? Alex: 3/8: AMPS:148 (1.5u) +2.5 62, + 3 71, + 3.5 66

alexMama

alexMama

Member Since 2026
Starting a new thread!!! Alex is potentially going into remission his vet thinks..No shot today since AMPS was 73.

Wants me to dial him back to 1.0 units and maybe only 1x a day???!! Thoughts?

His labs came back.. Phosporus was 5.6 and normal.

Sodium low

chloride and potassium low

creatine: 4.2 (shows kidney injury)

BUN :( Improved) 99 ,

electrolytes the issue , still needs more!

not stage 4 Kidney failure , is in stage 3, heading towards stage 2.

Still in acute phase???

Consider Give sub q fluids: however risk of overwhelming heart…

-Needs:
-potassium supplement
1 unit twice a day or once a day maybe?

Thread 'Alex:3/6: AMPS 187, +2 127, +4 111, +5 119., +8 148, +10 297,Pmps 141, +2 121, +5 74, +8 78, +10 68'
Alex:3/6: AMPS 187, +2 127, +4 111, +5 119., +8 148, +10 297,Pmps 141, +2 121, +5 74, +8 78, +10 68
 
It’s good the labs have improved.
Alex may be heading toward remission but we won’t know unless he stays between 50 and a max of 120 without any insulin for two weeks. I’ve seen lots of cats have cycles like these before… and we are hoping for remission… only to be disappointed so I try very hard not to speculate on that. I try not to jinx it. What is recommended is to lower the dose gradually according to protocol and go through all the doses gradually 1 unit, .75 units, .5 units, .25 units, .1 units and finally a drop dose. Sometimes the cat will get ahead of you, and sometimes they may only stay at the reduced dose for a single cycle before earning a reduction— with back to back reductions. Sometimes the cat just needs a lower dose, and they end up fooling us into thinking they’re going into remission — and then they stabilize at a lower dose and don’t go all the way. We find that the best way to achieve a lasting remission where the cat doesn’t end up back on insulin is to take things slowly — as long as the numbers warrant it. I would be VERY excited to see Alex in remission, but I have seen many vets call it remission when a cat really isn’t in remission.

He’s already into blue at only +5 though so we will have to see how the rest of the day goes.

As for shooting only once a day… it makes no sense. ProZinc isn’t going to keep BG under control for 24 hours. Not even Lantus will do that, although you would have a depot to carry you for a little while. It would be better to shoot a lower dose every 12 hours than to give insulin once day.

And I am really really happy to see those improved kidney values! He is heading in the right direction.
 
Suzanne & Darcy said:
He is doing great holding steady in blue. I really do think he’s going to need less insulin at least … and who knows what else 😀😀
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I am not sure what to give him tonight.. The vet said to do 1.0… thoughts? I am worried he’s not hydrating enough and his labs confirm…He seems slower an less aware today..
 
Is he drinking water? Can you encourage more water consumption? Can you use tuna juice watered down? Have you asked the vet about Purina Hydra Care? Are you adding water to his food?
 
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alexMama said:
The vet said to do 1.0… thoughts?
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Well… he is at 133 now… or at last test… last night he was 141 at PMPS and you gave 1.75. If he is in a similar place you could try 1.5 (a little less than last night.) In fact, even if he goes up higher and closer to 200, I would still try 1.5.
 
Suzanne & Darcy said:
Well… he is at 133 now… or at last test… last night he was 141 at PMPS and you gave 1.75. If he is in a similar place you could try 1.5 (a little less than last night.) In fact, even if he goes up higher and closer to 200, I would still try 1.5.
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Ok, he’s 132, so i feel comfortable doing 1.5… i did 1.75 when he was at 142 last night and he did well , so i think 1.5 is reasonable.. and i will be checking through the night…
Suzanne & Darcy said:
Is he drinking water? Can you encourage more water consumption? Can you use tuna juice watered down? Have you asked the vet about Purina Hydra Care? Are you adding water to his food?
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yes, drinking water, but I don’t think he’s drinking enough.
I keep bringing it to him and taking it over to him and he doesn’t really want much..,
I forgot to ask about the Purina Hydro care. I water to his food, but his food does have water in it… I’ve been using Weruva slide and Serve chicken.
 
Yikes. I saw the 200 on his SS. I hope that’s as high as he got. Oh well. Alex is doing his own thing.

Regarding hydration: it is kind of a problem with the Lasix. I would not attempt sub-q fluids without the guidance/approval of the cardiologist. When did the cardiologist want you to return? I know they were talking euthanasia, but if he improved they had a timeline I believe…3 months? But you should be able to call/email them with questions. I was always able to reach our cardiologist.
 
Suzanne & Darcy said:
Yikes. I saw the 200 on his SS. I hope that’s as high as he got. Oh well. Alex is doing his own thing.

Regarding hydration: it is kind of a problem with the Lasix. I would not attempt sub-q fluids without the guidance/approval of the cardiologist. When did the cardiologist want you to return? I know they were talking euthanasia, but if he improved they had a timeline I believe…3 months? But you should be able to call/email them with questions. I was always able to reach our cardiologist.
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fortunately, he went down to 168 so he seems to be trending down… Was very happy to see that just a few minutes ago.
I can email the cardiologist and will email them with some questions.
 
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Looks like you went with 1.5.

What caused the mid cycle spike last night? Did he eat medium or high carb food. It suspicious because the ProZinc was near the peak of its potency at the time that 200 was recorded. So it certainly looks like he ate something that raised his BG for a little while and then the carbs wore off and his BG dropped back down. The dropping before AMPS is probably due to lack of food. That’s normal.
 
Suzanne & Darcy said:
Looks like you went with 1.5.

What caused the mid cycle spike last night? Did he eat medium or high carb food. It suspicious because the ProZinc was near the peak of its potency at the time that 200 was recorded. So it certainly looks like he ate something that raised his BG for a little while and then the carbs wore off and his BG dropped back down. The dropping before AMPS is probably due to lack of food. That’s normal.
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Nothing high carb given. No idea why he spiked. He just had the low carb Weruva slide N Serve chicken breast dinner puree with some boiled shredded plain chicken.

I gave him a tiki treat with water around 1:30-2am or so when we went up to bed.. would that do it? He spiked before that though and was literally just sleeping that whole time..

I did do the 1.5 this AM.. Hoping he stays in the blues and greens.

I put in all the info into AI and didn’t like what it said.. I put in all the lab values from last Monday’s cardiologist visit and the new lab values. It says he’s still in a very dire situation with his kidneys because the creatinine is still so high.
I’m not sure if that number is going to go down or not with time? I did start the heart meds now that we’re done with the labs and I will be doing that every day… The clopidogrel. I had the low phosphorus food coming tomorrow or Tuesday from Weruva and the one he’s getting now is as well. Low carb and low phosphorus.

i’m going to email the cardiologist to ask about the Purina electrolytes you mentioned versus the sub Q fluids…want to hear what her take is on that…
We went down to a quarter of furosemide pill a day now starting today, so we’ll be monitoring his respiratory rate and making sure his heart stays OK.

Essentially, I think we’re on borrowed time here, but I’m trying to do all we can within reason to help him have a good quality life for whatever he has left.

I was so encouraged by how much better he was doing, but what I’m hearing from the vet and what AI is telling me is that he is still very much in a very difficult situation with three major issues. The diabetes has definitely subsided as far as the high numbers so that’s good but the heart issue is not going to improve…only get worse over time they said.. and the kidneys have an acute injury. So frustrating!! All of it!
 
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Holy cow, he dropped like a rock from 148 to 62 in 2.5 hrs. Watching him closely.. At what point would I need to be giving high carb food? At 50 or earlier.. only have the FF which is Not good for the phosphorus content.. So will run to our local co-op this AM to find some higher carb low phos food if possible!
 
1pm: 66
Is it my understanding that the level on a relion monitor is about 18 points lower than the alpha track? So in reality he’s really in the 80s if we were doing the vet/Alpha track monitor? So what numbers are you thinking are concerning then on my monitor?
40’s and lower correct?
 
5:30pm: Been in the green all day..,60-70’s…
I would only likely give .5 unit at PMPS if this low at PMPS… Thoughts?
 
alexMama said:
I put in all the info into AI and didn’t like what it said.. I put in all the lab values from last Monday’s cardiologist visit and the new lab values. It says he’s still in a very dire situation with his kidneys because the creatinine is still so high.
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I have found AI to be extremely alarmist on more than one occasion with my own cats. I think they’re trying to program it to be careful and have people go to the vet.
 
alexMama said:
did start the heart meds now that we’re done with the labs and I will be doing that every day… The clopidogrel. I had the low phosphorus food coming tomorrow or Tuesday from Weruva and the one he’s getting now is as well. Low carb and low phosphorus.
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Which heart meds? I thought you already had started the Clopidogrel? That’s very important. Tastes awful though. You need to gelcap it.
 
alexMama said:
1pm: 66
Is it my understanding that the level on a relion monitor is about 18 points lower than the alpha track? So in reality he’s really in the 80s if we were doing the vet/Alpha track monitor? So what numbers are you thinking are concerning then on my monitor?
40’s and lower correct?
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Wait. You are using a ReliOn meter at home to measure his BG. So the “take action” number (does not mean a hypo) is below 50. So high carb is given with a number below 50.

If you were using an Alpha Trak meter at home the “take action” number is 68.
 
alexMama said:
l

only right when he got his shot… Just before actually after I got his AMPS number
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Okay that explains the steep drop of this morning. He needs to eat regularly during that first half of the cycle— starting at least at +2. Hopefully his appetite is back
 
alexMama said:
80 at PMPs… .5 or 1.0? What do you think?
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I would have given only a very small dose like .25 or maybe.5 if I was sure I could stay up with him. And no matter what the dose … he needs those mini meals of a few tsp of LC food at regular intervals. That’s really the key to the cycle.
 
Suzanne & Darcy said:
I would have given only a very small dose like .25 or maybe.5 if I was sure I could stay up with him. And no matter what the dose … he needs those mini meals of a few tsp of LC food at regular intervals. That’s really the key to the cycle.
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Yeah, in the meantime I’m dying with a 101.5 fever, can’t breathe, pain all over and husband asleep and son gamin with friends. I have not been this sick in years and years!
 
alexMama said:
Yeah, in the meantime I’m dying with a 101.5 fever, can’t breathe, pain all over and husband asleep and son gamin with friends. I have not been this sick in years and years!
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Oh my goodness I am so so sorry to hear this! I hope you will get better soon!!!! You should shoot less in order to keep Alex a little higher and just rest! I see he decided to stay in blues for you. Good boy Alex! Get better, Maria!
 
Are you trying the 1 unit the vet recommended? I think it is a good idea so at least you can show/tell them what happened.
I hope your fever has broken.

I have a cat here who will not eat! You know what that is like. Just finished syringe feeding her. I think it’s just due to her sinus infection but I am still taking her in this afternoon. I had antibiotics on hand from the vet — and started them 3 days ago but she has green goop coming out of one side of her nose (the side that was badly damaged by inflammatory rhinitis) and she is prone to these infections because of the internal damage to her nasal structures. I am still taking her in to the vet today because I don’t like to take chances with her and her AKI/CKD.
 
that does not sound fun! Fever has not broken… I’m actually going into my office to grab some things for my listing which is having pictures today and I absolutely felt like death warmed over… Absolutely brutal that I have to be out today but pictures are scheduled for 1 PM so here I am… Alex is definitely not eating as much either we had to syringe feed him this morning as well. Was hoping we would be done with that! I hope your kitty gets better soon!
 
What was his PMPS last night?

It looks like things have stabilized somewhat for Alex. At this point we should be starting to try to follow a dosing protocol for Alex and holding the dose for a longer period of time to actually see what the dose is doing for him. If the dose keeps getting changed frequently then we aren’t going to be able to tell — and his BG may be all over the place.
 
Suzanne & Darcy said:
What was his PMPS last night?

It looks like things have stabilized somewhat for Alex. At this point we should be starting to try to follow a dosing protocol for Alex and holding the dose for a longer period of time to actually see what the dose is doing for him. If the dose keeps getting changed frequently then we aren’t going to be able to tell — and his BG may be all over the place.
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I was completely out of commission yesterday and the day before… This bug really knocked me out so my husband and son were in charge and didn’t quite follow my protocols. They didn’t get the PMPS last night. He’s 175 this morning so I’m going to stick with the one unit.

He was not eating much yesterday finally did later in the day. He had another BM yesterday too.
I still got a mild fever, but my sinuses are just killing me. My doctors office is making me come back in to give me prescription drugs, which is super frustrating since I was just there Friday. The last thing I wanna do is be out and about right now. I literally spent hours and hours yesterday afternoon in the hot bath just trying to stay warm because the chills were so bad and the body aches. This is the worst bug I’ve had in a very, very long time.
 
alexMama said:
He’s 175 this morning so I’m going to stick with the one unit.
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Wait? Spreadsheet says 213. Was there a delay. If you get one AMPS and then another AMPS a little bit later all the numbers are supposed to be in the spreadsheet with an indication of how many minutes there were between the tests (+ .25, +.5, etc.) in roughly quarters of an hour.

Anyway, I’m glad you went with 1 unit. I think the 1 unit should be held for at least 6 cycles— possibly more.
 
Suzanne & Darcy said:
Wait? Spreadsheet says 213. Was there a delay. If you get one AMPS and then another AMPS a little bit later all the numbers are supposed to be in the spreadsheet with an indication of how many minutes there were between the tests (+ .25, +.5, etc.) in roughly quarters of an hour.

Anyway, I’m glad you went with 1 unit. I think the 1 unit should be held for at least 6 cycles— possibly more.
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He was 175 at 6am as i show on his SS and then 213 at AMPS, as shown on SS..
He’s gone down all day today, now 115… but sticking with 1.0 units. I hope that’s ok!!! Tempted to reduce at that level..
 
If you’re following SLGS then you would not reduce unless he drops below 90.

It’s not necessarily what you want to do if you’re going for remission (MPM would be best for that) but it’s a perfectly good dosing method (tried and true) if you want to get him regulated.

Stay with 1 unit for now. He’s doing well on it. It’s far better for him than moving the dose too much. After 7 days on 1 unit we can reassess and see if it needs tweaking to 1.25.

If he drops below 90 — then his new regular dose going forward would be .75. If after a few days he isn’t doing well on .75, we could take him back up to 1 unit.

Alex has been through a lot lately and he needs that stability. Many cats also need more than a couple of days for a dose to settle.

I am taking a cat to University of Georgia today and won’t be around much.
 
It looks like Alex has earned another reduction down to .5 units, although if you want to keep him where he is, then just change your signature and spreadsheet header to MPM (as long as he’s not eating dry food) and keep the dose where it is now. His numbers are soooo much better. If he is eating dry food then put “Custom” for the dosing method and put your reduction point, e.g., “Reductions below 65” or whatever you choose. He’s already had a 69 I see, so that’s why I said 65.
 
alexMama said:
How did he earn the additional .25 reduction?
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He has earned a reduction on many occasions in the last few days. Every time he drops below 90, if you are following the SLGS dosing method, he earns a reduction. Alex has gone under 90 a total of 9 times since starting the .75 unit dose. According to SLGS, that means he’s earned a reduction (well, he earned the reduction the first time he dropped below 90, which was back on March 13. He has dropped below 90 eight more times since then.

Now I am not saying that he has been in any dangerous BG numbers because I don’t see any and I think Alex is doing great! That is why I tried to explain (above) some options above regarding dosing protocols. It depends upon your goals for Alex and where you want to keep his BG. Target nadirs for SLGS are between 90 and 150. Target nadirs for MPM are between 50 and 120. If dry food is in the picture you should not follow MPM. For safety reasons but you an choose a higher custom reduction point of around 65-70 if you would like to.

How is Alex doing overall? How is his breathing rate and activity level. Have you gotten an appointment set up for a followup with the cardiologist? I was really pleased to see him doing so well with his BG when I checked in on his SS today, but that doesn’t tell me about how he is overall.
 
Suzanne & Darcy said:
He has earned a reduction on many occasions in the last few days. Every time he drops below 90, if you are following the SLGS dosing method, he earns a reduction. Alex has gone under 90 a total of 9 times since starting the .75 unit dose. According to SLGS, that means he’s earned a reduction (well, he earned the reduction the first time he dropped below 90, which was back on March 13. He has dropped below 90 eight more times since then.

Now I am not saying that he has been in any dangerous BG numbers because I don’t see any and I think Alex is doing great! That is why I tried to explain (above) some options above regarding dosing protocols. It depends upon your goals for Alex and where you want to keep his BG. Target nadirs for SLGS are between 90 and 150. Target nadirs for MPM are between 50 and 120. If dry food is in the picture you should not follow MPM. For safety reasons but you an choose a higher custom reduction point of around 65-70 if you would like to.

How is Alex doing overall? How is his breathing rate and activity level. Have you gotten an appointment set up for a followup with the cardiologist? I was really pleased to see him doing so well with his BG when I checked in on his SS today, but that doesn’t tell me about how he is overall.
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Ok understood!!
I could try .5 and see how he does! We just don’t want him to get higher numbers and have been pretty happy with where he’s at!

Alex is doing amAzingly well!!! We have our old kitty back!!!! Cleaning himself, hind legs almost back to pre February conditions, great resp rate, totally normal 24-28 on avg..
He is back to his old self and sleeping in his usual spots, begging for food again, but he’s also being picky about his food he eats now!
He was Never a picky eater, but is now! He does NOT have dry food anymore. Only wet food. We are doing Weruva Phos line of foods for low phosphorus content.
I will be taking him back at the end of the week for a recheck on his liver enzymes to his regular vet. We also ordered the Purina pro plan hydra care, which will be here on Friday.
He is taking 1/4 pill of Lasix daily, his 1/4 of Plavix daily, Zobaline supplement daily and will start the Hydracare Friday as well as RenaKare Potassium supplement that arrives tomorrrow.
We aren’t sure how he managed to get back to the condition and why his blood glucose/diabetes is so well managed now, but we are very thankful that he is in such better spirits and overall condition… we weren’t sure if we would old Alex back as bad as things were getting. I’m so glad because our daughter will be home Thursday and she’ll get to see her kitty as she’s used to seeing him!! he’s got his spunk and his personality back and it’s just so great to see!!!
Thank you again for all of your help and advice!!
I have not been as up on the board and on his chart in the last week as I have gotten really busy with work and new listings…
It will be very anxious to see his liver enzyme numbers because I just have to believe they must be a lot better based on his clinical condition. 🙏🏻🙏🏻
 
alexMama said:
Ok understood!!
I could try .5 and see how he does! We just don’t want him to get higher numbers and have been pretty happy with where he’s at!

Alex is doing amAzingly well!!! We have our old kitty back!!!! Cleaning himself, hind legs almost back to pre February conditions, great resp rate, totally normal 24-28 on avg..
He is back to his old self and sleeping in his usual spots, begging for food again, but he’s also being picky about his food he eats now!
He was Never a picky eater, but is now! He does NOT have dry food anymore. Only wet food. We are doing Weruva Phos line of foods for low phosphorus content.
I will be taking him back at the end of the week for a recheck on his liver enzymes to his regular vet. We also ordered the Purina pro plan hydra care, which will be here on Friday.
He is taking 1/4 pill of Lasix daily, his 1/4 of Plavix daily, Zobaline supplement daily and will start the Hydracare Friday as well as RenaKare Potassium supplement that arrives tomorrrow.
We aren’t sure how he managed to get back to the condition and why his blood glucose/diabetes is so well managed now, but we are very thankful that he is in such better spirits and overall condition… we weren’t sure if we would old Alex back as bad as things were getting. I’m so glad because our daughter will be home Thursday and she’ll get to see her kitty as she’s used to seeing him!! he’s got his spunk and his personality back and it’s just so great to see!!!
Thank you again for all of your help and advice!!
I have not been as up on the board and on his chart in the last week as I have gotten really busy with work and new listings…
It will be very anxious to see his liver enzyme numbers because I just have to believe they must be a lot better based on his clinical condition. 🙏🏻🙏🏻
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I agree that we want Alex’s numbers to pretty much stay where they are. That is why I gave you options for keeping at his current dose. However, I have seen a lot of cats surprise us by continuing to do well after a reduction. You should just give him at least 2-3 days before deciding if you consider it a failed reduction and going back up. You can’t tell how a dose is doing until it has a few days to settle. Now if you saw a dramatic upward swing that would be different. I am happy your daughter will be home to see Alex doing so great!
 
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