? 8/13 Syko AMPS 144, lowest so far..

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meowsyko

meowsyko

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The vet had me increase Syko's AM shot to 2 units, and keep 1 unit in the evening.
Earlier in the week her AMPS was much lower than usual (11.3/203) so I called and vet said to just give 1 unit.
Now, it's even Lower than that this PM, at 8.0/144. She's eating now, I'm debating if I should give her her whole unit, half unit, or none at all.... Thoughts?

Will also be talking with the vet on Monday, I think 2 units in the morning is too much...

On another note, I just ordered an Aerokat chamber so I can give her some Ventolin when she has her little asthma fits. They haven't been bad but we're moving to an island with no emergency vet, so It will be nice to have for emergencies :cat:

(previous post)
 
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Lantus does best when it's given at a consistent dose, so we don't give a different dose in the morning and night.

We also don't do increases in whole units....just a tiny amount of insulin can make a big difference in the numbers, so we only do increases in .25 unit increments

What I'd suggest you do is hold the 1 unit dose for now.....Lantus is a depot insulin and every time you change the dose, you disrupt that depot

You need to hold the same dose for at least 6 cycles to let the depot stabilize and see what the 1 unit dose will really do for Syko
 
Is Sysko still eating the high carb vet food? Just wondering if you plan to keep her on that food, or try some of the commercial lower carb unique protein foods. If you were to switch food, then I'd definitely stay at 1 unit as the lower carb food can mean a reduction in insulin required. If you are staying with the high carb vet food, and since you are using an Alphatrak, I would at most increase to 1.25 units - same dose day and night. You've been on the Lantus long enough for the original 1 unit depot to build.

Lantus is a depot insulin, which means a couple of things. One, it likes consistent dosing. Keeping the same dose allows the depot to build to that particular dose. So if you increase, you may not immediately see changes (though you might), a the depot has to build to the new dose. That can take 3 days. The other impact of the depot is that it influences not just the current cycle (AM or PM shot) but also the next few cycles. What this means is that often what dose you shoot in once cycle may be felt in the next cycle. So instead of a 1 unit dose being a safer dose to shoot at night, you may be seeing the impact from the 2 unit dose you shot in the morning. For the older insulins, shooting a lower dose at night was a safety feature as people would not monitor their cat as closely while they slept. When Neko was on Caninsulin (older insulin not really good for cats), her vet had me shoot a lower dose at night. But Caninsulin would be in and out in less than 12 hours - there was no depot.

For others to follow along, here is your previous post here. http://www.felinediabetes.com/FDMB/threads/first-curve.162669/ If you include a link to your previous post, people can follow along what was previously discussed.

You are moving to an island in Alberta?
 
Yeah, I'm going to talk to the vet on Monday about her dosing but as it's the weekend I have to figure this out on my own for now :confused:
I haven't been able to give her her 2 unit dose for more than 2 days at a time because I'm terrified of having her go too low. I will try the 1.25 unit dose morning and night for now, that seems reasonable, and I will talk to the vet in the morning. Most I'll do is 1.5 if she wants her on a higher dose.. We never discussed what to do when her numbers are so much lower, so I'm trying to just be cautious.. I am glad I'm testing her before each shot, or we could have had some issues. I'm running low on test strips though and regretting getting the Alphatrak now that I see the price of them! :banghead:

For now I'm keeping her on the prescription food. I will try changing it, just not yet.. I'm in the middle of finals for school and haven't had time to search around yet.

I was trying to just stick with the vet said to do and assume she knows best, she is really a wonderful doctor... but the 2 units seems to be too much for her, and she should certainly be on the same dose morning and night. Her numbers are much lower now though, so I'm happy about that! Now if she would just hurry up and eat her breakfast...

I'm moving to Gabriola Island in BC :D
 
Your vet may be absolutely wonderful on most aspects of the care for Syko. It's actually appalling how little training vets get when they are in training on how to manage diabetes in any animal -- not just cats! I've attached the original article that was published in a leading vet journal on Tight Regulation with Lantus. The article is something you may want to share with your vet especially since it describes how to dose a cat using Lantus (or Levemir). It looks like your vet is more familiar with the shorter acting types of insulin where dosing is based on the pre-shot numbers versus the lowest point in the cycle (nadir) which is what dosing with the long acting, depot type of insulins require.

 

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It might be a good idea to pick up a backup human blood glucose meter. Most of us use them because their strips are cheaper and our dosing methods are based on human meter values. My vet actually recommended a human meter (she uses a Onetouch in her clinic) and said just to get one with a small blood drop requirement. The Onetouch needs a larger drop, but the Bayer or Aviva are popular ones here. And the nice thing about human meters (besides much cheaper strips) is that if you run low on strips, you can just head to the corner store. You can usually get decent deals on test strips on Ebay too. A backup meter is always handy - lots of stories of people microwaving their meter by accident :eek: or the cat knocking it into the water accidentally. I have a couple of backups. On Gabriola, you'll really want to think about availability. Not sure what is on the island, but other than trips to Nanaimo on the "big" island, you'll want to consider what you can easily get via mail. The Bravo test strip and meter is one of the cheapest on line deals in Canada.

I really like Neko's vet too, I've been seeing her for decades since she graduated and she did a lot of free work at the local animal shelter which earned her brownie points for me. But I was the first client who home tested, first client on Lantus, first cat (that she knew about then) with a cat with acromegaly (a high dose condition that can cause diabetes) - you get the picture. I had to learn and this place helped me. Even the senior vet at the clinic now admits I know more about acromegaly than he does. People here live and breath feline diabetes. I'm still with the Neko's original vet for everything else, except for insulin dosing or if Neko needs a specialist.
 
Hi!
Welcome:cat:
You already have great input from the experts... I am no expert but I can tell you that even 1 drop extra will send my boy into a dangerously low range. I hope you vet is willing to look at the info :bighug:
 
Thank you all so much for your help and advice :). Sorry I have been incredibly busy, had my last day of classes yesterday and 2 projects to cmpletr. Done for the term now :D

Haven't talked to the vet about dosing yet but I called the office today as Syko's blood sugar was 5.6 and I wanted to confirm that I should skip her shot as I work all day today.. I was right :). Haven't had a chance to update her spreadsheet yet. Was running late as she turned her head and made me prick myself instead of her, getting my blood all over her lancet device!

Off to work now :)
 
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