AMPS: 66, +5=35, +6=62....Dosage advice?

Haley&Diane

Haley&Diane

Member Since 2015
Hi everyone! It's been a bit since I last posted in here it feels like. I finally feel like I've gotten Diane's shots down (it's only been a month but I feel like we've been doing this for so much longer now). I started using relion confirm, switched to AT2 at my vet's request, and just recently switched back to relion for good. AT2 was mainly for my vet's peace of mind while starting out....I can't afford it.

So we started at 1 unit twice a day. I cut out DM dry food and stuck to only low carb wet food. Went down to .75 units twice a day after she dipped down to 62 on AT2. Went down to .5 units after another low dip. Last night she dipped down to high 40s after her PM shot (three hours post). This morning she dipped down to 36!! after 5 hours. Got her back up to 60's with some higher carb food.

My vet says that I shouldn't have given insulin at all when her levels are under 150 on AT. She says I should let her go back up to the 200s and it's better than shooting too low, but she also says Diane isn't regulated. I'm so confused....how do I determine if she is "regulated"?

Should I reduce the dose to .25 units? The vet says to just keep at .5 units and just not to shoot if her pre shot levels are in the normal range....but that just results in her sky rocketing to the mid to upper 200s. Also, is the reduction in dosage a good sign towards hopefully remission eventually?

I know I need to collect a lot more data!! I'm trying to get as much as I can with our work schedule. Today was going to be a curve but my car broke down which is why the earliest I got was a +5 test. I plan to do a curve tomorrow.
 
She's earned a reduction with that 36. Please reduce tonight. What type of food is she eating? Could you please add that to your signature and it would be helpful if you could add which protocol you're following: TR or SLGS?

After looking at your SS again - she earned a reduction last night when she went under 50 (if you're following TR; and if you're following SLGS, under 90 earns a reduction)...so any way you look at it she had already earned her reducie as of this morning. Please check as often as you can - her depot is likely full and she may go lower again today/tonight.
 
Sue and Luci said:
She's earned a reduction with that 36. Please reduce tonight. What type of food is she eating? Could you please add that to your signature and it would be helpful if you could add which protocol you're following: TR or SLGS?

After looking at your SS again - she earned a reduction last night when she went under 50 (if you're following TR; and if you're following SLGS, under 90 earns a reduction)...so any way you look at it she had already earned her reducie as of this morning. Please check as often as you can - her depot is likely full and she may go lower again today/tonight.
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Yes, I will update the spreadsheet! She is following SLGS. I feed 1 can fancy feast pate in AM and 1 can in PM. She also gets 1/2 can around 10 pm as her late night snack to munch on overnight. She gets a greenie treat each time I do a test.

My vet told me not to reduce until I do the curve tomorrow, but if I know she went low that seemed odd to me. I'll start .25 units tonight. I plan to keep testing every couple hours and am going to be home with her the rest of today to keep an eye on her. I'll be home all day with her tomorrow too.
 
Haley&Diane said:
My vet told me not to reduce until I do the curve tomorrow
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Your vet is wrong about that! I have to say it is not going to make him any $$$ if your cat doesn't go hypo. To be very blunt - your vet doesn't understand as much about feline diabetes as the individuals on this forum - and has given you poor advice. Please, please reduce the amount of insulin - IF it's a safe number to shoot. Do not give insulin if she's less than 50. I don't want to scare you but this is serious and you don't want to have to take her into the ER and pay $2000 to get her back - if they can. It happens typically because people blindly follow their vets advice.

You may want to feed her bit more when she indicates she's hungry - rather than a set amount am/pm. I free feed Luci - so unless Diane has a weight problem - it's ok to feed her more frequently - small amounts or whatever she eats. Do you have your hypo kit ready? (High and medium carb wet food, karo syrup or honey, plenty of test strips and lancets)...
 
Sue and Luci said:
She's earned a reduction with that 36. Please reduce tonight. What type of food is she eating? Could you please add that to your signature and it would be helpful if you could add which protocol you're following: TR or SLGS?

After looking at your SS again - she earned a reduction last night when she went under 50 (if you're following TR; and if you're following SLGS, under 90 earns a reduction)...so any way you look at it she had already earned her reducie as of this morning. Please check as often as you can - her depot is likely full and she may go lower again today/tonight.
Click to expand...
Totally agree with Sue, she needs a reduction
 
Sue and Luci said:
Your vet is wrong about that! I have to say it is not going to make him any $$$ if your cat doesn't go hypo. To be very blunt - your vet doesn't understand as much about feline diabetes as the individuals on this forum - and has given you poor advice. Please, please reduce the amount of insulin - IF it's a safe number to shoot. Do not give insulin if she's less than 50. I don't want to scare you but this is serious and you don't want to have to take her into the ER and pay $2000 to get her back - if they can. It happens typically because people blindly follow their vets advice.

You may want to feed her bit more when she indicates she's hungry - rather than a set amount am/pm. I free feed Luci - so unless Diane has a weight problem - it's ok to feed her more frequently - small amounts or whatever she eats. Do you have your hypo kit ready? (High and medium carb wet food, karo syrup or honey, plenty of test strips and lancets)...
Click to expand...
Totally agree here as well
 
Sue and Luci said:
Your vet is wrong about that! I have to say it is not going to make him any $$$ if your cat doesn't go hypo. To be very blunt - your vet doesn't understand as much about feline diabetes as the individuals on this forum - and has given you poor advice. Please, please reduce the amount of insulin - IF it's a safe number to shoot. Do not give insulin if she's less than 50. I don't want to scare you but this is serious and you don't want to have to take her into the ER and pay $2000 to get her back - if they can. It happens typically because people blindly follow their vets advice.

You may want to feed her bit more when she indicates she's hungry - rather than a set amount am/pm. I free feed Luci - so unless Diane has a weight problem - it's ok to feed her more frequently - small amounts or whatever she eats. Do you have your hypo kit ready? (High and medium carb wet food, karo syrup or honey, plenty of test strips and lancets)...
Click to expand...

Thanks! My vet is actually a family member...which does make it a bit difficult/awkward when I disagree with the advice! lol This is her first diabetic patient though, so I'm more heavily relying on this forum while I navigate. I definitely plan to reduce tonight (and trust my instinct when it comes to Diane's health).

Diane does have some weight issues, which is why I try to keep her on a schedule. She used to be 16 lbs, and went down to 9. After we started insulin she's up to 10.5 but anything higher is a bit heavy for her frame. I do have a hypo kit ready though! Lots of high carb fancy feast gravy foods, honey, and many strips and lancets ready if needed!
 
What you can do is take the total amount of food you feed in 24 hrs which looks to be 2 1/2 cans a day and split it up through day and night maybe every 6 hrs and it will keep her satisfied. A times feeder for overnight works great. Just pick up food 2 hrs before insulin shot and the rest you get just prior to insulin.
 
Tanya and Ducia said:
yes, the human meter numbers are used throughout this site.
You have wonderful momentum going on right now!
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Thanks! I'm kind of shocked because she's been only regulated on food for 4 years now...I thought for sure the insulin would be a struggle in getting her numbers regulated but it's been great so far.

Not that I'm at this point yet, but how do people determine if their cat goes into remission? Or how do they test it? I know Diane's not there, but am curious for the future just in case. :)
 
Haley&Diane said:
Thanks! I'm kind of shocked because she's been only regulated on food for 4 years now...I thought for sure the insulin would be a struggle in getting her numbers regulated but it's been great so far.

Not that I'm at this point yet, but how do people determine if their cat goes into remission? Or how do they test it? I know Diane's not there, but am curious for the future just in case. :)
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If course there is a protocol to follow. And the OTJ trial. Can't find the instructions though. I'm sure someone has them.
 
I don’t think your vet understands how Lantus works. She’s probably more familiar with in and out insulin’s that rely heavily on pre-shot values. We dose based on how low a dose takes a cat. On 0.5 units, it takes Diane too low.
 
Copying in the OTJ trial info from elsewhere:

Start the trial on the next green pre shot.

If he/she is green at your normal test times, no need to test further until the next "PS" time; just feed small meals and go about your day. If he/she is blue at your normal "PS", feed a small meal and test again after about 3 or 4 hours. If his/her number is lower 3-4 hours after a meal, then the pancreas is working!

Post every day so we can monitor your progress and see if any tweaks are needed. He/she may have a sporadic blue number. Don't panic but post before you decide whether to shoot so we can have a discussion.

After 14 days of no insulin, we have a party!!

Sometimes the trial doesn't work the first time and we have to give a little more support in the form of resuming insulin. It's not the end of the world if that happens; we just give him/her the support needed. Our goal is a strong remission and it's better to take our time to get that than to rush into remission just to have it fail later on.

Good luck with the trial!!!

Once he/she is through the trial successfully, you enter a new phase. Your cat is still diabetic but has now become diet-controlled. Continue feeding low carb food in the manner successful for your kitty. If you decide to change his/her feeding schedule, let your meter be your guide to the best times to feed. Avoid medications with sugar in them and steroid medications unless they are medically essential. Continue testing blood glucose weekly for the first month and then monthly forever. It's a good idea to weigh him/her monthly. Weight should remain stable. If he/she seems "off" or sick, or is showing signs of diabetes (excessive drinking, eating, urinating, weight loss), test his/her blood glucose right away. Keep the teeth and gums clean and healthy; dental issues can bring a cat out of remission. If you see rising blood glucose numbers, it's time for a visit to the vet!
 
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Haley&Diane said:
I'm kind of shocked because she's been only regulated on food for 4 years now...I thought for sure the insulin would be a struggle in getting her numbers regulated but it's been great so far.
Click to expand...
Haley&Diane said:
Not that I'm at this point yet, but how do people determine if their cat goes into remission?
Click to expand...
there is an instruction info re: the remission and its trials but just as you said - you are not there just yet. (I could not locate the post just now but it is there). In brief: if the cats remains for 2 weeks in the Green numbers like 50 - 80 daily with only occasional Blue up to 120 (not higher) on human meter - without insulin - than the cat is in remission. Low carbs food is the way to regulate FD from that point on which you already know well.

Might I suggest that you post daily for Diane?

- and to talk to people with experience in dosing and, especially, in micro dosing?
Diane's numbers looks so good you might need to provide just a little push for her to go off the juice entirely (touching the wood whilst typing). Reaching remission is rather a delicate process and it is best if discussed with those who went ahead of you and secure their guidance to avoid known pitfalls.

I hope the reduction to 0.25U works for Diane. And if yes - then the next stop for you will be the micro dosing. Could be a good time to invest in Digital Calipers.

Before going off the insulin completely this Board has - and with great success - advocated for the slow transition off insulin - there are doses to try before stopping the insulin entirely which are as small as a drop or so - (something my vet never heard of! - neither did yours, I bet - but the pain of micro dosing is often paid off handsomely BC it secures strong, lasting remission.

Another thing I wanted to mention is that I think that you might benefit from doing TR instead of SLGL.
Please re-read both methods and think about it. you can always go back to SLGL.
TR is not bad at all, not too demanding actually, and testing at strategic times as well as feeding smartly helps a lot with numbers - it puts you in control.
 
Tanya and Ducia said:
there is an instruction info re: the remission and its trials but just as you said - you are not there just yet. (I could not locate the post just now but it is there). In brief: if the cats remains for 2 weeks in the Green numbers like 50 - 80 daily with only occasional Blue up to 120 (not higher) on human meter - without insulin - than the cat is in remission. Low carbs food is the way to regulate FD from that point on which you already know well.

Might I suggest that you post daily for Diane?

- and to talk to people with experience in dosing and, especially, in micro dosing?
Diane's numbers looks so good you might need to provide just a little push for her to go off the juice entirely (touching the wood whilst typing). Reaching remission is rather a delicate process and it is best if discussed with those who went ahead of you and secure their guidance to avoid known pitfalls.

I hope the reduction to 0.25U works for Diane. And if yes - then the next stop for you will be the micro dosing. Could be a good time to invest in Digital Calipers.

Before going off the insulin completely this Board has - and with great success - advocated for the slow transition off insulin - there are doses to try before stopping the insulin entirely which are as small as a drop or so - (something my vet never heard of! - neither did yours, I bet - but the pain of micro dosing is often paid off handsomely BC it secures strong, lasting remission.

Another thing I wanted to mention is that I think that you might benefit from doing TR instead of SLGL.
Please re-read both methods and think about it. you can always go back to SLGL.
TR is not bad at all, not too demanding actually, and testing at strategic times as well as feeding smartly helps a lot with numbers - it puts you in control.
Click to expand...

Thank you for all of this info! I will try to start posting daily. I started the .25 units last night. Her numbers today have been up to 139 and lowest at 106. I'm hoping that she just needs to adjust and her numbers will go down after a few more days on this dosage.

Do you have any videos explaining how to use a digital caliper? It is difficult ensuring I'm even measuring .25 units at this point since it's such a tiny amount. I am definitely interested in investing in a caliper and learning how to use it, especially if she needs to be reduced even further!
 
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