? 3/5/25 Tiger AMPS 327, +9 307

[J9 Pearson]

Tiger has his teeth cleaned and 2 extracted last week. I was really hoping we would start to see his blood sugar drop after the procedure since in theory he should be feeling better. His blood tests prior were all within normal limits except for his glucose. He had one great number the day after surgery and now seems to be trending upward. His vet is wary of going any higher than his current 4.5 unit dose and wants to send him to another vet to possibly try a different insulin. I would welcome any thoughts from this group. Is it possible we missed his breakthrough dose when his teeth were hurting him? He's been eating and drinking well, a bit more lethargic and seems to be shedding some now which tells me his body is stressed (based on his past history.) Any thoughts/advice?

 

[Staci & Ivy]

I hope you get some answers soon.

It could be possible Tiger is bouncing to those pink numbers (but there aren’t any night time tests to show that happens at night). He could be going lower, like that occasional blue he’s had. That could trigger a higher bounce number.

Could you get some random pm cycle tests to get more information?
I hope he is feeling better as he recovers from the dental.

 

[Wendy&Neko]

It can take longer than 7 days for the inflammation from extraction to die down, up to 2 weeks. Is he going to the vet for a follow up after his dental surgery? Neko used to have follow ups to make sure there was no infection happening from the surgery. Infection can raise numbers.

Don't know why the vets are concerned about 4.5 as the upper limit for dosing. A cat needs however much insulin they need and every cat is different (ECID).

As Staci suggested, it is really hard to tell how he's doing on this dose with all holes in the spreadsheet data. Cam you get a couple nights in a row of a before bed test, say +3 or so? And a curve? That'll help tell the tale. It's also likely he needs an increase. With SLGS, you hold the dose for 7 days, do a curve somewhere in there, and if nadirs (plural) are not in the 90-149 range, you increase by 0.25 units. Holding a dose too long can cause glucose toxicity, meaning his body is getting used to higher numbers. The solution is an even higher dose to get over it.

 

[J9 Pearson]

It can take longer than 7 days for the inflammation from extraction to die down, up to 2 weeks. Is he going to the vet for a follow up after his dental surgery? Neko used to have follow ups to make sure there was no infection happening from the surgery. Infection can raise numbers.

Don't know why the vets are concerned about 4.5 as the upper limit for dosing. A cat needs however much insulin they need and every cat is different (ECID).

As Staci suggested, it is really hard to tell how he's doing on this dose with all holes in the spreadsheet data. Cam you get a couple nights in a row of a before bed test, say +3 or so? And a curve? That'll help tell the tale. It's also likely he needs an increase. With SLGS, you hold the dose for 7 days, do a curve somewhere in there, and if nadirs (plural) are not in the 90-149 range, you increase by 0.25 units. Holding a dose too long can cause glucose toxicity, meaning his body is getting used to higher numbers. The solution is an even higher dose to get over it.

Thank you so much. This is really helpful. I will take more night time ones before I go to bed (last night he was 261 +4 his PM insulin) and am doing a curve today. I did not increase last week due to the vet's recommendation and that could be part of it. Good to know it can take up to 2 weeks for extraction recovery.