3/21 Neko AMPS 434 +6 418 +10 396 confused

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Wendy&Neko

Wendy&Neko

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I have a couple of questions about Neko and her spreadsheet. Here is my last entry http://www.felinediabetes.com/FDMB/view ... =9&t=66476
I have started spreading out her meals in the last couple of days.

1) Any ideas on where her dosage should go? Since the 15th and her almost hypo and subsequent rebound, I have been giving her a skinny 2.25/fat 2.0 and afraid to go back up to 2.5 units. Her spreadsheet numbers are all high and fairly flat. The 2.5 seemed to get her down, but too far/too fast. Unfortunately I don't have good data on the lower dosages because that was with a Freestyle meter. If the Freestyle is more accurate at lower numbers (read that somewhere), it would suggest that I'm giving her too much and should go lower. Of course, it could just be the Freestyle meter was inaccurate there too. if you think I should go back to 2.5, is there a way to go there slowly so I don't get her body panicking and BG dropping so fast?

2) Any other kitty owners have a cat who doesn't show systems of excessive drinking/peeing at the high numbers? Neko has always peed twice a day since before her diagnosis and even when she seemed to be getting regulated on Caninsulin so that hasn't changed. The vet is mystified because I should be seeing LB flooding at these numbers. We did do a urine sample at the vet and hopefully it'll tell us something in the next day or so. She isn't straining or complaining at the LB so no typical signs. The Ketostix still aren't showing anything. Her only external symptoms of diabetes are intense hunger.
 
Hi, Wendy & Neko!

just stopping by to give your post a bump up to the top of the forum for better eyes :-D

celi & binks
 
Just out of curiosity, why did you drop Neko's dose to 2.0 for a day?

From what you indicated in your last post, the 45 was probably a meter/strip error. If you mean the blue numbers on 3/15 were "near hypo," those numbers are in a really safe range. Was Neko acting any differently when he was in that blue range?

Ordinarily, with numbers in the reds and pinks, I'd suggest raising the dose. I would, however wait at least another day. Generally, when you change a Lantus dose, you want to wait for the dose to settle. That usually takes 2 - 3 days. Are you shooting the same amount consistently?
 
I shot 2.0 for a day because I read something on rebounds that said you should lower the dose by 25%. Otherwise I've been shooting a "skinny 2.25" for the last several days. When I saw the vet yesterday he said to stay at 2.25 so I went back to it.

When I had the low blues at what I call the "near hypo", Neko was howling for food. Normally, like right now, she is letting me know her dinner is due soon (8 PM) by periodic meows and she will also do that for her 11 o'clock before bed snack. On the night of the 15th, I had done a PM+2 partly on a hunch and also because I notice changes on the second day of a dose change. That was when I saw the yellow and that her BG was dropping quickly. At midnight she was in the kitchen, continuously howling for food. Normally she will have settled down for the night after she has finished her last meal. I tested at midnight and noticed the drop to 110 which was a drop of 300 in four hours. Since nadir was a couple of hours away yet, I gave her a snack and she practically bit my fingers getting the food. She was crazy for food in a way I haven't seen before. The bounce into the black the next day shows her body was reacting to what were lows for her.
 
ah, she probably hated the feeling of her bg diving down like that. cats do get accustomed to whatever range their BG's have settled into and you have to help them get used to a new range. non-diabetic cats are under 120 - so that's our goal! the protocol was developed from a study that determined that if you can get the blood glucose of a newly diagnosed kitty (under 1 year since diagnosis) back into non-diabetic range, the pancreas has the potential to heal and begin producing insulin again.

this means that a cat can become diet-controlled and go off of insulin injections.

the way to get them used to the better range of numbers is to try to get them there and keep them there. that's what the dosing of the protocol is designed to do. the more neko is in lower, healing numbers, the more she'll get used to it and stay there. then she'll really feel better.

i suspect it's like when a person gets their caffeine taken away. it might be your natural state to be caffeine-less, but most people feel better with what they have become used to.

she's not in any danger until she's in much lower numbers. we start giving carbs when they dip under 50.
 
I guess that means I have to try to figure out when to start the 2.5 units so that she'll go low when I'm home and awake so I can keep testing if she starts howling again. I had seen a BG drop of 300 in four hours and was worried at that rate she would be way too low in a couple more hours. It seems like an abnormally fast drop for what I had read about Lantus. I had heard it was a gentler insulin than Caninsulin.
 
it is gentler. as you get closer to a better dose for neko you won't see the giant drops like that. if you're home on weekends, perhaps that's a time to do whatever increases are needed.

if you're going back up to the 2.25 you want to stay there for a minimum of 6 cycles before considering another increase, though. the cycle count needs to be continuous, so your count would start after the 2.0 shot.

of course, if neko drops below 50 you would decrease the dose. the comment above about staying at the dose for at least 6 cycles applies to increasing the dose.
 
Lantus is gentler than Caninsulin. Cat's can dive on Lantus. Gabby has gone from the 400s to the 40s to back to the 400s in one cycle. The bounces do begin to level out, though.

At least with Lantus, we don't change the dose with a bounce. That may work with a short acting insulin. Since Lantus is a long-acting insulin, frequent dose changes usually result in wonky numbers. Doses need time to settle since you are working with an insulin depot and the cumulative nature of the insulin.
 
Thanks all. It's good to hear from the collective experience. I was worried that we were at too high a dose but unsure because of that darn Freestyle meter.

I've started 2.25 full (not skinny) tonight and will hold there for a few days. I just hope I can figure out whether the 2.5 start should be day or evening. I can be at home most days (mostly work at home) and would rather deal with this during the day than at night.
 
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