12/08: Harry AMPS 340, +7 25!!!

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chatcat24

chatcat24

Member Since 2010
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So today was nothing more than a regular day, although when we JUST checked harry (10 mins. ago) at the +7 mark today, he was at 1.4 (for canadians) , a 25 for everyone else. . . . . what happened???

We immediately just gave him turkey and cheese & gravy dinner, which he engulfed. This is know is a higher sugar food just in case. But with his numbers being int he 200's and 300's, why would it suddenly drop? Is there something we missed? He has been eating his food, we give him new food bits or treats every few hours or so thru out the day and I am concerned about this.

Help? Anyone? nailbite_smile
 
How long since the test? If it has been at least 15-20 minutes, can you please test again and report back?

Was that Fancy Feast? What % carbs? (this answer is much less important than the BG check).
 
Now that I've looked at Harry's SS, I have some questions.

Why is your dose hopping around between 1.5 and 2.0 Units? Have you read the protocol? Doses are held for at least 6 cycles before increasing. Harry has for sure earned a decrease with this BG though.
 
Hello - Just wrote an update and for some reason it didn't work.....

We tested Harry's BG again and it was 88, as of 10 mins. ago now, we gave him some more Friskies shredded turkey and cheese dinner and he engulfed it all. We will do another check here in about 10 mins. or so. His food is 133 calories/ / 5.5 oz can, which he just ate all of it over the last 45 mins, carb level is 12.

He isn't showing any sings (nor was he) of being hypo, just seemed a little weak. No weird meows or anything.

We have been doing this for about 3 1/2 weeks, so it's still very new to us....with regards to the dosage changes, Cyn & Cosmo, we are still figuring out his doses.....in the sense of if he has higher numbers than we've been doing the 2 units, if it's lower than I've been giving 1.5 . Should I be doing 1.75 instead of 2 altogether?

Any advice I'm always happy to hear. (love the support here!!!!!!!!!!!!!!)
 
I'm glad he has come up. I think you'll need to test him for awhile, as the food spike can wear off and he can go low again.
88 is a good number, hopefully, he'll surf for awhile.

Have you read through the sticky's at the top of the page? Lantus needs consistancy. We call giving different doses "dose hopping". Others will be along to explain it better than I can.
 
Thank you Dyana, I will read about that!!! (appreciate it!!)
JUSt tested Harry again, he's at 169, will check again to see where he's at in an hour or so. He seems very content and full, and 1/2 asleep on his blanket.

;-)
 
We usually increase and decrease in 0.25 unit increments. Since your current dose is 2.00 units and he has just earned a dose reduction, normally, we would suggest that his next new dose would be 1.75 units. Do you have the syringes with the half unit marks on them? Someone, may suggest a different dose for his new dose because of the low low, so wait for more opinions.

You're doing good. Test again, and post the number. We will be here to help you.
 
It seems like you are choosing what dose to give by what the pre shot number is. People do that more when using other types of insulins. Lantus and Levemir are different. With Lantus and Levemir, we mainly base the dose on the nadir, which is the lowest number in the cycle. Usually at around +6, sometimes earlier, sometimes later. We try to hold the same dose for at least 6 cycles (3 days) unless the numbers go low and a dose reduction is warrented, and then normally we reduce by .25 units. Let's see what the others say about Harry's new dose, though.
 
Now that he's in a safe range of BG, can you please take the 911 sign off your first post?

As for the dosing, lantus dosing doesn't work by figuring it out from the AMPS (the BG before giving the shot in the morning) or the PMPS (BG before the evening shot). You base it off of nadirs (lowest BG of the cycle).

If you read the protocol sticky, you'll see that lantus has a "shed" or "depot." it takes several days to build it up, several days of administering the SAME DOSE. Unless Harry has had ketones or something, he shouldn't need to start on a higher dose. You give the initial dose for 5-7 days, unless a BG indicates he needs less. You have to wait the 5-7 days (10-14 cycles) before INCREASING the dose.

Again, unless the cat has a history of a medical condition (insulin resistance), the typical increase in dose is 0.25 units. Do you have the syringes with the half unit markings?

welcome to LL!!!

ps. you can also check the food charts and find some food with 16-18% carbs (high carb) What you fed (12% carbs) is considered medium carb.

FYI- NORMAL range of BG for a non diabetic cat is about 40-120 (I think you need to divide these by 18 to convert to non-US numbers).
 
hopefully this is the beginning of a bounce off of the low number. I would test again in an hour to be sure.

Harry definitely needs a dose reduction after a 25. The next dose is 1.75.

There's a really good chance that this is not the first time Harry has been this low. It's time to start getting more spot checks so you can see what is going on. The minimum is a before-bed test every night. Without any PM spot checks, you are missing half the picture. Many of our cats show more action at night than during the day, so those nighttime checks are even more important than the daytime ones (but you have to get those too!).
 
Thanks Cyn & Cosmo , Libby, and Dyana for the quick replies. I took the 911 off, as suggested.

When we first started, we had him on 1 unit twice a day for the first week, and then went to 1.5 units (as per vet) after that for another week, then to 2 units. That is obviously too much, (and I guess I have been going off of the AMPS and PMPS numbers, so I will stop that - thanks for mentioning that) - we will reduce by .25 and go with 1.75 from now on. His nadir, of what I thought it was, was between 200-340 during the mid-day. I have obviously been looking at the pre-shot figures and going by those.
Question: If the pre-shot numbers are at 250 or so, you still go with the same dose (1.75, or whatever the current dosage is at the time) for that day? I mean, if Harry happens to be in the blue do I go ahead and give him the shot? (I feel like I should hold off altogether and test again a few hours later and go from there?)
I do have the syringes with the 1/2 unit markings, which has been helpful.

So.....I will for sure be doing more spot checks on Harry. It's hard at times - he gets reallllly annoyed if we do the ear prick test too often, but oh well it has to be done!!!!
 
Helena

I just got home and saw your post on Gracie's condo regarding dosing. I think the others answered you. For Gracie, we started low and followed the protocol. We also follow the protocol the others have referenced when reducing her.

Question: If the pre-shot numbers are at 250 or so, you still go with the same dose (1.75, or whatever the current dosage is at the time) for that day? I mean, if Harry happens to be in the blue do I go ahead and give him the shot? (I feel like I should hold off altogether and test again a few hours later and go from there?)
Click to expand...

Here are links to very important "stickys" that give us information:
viewtopic.php?f=9&t=147
viewtopic.php?f=9&t=28888
viewtopic.php?f=9&t=27894

If his PS is 250 and you are worried about shooting his normal dose, then post and someone will look at his SS and walk you through whether it is safe to shoot. The above posts will give you some guidelines about shooting numbers like 150 or so. But you have to be data ready and I would imagine you aren't yet because you don't know if he will go up or down after you shoot a lower number than you have shot before. I think the above posts are invaluable...I have them printed and in a folder by my computer and read them often. It would be great if you would post every day like the rest of us and you could get consistent dosing advice.

I'm not sure I've helped you too much but I don't give dosing advice. I let the experts help me with dosing as well...I know the principles but I still check in and get their help.

Welcome to LL!! There is alot of help here...just ask!
 
Thank you Marjorie & Gracie - I WILL print those out and keep handy!!!!

All tips (like this one) are absolutely helpful to me!!!!!!!
I'm finding his bouncing around very confusing. I just advised the vet what happened today and he said to keep the units at 2, twice per day, and he was going on about basing it all on the pre-shot figures.
What the heck?? I am told (on this site) to NOT go by the pre-shot. I think he still may be new to diabetic animals???
 
Good to see you again, Helena.

Your getting very good information. Generally, when you're trying to bump up numbers, you want to feed HC by the teaspoon, rather than the can. If you overfeed, there's a chance that Harry will scarf-and-barf. When numbers are low, a kitty will inhale food. There's always the potential for the food to come right back up and, as a result, have no effect on BG numbers. You want to feed a little bit, test and repeat in 15 - 20 min. to see where numbers are going.

This post may help to outline the process of what to do when you run into low numbers like you did today.

I also agree with Libby. You need to get tests during the PM cycle.

Libby's recommendation regarding the 1.75u dose is based on your having shot 2.0u this morning. Again, not shooting consistently is a problem with regard to what your dose should be.

If your pre-shot is under 150, I would suggest posting and asking for help. This note on handling low pre-shot's should also give you some guidance. Many of us shoot considerably lower numbers but you don't yet have the data to do so.

I'm not sure how you're thinking about nadirs. You have peaks in Harry's cycle that were as low as 115 (on 11/26).

Please get a test at +11. We'll be able to gauge if numbers are continuing to go up. If so, it will be fine to shoot 1.75u tonight.
 
chatcat24 said:
I just advised the vet what happened today and he said to keep the units at 2, twice per day, and he was going on about basing it all on the pre-shot figures.
Click to expand...

Maybe your vet hasn't used Lantus before, or just isn't used to people who test more than once a day. You can try giving him this protocol: http://felinediabetes.com/Roomp_Rand_20 ... otocol.pdf It is basically the protocol we use here, but published by another vet. Maybe that will show him that there is science behind the recommendations.

Honestly, I can't see the logic in recommending that you stay with the same dose that just gave your cat a 25. What if you had not been home?! You don't even know if that was the lowest point of the day. We run cats in fairly low numbers here sometimes, even 40s, but 25 is just plain dangerous. Sure, his liver might have kicked in and released extra glucose to protect him, but do you want to depend on that? Cats' bodies do work very well to protect them from hypo, but one time it may not work. I wouldn't want to take that chance.
 
You're welcome Helena. We've got some great experience here and so I hope you'll get a chance to read the info I left for you which is the same that Sienne left.
And please don't be shy about asking questions...it's how we all learn!
 
Re: 12/08: Harry AMPS 340, +7 25, +8 88, +9 169, +11 434

Yes, all this was quite a day. . . .
First of all, Libby & Lucy - how do you mean? You wouldn't want to take that chance....of not doing a higher dose than 2 units? Instead of the 1.75? Please advise....
And as for the feeding Harry by the teaspoon rather than the can....you'd recommend doing a little syrup on his gums and a bit of food, see how that works, and like you said I would then go for the BG test again? Makes sense.
We're going to do a blood curve tomorrow, and I think for the initial future I will absolutely be doing an evening BG test!!

...Yes, the vet.....is only one person. I more than trust the sound walls and boards of the hundreds and hundreds of people that come onto this site and have the SAME problems, rather than one person who I'm not even sure made it a+ thru medical school.

Harry's numbers were (for the same of not having to go onto the chart to look)
+7 25, +8 88, +9 169, +11 434,
:? PMPS read "HI" on the precision plus blood tester, so THAT made me nervous. We gave him the 1.75 dose ASAP, and did another test at +1 which read 369. Better than "un-test-a-ble" and not even showing up. We just did one more BG for the night, at +2 it was 403...waiting for the insulin to kick in??

On with another fresh start tomorrow. . . . .
Sorry cat - your ears are mine......



Question: Why the SUPER low drop and then the super spike to be not even registering? He was a little hyper after his shot, and now he's back to sleeping in his cave. Just wondering if any one else has had this problem.

...It will be interesting (now that my hubby and I have done this for a little while and aren't as freaked out to prick his ears as much!) for tomorrow to see where his sugar levels are at.
Thank you Sienne and Gabby for the info, I'll be sure to print that out and have it handy as well!
 
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