8/17 Mew AMPS 358, +2 356, +6 350, PMPS 339 | +4 87

B

Bradly

New Member
Edit: THE PMPS WAS 339, but I can't figure out how to edit the subject

Hi all, I've been lurking for a few months now as I try to regulate Mews curve more strictly with some food change ups and attempting to implement the SLGS method. Recently I switched to a fresh insulin bottle, believing the old one was starting to degrade (7 months old) because his pre shot numbers were getting out of control.

In the last week with the new bottle though I am consistently seeing elevated but mostly flat curves, and I'm unsure of how to read the data. Particularly because a few of his spot checks have come back <90, I'm unsure if the dosage should remain as is (currently 1 unit)? Is he experience the bouncing effect I see mentioned around here?

I dug down the somogyi rabbit hole a bit, trying to figure out how it should effect his dosage changes, but it seems to be a hotly debated subject with no real answer how to best treat. Based on some Tight Regulation readings though, it seems to be generally recommended to leave his dosage as is until his curves settle in?
 
@Bradly
Welcome Bradley and Mew
I was looking at your information and see you wrote
Hometesting:
Alphatrak 2 with Frestyle Lite strips, testing near daily for Preshots and Nadir

Food twice a day - mostly low carb wet:
* Roughly 1 tbsp of Dr. Elsey's dry food 30 minutes before each shot
* 1oz portion of Wellness Chicken Pate with each shot
Using the Alpha Trak 2 meter we recommend not using any other strips for testing

Also your SS color coding is set up for a human meter ,the last 2 color coding are wrong
The dark green and the lime green
The dark green for using a pet meter should be
68-99
The lime green BG<68 I will tag Bhooma one of our members to fix it for you
@Bandit's Mom

Or if you want to switch to a human meter which most of us use since our numbers are based on human meters you can leave it .

Most members use the Relion Classic Premier
Here is the link for the meter and test strips so you don't have to search for them
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197
At least if you need more test strips you can run into Walmart and pick them up or if you're running low you can just order them from Walmart

We feed our cats more than just twice a day ,the bigger meal at AMPS and PMPS , then small snacks about 2 teaspoons of wet low carb food around #+2 and @+4.
You need to withholding feeding any food 2 hours prior to testing at AMPS and PMPS because you don't want the BG to be influenced by food .

It looks like you are basing how many units of Lantus you are shooting based on the Pre Shots. You are changing the dose too often which is not correct .We base how many units to shoot on how low the dose is taking them which is called the nadir. Lowest point in the cycle.

On your SS you say you are following the SLGS method, but in your signature you have custom ?
If you are following SLGS you need to put that in your signature instead of custom. In your title you have 8/18 +4 87. You have that on your SS for the date 8/17 . Correct that in your title please

When posting on the Lantus board we like members to do a new post every day like this
Date Mew AMPS BG number and any additional tests after that and you can continue with his PMPS BG and any additional tests after that
To add those additional tests tap on the word Thread Tool to the right then tap on Edit Title add those tests and tap save.
When you do a new post every day we ask you to link your previous days post to your new one in case members need to let ok at it . I'll tell you how to do that below

I'm really not experienced with the Alpha Trak so I am going to tag a few EXPERIENCED MEMBERS to take a look at your spreadsheet and try and help you out

To link your previous posts
Your previous days post will always be in the URL all the way up top ignore where it says insert or cancel I'm just trying to show you where your previous days post will be
Just ignore where it says insert and cancel
Just copy your previous days post and then paste it when you do your new post





Like I said
your previous days post it will be the one all the way up top, above the pic of that cat and the picture of a bottle of insulin there, let me know if you understand it




austin-logo-240.jpg


@Wendy&Neko
@tiffmaxee
@Sienne and Gabby (GA)

Thank you ladies
 
Last edited:
Bradly said:
Edit: THE PMPS WAS 339, but I can't figure out how to edit the subject

Hi all, I've been lurking for a few months now as I try to regulate Mews curve more strictly with some food change ups and attempting to implement the SLGS method. Recently I switched to a fresh insulin bottle, believing the old one was starting to degrade (7 months old) because his pre shot numbers were getting out of control.

In the last week with the new bottle though I am consistently seeing elevated but mostly flat curves, and I'm unsure of how to read the data. Particularly because a few of his spot checks have come back <90, I'm unsure if the dosage should remain as is (currently 1 unit)? Is he experience the bouncing effect I see mentioned around here?

I dug down the somogyi rabbit hole a bit, trying to figure out how it should effect his dosage changes, but it seems to be a hotly debated subject with no real answer how to best treat. Based on some Tight Regulation readings though, it seems to be generally recommended to leave his dosage as is until his curves settle in?
Click to expand...
@Wendy&Neko
@tiffmaxee
@Sienne and Gabby (GA)
Thank you ladies
 
Just to be transparent, the controversy over Somogyi is a soapbox issue for me. The term came into being in 1938 when Michael Somogyi, MD published an article in a local (St. Louis) medical journal. The research, such that it was, was based on a small number of human subjects. The results have never been duplicated in humans let alone in cats. Needless to say, the types of insulin that were available in 1938 are not what are frequently used now. There was a study of cats on Lantus that was published by a leading Lantus/glargine research team -- Roomp & Rand -- in 2016. They could find nothing to support Somogyi rebound in cats. What we have seen is that when members followed less than good advice regarding reducing the dose because their cat was having Somogyi rebound, the result was that they lost time getting their cat regulated. Reducing the dose is ineffective.

If you are using Freestyle strips in an AlphaTrack meter, I would discourage this practice. At one time, the AT meter and the Freestyle were manufactured by the same company. This is no longer the case. As Diane noted, the Relion meter strips are far less expensive than even the Freestyle strips. Fundamentally, you are best advised to use the strips that are made for the meter versus an off-label strip. There's no way to know if you're getting an accurate reading. I know you may have heard elsewhere that this is an acceptable practice. One of the other moderators spoke to the meter manufacturers and they advised against using strips not made for their glucometer.

I'd also encourage you to follow SLGS a bit more closely. Lantus is an insulin that really likes consistency. This is due to how the insulin depot works. You may want to look over the sticky note pertaining to the depot. Every time. you change a dose, it has an effect on the depot. This is why doses are held for a specific period of time unless a dose reduction is warranted. You need to let the depot stabilize with each dose change. We also make dose adjustments in .25u increments so that you don't inadvertently miss what may be a good dose for your cat. In addition, frequent dose changes can result in wonky numbers.
 
This is an amazing set of info, thank you!

Working through the responses with bullet points:

* Unfortunately the alpha trak 2 makers discontinued its strips to push the alpha trak 3, which had poor reviews when I researched it. As an alternative I found the freestyle strips recommended, since it's the same manufacturer, and they tested with near identical results using some high and low control solutions.
* However the human meter recommendation is waaaay cheaper, so I will switch to this after I use my current strips up. For now though I will try to switch my spreadsheet over to animal meter colors.

* The timings for food, makes way more sense, and I either misunderstood my vet initially or there was a miscommunication that he should be fed 30 minutes pre-shot to activate his liver(?).
* For the feeding schedule I unfortunately can't commit to the mid day feedings with wet food due to work schedulings long term, but will experiment with moving his dry food times to mid day / middle of the night and will cut them out preshot so that his AMPS and PMPS are no longer effected.

* I had been testing smaller adjustments in the last few weeks because the 400s pre-shots seemed concerning and I was curious on the effects, but ultimately I think this came down to the insulin degradation and my impatience.
* In the last week his dosages are weird because of a few preshot numbers that I was worried about fully dosing. I'm still nervous about the 150-250 range, because before I found this forum, thats the rough range that lead to his hypo events with his normal dose at the time.
* I'm currently trying to stick to 1 unit, but the high flat curves have me second guessing everything again.

* I initially started out with the SLGS method a couple of months ago (end of june) because of traveling and needing family members to watch him that aren't comfortable with the whole daily process of testing. So now while I'm home with him I have been trying to condense the amount of time between adjustments to refine his dose quicker, and make sure I'm not leaving them with bad information that may lead to another hypo event when I can't watch him. I believe is closer to the TR model.

I appreciate all the info and help, seriously, thank you.
 
Sienne and Gabby (GA) said:
Just to be transparent, the controversy over Somogyi is a soapbox issue for me. The term came into being in 1938 when Michael Somogyi, MD published an article in a local (St. Louis) medical journal. The research, such that it was, was based on a small number of human subjects. The results have never been duplicated in humans let alone in cats. Needless to say, the types of insulin that were available in 1938 are not what are frequently used now. There was a study of cats on Lantus that was published by a leading Lantus/glargine research team -- Roomp & Rand -- in 2016. They could find nothing to support Somogyi rebound in cats. What we have seen is that when members followed less than good advice regarding reducing the dose because their cat was having Somogyi rebound, the result was that they lost time getting their cat regulated. Reducing the dose is ineffective.

If you are using Freestyle strips in an AlphaTrack meter, I would discourage this practice. At one time, the AT meter and the Freestyle were manufactured by the same company. This is no longer the case. As Diane noted, the Relion meter strips are far less expensive than even the Freestyle strips. Fundamentally, you are best advised to use the strips that are made for the meter versus an off-label strip. There's no way to know if you're getting an accurate reading. I know you may have heard elsewhere that this is an acceptable practice. One of the other moderators spoke to the meter manufacturers and they advised against using strips not made for their glucometer.

I'd also encourage you to follow SLGS a bit more closely. Lantus is an insulin that really likes consistency. This is due to how the insulin depot works. You may want to look over the sticky note pertaining to the depot. Every time. you change a dose, it has an effect on the depot. This is why doses are held for a specific period of time unless a dose reduction is warranted. You need to let the depot stabilize with each dose change. We also make dose adjustments in .25u increments so that you don't inadvertently miss what may be a good dose for your cat. In addition, frequent dose changes can result in wonky numbers.
Click to expand...


It was actually one of your posts that I stumbled upon here that convinced me to backtrack on the lowered dose of .75 and going back to 1 unit this week until I could get a clearer picture. I am sticking with 1 unit to finish out this week and will run another 15 hour cycle to see how hes doing.

After seeing the second high, flat curve in a week though I wanted to reach out to the forum to confirm keeping his dose the same was the right move.
 
Last edited:
Bradly said:
For the feeding schedule I unfortunately can't commit to the mid day feedings with wet food due to work schedulings long term, but will experiment with moving his dry food times to mid day / middle of the night and will cut them out preshot so that his AMPS and PMPS are no longer effected.
Click to expand...
You can get an auto feeder for the wet or dry food and set it for certain times to open

some info on auto feeders always add a little water to the wet food
Here is an auto feeder that hold 5 slots and comes with 2 ice packs for wet food
https://www.amazon.com/Cat-Mate-C500-Digital-Automatic/dp/B01AUYLVU8/ref=sr_1_6?gclid=EAIaIQobChMIuM_y2p79_AIVDvrICh1_xAy6EAAYASAAEgJBDfD_BwE&hvadid=178540036693&hvdev=t&hvlocphy=9003521&hvnetw=g&hvqmt=e&hvrand=6990619631848479728&hvtargid=kwd-12652445711&hydadcr=10635_9894649&keywords=petsafe 5-meal automatic pet feeder&qid=1675560889&sr=8-6

Extra ice packs so you can keep them in the freezer ready to go
https://www.amazon.com/Cat-Mate-Rep...5c-bd5c-e23f6094563c&pd_rd_i=B091HTXNHR&psc=1

This one has 3 slots with one ice pack
https://www.amazon.com/Cat-Mate-Automatic-Feeder-Digital/dp/B01MXDFB28

Extra ice pack
https://www.amazon.com/Mate-Replace...cb-974a-deec2fb8a80c&pd_rd_i=B07KFP7PRG&psc=1
@Bradly
 
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It's fine to use the date where you're located. What I would do, though, is indicate where you are in your signature. We have members from all over the globe so it's helpful to know if we're replying when someone is sleeping!
 
Welcome. Did he have a symptomatic hypo or just low bg? M wondering when he got down to 56 specifically as the other green bg numbers while low typically would not cause symptoms. Did you feed hc? Next time get another test in 20-30 minutes after feeding if that happens. He didn’t bounce until pmps that day so there was the potential to go even lower.
 
tiffmaxee said:
Welcome. Did he have a symptomatic hypo or just low bg? M wondering when he got down to 56 specifically as the other green bg numbers while low typically would not cause symptoms. Did you feed hc? Next time get another test in 20-30 minutes after feeding if that happens. He didn’t bounce until pmps that day so there was the potential to go even lower.
Click to expand...

He was not obviously symptomatic this time, but I did give him a small portion of his higher carb dry food (roughly 20% carbs) as a precaution of it being under 60
 
Bradly said:
He was not obviously symptomatic this time, but I did give him a small portion of his higher carb dry food (roughly 20% carbs) as a precaution of it being under 60
Click to expand...
That’s what you want to do but then check again later to make sure the bg is going up and staying up. Has he been symptomatic on lantus in the past?
 
It is best to pick one of our dosing methods and stick to it. Don't mix and match. There are safety mechanisms built into each dosing method that work for that method if followed as described. Since you are feeding dry food, your only choice for dosing method is SLGS. Dry food is metabolized at a different rate from wet food. SLGS also says to reduce the dose by 0.25 units if they go below 90.

I'm glad you are switching meters. Abbott sold their Alphatrak business to Zoetis quite some years ago, so the test strips for the Freestyle were made by Abbott and the Alphatrak 2 meter made by Zoetis when Mew was diagnosed. The Freestyle strips and Alphatrak meter have not been made by the same company since 2015 when the animal business was sold.
 
tiffmaxee said:
That’s what you want to do but then check again later to make sure the bg is going up and staying up. Has he been symptomatic on lantus in the past?
Click to expand...

Yeah, two obviously symptomatic episodes in june, and a 3rd that was less obvious but still possible. This was when the vet was still saying to do 2 units and I began reading more about how to better refine the process beyond my vets advice.
 
Wendy&Neko said:
It is best to pick one of our dosing methods and stick to it. Don't mix and match. There are safety mechanisms built into each dosing method that work for that method if followed as described. Since you are feeding dry food, your only choice for dosing method is SLGS. Dry food is metabolized at a different rate from wet food. SLGS also says to reduce the dose by 0.25 units if they go below 90.

I'm glad you are switching meters. Abbott sold their Alphatrak business to Zoetis quite some years ago, so the test strips for the Freestyle were made by Abbott and the Alphatrak 2 meter made by Zoetis when Mew was diagnosed. The Freestyle strips and Alphatrak meter have not been made by the same company since 2015 when the animal business was sold.
Click to expand...


Thanks for the additional info, I will stick to the SLGS method more strictly going forward.
 
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