5/15 Wrigley AMPS=145 | PMPS=270 | 2.75=224 | 5.5=259

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ewalker405

ewalker405

Member Since 2015
5/14 Wrigley

Wrigley was 145 at his AMPS. This is the first time he has been this low in a while so I don't know what dose to give him or if we should skip the shot. We have to leave for work soon and can't test him at all today. We do have an automatic feeder that we use during the day.

He has been really high lately and also really fighting his ear pricks so we tried to do this one while feeding him. It was really easy getting the ear poke as he didn't even look up from his food. However now that he is low, we can't wait and test again. He ate about 1/3 can of FF classics this morning.

What do people think of his dose this morning since we can't test him and nobody will be with him during the day? Should I skip the dose? Give him half dose? full dose? Should I put some high carb food into the feeder? If so, what times in his cycle?

Thank you
 
The textbook correct answer by the protocol would be 0.75 since he's above 100. However, I noticed you just bumped him up from 0.5 and for very good reason. And I understand that rate of change looks pretty scary. Looks like that dosage increase is starting to work. If you can't check on him mid-cycle, I'd cut him back to 0.5 again for just that one dose. And by all means make sure he's eating and holding down food! But that's JMHO.

The protocol is the protocol. At some point common sense has to intervene. :p

And it ain't so common. It's one thing that's been awfully difficult to replicate in computers.
 
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Hi Eric,
It looks like the new dose is kicking in (this is the beginning of the 4th cycle on .75). On the one hand, it would be a shame to mess with the dose right now, since 145 is normally a safe number to shoot; on the other hand, you want to keep Wrigley safe from his notorious drops. I think that if you make sure he has enough food in his feeder, you will be OK to shoot the full amount. Since his shed is now calibrated to the .75 dose, you will still get shed "action" even if you skip the shot, or give a smaller shot. If you put a higher carb food in one or more of the feeder partitions (to coincide with onset), I think I would use MC, rather than HC.
 
I just tested him again and he is 178. That is probably the food rise though. I think Ella has a good point about the shed and what will happen with him in a .75 vs .5.

It sounds best to give .75 and make sure he has food in his feeder. I think I will put some MC or HC food in at +3 and +5. Does that sound good? I am not sure we have MC food. We have some HC food with gravy. How about the HC food but don't use the liquid gravy and use more of the meat?

Thanks
 
I have food that is his normal low carb FF. Then I looked up the rest on catinfo.org food comparison chart. I have food that the Carb % of calories is 10%, 16%, 17%, and 19%. Should I use the 16%? It is Fancy Feast Grilled Chicken feast in gravy.

I have to leave for work in 5 min.

Just gave him .75U shot.

Thank you all.
 
I don't agree with the use of anything but low carb. IMHO, that's more important than anything you do or don't do with insulin. But that's just me. Again, it's something I can't prove, but Dr. Hodgkins has been quoted as saying you never have to worry about a clinically significant hypo in a cat that's fed ONLY low carb moist. This may be an extreme position, but I can say I've never had a clinically significant hypo & aside from a couple drops of honey under the tongue for a biochemical hypo (only) of 36 on a human meter, I haven't given my cat anything above 10% dry matter carbs for months. I also never bounced even from that 36, though I must say it's hardly a clean experiment and has a sample size of one (cat was fairly well regulated before) and my cat is also free fed Young Again Zero Carb (kibble) with his fancy feast classic twice a day.

JMHO.
 
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Sandman said:
Again, it's something I can't prove, but Dr. Hodgkins has been quoted as saying you never have to worry about a clinically significant hypo in a cat that's fed ONLY low carb moist. .
Click to expand...

This is incorrect information and very dangerous advice. A cat on lantus absolutely can have a significant hypo when fed only low carb moist food.

Eric, please update us on how Wrigley is doing when you have a chance. I hope you followed Ella's suggestion and left out a little bit of higher carb food, just in case. Better safe than sorry!
 
The use of low carb food when managing low numbers is based out of Elizabeth Hodgkins, DVM webpage and what she refers to as "Tight Regulation." However, her approach was developed for use with the old, no longer available form of Prozinc. It is not recommended for use with Lantus or Levemir. Quite frankly, cats have died using this method of not feeding higher carb food in the face of low numbers. This is why her recommendations are not used here. If Dr. Hodgkins had stuck around her website long enough, she'd have seen the reports of cats dying from hypoglycemia. We've been very fortunate here in that we've not lost a kitty but many of us have worked in shifts to support a member who is managing a symptomatic hypoglycemic episode for well over 12 hours or kicked up a fuss about getting a cat to the ER to prevent symptoms from becoming unmanageable. To say that a cat that's only fed low carb cannot become hypoglycemic is not consistent with our observations or experience. There is a difference between low numbers and symptomatic hypoglycemia. The former is how you reduce the dose. The latter is a preventable health risk.

Eric -- You might want to take a look at the last section of the sticky note at the top of the board -- Shooting & Handling Low Numbers. There's information there on how to deal with a lower than expected pre-shot number. (Wouldn't it be much more convenient if our cats would throw us these numbers when we're going to be home?) FWIW, it's fine to shoot a reduced dose while you're in the process of getting more comfortable with (and collecting more data) shooting progressively lower numbers.
 
Hi Eric,
I apologize for this interruption, but unfortunately it's necessary for me to don my Moderator hat again today. Ella is right. Safety comes first... always.
Have a good day!
~ Jill



@Sandman :

Sandman said:
I don't agree with the use of anything but low carb. IMHO, that's more important than anything you do or don't do with insulin. But that's just me. Again, it's something I can't prove, but Dr. Hodgkins has been quoted as saying you never have to worry about a clinically significant hypo in a cat that's fed ONLY low carb moist. This may be an extreme position, but I can say I've never had a clinically significant hypo & aside from a couple drops of honey under the tongue for a biochemical hypo (only) of 36 on a human meter, I haven't given my cat anything above 10% dry matter carbs for months.
Click to expand...
Sigh... hi there. Yep. It's me again.

"... you never have to worry about a clinically significant hypo in a cat that's fed ONLY low carb moist."
I have to address this claim before I do anything else today. It cannot be left as is for the benefit of those reading/following along.

Yes, you are absolutely correct. Dr. Hodgkins did say it.

HOWEVER, years ago in the wee hours of the morning, I personally witnessed and tried to help in not just one, but two online situations on DR. H's web site where kitties DIED from hypoglycemic episodes while following her "no HC rule"... and I am not the only FDMB member who has witnessed these incidents online. There were several of us who witnessed separate incidents. Of course, all traces of these episodes are gone now. Threads erased from the board as if they never happened and members who tried to help (like me) were banned from the site. I still get a lump in my throat when I recall the agony and pain heard in the caregiver's voices.

Oh and about a symptomatic hypos... ECID. We've had some kitties who have shown clinical signs of hypo when throwing 50s and 60s on a human BG meter. It's rare, but it's happened. No one can make blanket statements about a cat that will hypo at any given number. No one. And unless a cat is hooked up to all sorts of machines to measure their stats and brain activity... we don't "know" what's going on even if there are no symptoms present. You must know this (being in the medical field) to be true... whether you've seen it or not.

Safety is and always has been THE number one priority on the FDMB.

On this board, the Think Tank Forum is the appropriate place for healthy debate. I think you'd be more comfortable there.
There you can debate to your heart's content... just sayin'.
 
Thanks for all the info. His feeder was already loaded up with his normal low carb food. I added a little bit of 16% carb food to his +2 hour (tiny bit), +3 hour, and +5 hour meals. I am still at work and won't be home for another hour. I hope everything is fine when I get there and he has some good numbers tonight.
 
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