Weruva/Tiki Cat (he’s picky so I switch it up) - he really misses his dry food). Could it be possible that the diet is starting to work and also the new insulin is helping? I am confused because on the Vetsulin he never got out of the 300s and he’s been on Semglee for 5 days and immediately went down (even before the seven days).

It's possible that the change to a low carb diet is the reason for the better numbers. We have also seen that cats whose diabetes is caused by steroids have a good chance of going into remission once they are off steroids. If he misses dry food, you could try freeze dried meat treats. They have the crunch factor of dry foods.

I will make sure to set up my signature, but can I keep y’all posted with the spread sheet if things change? I’m feeling nervous since things changed so rapidly and want to make sure that’s a good thing.

We have members who post every day and you are welcome to do the same. We request members to start a new thread every day so that the threads don't become too long to read.

 

[Bandit's Mom]

I forgot to respond on testing/doing a curve... We like to suggest getting a +2 because it can act a lot like a crystal ball in what the rest of the cycle is going to look like.

• If the +2 is about the same as the PS, it's usually going to be a pretty normal cycle....gradually down to nadir and then gradually back up to the next PS.
• If the +2 is a lot higher than the PS, that usually means there's a bounce starting and it's usually OK to take a little bit of a break on testing.
• If the +2 is lower than the PS, that's your "early warning" that Muffin might be going a lot lower later in the cycle and it's important to try to get some other tests in to keep him safe.

TR requires 4 tests per day, but that doesn't mean you should only get 4....if it's possible, it's better to get tests at different points in the cycles so you can start to get a good idea of when Muffin's onset, nadir and duration usually fall along the cycle. If you can only get 4 per day, then you always get the 2 pre-shots and then get at least 1 somewhere mid-cycle on the AM cycle (like between +4 and +6) and at least a "before bed" on the PM cycle (usually at least 2-3 hours after the PM shot).