Advice please lower amps?

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Ann & Liz

Member Since 2016
Lila has been getting quite low (for her) mid cycle bgs recently. But usually (see earlier thread )high pre shot bgs. However this am she is 16.9, unsure if to risk her full dose of 1.4 if Caninsulin. She tends to have steep drops (see ss) Advice please. Due to inject in next 30 mins. Thankfully we are around to monitor and test all day.
 
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Hi,

At the beginning of November, you had AMPS in the same range (around 300 -315 mg/dL), and you shot 1.25 IU.
With this AMPS of 304 mg/dL, I would shoot the same dose as at the beginning of November : 1.25 IU, or even a little bit less, let's say 1 IU.
 
Lila has been getting quite low (for her) mid cycle bgs recently. But usually (see earlier thread )high pre shot bgs. However this am she is 16.9, unsure if to risk her full dose of 1.4 if Caninsulin. She tends to have steep drops (see ss) Advice please. Due to inject in next 30 mins. Thankfully we are around to monitor and test all day.
Just looked at Lila's spreadsheet.

My but she is swinging!

Keep testing for ketones.

If it were my cat I would reduce the dose - those swings from black PS down to nadirs in the normal range are crazy (and could make Lila feel quite unwell).

Also, with Caninsulin the FDMB guideline for target nadirs as measured on human meters is in the 100/5.6 range (very rough pet meter estimate would be >135/7.5) because of the hard, fast way it can drop BG (needs a bigger safety cushion) and Lila's dipping down into that territory more frequently.

Have a look at the dose you were giving on 6.11.16 (1.25 IU). Lila was still getting good nadir BGs and her cycle was much more even.

I do wonder whether the extremely high preshot BGs are due to Lila bouncing badly on too high a dose.

I do think Lila could benefit greatly from a switch to a longer-acting insulin (could keep the PS BGs down and even her out).


Mogs
.
 
Just looked at Lila's spreadsheet.

My but she is swinging!

Keep testing for ketones.

If it were my cat I would reduce the dose - those swings from black PS down to nadirs in the normal range are crazy (and could make Lila feel quite unwell).

Also, with Caninsulin the FDMB guideline for target nadirs as measured on human meters is in the 100/5.6 range (very rough pet meter estimate would be >135/7.5) because of the hard, fast way it can drop BG (needs a bigger safety cushion) and Lila's dipping down into that territory more frequently.

Have a look at the dose you were giving on 6.11.16 (1.25 IU). Lila was still getting good nadir BGs and her cycle was much more even.

I do wonder whether the extremely high preshot BGs are due to Lila bouncing badly on too high a dose.

I do think Lila could benefit greatly from a switch to a longer-acting insulin (could keep the PS BGs down and even her out).


Mogs
.
Thanks Mogs, we have tried to persevere with Caninsulin and keep hoping that it will start to be more even. Thankfully we now have a new vet since early Dec who seems prepared to really follow Lila's case and also seeks advice from a more experienced colleague. We did mention change to a Prozinc and I think she will support this although admits she is not familiar with using it. The vet has link to ss and will ask her to check it again to see what's been happening over Xmas period.
 
She's not getting good duration on the Caninsulin and she's spending several hours out of each cycle at stratospheric levels of hyperglycaemia (not good for the nervous system and internal organs).

I know that we now have to go to Prozinc after Caninsulin in the UK or else I'd suggest you ask your vet to consider prescribing Levemir or Lantus (longer duration; better at holding down BG in better ranges cf. Caninsulin's style of yanking down BG levels only for them to head skyward again at the end of the cycle) .

If you do switch then if Prozinc gives greater duration it might help keep down those preshot levels (but you'll probably still see some bounciness issues).

BTW I strongly recommend you get more checks earlier in the BG cycle to see whether her BG may be going lower during that time. (With healing nadirs may start coming earlier in the cycle).

Be interested to hear how you get on.


Mogs
.
 
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