3/4 - Moby - AMPS 296 (could really use some help)

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Marciegee

Marciegee

Member Since 2015
Hello!

Moby's been on insulin since January 9. We were originally WAY over-prescribed (two units of Lantus, twice a day) and had a terrifying hypo incident that has left my husband and I extremely skittish. I trusted the vets we were working with and, sadly, their advice has never really worked. In fact, they were quite often wrong and that is what contributed to Moby's hypo incident. Since then, I have relied on advice from this board and its members.

We were giving Moby 0.5 units once a day, but dropped back to 0.3 units once a day because the Lantus was still hitting him too hard mid-day and also prevented us from giving him an evening shot.

Now, we are seeing his numbers going up, and his late cycle tests are showing me he may be ready for an evening insulin shot (going to stick with his 0.3 units, I think).

However, his hypo incident was at night, at around 2 a.m., so I am TERRIFIED of doing this again without me or my husband watching him, all night long, with hawk-like intensity.

Is there any wisdom or advice for keeping him from not going too low over the evening hours? He does well when he gets a +3 or +4 snack, and I plan to leave out his favorite selection of wet food for him to snack on.

Speaking honestly, I guess I'm just downright terrified. I probably won't sleep a wink tonight and will be hovering over him, lancet at the ready.

Thanks for hearing me, folks. I appreciate it!
 
I'm looking at his spreadsheet. Are you using a human glucometer or an Alpha Trak?

That 44 that you got on 2/22 would've earned a dose decrease by our guidelines, either the Start Low Go Slow or the Tight Regulation Protocol, regardless of which type of glucometer you are using. With either dosing guidelines, we'd have suggested you decrease the dose to 0.1u. It's possible that he's actually overdosed rather than needing a dose increase. There are circumstances where low numbers CAUSE higher numbers, instead of it being that the higher numbers mean that a cat needs more insulin.

I'd like to get some other experienced folks to take a look at his ss. Can you hold off on giving a shot tonight, since you haven't been recently anyway, and instead get a couple of tests in - maybe one at +12 (12 hrs after your morning shot) and a test right before you go to bed might be very revealing.
 
julie & punkin (ga) said:
sounds like it was a horrible experience for you. Did he have full blown hypo symptoms?
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He did. Full seizures. I plead my case to the vets two days before, saying he was showing mild symptoms and she poo-poo'd me. He nearly died.

julie & punkin (ga) said:
I'd like to get some other experienced folks to take a look at his ss. Can you hold off on giving a shot tonight, since you haven't been recently anyway, and instead get a couple of tests in - maybe one at +12 (12 hrs after your morning shot) and a test right before you go to bed might be very revealing.
Click to expand...

There's a piddly note at the tippy top -- we are using a One Touch Ultra Mini. And yeah, we can definitely hold off. He eats around +12, so I can do a test prior to meal, and then one before bedtime.

And thank you for taking time to help me. I am so grateful. It feels better just to say how scared I am.
 
i can't imagine how scary it was to have full seizures. that would've been terrible.

thanks for clarifying on the glucometer.

You're very welcome - you've had quite a time of it. Under the best of circumstances starting out with a diabetic cat is stressful, much less having a hypo like that.

People here will help you. Hang in there! Let's get a little more information and that'll help us figure out where to go next. :bighug:
 
Welcome to Lantus/LevemirLand! You won't get any better advice on treating a diabetic cat that what you'll get here. Julie is the best! Yikes, the hypo must have been terrifying. You are doing an excellent job with Moby. What does he eat?
Liz
 
Welcome!!

I guess we're throwing a lot of questions at you! Sorry!! I'm going to throw another at you. I'm not sure what guidelines you were using regarding dosing. There are 2 options with Lantus -- the Tight Regulation Protocol or the Start Low Go Slow (SLGS) approach. With SLGS, you reduce the dose when your cat's numbers are below 90. With TR, dose reductions occur when numbers are below 50. However, with both methods, you need to be dosing twice a day and getting a pre-shot test before you give insulin.

One other consideration. You do not want to be feeding Moby 2 hours prior to a shot. Food can influence his pre-shot numbers.

If you're nervous about his numbers dropping, it may be useful to get a test at +2 or +3. Ordinarily, you'd expect the +2 test to be very close to your pre-shot test number. If it's markedly lower, it's likely that you'll see an active cycle. Getting early tests can often help you to know what to expect as the cycle goes on.
 
Anne & Zener (GA) said:
What does he eat?
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Hey Liz, thanks for the welcome! Moby eats combo of canned poultry based pates. We have to keep rotating so he'll stay interested: Wellness Turkey/Chicken, Wellness Chicken Core, Halo Grain Free Chicken, Fancy Feast Turkey & Giblets. There's a link in my signature with the list. I also asked Young Again for a sample of the Zero Carb to see if he'll try that. We've fully converted him to the Liv-A-Littles treats!

Sienne and Gabby said:
Welcome!! 'm not sure what guidelines you were using regarding dosing. There are 2 options with Lantus -- the Tight Regulation Protocol or the Start Low Go Slow (SLGS) approach. However, with both methods, you need to be dosing twice a day and getting a pre-shot test before you give insulin.

One other consideration. You do not want to be feeding Moby 2 hours prior to a shot. Food can influence his pre-shot numbers.

If you're nervous about his numbers dropping, it may be useful to get a test at +2 or +3. Ordinarily, you'd expect the +2 test to be very close to your pre-shot test number. If it's markedly lower, it's likely that you'll see an active cycle. Getting early tests can often help you to know what to expect as the cycle goes on.
Click to expand...

Hello! No, I don't mind clarifying anything. My approach is basically what the vet told me to do. And I wanted to believe the vet, but I've come to realize that what the vet have been recommending have not helped regulate him. She wants to keep him at 0.5 units once a day, but everything I've read said this is not optimal.

Therefore, me coming my senses and asking questions and learning these methods. :)

Thank you for the +2 advice. It's hard for me to get that on work days, but I can definitely work on that on the weekends!
 
Hey @julie & punkin (ga), got some new #'s and I'm a tad shocked!

What would have been the PMPS was 274 tonight and what would have been the PMPS +3 is 211. But we gave no insulin as suggested. Is there a natural drop with the sleeping cycle? I'm kinda surprised!

Anyway, thanks again for everyone's help and questions. Hitting the hay now. Zzzzz.
 
Hi there and Welcome :cool:

What a horrible ordeal you have been through. I'm glad you found us - no better place to be.

Do you feed him at regular intervals or does he free feed?

Many kitties tend to run lower on the overnights.
If you and your husband could manage to sprinkle some overnight testing in over the weekend, the data you collect will be valuable - it will help round out the picture which will support making sound dosing decisions.

'Know thy Cat'
(one of many sayings here in L&L land) ;)
 
Numbers can vary. It was basically a flat day for Moby. It's helpful to keep in mind that there's about a 20% variance in any number you get due to measurement error with any meter.
 
Just adding our "Welcome aboard" to the pile. I'm so sorry you and Moby went through a symptomatic hypo...how terrifying, but how lucky Moby had you there to help him through it!

You have come to the best place you never wanted to be. Everyone here is very generous with their knowledge and support...we'll ask you lots of questions, and in return, ask us as many as you need, too!
 
Glad you were able to get a mid-cycle test last night. Keep it up - the more we can see the clearer it will be what's going on.

and yes, that's Amy's Trixie when she was little - was she adorable or what!?

Moby's profile pic is cute too - is he yawning?
 
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