12/16 Chronos AMPS 326 +3 316 +5 298

[Dan and Marc]

Intro post https://felinediabetes.com/FDMB/threads/12-15-chronos-new.271882/#post-3025636

Hello, just did Chronos' first injection, barely looked like anything was in the syringe and pushing the plunger basically didn't move. Guessing normal since 0.5 is basically a droplet in size.

I wanted to ask if I should be checking his BG throughout the day in the first days/week of him starting Insulin, or just stick to before giving a dose with maybe an occasional check. I normally have been checking at what would be his +5 the past few days so was least planning to keep that up just to see. But should I check other times, or mainly wait till we see what AM/PM numbers we get next few days and when we do a curve?

 

[tiffmaxee]

Welcome to LLB. The depot takes 5-7 days to build but sometimes a cat has a strong response to the first shot. It would be good to test at +3 and +5-6 if possible. Once the depot builds you will need to get tests at various times to see how low a dose takes your cat. With SLGS you do a curve once a week. If you get a second test and catch the nadirs a full curve may not be necessary. Lantus usually kicks in around +2 and if that bg is lower than the preshot you would want to test later if possible. If not much of a drop or if much higher you won't necessarily need more tests until the next shot but any extra tests you can get will be great. Does this help?

 

[Dan and Marc]

Thanks, I can do a +3 and keep also the +5 to see. I think I might need more clarification on the other points though.

When you say: "If you get a second test and catch the nadirs a full curve may not be necessary.", What do you mean by a second test? Is that in reference to the +3 and +5 tests?

When you say: "Lantus usually kicks in around +2 and if that bg is lower than the reshot you would want to test later if possible." What is the reshot you are referring to? Is that whatever value we find at +3 or +5?

Thanks for all your help.

 

[tiffmaxee]

I was referring to if you can do preshot and a +3 or +5 you might have all info you need and won’t need a full curve.
Auto correct changed preshot to reshot. So if the +2-3 is much higher than the Amps or Pmps you can stop testing.

 

[Dan and Marc]

Thanks for the clarification. So far doesn't seem to be much of a change from his normal trends past few days without insulin but wasn't really expecting a lot with the low dose and his size.

 

[chuckstables]

Thanks for the clarification. So far doesn't seem to be much of a change from his normal trends past few days without insulin but wasn't really expecting a lot with the low dose and his size.

It will take time to build up the depot. it took sam a week for his symptoms of diabetes to go away. Now i’ve been able to cut his dose down to 1 unit and he’s doing great (was on 3 units). Slow and steady wins the race.

As for testing; you want to do a pre AM shot test (do not feed for 2 hours prior to testing unless you’re testing to monitor him after a hypo episode) and a pre PM test. You want one at nadir (5-7 hours in most cats post shot). Ideally do one at +2 hours; if it drops a lot then you might have an active cycle, so more monitoring would be called for. We use the nadir numbers to determine dosing.

 

[Dan and Marc]

Thanks a lot. Yea Chronos (knock on wood) isn't displaying symptoms at least drinking/peeing wise. His weight fluctuates and we did decrease his overall calories recently for an unrelated reason. But the weight oddities could be due to his diabetes slowly over the past 2 months coming out of remission.

Testing wise I did 3 so far, one Pre and one at +3 and +5. Will do another before his PM shot and check at least a +3 since I usually go to sleep around then. Its hard with the dose being 0.5, just doesn't even feel like I push the plunger when I injected him. Will focus more on the PM one and test beforehand over the sink to be sure.

I did have a question in regards to his feeding schedule, Chronos (and our other two cats) currently eat (his choice not ours lol) at 4 am, then at 10:30am, at 4pm, 7:30pm and 10:30pm. We did his shot after the 10:30 feeding and will do the other after the pm one at the same time. He gets the same calories at each feeding. The 4pm is right around his +5 which I did test before feeding a little bit ago, but since food obviously will affect readings do you know generally how long after a cat eats that his BG would be elevated from the food? Just trying to think of for example if we wanted a +6 from the AM shot, it would be only like 45 minutes after he ate, so should we even try to check values an hour or more after a feeding?

 

[chuckstables]

Thanks a lot. Yea Chronos (knock on wood) isn't displaying symptoms at least drinking/peeing wise. His weight fluctuates and we did decrease his overall calories recently for an unrelated reason. But the weight oddities could be due to his diabetes slowly over the past 2 months coming out of remission.

Testing wise I did 3 so far, one Pre and one at +3 and +5. Will do another before his PM shot and check at least a +3 since I usually go to sleep around then. Its hard with the dose being 0.5, just doesn't even feel like I push the plunger when I injected him. Will focus more on the PM one and test beforehand over the sink to be sure.

I did have a question in regards to his feeding schedule, Chronos (and our other two cats) currently eat (his choice not ours lol) at 4 am, then at 10:30am, at 4pm, 7:30pm and 10:30pm. We did his shot after the 10:30 feeding and will do the other after the pm one at the same time. He gets the same calories at each feeding. The 4pm is right around his +5 which I did test before feeding a little bit ago, but since food obviously will affect readings do you know generally how long after a cat eats that his BG would be elevated from the food? Just trying to think of for example if we wanted a +6 from the AM shot, it would be only like 45 minutes after he ate, so should we even try to check values an hour or more after a feeding?

2 hours is the general rule of thumb for how long the food bump COULD last. The advice i’ve been given is the food goes away 2 hrs before testing. Even if it’s an hour that’s better than nothing.

 

[Dan and Marc]

Thanks so much, you all are great!

 

[Dan and Marc]

Just talked with our vet going over his blood results and urinalysis. She did a pancreas test, which came back high, since Chronos has been tested for it in the past and each time it has come back high, however he has never had any of the symptoms of pancreatitis. She said the test showed it was the enzyme portion of the pancreas with an issue. Otherwise all of his blood values were great, his kidneys values all went down and urine concentration back up to the levels we were at prior to the diet change. Can anyone offer any insights? She said to still do insulin and see if getting his BG under control will improve anything but that we can also go back to our Internal Medicine Specialists for an ultrasound of his pancreas, but that ultimately it will just tell us if its inflamed or if there is a mass or lesion.

 

[tiffmaxee]

The reason for withholding food two hours before insulin is so the preshot is not food influenced. Once you know how much his BG rises after eating that rule is not always needed. I followed the rule all the time once Max gave me BG under 100 at preshot to be sure it was safe to shoot unless my other tests showed he was on the way up. If ever you get a preshot BG a lot lower than he’s had before you would stall, don’t feed, and retest in 20-30 minutes. While waiting post for dosing advice.