? Bodie-AMPS-719, PMPS- "HIGH"

sadye claxton

sadye claxton

Member Since 2020
okay so we've done a dose of 1.75 consistently now for 6 full and one half cycle and it's not touching his BG readings. So much so tonight that the alpha trak just said "high". I'm very concerned. We took him in for labwork and a prophylactic shot of Convenia Friday. He has a follow up to review labs and treat as necessary this Friday. BUT...

What to do now about his sugars? Okay to increase the dose in the am? I know it's not a FULL 7 days of holding a dose but we're basically there. I know technically I need to do a curve tomorrow before upping the dose .25u but as you can see, we did some mid cycle checks in the beginning, and the 1.75 NEVER brough him under 400. I'm wondering if upping just .25u is even enough increase?

Just getting home from work, so I need to eat and get ready for tomorrow...If I don't respond right away, please know I will be back to check you all's recommendations! THANK YOU
 
tiffmaxee said:
You have not done a curve ever. You have no idea how low this dose is taking your cat which is how lantus is dosed. You need to test more to find this out. Please read the directions for SLGS . If we knew ho low I would suggest an increase of .50 but see if others agree.

https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
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thank you tiffmaxee..I understand we have not done a full curve in the last year. We did several curves when we first started him on the insulin last year. You can see, but it's at the top of his spreadsheet. I did read the SLGS method, that's why I referenced the rules in my post stating, " I know technically I need to do a curve tomorrow". My point was, yes I can do one, but I have been checking between +3-7 as well as AMPS and PMPS during this holding dose and he never went below 400 during those times in this 6.5 days of the 1.75. Which is really worrisome being that he has never been this high...I was worried waiting another day and keeping him this high could be detrimental to his organs. It's not even reading his sugars it's so high tonight. That's scary . But I understand what you're telling me. thanks
 
That seems like a long time to wait for labs. Here is your last post for continuity https://www.felinediabetes.com/FDMB...-pmps-570-6-432-amps-611.248793/#post-2806458

How is he doing generally? Ie. the five Ps, : preening, pooping, peeing, playing, purring? How is his appetite?

To be honest, that's pretty high overall even with AT2, something isn't right, I'd be asking for those lab results sooner than later, or at least a call to be informed of out of range values. Have you been able to test for ketones?
 
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Good. I would want increase by .50 provided you can monitor. Those numbers need to come down for sure. Perhaps the labs will give a clue and there may be an infection. Any signs of a uti?
 
Christie & Maverick said:
That seems like a long time to wait for labs. Here is your last post for continuity https://www.felinediabetes.com/FDMB...-pmps-570-6-432-amps-611.248793/#post-2806458

How is he doing generally? Ie. the five Ps, : preening, pooping, peeing, playing, purring? How is his appetite?

To be honest, that's pretty high overall even with AT2, something isn't right, I'd be asking for those lab results sooner than later, or at least a call to be informed of out of range values. Have you been able to test for ketones?
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he had a day and a half of not eating as good as usual, so we gave convenia which helped. he has history of UTI and protein in his urine. I alerted the vet to what was going on, which was why she wanted to do the convenia just in case it could help while we waited. Everything is taking forever with the vets these days. I'll call tomorrow to ask, but he's going in friday too
he's never been a super active guy. he's older and we just pulled him off the streets a year ago...he's mostly his usual self. Yes to preening, pooping, peeing. maybe not AS playful as usual. but purring and eating...
 
tiffmaxee said:
Good. I would want increase by .50 provided you can monitor. Those numbers need to come down for sure. Perhaps the labs will give a clue and there may be an infection. Any signs of a uti?
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no signs of UTI we can tell..BUT he's got a history of them which are cleared with Convenia. So we did a shot of convenia friday
 
Okay SO the SLGS says not to increase more than .25u ever, no matter how high he gets. Do I stick with that rule in this case?

Say his nadir this 12 hour curve is in the 500's....does that warrent the .5u increase suggested above?
In other words, tomorrow at 8 am when he's due to shoot, how low is low enough a nadir to stick with the .25u increase? And/or what nadir calls for a .5u increase IF if fact that's what suggested?
 
When bg is this high we sometimes increase by .50 and fast track. However considering the number of tests you get please ignore my previous suggestion and increase by .25. You also should be increasing every 7 days if the 7 day curve suggests that you need to increase. Two tests each cycle are suggested at a minimum, amps/pmps and one more.
 
If you are feeding 100% LC wet and can get at least one test per cycle in addition to PS tests, you may want to look at following TR - just till you can get him to better numbers.
Increasing him by 0.25U once a week will leave him in high numbers for too long - not only is it bad his kidneys - it's also harder to break through high numbers once his body gets used to it (glucose toxicity - Feline Diabetes and Glucose Toxicity links)

@Wendy&Neko
 
okay @tiffmaxee and @Bandit's Mom can you please clarify? I'm seeing @tiffmaxee is saying disregard the .5 increase suggestion and stick to .25u increase "considering the number of tests you get"....but I've gotten several tests per cycle in the first days of starting this dose ( more like a TR protocol testing method) and then seeing as the nadirs weren't ever below 400 we stopped checking but we're also getting a curve right now. SO, I would think seeing all my numbers and the fact that I'm testing more now ( and will continue to until we're back in better numbers to go back to SLGS) would suggest a .5u increase as @Bandit's Mom is also saying.

Can you all confirm a .5u increase with more testing is appropriate? Sorry if I'm slow to understand. I'm extremely tired and overwhelmed at this point....thank you all
 
Bandit's Mom said:
If you are feeding 100% LC wet and can get at least one test per cycle in addition to PS tests, you may want to look at following TR - just till you can get him to better numbers.
Increasing him by 0.25U once a week will leave him in high numbers for too long - not only is it bad his kidneys - it's also harder to break through high numbers once his body gets used to it (glucose toxicity - Feline Diabetes and Glucose Toxicity links)

@Wendy&Neko
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and yes he gets Purina DM wet food only with boiled chicken....as he won't eat it without the chicken. Sometimes we have to mix Weruva Chicken Frickazee which is LC or EZComplete...all wet and LC
 
sadye claxton said:
Can you all confirm a .5u increase with more testing is appropriate?
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Yes. That's what @tiffmaxee was saying. She would like you to increase by 0.5U if you can test like you did between 6/16 and 6/19 - that is, 4 tests per day - 1 pershot and 1 more test per cycle. If you cannot test, it's increases of 0.25U per SLGS which is not a great idea considering his numbers.

sadye claxton said:
and yes he gets Purina DM wet food only with boiled chicken....as he won't eat it without the chicken. Sometimes we have to mix Weruva Chicken Frickazee which is LC or EZComplete...all wet and LC
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Purina DM is 6% carbs but Purina DM Savoury Selects is 10% carbs. If he doesn't like Purina DM, you can feed him any other LC wet food - Fancy Feast, Friskies, Tiki Cat, Weruva etc - all have low carb variants. There is nothing special in prescription food (especially for the price) and we find a lot of cats don't like them.

Cat food list - https://catinfo.org/chart/index.php
 
Bandit's Mom said:
Yes. That's what @tiffmaxee was saying. She would like you to increase by 0.5U if you can test like you did between 6/16 and 6/19 - that is, 4 tests per day - 1 pershot and 1 more test per cycle. If you cannot test, it's increases of 0.25U per SLGS which is not a great idea considering his numbers.



Purina DM is 6% carbs but Purina DM Savoury Selects is 10% carbs. If he doesn't like Purina DM, you can feed him any other LC wet food - Fancy Feast, Friskies, Tiki Cat, Weruva etc - all have low carb variants. There is nothing special in prescription food (especially for the price) and we find a lot of cats don't like them.

Cat food list - https://catinfo.org/chart/index.php
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yes! Thank you so much! I've seen this VERY helpful chart and tried quite a few of the low carb options. He's also got IBS, and had constant diarrhea. On the DM and chicken it's been firm stools every day! So for now we've tried not to stray from that as long as he's eating..trying to keep his belly happy. But we do keep others around for when he gets finiky so we can make sure he keeps eating. Will try again with more options once we get his sugars under control! thank you
 
In looking at the dosing in the syringes guides in preparation for upping his dose again, I read not to push extra insulin back into the pen because silicone is in the needle and can contaminate the pen. I had no idea...I have not done that often but am sure I have once or twice while dosing. Of course I won't anymore, but you guys don't think THAT could be his problem right now do you? This pen is only a couple weeks old. Financially it would hurt to buy a new one already but if i need to I will...AY YI! I've done so much wrong, Poor Bodie! I'm trying tho. I'll get it!
 
sadye claxton said:
In looking at the dosing in the syringes guides in preparation for upping his dose again, I read not to push extra insulin back into the pen because silicone is in the needle and can contaminate the pen. I had no idea...I have not done that often but am sure I have once or twice while dosing. Of course I won't anymore, but you guys don't think THAT could be his problem right now do you? This pen is only a couple weeks old. Financially it would hurt to buy a new one already but if i need to I will...AY YI! I've done so much wrong, Poor Bodie! I'm trying tho. I'll get it!
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Does the insulin look clear? Any floaties?
Bodie has been heading higher for longer than 2 weeks.

Where do you buy Lantus from? Buying it from Marks Marine Pharmacy in Canada is much cheaper than buying it from you vet.
https://www.felinediabetes.com/FDMB/threads/buying-insulin-from-canada.203498/
 
Is that 1 pen for $100, or a 5 pack of pens for $100? In Canada the 5 pack is under $200. I'd have to look what Marks is charging, but their price is higher than we pay over the counter. I live 20 minutes away from Marks. We've had members push back insulin a couple times (before they discovered not to), without harm.

If you can commit to at least 2 tests per cycle (preshot plus one other), then I'd increase by 0.5 units.
 
Wendy&Neko said:
Is that 1 pen for $100, or a 5 pack of pens for $100? In Canada the 5 pack is under $200. I'd have to look what Marks is charging, but their price is higher than we pay over the counter. I live 20 minutes away from Marks. We've had members push back insulin a couple times (before they discovered not to), without harm.

If you can commit to at least 2 tests per cycle (preshot plus one other), then I'd increase by 0.5 units.
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thanks @Wendy&Neko Yes, I have committed to at least 2 tests...just did one +6 after his increase by 0.5u this am AND HE'S HIGHER THAN PRESHOT!! IDK WHAT TO DO?! I guess i'll start a new post for today with this new info AND I got labs back from the vet. She said the only thing she really sees that may need intervention right now is low potassium and she suggested possible subq fluids....poor Bodie. Headed to get ketone strips now too but they did check them ( granted it was last friday) and there were none thank goodness
 
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