5/27, Tux AMPS 182, +3 44, dose advice

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Julie & Tux

Julie & Tux

Member Since 2014
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=119196

Tux's numbers had been staying in the 200's even with the increase in insulin so I was suspecting the Nature's Variety was the cause. I wrote to them and they told me the as fed % is 2%. They did not give me any specific formula. It was a generic response. Please click here for a different post regarding food. http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=119289

We switched him back to Ziwi Peak and he was in the 100's. Today while I was at school (on Tuesdays I am at school from 11 am to 1030 pm) I had my husband do a random check and Tux was at 76. My husband waited a little longer and checked again and he had dropped to 44. Tux was fed some gravy lovers FF and his numbers slowly climbed up to 93, dropped back down to 61 at +8 and the PMPS was 290. With his numbers being so low like this we gave him a "skinny" 2 unit dose. He was getting 2 units each shot but the vet wanted us to go up to 3 units so we went to 2.25 units. Thoughts on his numbers?
 
Re: 5/27, Tux AMPS 182, +3 44, PMPS 290

Hi Julie.

I'm not an advice giver, but I wanted to say hi. Looks like you've been changing Tux's dose quite a bit, and I think maybe that's why his numbers are wonky. Normally we hold a dose for 6 -10 cycles unless a reduction is earned, and when we change the dose we do so by .25 increments. I know it's hard when your vet is telling you something different than the TRP says. No matter how wonderful the vet, most of them just don't have the time to learn a lot about any one disease or condition, so they have to give generalized advice.

I suggest you add "dose advice"? to your subject line and maybe one of the more experienced people will get a look at your spreadsheet and help you sort out where to go from here. There's a lot to learn about FD, but you are in the right place. I hope you've taken the time to read the "stickies" for beginners - they are packed with so much info your head will spin. Cinco was diagnosed in 2011 and I still refer to them regularly.

That PMPS is probably a bounce, caused by the 44 he had earlier today. Remember, we adjust the dose based on the nadir, or lowest number, not by the pre-shot number. I can't say if giving the skinny dose was right or wrong, but you have to do what you are most comfortable with. It's quite possible his dose had been too high, and that contributed to the bounce.

There are tons of knowledgeable, caring people on this board, and you will find they are all eager to help you get your kitty back to his best possible health. Ask lots of questions and you'll get plenty of answers. Good luck!
 
I haven't been changing his dose that much. It went from 2 units to 2.5 for one cycle. After talking to some folks on here and looking at his numbers, we dropped to 2.25 and have stuck with that until tonight. Tonight's shot was back down around 2 units as his lowest number was much lower than usual. I, too, think his PMPS is a bounce from this morning as he was fed a high carb food. I have read the stickies multiple times and still refer to them often. Thank you for the response and suggestions.
 
Julie --

Thanks for filling in the details about the dose adjustments. Without the info you provided, I might have drawn the same conclusion as Tricia.

With the 44 at +3, Tux's dose should be reduced by 0.25u. Dropping from 2.5 to 1.8u might be too big of a reduction. Would you be comfortable increasing back to 2.0u for tonight? If so, you might want to put a comment on Tux's SS about why the change from 1.8 to 2.0u (because I doubt that I'll remember having made this suggestion! -- too many SS and too little time!!!!) Do you know how much experience your vet has with Lantus? It sounds like he may be more familiar with insulins like ProZinc where you have greater flexibility with dose adjustments and make those adjustments based, in part, on the pre-shot numbers.

Good investigative work on the food.
 
Thanks! It was a "skinny" dose of 2 units so I just said 1.8. My thought was to go back down to 2 units. As far as I know my vet only has experience with Lantus. She also had a diabetic cat and has said she has had many cats go into remission. I know some of her information is dated however and she has mixed up some of the information and given me treatment methods for dogs instead of cats.
 
Hi Julie,

Good detective work with both the food and Tux's dosing. You're definitely asking the right questions and no doubt Tux will benefit by your persistence and digging. The experience here on the board is invaluable and the wealth and breadth of knowledge is formidable. Between you, your vet and FDMB, Tux is in good hands. Have a great day, Julie!

Anne
 
good call on the reduction last night. with a newly diagnosed cat, you do want to reduce if he goes below 50, so you made the right choice. let's stick with the 2.0 now for 6 cycles or so, unless he goes below 50 again.

Sometimes if they go below 50 in the next few cycles (up to 6) after a dose reduction and it's not too low (ie, if he just goes into the 40's) we suggest people hold the dose instead of taking an immediate back-to-back reduction. Because Lantus is long-lasting and builds up in the body, a previous larger dose (ie, the 2.25) can sometimes still be influencing numbers and causing a low number in the few cycles even after a dose reduction. So if he clears the bounce and gets into low numbers right away, give a holler and let's look to see if you want to reduce or not.

nice to see you! Hi Tux! Good boy - way to work the insulin! cat_pet_icon We love seeing kitties doing well!
 
Thank you everyone! I was in class all day and I had my husband do some random testing before he left for work. I'm so glad he did and was able to catch the 44. He stayed home from work and I talked him through the hypo instructions via phone. Spot checking is so valuable! Tux is feeling fantastic today. He's been playing with the other cats which is something he hasn't done in a LONG time.
 
Hi Julie!

Isn't it wonderful to see them playing the games they used to play? I had thought China was suffering from "old cat" and had just slowed down, but once we got the diagnosis and started Lantus, I started to see her playing games she hadn't played in a long time too! It was so wonderful!

Looks like Tux is still bouncing off that 44! Great catch by the way!!

On our spreadsheets, when we give a "skinny" dose, we usually put s2.0 or if it's a "fat" dose, f2.0 for example

OK now Tux...that's enough of that bouncing!
cat1.gif
 
Thanks Chris, I didn't know about the s and f. I thought Tux was just being a grumpy old man at 7. I love seeing him being back in playful kitty mode.
 
Good catch yesterday. Now we hope he clears the bounce soon.

Julie could you please start a new condo tomorrow? We do one condo per cat per day because we have so many members. It helps us keep track of everyone. Thanks! :-D
 
Thanks again, Chris. I saw that yesterday but condo wasn't on it. "Condition report" makes sense as does kitty condo ;)

I'm really thankful for catchy that low number when we did because my husband would have just left for work and Tux would have been alone for 8 hours. I hate to imagine what I would have come home to and at 1030 pm, the nearest E.R. vet is 22 miles away. If I wasn't a believer in spot checking before, yesterday definitely made me one.
 
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