8/24 Achilles AMPS 140, 156(+5), 303 (+11), PMPS 318, 376 +1

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Eva and Achilles

Eva and Achilles

Member Since 2010
Hi everyone. This is my first post on the Lantus board. Achilles, my 11 year old kitty was diagnosed about a week ago. Our first vet started him on Humulin N. We saw a new vet last night who started him on 2 units of Lantus b.i.d.

We gave him the 2 units last night and his BG at +10.5 was about 140. (I say "about" 140 b/c we had some problems with the Relion meter this morning, and had to test 3 times in a matter of minutes. First test: 53, Second test: 143, Third test: 137. I decided to throw out the first reading of 53 and take the average of the last 2 readings.)

Anyway, we gave him another 2 units after his AMPS 140 number, and DH is going home to check his BG levels periodically. But I am on the fence as to whether to follow the vet's advice and stay at the 2 units or lower it to 1 unit b.i.d. I've read on the maid FDMB board that starting at 2 units of lantus b.i.d. is considered high. I will say though, that it was nice to see Achilles' number down to about 140 at +10.5 after his first lantus injection.

Can someone look at Achilles' spreadsheet and offer advice? Thanks.
 
Re: 8/24 Achilles AMPS 140

Hi Eva!
Welcome to you and Achilles!! :mrgreen:

Glad to see you have your SS attached and filled it! Very nice job!! That is a nice AMPS today...but I am glad if your DH will be getting tests during the day...do you have some canned foods that are high in carbohydrates at home. These HC cans with gravy are important tools if we need to raise his BGs quickly. We usually use only the gravy so the kitty doesn't get too full in case we need to give more gravy.

Can you repost when you get another BG reading?

Did I read correctly that you gave the insulin at +10.5? It is best if we do a 12/12 schedule....is that doable with your work hours, etc? So, can you shoot again in 12 hours from the morning shot?

I see that you are now feeding low carb LC canned foods. That is a very good step! Nice!
Does Achilles have any other medical issues? On an other meds?

There are more experienced people here who will come back and talk to you about dosing. You are correct that we like to start at 1.0u twice each day (bid) 12 hours apart. We have a saying "Start low and go slow" and we increase by .25u when we do increases. The more BG tests you do, the more data you will have which is important to see how the insulin is working in Achilles.

I will be looking for your next BG number...so happy to see you both here. This is a big family of folks who post a thread or "condo" each day....hope you will learn a lot and see much success by being here...
 
Re: 8/24 Achilles AMPS 140

There are starred Stickies at the top of the page with lots of important information.
Maybe start with this: STICKY: LANTUS & LEVEMIR - NEW TO THE GROUP? PLEASE READ...
viewtopic.php?f=9&t=18139

Feel fry to post again in this condo today with any questions you might have. Hopefully someone will be along to talk to you about the dose so repost the numbers if you can.
 
Re: 8/24 Achilles AMPS 140

Pat+Raja+Shadow said:
Hi Eva!
Welcome to you and Achilles!! :mrgreen:

Did I read correctly that you gave the insulin at +10.5? It is best if we do a 12/12 schedule....is that doable with your work hours, etc? So, can you shoot again in 12 hours from the morning shot?
Click to expand...

Thanks for the warm welcome.

We tested him at +10.5, but we gave him his injection at +11.5. His schedule was a bit off last night (b/c of the late visit to the vet), but I will have him on a 12/12 schedule by this evening and going forward.
 
Re: 8/24 Achilles AMPS 140

Hi Eva, welcome to Lantus Land!

Do you know what Achilles ideal weight is, approximately? The starting dose for Lantus is usually 0.25 unit per kg of ideal weight. For most cats, that works out to about 1 unit. Some vets seem to overlook the word "ideal," and I think some refer to an older version of the protocol that starts at 0.50 units per kg. 0.25 units per kg is usually a safe starting dose, though.

Good job with the testing, keep it up! You'll see that we love numbers around here.
 
Re: 8/24 Achilles AMPS 140, +5 156

Achilles is about 15.5 lbs now and vet said that he could stand to lose a bit of weight. He has always been a big cat. I would be surprised if the vet expected him to get any lower than 12-13 lbs. But I will ask.

So, at +5 his BG went up to 156. What, if anything, can I make of this? DH will get another reading at +10 and then we will test at +12 right before his evening shot.

Thoughts?
 
Re: 8/24 Achilles AMPS 140

Welcome to Lantus Land (LL)

There is virtually no difference between your AMPS and +5 tests. There's about 10 to 20% variance due to any meter so you have virtually the same number at pre-shot and +5. This is the kind of "flat" curve Lantus is known for and is very desirable.

I would be attentive to Achilles numbers. You've seen a dramatic decrease since changing his diet. We've seen this in any number of kitties.
 
Re: 8/24 Achilles AMPS 140

Funny you should mention the diet. I switched his diet 4 days ago which he was still on Humulin N. I was attributing the drastic decrease to the change from Humulin N to Lantus and not the diet change. In fact, I was upset that I wasn't seeing a change in his numbers while he was on the Humulin N because I kept reading reports that I could expect a 100 point drop immediately after food change. But, as I learned from reading these boards "ECID."

I guess I won't learn where his nadir is until I do a true curve this weekend.
 
Re: 8/24 Achilles AMPS 140

Please post your PMPS number tonight and a before bed BG check is the very least at night (unless his numbers warrant testing more.) The test is good at night so you will be able to see where he is heading during the PM cycle(the cycle where many kitties have their lower BGs of the day!)

I am wondering if he has any other medical issues? On any meds?

I hope you do get a chance to read the stickies at the top of the page....there is information there about Hypos and what you will need for your Hypo kit. That's an emergency kit just in case but hopefully you won't need to ever deal with that...but it is imperative that you read about it.

I mentioned earlier about having gravy cans in the house...Fancy Feast has a new flavor called "Gravy Lovers" and it does have LOTS of gravy in it. We keep cans of high carb foods like that on hand in case Achilles gets a low BG reading. You will be able to raise his number using the gravy only from the can so he doesn't get full. Keep the HC in a separate spot or mark it in some way so you don't feed that by mistake. Food is your friend when the numbers go lower....like <50. Whenever you get a reading of a low number, just post and someone hopefully will be right here to help you, okay?

For tomorrow, you can open a "condo" with the "date, Achilles name and AMPS=the number" in the heading. We link the previous day's condo in that first post of the day....do you know how to do that?
If you read other condos here you will see how it looks. That way, we can click on the link and read everything that was said the previous day. Know what I mean? There are so many kitties on this forum and we have certain things we do to keep it less confusing and easier to manage. If you have any questions, just ask... okay? We are all willing to help and look forward to seeing your daily condos.
Hope I'm not throwing too much your way right now...but if you have trouble, don't worry. We will be here to give you a hand! :razz:
 
Re: 8/24 Achilles AMPS 140

Hi Eva and Welcome! I'm not experienced enough to really offer dosing advice, but I will say that my vet also started Muffin at 2u bid (she weighs 12 lbs). While she never hypo'ed on me with that dose, when I finally started with frequent testing and lots of data collection 20 days ago, she's down to a skinny .5u bid now. So had I known then what I know now, I would have opted to start at 1u. Muffin is not Achilles and ECID, but I'm just sayin' :smile:
 
Re: 8/24 Achilles AMPS 140

Pat+Raja+Shadow said:
I am wondering if he has any other medical issues? On any meds?
Click to expand...

Achilles is on no other meds and we are not aware of any other medical conditions :smile:
I would note, however, that his AST and ALT numbers were berderline high -- 155 and 191 respectively. His new vet is aware of the numbers and attributes them to the high BG levels. He thinks they will come dowen when the BG level comes down. We will take him back to the vet to retest these values in a few weeks.

Pat+Raja+Shadow said:
I hope you do get a chance to read the stickies at the top of the page....there is information there about Hypos and what you will need for your Hypo kit. That's an emergency kit just in case but hopefully you won't need to ever deal with that...but it is imperative that you read about it.
Click to expand...

Thank you. We have a vial of syrup his vet gave us and plenty of FF wet food with gravy. Both he and his civ sister "Fluffy" love the stuff. So I will be keeping those cans, the syrup, some high carb dry food and treat and the hypo directions in Achilles' emergency kit.

How do I link the previous day's condo to tomorrow's new post?

Pat+Raja+Shadow said:
Hope I'm not throwing too much your way right now...but if you have trouble, don't worry. We will be here to give you a hand! :razz:
Click to expand...

I am grateful for all of the information. Please keep it coming. Thank you for taking the time to write back. I am so happy to have found this website and all of you wonderfully generous people. Thank you!
 
Re: 8/24 Achilles AMPS 140

Anne&Muffin said:
Hi Eva and Welcome! I'm not experienced enough to really offer dosing advice, but I will say that my vet also started Muffin at 2u bid (she weighs 12 lbs). While she never hypo'ed on me with that dose, when I finally started with frequent testing and lots of data collection 20 days ago, she's down to a skinny .5u bid now. So had I known then what I know now, I would have opted to start at 1u. Muffin is not Achilles and ECID, but I'm just sayin' :smile:
Click to expand...

Hi Anne

Thanks for sharing your experience. It is comforting to hear that Muffin never hypo'ed. I am looking forward to getting more testing data on Achilles this weekend. I woud be thrilled if we could start reducing his dose slowly. I need to read up on when and how to start doing that.
 
Re: 8/24 Achilles AMPS 140, 156(+5)

Tomorrow you will scroll down the list of condos until you come upon this one...
click on it and bring up your first post.
Then, highlight the address at the top of the page....http://etc
You will then click the back arrow at the top and go to the box on the home page of this forum that says "New Topic" A blank message page will appear and you enter the date, Achilles AMPS just as you did today. In the body of the post,you will go up to the EDIT drop down list and select paste.
Your previous condo should appear where the cursor was....
When the message is posted, it will be in blue. Anyone can then click on that link to today's condo.
Did I explain that right?

Anyway, here is the link to this whole condo and what it will look like: viewtopic.php?f=9&t=23190

Again, if you can't do it that's okay for now....someone will usually find the last condo and post it if you forget....Good job on updating your heading with the +5 number too...you are doing great!! :mrgreen:
 
Re: 8/24 Achilles AMPS 140, 156(+5)

hello and welcome to the group!

as was mentioned, please read the starred "stickies" at the top of the forum. there's tons of material to absorb. no one can take all of it in at once. just refer to them often. as time goes on, the info will begin to make more sense. :-D

lantus is different than humulin N. N offers an immediate response. lantus has a cumulative effect, meaning one dose builds on the next. for this reason, we usually hold each dose for at least 3 days (6 cycles) before increasing... unless the numbers tell us otherwise.

you asked about dose...
if achilles ideal weight is 12 - 13 pounds, using the formula in the tight regulation protocol, his initial starting dose would be just a tiny bit less than 1.4 to 1.5 units dosed twice a day. since you changed his diet only 4 days ago (a diet change can make a huge impact), my suggestion would be to drop the dose to no more than 1.5 units every 12 hours.

please, ask any questions you may have. hope to see you posting often!
 
Re: 8/24 Achilles AMPS 140, 156(+5), 303 (+11)

303 at +11. I'm a bit disappointed, but perhaps my impatience is getting the best of me. I will retest at +12 and post his number. For all the new readers, this is Achilles' first full day on Lantus. Vet prrscribed 2 units bid. Should I follow vet's advice and stick to 2 units or should I take it down to 1.5? On the one hand, I'd like to have a few days at a steady dose, on the other hand I certainly don't want him to go hypo or to be rebounding from a high dose. what do you think?
 
Re: 8/24 Achilles AMPS 140, 156(+5), 303 (+11)

I can tell you that Jill is probably the person I trust most on this board, so I would consider her advice carefully. What she said about Lantus having a cumulative effect is true. Usually we don't see numbers this good the first few days on Lantus. If we're seeing lower 100's now, then when the dose settles the numbers could get lower. They also might not get lower, these are cats and they do whatever they want. :lol: It's something to think about, though. Usually it's safer to start a little bit low, and work UP to the right dose, instead of starting higher and never being 100% sure if your dose is safe.
 
Re: 8/24 Achilles AMPS 140, 156(+5), 303 (+11)

Hi Eva

I haven't visited you yet, welcome to Lantus Land!

Actually, you have had awesome replies from some of our most trusted beans here in Lantus Land when it comes to dosing guidance.
Libby, Jill and Sienne have studied a lot of spreadsheets, including my own to guide me along too.

It's hard at first, getting everything going, but you gotta put your patience cap on and bear with this sugar dance.
It's great that you found this board and this group of amazing beans who check in on us everyday.

The diet change is a good step forward, this too worked very well for my own kitty.
Now he is strictly diet controlled on low carb wet food and no insulin.

You're in good hands here!

Hope to see you posting often.
 
Re: 8/24 Achilles AMPS 140, 156(+5), 303 (+11), PMPS 318

Ditto what Libby just posted. Once you've had a chance to look at the Protocol sticky, you'll see that the initial dose of Lantus is held for 5 - 7 days. This allows the shed (and there's a sticky explaining the shed) to build. Lantus will not have the dramatic effect on numbers the way that N does. The big trade off, though, is that you won't see the sharp drop in numbers or spike at the end of the cycle -- and Lantus is longer acting and gentler. It will take several days to begin to see the cumulative effect. In other words, Lantus takes patience!
 
Re: 8/24 Achilles AMPS 140, 156(+5), 303 (+11), PMPS 318

we are fellow newbies bidding you welcome! you'll like it here, these folks really know their stuff. good luck to you...

celi & binks
 
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