? 6/20 Goose AMPS 515 +1.5 414 +3.3 250 +5.5 187 +7.5 355 +9.5 430 Bouncing

[Anshu and Goose]

Note: All BG numbers are using an AlphaTrak meter, sorry for that.

Hello all, and thanks in advance for your help. We are new to the forum, but have been trying to read widely and get up to speed.

Goose's numbers have been varying wildly recently, especially today, where he hit a high of 515 on the AlphaTrak meter.

Question 1 is just whether this is 'bouncing' that we should wait out?

The high numbers worry me a little. He had DKA when he was first diagnosed about a month ago (05/11/2023). We are getting test strips tonight and will start ketones testing ASAP.

Question 2 is more broad. Are we dropping his insulin dose too fast?
He has gone from 3U (eating dry food), to 1 (canned food) -> 0.5 -> 0.25 -> 0.1 in just 11 days.

We had wanted to dose him following the SLGS method, but his BG numbers dropped so fast that we've basically ended up doing an even faster TR. We've been trying to follow along with the guideline to dose based on nadirs.

In TR that says

• "If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit."

In SLGS it says:

• "If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately."

I know those numbers are for human meters. For now, we've just been assuming the thresholds would be ~20-30% higher for the AlphaTrak.

I'm sorry the SS is a mess. We want to hold him on the same dose for longer like the protocols say, but we keep consistently seeing his numbers drop into the green on cycle 6 at a given dose and then having to give NS (so then his numbers spike... ).

Thanks so much for any help.

 

[Wendy&Neko]

Hello and welcome. Normally we ask first time posters to post in the Feline Health forum first, but since you have the signature set up and a spreadsheet, I'll let this one stay here. However, I do have a few questions. And one comment first. If following TR, the reduction point is below 68 on the AT. The authors of TR have suggested 68 is a good point when using an AT. With SLGS it's below 90 on the AT. Many people have tried, but there is no formula that allows you to convert from human to pet meter or the other direction.

Which syringes are you using? Some syringes have a reputation for inconsistent marking, leading to uneven dosing and odd numbers. Good to see you are using calipers now.

What food are you feeding, and how often? The reason I'm asking is that Goose's numbers don't look like they should for a cat on just a tiny bit of insulin. It may be that if you change how you feed him, you can prevent those sudden drops and get him to stay in safe numbers with a higher dose of insulin. He could also be really bouncy, which is almost universal for all newly diagnosed cats. And yes, you need to wait that out. However long it takes his body to become used to normal blood glucose numbers again, is what it'll take before the bouncing decreases. The only thing you can do is get him to a dose, with the appropriate feeding schedule, that maximizes how much normal BG numbers he sees.

On the morning of the 18th, the spreadsheet shows a 65 (which earns a reduction) and a 111. What's the story behind the two numbers?

Are you able to get any tests at night after the PMPS shot? Even a +2 or +3 at night will help us get an idea what the night time cycle looks like.

And yes, the switch from high carb dry to wet food can make a drastic change in the amount of insulin needed. Since Goose has a recent background in DKA, we will have to make sure he gets as much insulin as he needs. Good to see you are getting test strips to test the ketones too.