AMPS 14.4 mmol/L ~ 260 mg/dl DO I SHOOT? (PS never been below 20 mmol/L ~ 400 mg/dl)

[.:. in.active .:.]

His pre-shots NEVER been in the low teens (200s). He gave me the first ever high teen (300s) last night PMPS but before he was always 20+ all the way beyond 40! (400 up to 720)!
Caninsulin is in-and-out... Not a depot. (I posted this thread to the Caninsulin sub part of the forum, but it's dead, so I brought it here as I need and answer!)
We are on the same dose for 12 full cycles. He has NEVER given me this low pre-shot on this dose, in fact only 2 cycles ago (aka yesterday during the day) his now pre-shot number was his nadir!
Did he regulate? He was begging for food, and I saw excessive pee in the litter box this morning.
I tested, then fed (I know now I shouldn't have, should have stalled )


DO I SHOOT? And do I shoot the same dose or lower it?

 

[Bron and Sheba (GA)]

I'm sorry no-one got to you sooner.
It looks like you reduced the dose and gave 3.5 U. I would continue to monitor the cycle.
Next time, I would stall, don't feed and test again in 20 minutes to see if the BG is rising.
It would also help if you swapped to our SS so it would transfer over to the US BG numbers. You would get more help with US numbers in the SS. Also the colours in your SS are quite different to our SS and it is confusing.

 

[.:. in.active .:.]

Hey Bron, thanks for getting back, better late than never

I expected the delay, I'm fully aware most of you are in the US, but I saw 300+ members online at the time, so thought I'd shoot my shot. I ended up doing what thought was best, and shot his shot, hah! I do wonder whether I should've stayed on 4 IU but I panicked, plus last night I could only test him at +4 and +5 (midnight and 1am ugh!) and he seemed a little on the floppy/droopy side thereafter. He was begging for food this morning, and when he is like that, testing is near impossible, I'm even surprised I managed to pull this AMPS off. Rest assured I'll be on his case every 2hrs today.

Q: If his PMPS go back up to between 16.6-22.1 mmol/L (300-400 mg/dl), like last night, do you think I should go back to 4 IU? As it's not a depot, the dose change has pretty immediate effect... or since I dropped it this morning, am I still advised to stick with it for 3-5 days again, like you do when you initially increase it?
This Caninsulin inconsistency is a killer.

Yes I'm aware my sheet is different to yours, but your colour coding and measurements are confusing to me I'm using a more straight-forward traffic light system in mine, where all shades of green is go[od] and red is no go[od]. I also have the mg/dl conversion in the table, and it's stated I'm using a pet meter, so I assumed it'd suffice.

 

[Bron and Sheba (GA)]

Are you giving snacks early in the cycles? They might help stop the early drops he is having.
The 4 units dropped him to 5 a couple of days ago so that is very close to a reduction.
Apart from that one BG at 5, all the other BGs are quite a bit higher.
You can go back to 4 units and see how he goes. If he gets a lower than normal preshot it is OK for you to give a reduced dose as a one off.
Eve, would you mind putting you are using an alphatrak meter in the signature please. Thanks

 

[.:. in.active .:.]

I already have, as realised upon receiving your first reply, that it was missing Shall I put the food and dosing in my signature too?

I'm feeding him twice a day pre-shot, and give him a snack after each shot. Usually a bite or two of cat sticks, which are 4-6% carbs for 100g, so about <0.5% for the mouthful he has, and Lick-e-Lix once a day either after +4 or +6, which works out higher, about 2.5% carbs for the amount he has, however, these never have influenced his next reading.

He has just dropped to <10 mmol/L (<180 mg/dl) at +4 so will test him hourly for now and have the Karo syrup ready, just in case.
See what he gives me in the upcoming hours and will base his evening shot on today's nadir. Due to this morning's events, I pushed the shot back with an hour, to 9am. I will not be able to monitor his +6 tonight as it'll fall to 3am.

 

[Bron and Sheba (GA)]

Shall I put the food and dosing in my signature too?

Yes please.

I will not be able to monitor his +6 tonight as it'll fall to 3am.

Just get the latest test you can and maybe leave some more food out for him.

 

[Sienne and Gabby (GA)]

Can you PLEASE at least use the color coding that we use for our spreadsheets if not transfer your data to our spreadsheet template? The colors that you're using make it far too difficult for those of us that open the spreadsheet of every single cat we are looking at next to impossible to read in an efficient way. If you need help, I suspect that @Bandit's Mom can change over the color coding easily. If you want help from the experienced members here, please make it easier for us.

 

[.:. in.active .:.]

Can you PLEASE at least use the color coding that we use for our spreadsheets [...] please make it easier for us.

Guys, I do understand what you're saying, and I appreciate both your individual responses, as well as the astronomical amount of information this site provides. It is honestly invaluable; I have and am learning heaps from you all!
However, my main concern regarding my spreadsheet is, for it to be easily understood by me. Like this morning, when I had to act semi-quick, in a half-conscious daze. I see why it is not helpful to you, and if each of us members had a different coding it would be mayhem here, but being autistic, using the traffic light system with the mmol/L reading my meter gives, makes a world of difference to me. Especially when my brain has to interpret stuff quickly, on occasions when I know I can't afford to lose time to figure out what pink, yellow, blue etc. represents in which-hundred bracket.
I do apologise, as I understand it's inconvenient for most of you, so I'll keep in mind for the future to post by "your" system/standards, should I have a specific question again.
I do understand you, and I can only hope, even if you can not understand, at least you can try to accommodate me, too.

So let's forget the entirety of my spreadsheet for now if you find it an eyesore, I'll "translate" todays numbers here for you. Mind that I'm using a pet meter in mmol/L, and I put the below numbers into place via looking at Bron's Sheba's sheet re: mg/dl with their allocated colours.

AMPS (14.4) 260
AM+4 (9.8) 176
AM+5 (8.4) 151
AM+6 (5.1) 92
AM+7 (4.9) 88
AM+8 (8.0) 144
edit:
AM+11/PMPS (21.0) 378

Are you giving snacks early in the cycles? They might help stop the early drops he is having.

I literally just came back to fully understand your previous question, Bron - He doesn't seem to have scary and steep early drops, in fact, his nadirs seem to predominantly (and nicely) fall between +4 and +8, which I know is unusual for Caninsulin, but I can't complain.
His BG always seems to be slightly lower during the night, so given today's AM+7 88 nadir, and the fact that his AM+8 was slightly lower than his AM+4, I think I'll likely decrease his evening shot again, just to be safe.

So far my gut hasn't failed me, so fingers crossed. I just hope it's not life playing a cruel trick, giving us false hope, but it turning out to be a genuine example of a possible remission-journey.

edit:
Scratch all the above. This is a bloody nightmare.

 

[Bron and Sheba (GA)]

He earned a reduction in dose dropping to 88 (4.9) at +7 in the am cycle.
The drops I am talking about may not be low drops but they are still big drops. Dropping 10 points in2 hours is enough to trigger a bounce. Giving a snack before the drops can help stop the big drops.

 

[.:. in.active .:.]

OK thank you, I think I'm seeing the pattern you speak of now, with an hourly 5 drop after +2 (onset) and after +3. Then it eases up.
It's like he heard you, I just checked his PM+3 (5.3 drop from PM+2) and the next thing I knew, his head was in the bowl of left out food.
I held the 3.5 IU dose, based on the logic of his PMPS was the same as yesterday's (when he got 4 IU and compared to that, 3.5 IU is a reduction). This was definitely a flawed logic, especially since I know we titrate to nadirs, not pre-shots. I guess I'm staying up until 3am, after all. But I fully deserve this one, so I'll take it to the chin.

 

[Bron and Sheba (GA)]

I’m sorry I didn’t mention the new dose he should be on now. It is 3.25 units as he dropped under 5 (90) on 3.5 dose.

 

[.:. in.active .:.]

Do we do that with Caninsulin then too, not only with depots? (Yes, I read the Caninsulin Dosing thread, and it did make me wonder there as well.)
I'm mainly questioning this, because the vet here only mentions 0.5 units (presumably cause there are no quarter units on the u40s either).
Rest assured, I'll adjust his AM shot.

What bothers me, is his nadirs being at the right spot, whilst his pre-shots are still high. (I realised -albeit quite late- that I can account today's lower AMPS to an external factor, which is always going to be a hit and miss.) With that said a 300s to <100 cycle doesn't count as regulated, because it's not healthy on their system, correct?
So the million dollar question: Given all these sweet-spot (and low ish) nadirs, general insulin reductions yet higher pre-shots, would it still be advised to put him through a switch-over to a depot insulin, or would it be better to stay put and see where Caninsulin takes us?

 

[Bron and Sheba (GA)]

Do we do that with Caninsulin then too, not only with depots?

If you are asking do we reduce in 1/4 unit increments with caninsulin...the answer is yes.

What bothers me, is his nadirs being at the right spot, whilst his pre-shots are still high. (I realised -albeit quite late- that I can account today's lower AMPS to an external factor, which is always going to be a hit and miss.) With that said a 300s to <100 cycle doesn't count as regulated, because it's not healthy on their system, correct?

Caninsulin will not last the 12 hours so a cat will go back up high again when the insulin wears off. And remember your kitty is bouncing because he is dropping fast. Those two things will account for the high AMPS and PMPS. And it is not good for a cat to have such large fluctuations in the BG all the time.
Also nadirs move around, they dont stay in the same place.
A cat is not regulated until he is in much lower numbers than your kitty.

Given all these sweet-spot (and low ish) nadirs, general insulin reductions yet higher pre-shots, would it still be advised to put him through a switch-over to a depot insulin, or would it be better to stay put and see where Caninsulin takes us

Absolutely, I would swap to a depot insulin. You will get much better duration. Most cats settle down quite well once they swap over to a much more suitable insulin.

 

[Bandit's Mom]

Can you PLEASE at least use the color coding that we use for our spreadsheets if not transfer your data to our spreadsheet template? The colors that you're using make it far too difficult for those of us that open the spreadsheet of every single cat we are looking at next to impossible to read in an efficient way. If you need help, I suspect that @Bandit's Mom can change over the color coding easily. If you want help from the experienced members here, please make it easier for us.

However, my main concern regarding my spreadsheet is, for it to be easily understood by me. Like this morning, when I had to act semi-quick, in a half-conscious daze. I see why it is not helpful to you, and if each of us members had a different coding it would be mayhem here, but being autistic, using the traffic light system with the mmol/L reading my meter gives, makes a world of difference to me. Especially when my brain has to interpret stuff quickly, on occasions when I know I can't afford to lose time to figure out what pink, yellow, blue etc. represents in which-hundred bracket.
I do apologise, as I understand it's inconvenient for most of you, so I'll keep in mind for the future to post by "your" system/standards, should I have a specific question again.
I do understand you, and I can only hope, even if you can not understand, at least you can try to accommodate me, too.

Hi @evedroid, Sienne has suggested an elegant solution that works for both of us. I could add a tab/sheet to your SS which would be in our format and automatically take data from your tab. We would look at the tab that is in our format. There would no extra work for you. You would continue to maintain your sheet just the way you like it.

I have sent you a request for edit access to your SS. It will come to the gmail account associated with the SS. Check the spam folder as well since it sometimes goes straight there!

 

[.:. in.active .:.]

A cat is not regulated until he is in much lower numbers than your kitty.

This (and both yesterday's events alongside something happening today) actually brought up a few questions in me on the ECID front... my guy seems to do be the "exemption to the rule" in most of the cases listed re: diabetes.
Housekeeping: Should I ask for advice on those in this thread and change the subject on top, or am I advised to open a whole new thread for it?

I could add a tab/sheet to your SS which would be in our format and automatically take data from your tab.

I was thinking of doing the same last night, but I couldn't "crack the code". I've sent you a PM

Edit: I DID IT! I think... If someone can let me know if you can see the FDMB tab on the bottom of the sheet too, that'd be great.