7/2 | Marley | AMPS 161, +1 104 +3 189

marleyboy

marleyboy

Member Since 2021
7/1: https://www.felinediabetes.com/FDMB/threads/7-1-marley-fairly-new-dx-amps-452.249285/#post-2812582


Good morning! We have reached a new AMPS low! I am not entirely sure if this seems great but isn't a great sign because we were consistently in the 400-500's yesterday and this is a little dramatic, but I would like to believe we're headed in the right direction. He is a very hungry boy this morning, but I wanted to figure out his dosing first.

Any advice on his dose this morning? We began at 3 units (he is a hefty kitty, ~15 pounds) and I upped it to 4 units about a month ago due to poor response symptomatically. I had no idea I could use a syringe with the Lantus SoloStar pen to get smaller increments of units, and I am willing to do that today if the consensus is that it would be best. I gave him 4 units last night after a PMPS of 519.

No wet food has been decided on yet, trying to really find what's gonna be the most cost efficient canned food for him long-term. Everything I see doesn't look expensive on first glance, but because he is a big cat would cost me a good chunk. If that is the only option then I guess it is what it is and I will accept that. All insight welcome here!


Thanks everyone and happy Friday! :)
 
Hi Britanny,

Welcome to the Lantus forum. I have only quicly glanced at your previous threads, so forgive me if I have missed something.

Lantus works best when dosed consistently (same dose AM and PM for a few cycles). It is a depot insulin unlike insulins like Vetsulin which are "in and out" insulins and can be dosed based on pre-shots. Marley was on 4U for a month before 6/28? I see that he dipped to 78 (if not lower) on it.

Have you fed? If not, can you test again 20 mins after that 161? If you give insulin this morning, will you be able to monitor him?
 
Thank you Ms. Bhooma!

Sounds like maybe 4u would be best then. Yes, it had been about a month on 4 units. Was not taking BG much because I had a lot going on, but symptoms seemed better. Started peeing on my bed again :( which pushed me to really finally figure this out. The spreadsheet start date is essentially all of the data I have. I know that he usually ran about 400-500+ consistently on his crappy carb rich food that he loved + 4 units BID. Have switched to only protein rich, but still dry food since 6/28. The response seemed to be better, but that first day was also when we dipped to 78. I will say that he hardly ate any of the food that day.

I have not fed yet, I have been hanging tight. I will test again right now! Yes, I should be able to monitor him today.
 
Awesome. Will do that and give updates. Thanks a lot

Another kind of large issue I am trying to figure out, is I am leaving to go out of town tomorrow for about a week. I do have a roommate who will likely be around, and I am going to ask him to look after Mars, but I am not sure what is best without monitoring. Any thoughts on this? Should I just give him a set amount of food to give him and keep him at a set amount of units, like 3? I realize this is so far from ideal, but I want what's best for Marley despite the circumstances.
 
So, we know that he dipped to at least 78 on 4U. It's possible that he dipped lower. Since you are using a pen and not syringes, we cannot reduce in multiples of 0.25U like we normally do. I would err on the side of caution and give less insulin than more.

Now that you are testing, we will have some idea of how he does on 3U over the next few days. I would hold the dose for at least 3 days (6 cycles - each day has 2 cycles of 12 hours - AM and PM) because that's how long it takes for the Lantus depot to adjust to a change in dose. Even if you see a higher pre-shot (400s-500s), do not take him back up to 4U. The higher numbers you see after the low are what we call "bounces".

Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". Usually, a bounce will clear kitty's system within 3 days (6 cycles).

Without enough testing, too much insulin can also look like too little insulin on account of these bounces. Which is why we ask members to get pre-shot tests and at least one more test per cycle between (+2 and +6 for Lantus).

I would recommend that you get syringes with half unit markings as soon as possible so we can adjust his dose by 0.25U. You can get the syringes in Walmart (@Diane Tyler's Mom has posted photos in the prev thread) for $12.58 for a box of 100.

On the food front, it would make a big difference to transition Marley to a low carb food. A lot of people here feed Fancy Feast Classic/Pates, Friskies Pates etc which are affordable. I am told that Walmart's Super Kitty pates are even cheaper than FF. There are low carb dry food options available - Young Again Zero, Dr. Elsey's Cleanprotein and Wysong Epigen 90 but those are quite expensive.

The principle wrt diet is the same as with human diabetics. Just like you would cut out carbs (rice, potatoes, bread etc) if you had diabetes, similarly, you would feed a little carbs as possible to Marley. Feeding high carb food and then giving a really high dose of insulin is counter-intuitive. We have had cats go off insulin from a diet change. The chances are especially good for newly diagnosed cats.
 
I do happen to have some syringes available, they were given to me when he was dx by a friend, just thought I would never be able to use them.

Did you read my previous post on this thread about going out of town this next week? I hate that this is the case, especially with him doing seemingly well.

I had no idea about the bouncing, but it makes complete and total sense. Thank you for that explanation. Comforting to know that it's a predicted response to the low number and not necessarily him being unresponsive to his insulin and new feeding. Maybe we are on the other side of the bounce

I have ordered just now a pack of wet food, a relion prime meter, and some strips from Walmart.

Thanks for all of your help, I will have data for +1 in about 30 minutes.

Britt and Mars
 
marleyboy said:
Did you read my previous post on this thread about going out of town this next week? I hate that this is the case, especially with him doing seemingly well.
Click to expand...
Yes, I did. Unfortunately, we dont have enough data to know which dose is safe for him. Any chance your roommate can also get a test or two in a day? At least pre-shots, if not more?
 
I could ask him, but I don't know that he'll be comfortable with it. We'll see.

Okay update: +1 - 104
Feed more? continue monitoring? Not sure if I should be worried
 
@ +3 189

Was out of the house for +2, gave his protein rich food and a couple treats when I fed him after +1 104
 
marleyboy said:
Another kind of large issue I am trying to figure out, is I am leaving to go out of town tomorrow for about a week. I do have a roommate who will likely be around, and I am going to ask him to look after Mars, but I am not sure what is best without monitoring. Any thoughts on this? Should I just give him a set amount of food to give him and keep him at a set amount of units, like 3? I realize this is so far from ideal, but I want what's best for Marley despite the circumstances.
Click to expand...
@tiffmaxee Think 3U should be a safe dose to shoot for the next week? 4U took him to 78 (at least).
 
I should be home for the next 4 or so hours so I'll be monitoring until then.

no, the treats are not low carb. He wouldn't eat much of his food and I was nervous his BG would keep dropping while I was out of the house. Should I get low carb treats for that purpose? Was I too reactive?

I was contemplating mixing like 1/4th of his crappy corn meal food with his high protein food until I get back, because I doubt my roommate will be comfortable checking his BG. Bad idea? Am I being too nervous?
 
marleyboy said:
no, the treats are not low carb. He wouldn't eat much of his food and I was nervous his BG would keep dropping while I was out of the house. Should I get low carb treats for that purpose?
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At some point you want to transition him to low carb (food, treats..everything). But that should be when you can test him through the transition and adjust his dose accordingly. Maybe after you are back. If you order the half unit syrings now, they would be available to use then?

marleyboy said:
I was contemplating mixing like 1/4th of his crappy corn meal food with his high protein food until I get back,
Click to expand...
Which is the crappy food and which is the high protein one? Do you know their carb%?
 
For tonight 3.0 is good but I am not sure about the week if he starts hitting even lower nadirs and is eating lower carbs.
 
I don't think there is a food change planned for the week that Brit is away. Marley will continue to be on the high carb dry he was on all these days (even on 4U).
@marleyboy correct me if I'm wrong?
 
marleyboy said:
I had no idea I could use a syringe with the Lantus SoloStar pen to get smaller increments of units, and I am willing to do that today if the consensus is that it would be bes
Click to expand...



I told you about this in your first post
You can go buy U-100 syringes with half unit markings and draw from the pen.
Those test strips look expensive to use
Do you live in the US?
You can go to Walmart and get a Relion Prime human meter forc9 dollars
17.88 for 100 test strips
Just take the cap off the pen and use a U100 syringes and pull the insulin out of the pen!
syringe-in-pen-pic-jpg.45006
 
Their 30 unit/0.3ml syringes come with half unit markings. They're $12.58 for a box of 100.
These are not available on line you have to go into the store for these with a script
I would go and get these as soon as your get back

There are also several brands on www.adwdiabetes.com selling u100 syringes with half unit marks - BD, Ulticare, Sure Comfort, Care Point Vet etc.


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