24/2 Angie AMPS 137, +2 49, +3 86, +4 130 PM+198

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GraceAndAngie

GraceAndAngie

Member Since 2013
Good morning! Day 3 of home testing. Angie has been diabetic since August 2012.

Yesterday (23/02)
I could only get a large enough blood sample for two tests:
PMPS 8.2 (148)
+2 6.7 (121)

Today
AMPS 7.6 (137) Poor Ang bled a lot this morning (perhaps making up for yesterday)

Still on dry food with chicken treats after each test. We're going to transition to Dr Lisa Pierson's recipe for home-made food once I see what her levels are like.
 
Re: 24/2 Angie AMPS 7.6 (137)

She's ok. I think I was more distressed then she was. It's Sunday morning over here!
 
Re: 24/2 Angie AMPS 7.6 (137)

welcome to Lantus Land!

These are really great numbers for a cat still on dry food. It will be interesting to see what she does on a lower carb diet.
 
Help! 24/2 Angie AMPS 7.6 (137), +2 2.7 (49)

I've just taken Angie's 2+ reading and it's 2.7 (49). She has gone to her food bowl to eat afterwards but she had food available this morning (I don't know that she ate any though).

I'm worried that her levels will keep coming down (from what I've read they will come down for a few hours more). Is there anything else to do except for keep testing her and let her keep eating her dry food? She has no symptoms of hyperglycaemia. According to what I am reading, I'll give her some honey if she is lower next time I test her. How often should I test her?
 
Re: Help! 24/2 Angie AMPS 7.6 (137), +2 2.7 (49)

Grace, I'm not one for giving dose/food type advice, but would you please click on the "911" icon (in your original post...it will replace the heart)...that will get people's attention and someone with more experience can look at the numbers, etc.

p.s. Happy Sunday! ;-)

The cavalry is here! ignore my "911" suggestion!
 
Re: Help! 24/2 Angie AMPS 7.6 (137), +2 2.7 (49)

Do you have any karo or honey? She's ok in the 40s but you need to bring her up. Test again in 30 mins. This number also warrants a reduction in dose but you should get a dosing expert's input. Welcome to Ll! You're doing a great job with testing. It's hard at first but necessary to keep your kitty safe.
Liz
 
Re: Help! 24/2 Angie AMPS 7.6 (137), +2 2.7 (49)

Dry food can take quite some time to raise your kittie's blood glucose levels. Do you have any canned, high carb food (e.g., food with "gravy")? if not you can add a couple of drops of corn syrup, honey, maple syrup, etc. to Angie's low carb food. You want to feed and re-test in 30 min.

This is a link to a post on how to handle low numbers.

You don't need the 911. We're here to lend a hand.
 
Re: Help! 24/2 Angie AMPS 7.6 (137), +2 2.7 (49)

Sienna and I cross-posted :-D

Do you have any high carb wet food? Usually something in gravy.
You can give her a tsp or 2 to get her up - it stays in the system a little longer than syrup. But, be careful not to fill her up as you may need her to carry on eating.

You also need to keep testing - with numbers below 50, test every 30mins.

Have you read the stickies on handling low numbers and hypos?
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=147
 
Re: Help! 24/2 Angie AMPS 7.6 (137), +2 2.7 (49)

Hi Grace, a lot of us don't allow free feeding (and feed timed snacks instead) so that way we can get the kitty to eat when we need to. Do you have any high carb wet food? (food in gravy?) It's a good item to add to your hypo kit, just in case. Most cats reach their nadir (lowest point) at +6 so she is pretty low for a +2. Will you be able to monitor her closely throughout the day? Honey and or karo are short term solutions, but you will want to make sure you have some in your kit, as well.

Hopefully one of the advice givers will be by soon to give you more advice! EDIT: Ahhh, okay! I see Sienne got here! You're in good hands... don't panic! Angie is going to be fine :D
 
Re: Help! 24/2 Angie AMPS 7.6 (137), +2 2.7 (49)

It's generally recommended that for a diabetic cat, you feed low carb canned food. There are a few dry foods that are lower in carbs. Unfortunately, those foods are often not good quality. Given what Angie's numbers look like on a dry food diet, I would not be surprised if you could easily get her into remission on a canned food diet. Let's get Angie through this drop and a food change may be worth considering.

There's very good info on feline nutrition on this site that's written by a vet.
 
24/2 Angie AMPS 7.6 (137), +2 2.7 (49), +2.5, 3.7 (67)

Wow! Thanks so much for your fast help.

I've just retested her (half an hour after the 2.7/49 reading). She just tested 3.7 (67) so she's gone back up for the moment. Should I still be testing every half hour just in case?

I wonder how often this has been happening to her?

I don't have any canned food in the house. I'll ask my partner to pick some up for me so that it's on hand if she does drop further.

I only free-feed her because she eats slowly and walks off in between. In the mean time Jetzin comes and eats the rest of her food - I was worried about her getting hypo. I could measure out her amount and give it to her when she asks only. I was just trying to protect my family from her constant begging (she begs if she knows she gets food whenever she asks and doesn't when she has regular meal times). Jetzin is the more agile one.

I'm quite familiar with catinfo.org. I found this site (and about home testing) through it because I was looking into alternative food options. I didn't want to switch her and risk a hypo event until I got to see what her numbers were like. I will be switching her onto the home-made recipe from catinfo.org.
 
Re: Help! 24/2 Angie AMPS 7.6 (137), +2 2.7 (49)

I can't give advice, but if Angie were my cat, I would continue to test every half an hour to make sure her numbers stay up and to determine if you need to feed more. You are most likely seeing a "food spike" which can wear off. I would watch Angie very closely until about mid-cycle at least (when they normally start to rise) if she were mine. Since you don't have much data on Angie, we don't know when she normally hits her nadir. Most cats hit it at +6, but anytime between +4 and +8 is possible.
 
Re: Help! 24/2 Angie AMPS 7.6 (137), +2 2.7 (49)

Hi Grace, wow I'm glad you caught that number!

Approximately how much did she eat after you measured the 49?

Yes, you'll want to keep testing every 1/2 hour for a little while. Nadirs are a lot less predictable with cats eating dry food, so we'll have to test until we know she is heading up and will stay up.
 
Re: 24/2 Angie AMPS 7.6 (137), +2 2.7 (49), +2.5, 3.7 (67)

She is coming back up. +3 was 4.8 (86). I had a big panic because she was lying on the floor (which she doesn't usually do) and looking a bit dopey. Thankfully she was higher not lower. I'll keep testing half hourly.

GraceAndAngie said:
I'm quite familiar with catinfo.org.
Click to expand...

Gosh - I'm so sorry that I sounded ungrateful! I really appreciate the advice you're giving. I was just panicking and have been very upset about the advice I have been given prior to finding catinfo.org so it touched on that note. I put a lot of my savings into the vet's recommendations at the same time as I had to quit work for my own health issues. Before I found catinfo.org I was really worried that she would have more difficulties and I would need to borrow to pay for them or put her to sleep. It was horrible to discover that I could have done it a different way that would have been better for her and not put such financial stress on my family!
 
Re: Help! 24/2 Angie AMPS 7.6 (137), +2 2.7 (49)

Free feeding as a general strategy isn't a problem. When you're steering numbers, obviously you want Angie to eat. As Libby noted, dry can produce less than predictable nadirs and you don't get the same immediate response that you do with canned food. It also tends to hang around for a long time whereas high carb (HC) canned food is metabolized much more quickly -- HC canned is quick in and quick out.

Most of the people here who free feed leave canned food out or use a timed feeder. Or, like Angie, their cat(s) graze if food is available.
 
Re: Help! 24/2 Angie AMPS 7.6 (137), +2 2.7 (49)

Libby and Lucy said:
Approximately how much did she eat after you measured the 49?
Click to expand...

She ate like she was hungry. I should have watched to see how much but instead I came running to the computer!

Timed feeding is a great idea.
 
Re: 24/2 Angie AMPS 7.6 (137), +2 2.7 (49)

No worries. I certainly didn't interpret your post as being negative in any way, shape or form.

Finding out your cat is diabetic can be one of the worst days in your life. It's certainly among the most stressful. The amount you need to learn is overwhelming, Many vets don't approach FD management the way we do and while managing your cat's diabetes isn't cheap, many vets don't help to make it affordable. I suspect most of us have been told to bring our cats in for curves or repeated fructosamine tests and to buy the expensive prescription food. And, none of that is necessary if you're home testing, using a human glucometer, and feeding low carb food. There are also many vets who will claim to be "experts" in diabetes but are far from being experts -- at least they don't have expertise in all of the available insulin for treating FD.

In any event, I'm certainly glad you found Dr. Lisa's site and your found FDMB and Lantus Land.

Could you edit the subject line of your first post to include your +3 test? You'll want to re-test in another 30 min. to see where the numbers are heading.
 
Re: 24/2 Angie AMPS 7.6 (137), +2 2.7 (49)

Hi Grace

Welcome to you and Angie!! Looks like you are having to learn quickly. I'm glad she came back up but it's a good idea to stay on top of the testing until you get a couple of rising, non food influenced numbers before you stop testing.

Let us know what questions you have!! We're here to help.
 
Re: 24/2 Angie AMPS 7.6 (137), +2 2.7 (49), +4 7.2 (130)

She's still coming up and out of greens.

AMPS - 7.6/137
+2 - 2.7/9
+2.5 - 3.7/67
+3 - 4.8/86
+3.5 - not able to do test
+4 - 7.2/130

Could I test her hourly? She wouldn't hold still for 3.5 and she was a bit tricky for +4. I don't want it to get too much for her too quickly but on the other hand, I don't want to risk her health.

Three times we have had to rush her to the vet and emergency because she has been very lethargic and not very responsive. When I drove her to emergency she was almost entirely unresponsive I had to tap her on the head to get her to blink. Each time her levels haven't been too low. Could she have had a low prior and then shown the main symptoms afterwards as she was coming up? The vet concluded that she was just feeling sorry for herself. She seemed normal this morning when she tested at 2.7/49 and then very lethargic half an hour later when she tested at 3.7.
 
Re: 24/2 Angie AMPS 7.6 (137), +2 2.7 (49), +3 4.8 (86)

Really? Feeling sorry for herself? I tend to not think that was the case. I think your instincts were right on target. And now that you're testing, you'll have the data to prove it.

I think you can test every hour. There's also a very good chance that Angie will "bounce." This means that her liver and pancreas will release a stored form of glucose (i.e., glucagon) and counterregulatory hormones in response to the low numbers. Essentially, the organs respond as though this is a dangerous situation and the glucagon and counterregulatory hormones act to cause a spike in numbers. It can take 72 hours (give or take) for the bounce to clear.

FWIW, the convention here is to use US numbers (mg/dL). It will save you space in your subject line.
 
Re: 24/2 Angie AMPS 7.6 (137), +2 2.7 (49), +3 4.8 (86)

I think you're ok to wait an hour.

Now, we need to talk. :mrgreen:

You say you want to try tight regulation, which is great and I think Angie is a very good candidate. You say you want to switch her diet, which is also great.

However, one of the prerequisites for using the Tight Regulation protocol is that the cat is on a 100% wet (or low carb raw) diet. Cats eating dry food should not be following Tight Regulation because their response to dry food is much less predictable than the response of a cat on low carb wet food.

Until you can get her diet switched, I suggest setting a "no-shot" number of about 180. If she is lower than that at shot time, then you can either skip the shot or stall and test every 30 minutes until she gets up to 180. Then when you're ready to switch foods, I would also reduce her insulin dose to be safe. If she is getting 40s on 1 unit with dry food, then she will probably go lower than 40s when you switch to low carb, so that's not a good thing. Maybe try 0.5 unit instead. Be prepared to monitor closely in case even that is too much. Or you could switch food, give NO insulin for a day or two, but check daily for ketones. Has Angie ever had ketones as far as you know?

I know Angie is doing very, very well. We just want to help you help her.

REQUISITES WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR:

Kitty should be monitored closely the first three days when starting Lantus or Levemir.
Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
More monitoring may be needed.
It will be necessary to test kitty's blood glucose levels multiple times per day.
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 U-100 3/10cc syringes with half units marked on the barrel for fine dosing.
Feed a high quality low carb canned or raw food diet.
Feed small meals throughout the day. Some kitties adapt well to free feeding.
Click to expand...
 
Re: 24/2 Angie AMPS 137, +2 49, +3 86, +4 130, +5 113

I'd switch her today if it were safe. I just didn't think that it was a good idea to change anything until I could see what her levels were doing. If I am going to skip her insulin tonight (we'll see what her levels do first), perhaps I should swap her today?

Am I right in guessing that if I don't give her insulin tonight and give her a wet meal then I won't push her too low without the carbs?

I was hoping that I wouldn't need to make any decisions until I had a few curves done!
 
Re: 24/2 Angie AMPS 7.6 (137), +2 2.7 (49), +3 4.8 (86)

Libby and Lucy said:
Until you can get her diet switched, I suggest setting a "no-shot" number of about 180. If she is lower than that at shot time, then you can either skip the shot or stall and test every 30 minutes until she gets up to 180. Then when you're ready to switch foods, I would also reduce her insulin dose to be safe. If she is getting 40s on 1 unit with dry food, then she will probably go lower than 40s when you switch to low carb, so that's not a good thing. Maybe try 0.5 unit instead. Be prepared to monitor closely in case even that is too much. Or you could switch food, give NO insulin for a day or two, but check daily for ketones. Has Angie ever had ketones as far as you know?
Click to expand...

A no shot number is very helpful. Thanks. She has never had ketones when the vet has tested, which is only about 6 times since August last year. Is there a protocol for how often you test for ketones? I have been looking for info on it on this site but haven't yet found it.

We have had more troubles with lows than highs although she once got a reading of 504. I think she's been in the blue and yellow ranges mostly.

She's been in and out of remission once already.
 
Re: 24/2 Angie AMPS 137, +2 49, +3 86, +4 130 +5 113

There isn't any protocol as to when or how often to test for ketones. A great deal depends on whether you have a cat that has either had an episode of diabetic ketoacidosis (DKA) or is prone to developing ketones. I try to test for ketones whenever I can catch Gabby in the litterbox. It's usually about once every several weeks.
 
Re: 24/2 Angie AMPS 137, +2 49, +3 86, +4 130 +5 113

Can you get the ketostix? They are at the pharmacy here, for humans. We try to test every few days but have never had a problem.
Liz
 
Re: 24/2 Angie AMPS 137, +2 49, +3 86, +4 130 +5 113

My blood glucose meter can test for ketones. I'll get some test strips tomorrow when the chemist is open.

Today
AMPS 137
+2 49
+2.5 67
+3 86
+4 130
+5 113
+6 157
+7 140

Does anyone have any thoughts about skipping her insulin tonight and making the switch to wet food? I couldn't keep doing 1 hourly tests overnight though. I could do +1, +2, +6 and +10 at the most.
 
Re: 24/2 Angie AMPS 137, +2 49, +3 86, +4 130 +5 113

Libby said:
Then when you're ready to switch foods, I would also reduce her insulin dose to be safe. If she is getting 40s on 1 unit with dry food, then she will probably go lower than 40s when you switch to low carb, so that's not a good thing. Maybe try 0.5 unit instead. Be prepared to monitor closely in case even that is too much. Or you could switch food, give NO insulin for a day or two, but check daily for ketones.
Click to expand...

You can skip tonight. Is there any way you can pick up some low carb canned food for Angie's evening meal?
 
Re: 24/2 Angie AMPS 137, +2 49, +3 86, +4 130 +5 113

GraceAndAngie said:
Does anyone have any thoughts about skipping her insulin tonight and making the switch to wet food? I couldn't keep doing 1 hourly tests overnight though. I could do +1, +2, +6 and +10 at the most.
Click to expand...
I think that is a good idea. Skip insulin tonight and feed just wet food, no dry (assuming she eats the wet food readily). Get some spot checks whenever you can during the cycle to see what happens. Then see where she ends up the next morning before deciding how much insulin to give.

Ketone testing is a precaution whenever you significantly reduce the insulin amount or stop giving insulin. If she does start testing positive for ketones, then we would have to start insulin again.
 
Re: 24/2 Angie AMPS 137, +2 49, +3 86, +4 130 +5 113

Sienne and Gabby said:
You can skip tonight. Is there any way you can pick up some low carb canned food for Angie's evening meal?
Click to expand...
I've got it ready and waiting to go. I've switched my other cat already. She likes wet food so the switch will be easy from that point of view.
 
Angie had a low today on her first day of home testing. I had some advice to use this point as an opportunity to switch her from dry food to wet food and skip her insulin dose. I wasn't able to get a pre-test from her. She was a bit fed up with my testing.

I gave her cat mince (kangaroo, lamb, beef, kidney plus vitamins mix, no carbs ) and she was delighted and ate her whole meal in one go. She didn't eat her whole dry food meal in one go previously. I took the dry food away at +10.

Today
AMPS 137
I unit
+2 49 (and then ate a fair bit of food - she may not have eaten much before?)
+2.5 67
+3 86
+4 130
+5 113
+6 157
+7 140
+8 146
+10 not able
PMPS not able (ate her whole meal of raw food)
+1 198

I plan to test her again at +2 (10:30 pm) and then get up again in the middle of the night to test her +6 (2.30 am) and then at +10 (6.30 am).

Her levels are almost into the yellows. Should I give her 1/2 a unit of insulin or wait and see what her readings are in another hour? I'm so new to this and had hoped to see a couple of her curves and switch her over to raw food in a planned way but her low this morning threw everything out.
 
Her higher numbers now are probably just a bounce from the 49. I think I would wait and see on the insulin in the morning.
 
good luck!

As Dyana said, I would hold off on insulin and see how she does overnight (it's still night there, right?). We have seen some cats drop over 100 points when they switch to low carb. Others don't drop much at all, but better safe than sorry. Missing one shot won't hurt.

Goooooooooooo Angie!
 
It is night here - 2.30 am. I just got up to do a middle-of-the-night spot check at +6.

PMPS not able
+1 198
+2 164
+6 146

She hasn't had a big drop (but then I didn't give her insulin). I can't think of anything except going back to sleep. I'm going to try again in another 4 hours.
 
That's a very nice sized drop especially without insulin.

When you get up, start a new thread for Angie with your AMBG (we use AMBG not AMPS since you're not shooting).
 
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