9/20 Millie AMPS 540 +3 414 UGH...confused newbie

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Heidi n' Millie and...

Member Since 2022
Millie was diagnosed in July. My vet practice starts with Vetsulin, which didn't work. New vet to practice, just out of vet school suggested Lantus. YES, because of this site. (Using AlphaTrak2, at vet's insistence. Will change as soon as I can) Tested numbers the first day, vastly improved. 2nd day, Millie fought it couldn't get blood. After a couple of days, her appetite significantly decreased which, I think significantly affected her AMPS. Then, it all got wonky. For the 6 weeks she was on Vetsulin, she ate 1/2 can DM, 1/2 can FF and 1 Tbsp Tiki CAT 0 carb, twice daily, usually taking a couple of hours to clean it up. Two days into Lantus, she was sniffing, licking at it, but my other cats are eating a lot of her refusals. Her numbers are all over the place. Drinking 1 to 1.5 oz of water from bowl, urinating normally. I work on Fridays, Saturdays and Sundays, so can only do pre-tests, AM and PM on those days. We're getting better at the testing. Do I need to get Keto Stix or the meter? What kind of litter to use the Stix? Ugh...my old brain hurts.

Millie's AT Spreadsheet - Google Drive
 
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Heidi n' Millie and... said:
Millie was diagnosed in July. My vet practice starts with Vetsulin, which didn't work. New vet to practice, just out of vet school suggested Lantus. YES, because of this site. (Using AlphaTak2, at vet's insistence. Will change as soon as I can) Tested numbers the first day, vastly improved. 2nd day, Millie fought it couldn't get blood. After a couple of days, her appetite significantly decreased which, I think significantly affected her AMPS. Then, it all got wonky. For the 6 weeks she was on Vetsulin, she ate 1/2 can DM, 1/2 can FF and 1 Tbsp Tiki CAT 0 carb, twice daily, usually taking a couple of hours to clean it up. Two days into Lantus, she is sniffing, licking at it, but my other cats are eating a lot of her refusals. Her numbers are all over the place. Drinking 1 to 1.5 oz of water from bowl, urinating normally. I work on Fridays, Saturdays and Sundays, so can only do pre-tests, AM and PM on those days. We're getting better at the testing. Do I need to get Keto Stix or the meter? What kind of litter to use the Stix? Ugh...my old brain hurts.

Millie's AT Spreadsheet - Google Drive
Click to expand...
I can tag a few members for you

@tiffmaxee

@Suzanne & Darcy

@Bandit's Mom

@Wendy&Neko



But here is your post that you did on the Main forum
https://felinediabetes.com/FDMB/threads/new-member-spreadsheet-woes.268628/#post-3001417

I replied back on your post on the main forum here's what I said
I see you are following SLGS and here's what it says
Can you get more tests in after the PMPS cycle , you are only seeing half the picture,try not to skip testing her before you give the insulin. Most cats usually drop lower at night so you don't want to skip over if a decrease is needed

Would you like someone who is more experienced than me to look at your SS and see if you should increase the dose, ?
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
Part of that process is getting a feel for basic concepts:
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
 
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I read the rule about just one post after I did these and not sure if being on different forums was a problem and, if so, how to correct. One was technical, one was specific.
I missed tests the second day because we were locked in a battle royale. Then, one evening after that. I can't test during the day on Friday, Saturday and Sunday and my job requires that this old body sleeps. I can be more flexible Monday through Thursday. I know it takes a while for things to settle in but, with her appetite in flux, I was concerned at all the wonkiness of the numbers. Digesting lots of info, trying to make sense. I welcome all the input I can get, I guess the more experience, the better.
I will try tonight to get every 3 hours, through the night. I'll have to go to Petsmart, buy every flavor of FF and Friskies' pate, and try to find something she likes more than the others.
Thanks for your assistance and input. New tricks for this old dog.
 
Thanks. I have the chart, have printed it out so I can highlight the qualifiers. I look for the carbs as low as possible and the phosphorus number, too, as they are all over the place. Also, I try to get a larger percentage of calories from protein, than fat, but that usually is fish/seafood, which is higher in phosphorus. It's like a delicate ballet.
 
I see you have two threads on LLB. A moderator will merge them. Ignore the other one on this forum. I can’t see your spreadsheet because it says permission is needed to access it.
 
Sorry, I'm not sure where you are saying to leave space. On my signature or on my spreadsheet? I didn't start testing until I started Lantus last Tuesday. Today is the 8th day. Also, not sure why you can't see it or where I should change permissions. It's my first day to have the spreadsheet and to post, trying to keep parameters/rules, etc... straight. A bit of a learning curve. YIPPEE...I believe I just changed the permission to anyone with a link!!
 
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Heidi n' Millie and... said:
Sorry, I'm not sure where you are saying to leave space. On my signature or on my spreadsheet? I didn't start testing until I started Lantus last Tuesday. Today is the 8th day. Also, not sure why you can't see it or where I should change permissions. It's my first day to have the spreadsheet and to post, trying to keep parameters/rules, etc... straight. A bit of a learning curve. YIPPEE...I believe I just changed the permission to anyone with a link!!
Click to expand...
I can see it now, what @tiffmaxee (Elise) meant about leaving a space on your spreadsheet was that if you have any tests when Millie was on Vetsulin she wanted you to put a space above the date you switched to Lantus and write Switched to Lantus
 
I finally decided that was what she meant, thus explaining in my last post that I didn't test while on Vetsulin. Vets don't tend to promote a lot of testing but the more I read and the deeper I got here, the more I realized that I would have to test with Lantus. I can't wait for my vet to see my SS. Not that it's good but that it's more thorough than bringing her in. Baby steps.
 
Heidi n' Millie and... said:
I finally decided that was what she meant, thus explaining in my last post that I didn't test while on Vetsulin. Vets don't tend to promote a lot of testing but the more I read and the deeper I got here, the more I realized that I would have to test with Lantus. I can't wait for my vet to see my SS. Not that it's good but that it's more thorough than bringing her in. Baby steps.
Click to expand...
@tiffmaxee

@Suzanne & Darcy

@Bron and Sheba (GA)

@Wendy&Neko

Hi ladies @Heidi n' Millie and... Is a new member can one of you take a look at her SS , shouldn't she increase the dose now
 
I can see the ss now. You said you were only two days into lantus I thought. If it’s 8 days you need to do a curve testing every 2 hours for 12 hours or every 3 hours for 18 hours. Then we decide if you can increase as dosing is based upon the nadir, lowest point in the cycle. From your day tests it looks like you should increase but I do wonder how low she went last night. When there’s a big drop at your last test and then a high test at the next shot time it’s often do to a bounce because the bg dropped lower but I doubt lower than she’s been. So I think you can increase to 1.25.
 
I am going to test every three hours through the night, since I'm already started, and see what we end up with in the morning. I was concerned with the 193 AMPT, yesterday, then the bounce to 505 at +9, then 540 AMPT today. It was the number 193 AMPT that got me, especially when Millie's first day looked like a good start. I will update the SS through the night, since it has now taken over my laptop and I'll have a 24-hour curve. Thank you so much. I'll be glad when it all makes more sense.
 
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