? 6/29 Ollie AMPS 234, +7 186

[Sugarbun]

https://felinediabetes.com/FDMB/threads/5-1-ollie-amps-202-7-181-pmps-225.246862/

https://docs.google.com/spreadsheets/d/1gpSrgnZaOgi1OfOav6kSwg7OtY18dFvaNPIwwXW_WjI/edit?usp=sharing

I'm not sure what to do anymore, his numbers keep increasing even though I am increasing his dose of Lantus. On 6/11 I noticed a small spot of ringworm on his back - he has had this before and is very susceptible to it. On 6/24 he went to the vet, who thought his skin had a bacterial infection component to it as well as fungal, so Ollie had a Convenia shot.

Are these numbers not concerning since they are still not that high? Is this just how diabetes progresses? Will he keep needing higher doses as time goes on? He had low numbers right off the bat with insulin so I'm not used to these 200s which keep increasing even though the dose has increased. Thank you for any help.

 

[JaxBenji]

So sorry no one has chimed in FWIW I always tried to remember insulin is a hormone and the cats needs can fluctuate (up and down - just part of the so called sugar dance). With dry food in the picture, are you following SLGS? It's described in the Dosing Method sticky. In summary, you hold the dose for 7 days (unless Ollie goes <90 in which case you reduce by 0.25 at the next shot) and then do a curve. Are you able to do a curve once a week? That would be helpful and then we could see how low Ollie is going. IMHO, you're holding the dose too long (i.e. longer than 7 days) but I can't advise on increasing personally without more data (perhaps other seasoned folks can ). I see @Wendy&Neko stopped by in the past - perhaps if she's on later, she can stop by.

It would also be helpful to get tests you don't usually get (i.e. move those mid cycle tests around so we can see what happens at other times in the cycle)...but that of course depends on your schedule

I also see in your notes that you're feeding at AMPS+7 - feeding past nadir can impact insulin duration. So if Ollie is hungry then, you can try adding more food earlier in the cycle and/or feeding a low carb (e.g., 0%/1% wet food rather than the dry) that late in the cycle. Just something to think about. I personally tried to feed Jax all his food before +6, with the majority being being before +4 (ECID though! it takes some experimenting to find out what works for your kitty).

If you ever decide to give up the dry food, you could also switch to Tight Regulation (described in that dosing method sticky linked above, but no dry food is allowed).

Hope that helps a little bit - at the minimum, my comment will bump up your post.

 

[Sugarbun]

So sorry no one has chimed in FWIW I always tried to remember insulin is a hormone and the cats needs can fluctuate (up and down - just part of the so called sugar dance). With dry food in the picture, are you following SLGS? It's described in the Dosing Method sticky. In summary, you hold the dose for 7 days (unless Ollie goes <90 in which case you reduce by 0.25 at the next shot) and then do a curve. Are you able to do a curve once a week? That would be helpful and then we could see how low Ollie is going. IMHO, you're holding the dose too long (i.e. longer than 7 days) but I can't advise on increasing personally without more data (perhaps other seasoned folks can ). I see @Wendy&Neko stopped by in the past - perhaps if she's on later, she can stop by.

It would also be helpful to get tests you don't usually get (i.e. move those mid cycle tests around so we can see what happens at other times in the cycle)...but that of course depends on your schedule

I also see in your notes that you're feeding at AMPS+7 - feeding past nadir can impact insulin duration. So if Ollie is hungry then, you can try adding more food earlier in the cycle and/or feeding a low carb (e.g., 0%/1% wet food rather than the dry) that late in the cycle. Just something to think about. I personally tried to feed Jax all his food before +6, with the majority being being before +4 (ECID though! it takes some experimenting to find out what works for your kitty).

If you ever decide to give up the dry food, you could also switch to Tight Regulation (described in that dosing method sticky linked above, but no dry food is allowed).

Hope that helps a little bit - at the minimum, my comment will bump up your post.

Thanks so much for your helpful reply. I never knew that about feeding past nadir, I'll try to tweak his lunch time. I know on my spreadsheet it says dry food, but now I only give him about a tablespoon at night after his final BG reading. I wasn't really following either dosing protocol because of the tiny amount of dry he was eating and while following SLGS, I didn't want to reduce his dose when his nadir was <90 since he had very reliable small drops early in the year when he was more regulated. I'm going to revisit the dosing protocols and I will try to run a curve tomorrow. Thank you again!

 

[JaxBenji]

Thanks so much for your helpful reply. I never knew that about feeding past nadir, I'll try to tweak his lunch time. I know on my spreadsheet it says dry food, but now I only give him about a tablespoon at night after his final BG reading. I wasn't really following either dosing protocol because of the tiny amount of dry he was eating and while following SLGS, I didn't want to reduce his dose when his nadir was <90 since he had very reliable small drops early in the year when he was more regulated. I'm going to revisit the dosing protocols and I will try to run a curve tomorrow. Thank you again!

You are welcome FWIW, some people do modify SLGS and lower their reduction point (e.g., reduce at 80 instead of 90). A couple people on here do that - if you do that, you'll want to add it to your signature and your SS (e.g., "SLGS w/ reductions at ##" (where the ## is your number)). You still hold the dose for a week (unless a drop below your reduction point) and do a curve every 7 days.