12/8/15 Keiko AMPS 362

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KeikosHuman

KeikosHuman

Member Since 2014
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I did not see the last message in my last post until this morning. I ended up giving Keiko 6 units instead of 11. He's now too high this am. Next time if he's in normal range I will lower .5. I need to have a strategy but I do not see a clear pattern with him. Recently he's been on a plateau then yesterday he went from 112 AMPS to 57 PMPS.
My boyfriend is a scientist and he thinks Keiko needs the full dose to stay normal. Isn't it normal to have low BG after not eating for 12 hours? The vet thinks I should lower the dose to 9 units. I don't agree since he has only had normal BGs at 11 I don't want him back in the 200s or 300s.
I need a strategy for next time. I guess full dose or lowering .5 or 1 may be best to keep him in normal range. I hope lowering him yesterday doesn't send him to high numbers very long.
Thank you.
 
Hi Maria - giving 6U last night instead of skipping probably helped Keiko not be even higher this morning. He should get over the lowered dose in a coupe of cycles. However, it's worrisome to shoot that low and then leave him with no more tests last night. The nature of the insulin depot means the 11.0U you shot yesterday morning could still impact last night's cycle.

Julie and I discussed Keiko's dose, and we both thought he should go down to 10.5U, for safety's sake. As kitties get into better numbers like Keiko has been doing the last few days, their insulin needs may diminish. Something has changed in Keiko and he doesn't need as much insulin as he did even a few weeks ago. It's just not safe to shoot a dose that's getting him to a 57 before shot time, without getting mid cycle tests. We don't know where he was before that 57. I'm guessing there's a good chance he earned a reduction (by going below 50) which the protocol says means going down to 10.5U.

Does your boyfriend help with testing at all? I too have a science background, but that doesn't really help. We are following a dosing protocol here that was researched and published in a technical peer reviewed veterinary journal. We've seen higher dose cats that for some reason suddenly break some of their resistance and need less insulin. The protocol is a safe way to dose and that's what we use as our strategy.

You mentioned Keiko not eating for 12 hours. It's better for a healing pancreas to have several smaller meals so it's not overwhelmed at once. Do you have an automatic feeder? It's also safer if you are going to leave a kitty in low numbers, to leave him some food so he can help bring his blood glucose up by eating, if he needs to.
 
Hi Wendy,
To clarify, are you saying I should decrease his dose now to 10.5 units twice a day? (or decrease to 10.5 if he's low -like 57- and only if I'm not going to be home with him)? I agree, something has changed with him.
I'm still working on understanding how a morning dose could affect his night numbers/dose. Is there something I can read?
I will start give him smaller meals when I'm home. When I leave extra food for him and I'm not staying he'll eat it immediately, or my other cat eats it, so he ends up foodless for the rest of the cycle.

Today he started in the mid 300s and is now down in the mid 200s (+11).
I only give wet food. Does an auto feeder accomodate this?
Thanks again very much for your help!
Maria & Keiko
 
Yes, we were thinking it would be good to go ahead and decrease his dose now.

It is hard to wrap your head around. Lantus and Levemir are both called "depot" insulins. When they are injected, some is available immediately to lower blood sugar, but some builds up in the body and slow-releases. That's the beauty of these insulins and why they work so well with cats with fast metabolisms.

But it also means that when you decrease the dose, you have a "pool" already built up in Keiko's body that is going to continue to slow-release regardless of anything you do with the dose. The size of the depot is in relation to the size of the dose. In other words, the larger the dose, the larger the depot. Depots can influence as many as 6 future cycles. So when you reduce the dose from 11u to 10.5u, the former 11u dose will continue to help reduce his blood sugar for as much as 6 more cycles.

By the same action, when you increase a dose the depot has to grow to "fit" the new larger dose. So we hold doses for at least 6 cycles when we increase in order to let that depot grow to fit the new larger dose. Then we can see what the dose will really do.

The sticky on the Insulin Depot goes into all of this. Near the top on that page is a link to the differences between Lev & Lantus, and reading that helped me understand better how Lantus worked.

Something else that I'm noticing this evening about Keiko's ss - it looks like he might already be beginning to clear the bounce from hitting the 50's yesterday. That's pretty fast, and it tells us that he's been seeing plenty of green numbers. Also he stayed at least 3 hours in the 50's and 60's last night. Cat's that aren't used to lower numbers will most of the time just touch down and immediately soar back up. This is another indicator that he's spending some time in green numbers.

Yes, you can use canned food in a timed feeder. I liked the PetSafe 5 Compartment one because I could set multiple times to open.

Hope some of that helps.
 
I recently switched to the Petsafe 5 feeder too. There's a spot below the rotating feeder tray where you can put a small freezer gel pack. Which I do with the raw food Neko gets. For wet food, just add a tsp or two of water, and that will help it from getting crusty and the extra water is good for them anyway. If you are shooting lowing numbers or a bounce clearing cycle where you think he might go low, you can put some medium or higher carb food in the feeder to open mid cycle if you aren't going to be around. Otherwise just put a portion of his lower carb food.
 
I also put an ice cube or two in each section of the feeder to help keep it fresh. Punkin didn't mind it being soupy so that worked for us. Some people make frozen cat-food ice cubes and put those in the feeder.
 
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