7/14 Muffin PMPS 526, AMPS 426...Should I get a new vial?

[Anne&Muffin (GA)]

If I've been rolling my Lantus since 7/1 up until yesterday (7/13) have I ruined it? Should I ask vet for a new vial? It still looks clear and no floaties, but Muffin's numbers last night and this morning (just started home testing) are higher than during her curve test at the vet. She's been eating more dry food and less chicken than she was at that time, too, tho, so could it just be due to that? The vet wants a +4 number today to decide whether to increase her dosage. Wondering if maybe the diet and/or insulin maybe being bad is responsible and worth changing before her dosage. What do you think?

 

[Blue]

Re: Should I get a new vial?

If you remove the dry food, you should see better numbers, and then there may be no need to increase the dose.
If you test every 2 or 3 hours and see that there is a response, with lower numbers, then you insulin may be still OK. Keep in mind that it may take a couple days for that high carb kitty crack to get out of Muffin's system. You have to give it some time. If my Shadoe gets ahold of even a mouthful of dry food, her numbers spike up very high and it takes at least a day to get her back down again. Try to take away the dry foods and see how her numbers change.

Your vet wants you to test at +4 to see if Muffin is still rising? When is Muffin's nadir? It could be that Muffin may have a late nadir or be responding slower than other cats; My Oliver is sometimes still rising at +4 and may not start dropping till later. His lowest number is often at +11 as he has a late nadir.

Try testing at +3, +6, +9 and see how the numbers look; not every cat will be the same.
If the numbers are showing some movement, you may be able to keep using the same vial.

 

[Meadow]

Re: Should I get a new vial?

I'm curious to the answer, Anne. I can't venture an opinion but I have read that dropping it is bad too and this morning my cartridge fell off the shelf in the friedge and roll across the floor. So now I am wondering if any damage was done to the insulin in my case too.

If I've been rolling my Lantus since 7/1 up until yesterday (7/13) have I ruined it? Should I ask vet for a new vial? It still looks clear and no floaties, but Muffin's numbers last night and this morning (just started home testing) are higher than during her curve test at the vet. She's been eating more dry food and less chicken than she was at that time, too, tho, so could it just be due to that? The vet wants a +4 number today to decide whether to increase her dosage. Wondering if maybe the diet and/or insulin maybe being bad is responsible and worth changing before her dosage. What do you think?

 

[Ann & Tess GA]

Re: Should I get a new vial?

Anne, you have 2 threads going on the same topic. I know the other is from yesterday but it can get confusing. I'm not techie enough to be able to tell you how to combine them, but here is the link to the other thread http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=19695 There are some new comments there.

Can you get a spreadsheet up so advisors can look at the numbers? Also we usually make our subject Date Cat's name BG readings and then a queston It helps for finding you again.

 

[chriscleo]

Re: Should I get a new vial?

i've dropped cartridges PLENTY of times. one of them i'm sure i've dropped at least 6 times. no problems with any of them.

if you're concerned, look carefully at your vial. do you see any particles floating in it? if you sniff it, does it smell like it normally smells or is there a really strong bacon odor? if you see no particles and it smells normal i wouldn't worry about it.


re the food, your dose would be more predictable if your feeding is relatively the same. so adding more dry food or higher carb food could necessitate a higher dose. unless you absolutely have to feed dry because your cat won't eat and will get sick because of it, it's better to stick to canned food under 10% carbohydrates as listed in janet & binky's list.

 

[Anne&Muffin (GA)]

Re: Should I get a new vial?

Ok, sorry for the double thread thing...I don't know how to combine them either. I'll get a spreadsheet up ASAP, but have only tested her twice so far, so not enough numbers to tell anyone anything probably. I will do +3, +6, and +9 today, and the +4 the vet wants, then will put all of that in the sheet. Am new here and still learning the ropes, so thanks for the info.

 

[Sienne and Gabby (GA)]

A couple of thoughts...

First, I wouldn't take one day's worth of tests and make a decision about dose. I don't think you mentioned how long you've been giving Muffin insulin. With Lantus, you need to establish a shed -- what amounts to a storage area under the skin. It takes 5 - 7 days when just starting Lantus for this to build so that all of the insulin you are giving is available for use. So, it takes roughly a week for Lantus to really start working. According to the dosing protocol we use, you hold the initial dose for 5 - 7 days. Changes in dose are then made in no more that 0.5u increments.

Lantus is a 12 hour insulin. I'm not sure how getting a +4 test will inform your vet. A curve would be more useful since dose adjustments are made based on the lowest point in the cycle. This is most often somewhere between +5 and +7.

As others have mentioned, dry food will drive numbers higher. Depending on the carbohydrate count, dry can elevate numbers to a very high level. The vast majority of cats here eat low carb, canned food.

I would encourage you to read the starred, sticky notes at the top of the Board. In addition, the notes will link you to other information on food, formal versions of the dosing protocol, our slang dictionary, symptoms of hypo and what you need for a hypo kit, etc.

 

[Anne&Muffin (GA)]

Muffin started insulin on 7/1/10. Her initial dose was 2.5 units. She went in to the vet for a curve test on 7/9/10 and dr lowered her dosage to 2 units. I gave the first successful home test on 7/13/10 which was 526. I was alarmed, as during her curve test her numbers peaked somewhere in the mid 300's (I don't have the actual numbers) So after getting the PMPS of 526 and then an AMPS of 426, I was concerned and called the vet. I'm thinking it's due more to her diet than the dosage reduction, but am having trouble changing her diet, and didn't want to do anything drastic until I had competently learned to do home testing, which I now feel I am. I ordered the sample of Feline's Pride which should be here Friday and will then make a more determined effort to get her off of the dry food. She has never liked canned food of any kind, but she does enjoy some people food, so am going to try the raw diet first and work thru the acceptable foods until I find something she will eat. At this point she is opting for her FF dry even over chicken breast, so I'm afraid to remove it, for fear she won't eat anything.

 

[Ann & Tess GA]

Nice work on getting the SS up. You are going to hear this a lot, Patience. You can't expect to see much until the shed is filled as Sienne explained. Do spend the time reading the stickies. Also check out Dr Lisa Pierson

Transitioning to dry is hard w/ a lot of cats. Dr Lisa's site has some good tips. Have you checked out the canned food list that Janet and Binky compiled? Most of us feed Wellness, Evo, Fancy Feast Friskies, commercial or homemade raw. When you take the dry away BG can drop suddenly so test frequently. Right now you are at a place where the insulin hasn't taken full effect and the carbs in the dry food are spiking the BG way up. First get rid of the carbs then you can work on finding the ideal dose.

You've come to a good place for help the peeps here know a lot about using Lantus and FD, probably more than your vet. They probably only see a few cases.