8/28 Austin AMPS - BG 39, +1#51 +2 #45 and monitoring

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Tara and Austin (Aussie)

Tara and Austin (Aussie)

Member Since 2010
Editting this thread as suggested. Thank you for the help and close monitoring. 1230pm EST marks the +3 and I am re-testing now. He just finished washing up from his Whiskas gravy. Luckily he isnt one to refuse food.

Oh and I apologize for not updating the SS today - this computer has an issue running the google docs program but I am trying...


Said earlier....
Just wondering does anyone have experience with Lantus shots that differ? My vet, who I love and trust just advised we try 4 units AM and 3 units PM to basically "split the difference" (her words) instead of doing 1/2 unit increase.

Austin has only been on Lantus about a month and is slowly starting to come down - she just wants to really get him to 100 and regulated a bit faster. He is a big boy, 20 lbs - wet food diet only.
 
Re: Different AM vs PM dose

All the info available on Lantus is that it really likes consistency. I think that would play havoc with the shed. IMHOP I would split the difference by shooting 3.5u am and pm, but I'm not an advisor. This should at least bump you up the list. Do you have half unit syringes?
 
Re: Different AM vs PM dose

I'm not sure your vet should be making such a black and white call without knowing what your cat's BG readings are from cycle to cycle. Not trying to scare you,
but if I had listened to my vet's advice a week ago, my cat would not be doing well right now. Even after 3 days under observation at the vet's office, they decided to
prescribe a dose which I later learned was much too high. I booked a few phone consults with Dr. Pierson and now know how to home test and do my own curves, and let each cycle's numbers determine the dose. So here I am on day 9 of the diagnosis and my cat is doing better with every cycle. If you are inclined, you can contact her via her site at catinfo.org. I can't imagine where I'd be if I'd gone with my regular vet's advice.
 
Re: Different AM vs PM dose

hello tara and welcome to the group! :-D

years ago, we muddled our way through learning how to best use lantus. shooting different doses for AM and PM shots wasn't unusual. been there. done that. and it didn't work too well. kitty would yo-yo back and forth having good and bad cycles. shots had to be skipped. it wasn't pretty. since then we've come a long way in understanding how one lantus shot builds upon the next... thus the reason behind consistent dosing. today, shooting different doses at shot times is almost unheard of.

we've also found a little bit of lantus goes a long way. dose adjustments are usually made in increments of 0.25 unit or 0.5 unit. some of us have even found ourselves adjusting doses by just a drop of insulin.

there's a whole lot of good information for you and your vet on the use of lantus in the STICKY: LANTUS & LEVEMIR - TIGHT REGULATION PROTOCOL including the latest study published in The Journal of Feline Medicine and Surgery.

check it out. the tight regulation protocol with lantus and levemir has been extremely successful!



edited to add: if you'd like suggestions about dose, please update your spreadsheet.
offering any advice is next to impossible without data from the last several days.

also... i noticed there is data missing from several days. if you have the data, it would be helpful to see it.
 
Re: Different AM vs PM dose

I can talk from experience about the split dose issue. Harley was at 6.5 units AM, 6.0 units PM. Everyone encouraged me to go to same dose for both times. I was really hesitant about it, but jumped in one day and gave both the same. It was great. Although Harley is hard to regulate, he acted better, more life in him and even his bg were better.

I would never hesitate again to advice. People know of what they speak here.

pattie
 
Re: Different AM vs PM dose

I was in the same position you are a few months ago! My vet advised 3u and 2u. Of course, I asked the board and was told to split the different and give 2.5 each time to keep the shed consistent. I called vet back to talk about the effects on Trouble's shed and she was shocked I new about such a thing or even the idea of researching her advice. She said I was probably right and stick to splitting the difference. I am not an expert here, but that has been my experience. Good Luck!
 
Re: Different AM vs PM dose

Thank you for all the responses. I don't have .5 unit syringes but I can still figure out a half dose. I think everyone is right as well - that it would be better to do 3.5 and 3.5 to keep things even. I shot 4 units this morning and he'll get 3 tonight but that will be the end of it.
I am inconsistent with home testing simply because of my work schedule. I will get some reading this weekend though.

I can see a lot of improvements with him - but he still acts like a diabetic cat - drinking a lot of water (but only in the early AM - 430am, 5am) If I got up to feed him then he would probably avoid the water. He has neuropathy too - which is why I am anxious to regulate him. I know it's not a fast thing though. He's gone unregulated for many months now and has only been on insulin and with his new vet a month today.

I appreciate those with experience speaking out about keeping everything the same is usually better.
 
Re: Different AM vs PM dose

You can get 3/10cc syringes with 1/2 unit markings from Hocks (link at the top of the page). I like the Monoject rather than the BD. The lines look a little longer making it a little easier to read. My last order took all of 3 days to show up on my doorstep. :-D

You can just save your old 1 unit marking syringes for when you adjust at some point to an even unit dosage.
 
Re: Different AM vs PM dose

Tara --

I don't know if anyone suggested you give Aussie methyl-B12 to help with the neuropathy. This is a link to the methyl-B12 I've used. You add a capsule to food daily. You can't give too much -- it's a water soluble vitamin and will be excreted if there's more than what you're cat needs. Many people find that after a couple of months, there's improvement in the neuropathy.
 
Re: Different AM vs PM dose

There are 3 tests that are most important; I would say they are vital.

1. just before the AM shot.
2. just before the PM shot.
3. just before you go to bed.

For the first two, you MUST know what the BG value is before giving a shot. If you test and get a low number, you may need to reduce the shot or skip the shot.
What your goal is, if possible, is to get your cat off insulin if possible. Yes, regulation is first, but then you want to be heading towards a nice healed liver and pancreas, organs that function well on their own with no insulin to help them along.
So as there is some healing going on, you may see some reduction in insulin needs.
It's a good idea to have a no shoot number and even a "ok, what now?" number.

The third important test is just before you go to bed. there have been many, many many people who have been heading to bed, did one last test for the night and found their kitty very very low! Many have had sleepless nights because of the need to stay up a bit until their kitty has numbers back in a safer zone.
I know you can't stay up all night, and even I have tested at 1am and got a good number, but then when I am up 5hrs later, I test and get a low number, but still the odds are in your favor that any low number will happen before you head to sleep. You would feel better to catch it before bed than find your kitty very low in the morn and wonder 'when did this happen'?

So rock bottom, try to catch those 3 tests. They will give you some stress release.

Example of a typical curve:
+0 - PreShot number.
+1 – Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 – Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

Syringe info/ ½ unit markings

I also keep my 1unit markings syringes for full u doses. If I am giving say 8units, I can use the 1unit syringes. If I need to reduce to 7.75units, there is no way Ican measure that dose with the full unit markings, but I can see half way between on the 1/2 unit marking syringes.
 
Re: Different AM vs PM dose

Thanks again for the responses. I had already given him his 4 unit dose this AM when I last posted. Checked just to be sure at the almost 3 hour mark and he was 39. New mantra is check before AM, check before PM and 1 before bed. *sigh*
There were NO signs like drunk staggering, vomit, etc - that would lead me to believe he was so so low. I immediately fed him a can of FF that he loves - he walked right over and gobbled it down. Called the vet - she took my emergency call and I'll be testing on the hour today and adjusting with food if necessary. The vet recommended at his weight (and I know some do not agree with weight vs units and bg numbers) he can hang around the 60's and be just fine. So that's what we are shooting for today. For peace of mind I am skipping his PM dose. She said I could skip it or I could shot 3 units if he is in the 150's.

Also just for the person who mentioned methyl-B 12 - he has been on that about a month now as well. I give him Xobaline for cats and it crushes up very nicely to blend with a little water and his runny FF. I tried a variety from Vitamin Shoppe but they were to crunchy for him and he'd just skip that part of his food.

Thank you everyone for helping me and responding. This experience has bonded me even closer with my kitty - he knows I am trying to help him but I'm pretty new to all of this too.
 
Re: Different AM vs PM dose

how long ago was the 39? Test again to be sure the food brought him up, ok? If that was +3, low carb food might not have been enough.
 
Re: Different AM vs PM dose

Hi there

please re-test after that 39, that is very low, and needs to be monitored.

If you have some time today - could you update your spreadsheet? This will helps others guide you along.
 
Re: Different AM vs PM dose

Thank you for checking back in. An hour after the 39 he was 51. Now two hours later it's 45. I am not sure what to do - I had my husband run out to buy some carby food - and I'm giving him Whiskas pouch food which he loves. He is purrring, laying by the window watching birds like nothing is happening! Im the mess.
My vet said it was wiser to give food and re-test and watch, rather than jump to the Karo which is why I haven't given it yet - but knowing that Lantus is so long lasting and his numbers don't go back up after 6 hours historically - Im very nervous. Any advice please?
 
Re: Different AM vs PM dose

ok, so you have pouches that contain gravy yes?

let him have a bit at a time and re-test the 45


numbers in the 30's you'll want retest within 15 to 20 minutes rather than an hour.

numbers in the 40's as well, just to make sure the numbers are going up and kitty is not diving again.
 
Re: Different AM vs PM dose

It's OK to not give Karo. BUT, you want to feed HC food and re-test in 20 min., not in an hour. Numbers may bobble around. When you are feeding frequently, give a small amount -- a teaspoon or two -- so your cat doesn't get too full and refuse to eat. It's also why we use gravy -- it's less filling than solid food. If you don't have a food with gravy, you can add a couple of drops of Karo to LC food. It will act much in the same way to bump up numbers.

You do not stop testing until numbers are stable at a good and safe level.
 
Re: Different AM vs PM dose

Please come back and post your updates, okay? We are all watching out for you.... :razz:
You are doing a fine job...keep up the great work!
 
Re: Different AM vs PM dose

Tara:

When you have a chance, can you edit your subject line? We're keeping a close watch on your condo due to the low numbers so we can lend a hand and support. It's easier to see what's happening if the numbers are in your subject line.

If you go to the first post, the post you opened the thread with, and click on the "edit" button, you can change the subject line so it will be what appears on the Board. It should use the convention you see in the other condos:

Date Cat's Name AMPS - BG#, +1 - BG#, etc.​

Also, could you please update your SS.
 
Editting this thread as suggested. Thank you for the help and close monitoring. 1230pm EST marks the +3 and I am re-testing now. He just finished washing up from his Whiskas gravy. Luckily he isnt one to refuse food.

Oh and I apologize for not updating the SS today - this computer has an issue running the google docs program but I am trying...
Click to expand...


Hi Tara


editing subject line is great to keep everyone posted on current numbers, but what you added to the text box in your first post can be done as a reply to the last post in this thread, that way it bumps your thread up. We don't usually go back to read the original post, so add a reply to your thread instead ok?



I've added what you put in your first post.
 
Thank you!! It's much easier for everyone here to follow and lend you a hand.

Just a thought.... Since we don't know when Austin nadirs, one way to help get the numbers up a little more quickly is to give a few drops (and I do mean drops) of Karo with Austin's food. If you look at Gabby's SS, you'll see I've done this as well. It's easier to keep the numbers up once you get them up.
 
Replying - hoping this helps.
Sorry I should actually re-post again - the 39 wasn't his AMPS - it was +2 after his AMPS. Then the +1 AFTER that was 45. I am just frantic after seeing the dip so I'm not operating at 100% today.

Ok 1230pm test is 65 after some gravy and Whiskas. Will continue to test on the 20 min just to make sure there are no more drops. He is actually at his +6 right now.

Sorry to say, I'm a newbie right now and don't know what a nadir is...I see it all the time, and am trying to learn. With Austin for this past month there really wasn't that much movement with his changes - so I just did not anticipate as much as I probably should have. Hindsight.
 
Tara and Austin (Aussie) said:
Replying - hoping this helps.
Sorry I should actually re-post again - the 39 wasn't his AMPS - it was +2 after his AMPS. Then the +1 AFTER that was 45. I am just frantic after seeing the dip so I'm not operating at 100% today.

Ok 1230pm test is 65 after some gravy and Whiskas. Will continue to test on the 20 min just to make sure there are no more drops. He is actually at his +6 right now.

Sorry to say, I'm a newbie right now and don't know what a nadir is...I see it all the time, and am trying to learn. With Austin for this past month there really wasn't that much movement with his changes - so I just did not anticipate as much as I probably should have. Hindsight.
Click to expand...

amps ? (4u)
+2 39
+3 45
+6(?) 65

if the 65 was taken 6 hours after the shot this morning, you could wait 30 minutes to retest.


nadir is when the action of the insulin peaks. in other words, it would be the lowest number of the cycle.

please continue posting. austin's numbers may bobble up and down for a awhile. we can guide you...
 
Thanks.

AMPS ? (4 units)
+3 39
+4 51
+5 45
+6 65

I don't really have a good grasp on his nadir yet. I need to test better and do more curves to truly get that lowest number. So far the lowest I've SEEN has been 186. But the numbers when I did that curve made my vet think maybe to change a bit. After today i think she is changing her tune.
 
Tara and Austin (Aussie) said:
Thanks.

AMPS ? (4 units)
+3 39
+4 51
+5 45
+6 65

I don't really have a good grasp on his nadir yet. I need to test better and do more curves to truly get that lowest number. So far the lowest I've SEEN has been 186. But the numbers when I did that curve made my vet think maybe to change a bit. After today i think she is changing her tune.
Click to expand...

yes, the 186 @ +9 is the lowest i saw on your spreadsheet. since we don't know when austin peaks, it's probably a good idea to stay on top of the numbers today in case his usual peak is later in the cycle. it's possible his numbers could drop again.

most here haven't been around long enough to see it, but unfortunately, what you're seeing today is common when shooting different doses at AM and PM shots. hope your vet changes her tune about that, too. :-D
 
No worries about being a newbie. We've all been there and the first time you see low numbers it does get your heart racing. It will get much easier after a few times through the process. I promise!

Just to clarify what Jill said. The nadir is the lowest point in any cycle. It's not so much the number as the time during the cycle when this happens. While the nadir on any given cycle can be at any time, there is usually a pattern to when the nadir occurs. If all kitties behaved perfectly on Lantus, the nadir would be at +6 -- right in the middle of the cycle. Not all cats are that well behaved. Some will have early nadirs and others will have late nadirs. Knowing when your cat typically has his nadir, will help you to know how his cycle progresses.
 
Update on Austin (although I know it's late)

AMPS ? (4 units)
+3 - 39
+4 - 51
+5 - 45
+6 - 65
+7 - 58
+8 - 72
+9 - 75
+10 - 63
+11 - 71
+12 - 113
+13 - 139

I fed him his dinner right around the +12 time frame. He didn't eat as much as usual from eating all day. Thank you for the tiny drops of Karo tip - I did that and it seemed to help a lot without overwhelming. He didn't really care for the flavor I could tell.

This morning AMPS was 298 - gave him 2 units. Long weekend. Thanks for checking back in everyone! It is much less scary when people are asking how things are going.
 
Hi Tara...
It's time to open a new condo this morning for Austin...can you put in the header
8/29 Austin AMPS=298

If you know how to link this condo the the first post that would be good. If not, we can help.
 
Here is the link that you can put in your Sunday condo, okay?
viewtopic.php?f=9&t=23406

We do one new condo each day for each kitty.
We link to the previous day's condo so that everyone can easily click back and see what happened the day before.
I am hoping that you read this soon because that 39 from yesterday is going to cause some hearts to stop this morning!!!
:o It looks as if he is 39 again today!! nailbite_smile
Hurry Tara! :lol: Post a "New topic" condo soon....
 
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