2/24 Murphy AMPS 377/321

Murphy's Momma

Murphy's Momma

Member Since 2020
Hi all. This is my first time posting here, and it's a little intimidating but here I go!
My baby Murphy is diabetic, he's 11 years old, and has been diabetic since 2018.
He was first on Vetsulin for years, and did well on it. In September 2023, I changed him to Lantus.
He's on 3 units right now. I do have a spreadsheet that needs to be updated, and I'll add that later, but I just wanted to get my first post going, as I could certainly use some help.
His numbers kind of stay consistently high, in the 300's usually.
I'm not sure if he's receiving too high of a dose, as the reason I've upped his dose is because he'd randomly get a slight trace of ketones and I know that's definitely a reason to give an increase.
I'm not sure how this works, I Hope I can add to my post later.
Again, my first time, so here goes! Thanks so much in advance!
 
Hello and welcome to FDMB! :-)

Here's some info we give new members: HELP US HELP YOU

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 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.

I can help set up your spreadsheet and signature. Let me know if you need help :-)
 
Welcome to LLB. Don’t be intimidated. We are here to help. While you get together your signature and spreadsheet which I suspect will take a little time can you tell us what you are feeding Murphy? Are you following a dosing method either from here or somewhere else?
 
Bandit's Mom said:
Hello and welcome to FDMB! :)

Here's some info we give new members: HELP US HELP YOU

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 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.

I can help set up your spreadsheet and signature. Let me know if you need help :)
Click to expand...



Hi!! Omg thank you so much! I will definitely get all of that done this weekend!!! THANK YOU!
 
tiffmaxee said:
Welcome to LLB. Don’t be intimidated. We are here to help. While you get together your signature and spreadsheet which I suspect will take a little time can you tell us what you are feeding Murphy? Are you following a dosing method either from here or somewhere else?
Click to expand...


Hi!! Thank you so much! I have a spreadsheet that's all set up, I just have to update a couple of weeks worth of numbers :) I'm feeding Murphy Dr. Elsey's dry food, and he gets wet food twice a day. It used to be only Fancy Feast pate, but he's picky sometimes, and so I've started giving him whatever he'll eat - always Fancy Feast, sometimes it's chunky in gravy, flaked in gravy, etc. As far as dosing methods, I was going on the Facebook group for a bit, but to be honest I've just been adjusting it based on his curves which I do at home, I test him every day at LEAST twice a day (before each shot and if I'm home with him than as many times as I can!) and I can also tell by his breath whether or not he's got a trace of ketones.
 
Since you are feeding dry food you would follow SLGS if you want to follow one of our methods. . The gravy foods are usually high in carbs. So best to reserve that for when the bg is low or when he won’t eat and needs some food. Have you looked at food lists to see what foods he will eat that are lc (under 10%) and mc (10-15%). Was he ever DKA?
 
START LOW, GO SLOW (SLGS)

The Start Low, Go Slow Method (SLGS) with Lantus, Levemir, or Biosimilars for Diabetic Cats has been adapted from the FDMB's original 5 Steps to Regulating Your Diabetic Cat. Adaptations were necessary to accommodate the action, nuances, and exceptions of the newer Lantus, Levemir, and their Biosimilars insulins.

Requisites when following the Start Low, Go Slow Method:
  • Learn the signs of and how to treat Hypoglycemia and prepare a Hypo Toolbox.
  • Test regularly for ketones and know about Diabetic Ketoacidosis (DKA).
  • Use a meter calibrated for humans, not a pet-specific meter. Reference numbers given are for measuring blood glucose with a human meter.
  • Use U-100 3/10cc syringes with half units marked on the barrel for fine dosing.
  • Most kitties are easier to regulate when fed small meals throughout each cycle. Others adapt well to free feeding

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.
  • 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
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change).
 
tiffmaxee said:
Since you are feeding dry food you would follow SLGS if you want to follow one of our methods. . The gravy foods are usually high in carbs. So best to reserve that for when the bg is low or when he won’t eat and needs some food. Have you looked at food lists to see what foods he will eat that are lc (under 10%) and mc (10-15%). Was he ever DKA?
Click to expand...

Yess, I do usually save the gravy for when he won't eat! He's been picky lately, and we've had some issues with him refusing ALL Wet food in the past, and then he started liking it again. so I tend to give him the gravy food just to ensure he's eating.. it's not the gravy lovers tho, if that makes any difference! Just a little gravy.. lol I do know that it spikes their BG tho. I try to give him without as often as I can. and I have not looked at any lists regarding food since he's sooo stinking picky. I tried other kibble that is low in carb, and he refuses. (Expensive stuff too..) Dr. Elsey's is the only one he liked! No, never DKA. Just a few random times where he'd have a slight trace of ketones, and then I'd up his dose, and he'd bounce back as if nothing happened.
 
You want to try to get his bg under 300 so you have come to the right place! Does he have any other medical issues? Often picky eating is due to nausea. How is he otherwise? Peeing, pooping, preening, playing like normal?
 
tiffmaxee said:
You want to try to get his bg under 300 so you have come to the right place! Does he have any other medical issues? Often picky eating is due to nausea. How is he otherwise? Peeing, pooping, preening, playing like normal?
Click to expand...

Yesss, I know, I've been trying :( and no, no other issues! the random bout of pancreatitis, but not in a long time (knock on wood..) and I understand it sometimes might be due to nausea ! but I'm not sure that's the case with him, he'll eat certain flavors and not others some days, and then the total opposite other days. I've even given him Cerenia for nausea on days that I thought that might be the issue. When I update my spreadsheet tonight and post here, hopefully that can paint a bigger picture of what he's been like with his BG! I appreciate this help so much an am already feeling better about posting here. As far as otherwise - he's peeing, pooping, and playing like normal. He's actually been more active with his toys in the last few months than in a long time. LOL we moved from NY to Florida to a bigger home and I think he's just much happier overall! SOO yes, he's normal otherwise :)
 
SO I should actually post about what happened this morning - which is what prompted me to post today. He threw up a little right before I was going to feed him/give his insulin. We lift his food two hours prior to his shot so it was pretty much all liquid & the denamarin I had JUST given him. When I offered food after that, so he can eat before his shot, he refused. I tried a few different flavors, and he only nibbled a bit on his Gravy Lovers food. I gave him 1.5 units instead of his normal 3, because when I tested his BG for the second time this morning, it went from 377 to 321 without insulin, so I didn't feel comfortable giving him his full dose. I gave him Elura before I left for work, to entice him to eat. I also give him Mirtazapine here and there, just to make sure he's got an appetite. He's on Denamarin twice a day, and also 1/4 pill of Ursodial once a day.
 
Max had chronic pancreatitis and the one symptom he had always when it flared was inappetence. I gave him ondansetron for it and it worked better than cerenia. I found that if I eliminated the nausea he ate well without needing any other meds. I’m not a fan of either Elura or mirtazapine. Mirata , the gel is milder and I also used cyproheptadine or Zyrtec but rarely needed if the nausea was controlled. Why are you giving denamarin?
 
tiffmaxee said:
Max had chronic pancreatitis and the one symptom he had always when it flared was inappetence. I gave him ondansetron for it and it worked better than cerenia. I found that if I eliminated the nausea he ate well without needing any other meds. I’m not a fan of either Elura or mirtazapine. Mirata , the gel is milder and I also used cyproheptadine or Zyrtec but rarely needed if the nausea was controlled. Why are you giving denamarin?
Click to expand...

Mirtazapine actually works great for him! This was my first time giving him Elura tho. He has a fatty liver and has also had issues with his liver values and he's been on denamarin for years now.
 
tiffmaxee said:
Max had chronic pancreatitis and the one symptom he had always when it flared was inappetence. I gave him ondansetron for it and it worked better than cerenia. I found that if I eliminated the nausea he ate well without needing any other meds. I’m not a fan of either Elura or mirtazapine. Mirata , the gel is milder and I also used cyproheptadine or Zyrtec but rarely needed if the nausea was controlled. Why are you giving denamarin?
Click to expand...

He also hasn't has any issue with pancreatitis since early 2023!
 
Murphy's Momma said:
Hi!! Thank you so much! I have a spreadsheet that's all set up, I just have to update a couple of weeks worth of numbers :) I'm feeding Murphy Dr. Elsey's dry food, and he gets wet food twice a day. It used to be only Fancy Feast pate, but he's picky sometimes, and so I've started giving him whatever he'll eat - always Fancy Feast, sometimes it's chunky in gravy, flaked in gravy, etc. As far as dosing methods, I was going on the Facebook group for a bit, but to be honest I've just been adjusting it based on his curves which I do at home, I test him every day at LEAST twice a day (before each shot and if I'm home with him than as many times as I can!) and I can also tell by his breath whether or not he's got a trace of ketones.
Click to expand...
I’m glad you are posting. Just a quick comment, if you can smell ketones in his breath, they are too high. You should be urine testing them and take action when they are trace.
 
Marje and Gracie said:
I’m glad you are posting. Just a quick comment, if you can smell ketones in his breath, they are too high. You should be urine testing them and take action when they are trace.
Click to expand...


I do, and anytime I did test, it was a slight trace, never more, and when I would increase his insulin dose, the smell would disappear and he would have zero ketones. He is always close to my face, licking me, and I am SUPER aware of any changes in him, in every aspect. I am a helicopter mom - FOR SURE. I notice any and every little change in his behavior.
 
Murphy's Momma said:
I do, and anytime I did test, it was a slight trace, never more, and when I would increase his insulin dose, the smell would disappear and he would have zero ketones. He is always close to my face, licking me, and I am SUPER aware of any changes in him, in every aspect. I am a helicopter mom - FOR SURE. I notice any and every little change in his behavior.
Click to expand...
Just remember when you get a trace, you can also up the food and water along with the insulin. Thanks for clarifying.
 
Stalin is not recommended for cats. Lantus is dosed based upon how low it takes your cat. Cats often drop lower at night and that often is mid cycle. To accurately dose Lantus we need more than a pmps. Vetsulin was actually a dog insulin and dosed differently for cats. It often causes big drops and then doesn’t last 12 hours. You can read about depot insulin and how they work on one of the stickies at the top of this forum.
 
tiffmaxee said:
Stalin is not recommended for cats. Lantus is dosed based upon how low it takes your cat. Cats often drop lower at night and that often is mid cycle. To accurately dose Lantus we need more than a pmps. Vetsulin was actually a dog insulin and dosed differently for cats. It often causes big drops and then doesn’t last 12 hours. You can read about depot insulin and how they work on one of the stickies at the top of this forum.
Click to expand...

I'm very well versed in both insulins and what the differences are! I do know what the benefits are to Lantus vs. Vetsulin, but I'm just struggling with getting my baby regulated and he seemed to have better +6 numbers on it. I know his AMPS was always high (it's in my spreadsheet) but it got him to a lower nadir. I'm just trying to mull over some options.
 
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