9/18 Sooty AMPS 331 newbie here, advice sought!

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Perry and Sooty

Perry and Sooty

Member Since 2010
Hi I'm Perry, in Atlanta GA and Sooty (NM, Black LHD, 15 lbs 5.8Kg - not obese) was diagnosed late June. Was in the 480s then. We switched to wet / low carb (Fancy Feast etc) and stopped the dry food right away when we found out...!
Since then he's been (on Vet's orders) on steadily increasing doses of Lantus starting at 2IU BID (8AM and 8PM) increasing after 1 or 2 weeks in 0.5 increments, ending up at 5.5 IU early September - and we were getting absolutely nowhere. After we reached 5.5 units BID and were still getting 260s to mid-300s and him spending ALL DAY crying for food (in spite of eating normally all day!!) we went to a referral specialists last week, $760 and some blood tests / ultrasound exam later and all they could do was tell us to go back and do the same thing all over again. He seems to be very insulin reistant so I asked the specialist "could he then, maybe have Type 2 Diabetes?" and he replied "There is no such thing as Feline Type 1 and 2 diabetes. That is only for humans. there is only Feline Diabetes Mellitus and the only treatment is Insulin" - he now wants us to (again!) increase the dose every 3 days or so by 1 Unit at a time until his BG numbers change! But we have been there and done that and after 2 months we never did see any significant downward trend in his BG levels. We are keeping him at 4.5IU BID while we try and understand where we can go from here. Last Saturday I did a full Curve on him and here are the numbers:
AMPS: 331
+2: 335
+4: 278
+6: 286
+8: 300
+10: 340
+12: 282
Can anyone give us any advice please?
 
welcome Perry and Sooty!

Do you know what the blood tests were, and what they looked at with the ultrasound? Also, have you been home testing often? If you have your numbers somewhere and can put them into a Google spreadsheet, that would be helpful in seeing any patterns.

There are a few possibilities for why a cat can be on a higher dose and not getting much movement. One possibility is just that the cat hasn't gotten to the breakthrough dose. Another possibility is that the breakthrough dose has been passed by increasing the dose in big increments or too quickly, or without enough data. We see those often. Chronic pancreatitis can be a possibility if it is not under control. There are other possibilities. I usually bring this up more gently, but since it seems your mind is already looking toward insulin resistance, please read this thread and see if anything sounds familiar: viewtopic.php?f=12&t=375

Please let us know how we can help.

edited to fix the link
 
Not sure what all the blood tests were; Ultrasound was to check for abnormality of the Pancreas (indicaton of Pacreatitis) - it looked normal; and his Kidneys (which they said are a little large at 5cm but otherwise normal - good to know no renal issues!)...
 
I replied over in health but I'll copy it here for the others in LL to see.

About your tests and the results .... get copies of all of them and keep them for reference. You may need the info later. I keep a binder for each of mine so I can track what numbers have changed.

OK here's my post from health:
Welcome to the site.

So, first is YAY that you are home testing; testing at home is the best way to know how well the insulin is working.

It would be a great idea if you can set up a spreadsheet as it will help you to keep track of all progress, and it will also allow others to see how things are going and to offer you some help, advice, and suggestions.

One thing you can consider, maybe later on, is that there were IS a resistance, and there are tests that can be done.
Both of my cats are resistant and tested positive for acromegaly, with Oliver also testing positive for IAA.
The links for you, in case you want to look into it:
IAA Test
IGF-1 (Acro) Test

Please know that there have been some cats with doses higher than where you are right now, and I know of one who did go OTJ, you may just have a thirsty fella!

Another very important part of the picture is food. By changing from dry foods to wet, and only low carb, some cats have gone OTJ or drastically reduced their insulin needs.
One VERY IMPORTANT point to keep in mind is that you need to be careful with dose when making food changes.
Some food links - one is a list of foods to see if you are feeding low carb, and the other has a great deal of good info on nutrition:
Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition

If you have been testing regularly and have seen fairly high and flat numbers, and are feeding low carb, you may just need to give more insulin.

Be sure to ask all questions you have, and feel free to have a look at my spreadsheets for my two cats, to see what I record for them.
 
Gayle and Shadoe said:
I replied over in health but I'll copy it here for the others in LL to see.

About your tests and the results .... get copies of all of them and keep them for reference. You may need the info later. I keep a binder for each of mine so I can track what numbers have changed.

OK here's my post from health:
Welcome to the site.

So, first is YAY that you are home testing; testing at home is the best way to know how well the insulin is working.

It would be a great idea if you can set up a spreadsheet as it will help you to keep track of all progress, and it will also allow others to see how things are going and to offer you some help, advice, and suggestions.

One thing you can consider, maybe later on, is that there were IS a resistance, and there are tests that can be done.
Both of my cats are resistant and tested positive for acromegaly, with Oliver also testing positive for IAA.
The links for you, in case you want to look into it:
IAA Test
IGF-1 (Acro) Test

Please know that there have been some cats with doses higher than where you are right now, and I know of one who did go OTJ, you may just have a thirsty fella!

Another very important part of the picture is food. By changing from dry foods to wet, and only low carb, some cats have gone OTJ or drastically reduced their insulin needs.
One VERY IMPORTANT point to keep in mind is that you need to be careful with dose when making food changes.
Some food links - one is a list of foods to see if you are feeding low carb, and the other has a great deal of good info on nutrition:
Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition

If you have been testing regularly and have seen fairly high and flat numbers, and are feeding low carb, you may just need to give more insulin.

Be sure to ask all questions you have, and feel free to have a look at my spreadsheets for my two cats, to see what I record for them.
Click to expand...
Found some info on the blood tests:
CBC w/ Diff
Biochem Profile
Thyr T4 Total

That's all I can find from the bill...!
 
Welcome to Lantus Land!!

It sounds like you've been home testing for a while. Is there any possibility that you could put any test data you have on a spreadsheet? I linked the instructions for the spreadsheet we use here and how to attach it to your signature.

Having more data than your latest curve will help us get a bigger picture of what's going on with Sooty's numbers.
 
Sienne and Gabby said:
Welcome to Lantus Land!!

It sounds like you've been home testing for a while. Is there any possibility that you could put any test data you have on a spreadsheet? I linked the instructions for the spreadsheet we use here and how to attach it to your signature.

Having more data than your latest curve will help us get a bigger picture of what's going on with Sooty's numbers.
Click to expand...
Thanks for posting the link to the SS instructions - I'll try and get it done...
 
Perry and Sooty said:
Got it, thanks. Interestingly, Sooty has NONE of the "red flags"...
Click to expand...

that's good. Not definitive, but a good sign. Maybe he's just not up to his dose yet. Whenever you get the spreadsheet done, hopefully we can help you interpret it.
 
Libby and Lucy said:
Perry and Sooty said:
Got it, thanks. Interestingly, Sooty has NONE of the "red flags"...
Click to expand...

that's good. Not definitive, but a good sign. Maybe he's just not up to his dose yet. Whenever you get the spreadsheet done, hopefully we can help you interpret it.
Click to expand...
Understood! Thanks. WIll try and get the spreadsheet done soon as I can...!
 
Hi Perry and welcome to FDMB.
I thought I would post here so that you can have a look at my Max's ss (spreadsheet)
You can see that we started at 1u, went up to 6u and then all the way down
to being OTJ (off the juice) since April 6.

Just as Max "cracked" I was about to start the testing going for IAA and Acro.
You have come to the right place in getting help for you and Sooty.

Have you read the "stickies" at the top of the Lants group. You will see how the
doses are adjusted up and down. We go slow to stay low.

As Libby said, it is very possible that the perfect dose just has not been hit yet. However
getting there takes time and patience in addition to the correct increases and decreases.

Your spreadsheet will be a very valuable too in getting the help you need.
 
Randi & Max said:
Hi Perry and welcome to FDMB.
I thought I would post here so that you can have a look at my Max's ss (spreadsheet)
You can see that we started at 1u, went up to 6u and then all the way down
to being OTJ (off the juice) since April 6.

Just as Max "cracked" I was about to start the testing going for IAA and Acro.
You have come to the right place in getting help for you and Sooty.

Have you read the "stickies" at the top of the Lants group. You will see how the
doses are adjusted up and down. We go slow to stay low.

As Libby said, it is very possible that the perfect dose just has not been hit yet. However
getting there takes time and patience in addition to the correct increases and decreases.

Your spreadsheet will be a very valuable too in getting the help you need.
Click to expand...
Thanks!! much appreciate that will check your SS - also thanks for the kind thoughts and encouragement! I really do hope it is just that we just didn't go high enough when we got discouraged after geting to 5.5 BID and seeing absolutely NO significant drop in BGs at all - anyhow we're back on the path again, we're back up from 3.5 to 4.0 BID at the moment, waiting 3 days to see if there's any change (tomorrow)... after that the Vet wants us to increase by 1.0 each time (given that 5.5 BID had not done thee trick before)... thanks for the encouragement and I sure will get the Google SS set up just as soon as I can get to it.
 
have you read the sticky with our dosing protocols? viewtopic.php?f=9&t=1581

I don't recommend increasing the dose by 1 unit at a time. We suggest no more than 0.5 unit increases (most cats increase by 0.25 at a time, but at higher doses we will sometimes increase by 0.5). What you don't want is to bypass Sooty's best dose by going up in large increments. Believe me, even at a 5 unit dose, the 0.25 increase can make a difference. With Lantus, most cats look like they are not responding to the insulin at all, increase after increase, until BAM! One day all of a sudden they are in low numbers. It happens over and over again, it's pretty amazing!

The only time you will see Lantus Land cats increasing by a whole unit at a time is if they are diagnosed with acromegaly or IAA. Those cats can usually afford larger increases once their bean understands their patterns very well.
 
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