? AMPS 224 - How to slowly lower dose potentially?

tackeee

tackeee

Member Since 2019
Post to prior thread:
http://www.felinediabetes.com/FDMB/threads/6-508-need-advice.212421/#post-2354119

Little one is on full day two of recovery after his Thursday dental. He got everything removed except for canines and his upper incisors. His numbers finally slowly started dropping as of yesterday and this am he had an AMPS of 224, which is still too high, but the lowest number I’ve seen in weeks!

I’m planning on keeping his dose at 6 for a couple more days in case post dental and post two week antibiotic shot he actually starts responding to lower doses of insulin. If that’s the case:
1) How do I keep track and lower insulin doses if his numbers continue to drop?
2) what’s the protocol for moving in the opposite direction? After all this, I want to be prepared so he doesn’t get a possible hypo episode.
 
Saw you had not gotten a response yet, just posting to bump your question up the board, hoping someone with more knowledge will respond soon so you are not caught off guard with BG changes that should come after dental:)
 
tackeee said:
Post to prior thread:
http://www.felinediabetes.com/FDMB/threads/6-508-need-advice.212421/#post-2354119

Little one is on full day two of recovery after his Thursday dental. He got everything removed except for canines and his upper incisors. His numbers finally slowly started dropping as of yesterday and this am he had an AMPS of 224, which is still too high, but the lowest number I’ve seen in weeks!

I’m planning on keeping his dose at 6 for a couple more days in case post dental and post two week antibiotic shot he actually starts responding to lower doses of insulin. If that’s the case:
1) How do I keep track and lower insulin doses if his numbers continue to drop?
2) what’s the protocol for moving in the opposite direction? After all this, I want to be prepared so he doesn’t get a possible hypo episode.
Click to expand...
You’ll want to be sure and always get preshot (PS) tests. If you work, grab an out-the-door test and an in-the-door test. At night, grab a PS, +2 and a before bed test. Let the numbers guide you in following the SLGS method for reductions. If he drops below 90, lower the dose by 0.25u. If you are really fighting to keep him above 90, post for help as we might suggest a larger reduction if the dental and antibiotic really affect him with lower numbers.

From what we’ve seen here, it can take a couple weeks to see an effect but ECID. Also, we haven’t typically seen situations where the BG starts dropping so radically that it’s tough to keep ahead of. Normally, we see more gradual and slow changes but, again, ECID, so it’s best to be on your toes.

Always feel free to post for help at any time if he does take some quick drops.
 
With the extractions, there will be some inflammation present for a bit, so as Marje said, still keep track of the numbers and hopefully, you will see a gradual decline in numbers which is more typical, but, kitties can be sneaky.....

I know you are so glad this is behind you!

ETA: With inflammation there will be higher numbers.
 
One slight modification to the above. Since Little One is on a higher dose and thus a higher depot, I would reduce by 0.5 units the first couple of times he goes under 90.

I found it took 7-10 days for the inflammation to come down and the dose need to drop. How is Little One feeling/eating?
 
To follow up on Wendy's question about how Little One is doing, if your usual food is hard for him to eat given the extractions, I'm hoping someone had suggested that baby food (Stage 2 that's all protein and broth -- no veggies) is a good substitute for a couple of days.
 
Sienne and Gabby (GA) said:
To follow up on Wendy's question about how Little One is doing, if your usual food is hard for him to eat given the extractions, I'm hoping someone had suggested that baby food (Stage 2 that's all protein and broth -- no veggies) is a good substitute for a couple of days.
Click to expand...
Good idea, just want to mention some baby foods ie. Gerber and some others have corn starch (carbs). One that does not is Beechnut, which most Walmart’s carry. Also some organics may leave out the corn starch.

Just look at labels and try to find one with just meat and broth. Beechnut has chicken, turkey and beef flavors. From past experience, I think the beef may have a little more smell to it and may be more enticing if your cat likes beef. Maybe try a couple flavors. If you get a different brand, just make sure it is not ham flavor, that is not recommended by vets as it has too much sodium for cats.
 
Thanks all! Little One has been eating well from the first day of post surgery, and he was only on his drugs for a that evening and a half dose the next morning and evening. He's been getting his wet food watered down to a slurry for a few years now, and so he's been good just lapping it up. He's eating, drinking, and using the litterbox as normal too. He's been a bit slow/weak/wonky (assuming from the lingering effects of anesthesia), but that's starting to wear off too. He hasn't slept in my bed since his diagnosis in December, and this morning I woke up to him perched on top of me like old times. He just ate, had his 6 of Lantus and is now sitting under my coffee table purring his little head off.

So his numbers this am PS were 191. Again, still too high, but he's never had that PS number before since his diagnosis! I'll get another in two hours and be on top of it as much as possible. My work some days allows me to get in extra tests, and others not, so I'd rather be more careful and have him slightly hyper than come home to a hypo cat. I've kept it at 6 today, and will see how his numbers look again in the next couple of hours. For days that I know I won't be home, should I give him less insulin even if he's above 90? Is there a threshold for him considering ECID and I've never seen a green testing before?
 
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