Charlie AMPS 139 didnt give insulin, should I?

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EllieKozak

EllieKozak

Member Since 2014
Hello my friends. I am sorry I haven't posted any Charlie updates lately, there really hasn't been any change in his numbers, until this am! For the first time ever, he had a AMPS of 139. I am expecting a bounce to the moon from this, but I am hoping that his poor body starts to get used to the lower numbers eventually. He has been doing very well overall. He is up to 8.75 lbs, can start to feel a little meat on his bones now. He is still eating 10 cans of food a day, but Ill take it! He was up to 9 units for a few days, but I switched him back to 8 for his last 2 shots due to a "reasonable" pm/am/ps numbers. I hope I did the right thing, and even on his second shot at 8 units is when todays amps came back at 139. No clue as to why it is as low as it is, nothing has changed. Was I right in not shooting at the 139? I will be home most of the day today and am able to get bgs throughout the day. Hope all is well with everyone! Thanks again!
 
If you're home to monitor, I'd shoot it. Absolutely - shooting the full dose into normal numbers is the path to getting a cat's blood sugar to stop zooming up and down. It's better for everyone.

If gettting him regulated is your goal, go ahead and shoot the 8u and then get a +1 and a +2. I'm around today and will check back in on you in an hour.
 
Here's a post I wrote for someone else recently on Shooting low. Maybe it will help you understand what happens when you shoot normal numbers - it can completely change the game for any cat.

If you're not comfortable shooting the whole 8u, you can shoot a reduced dose, but with a cat with a history of ketones (and not very long ago) skipping the shot would be a mistake, in my opinion. You're finally getting an opportunity to change his game. As long as you're prepared to deal with low numbers (less than 50) if they happen, I'd take it.
 
Hello and thank you for the reply Julie. I had to run out this am for one stop and didn't feel comfortable shooting that low quite yet. Of course by the time I got back he had already bounced. I feel terrible that this happened but there was no way around rearranging my schedule today. I am now home for the day, although the bounce has already happened, but I am grateful to the article on shooting low. I have to get a little more courage on those low numbers.
 
Please read the link I gave you above about shooting low - you just have to wrap your head around it.

It's probably not just a bounce, but also from the skipped shot. When cats come to the end of the previous shot's effectiveness, they will often begin to zoom high quickly.

Since you didn't give the L this morning, you could use R now and again in 4 hours to help keep him down until this evening's shot.

Keep in mind that numbers over 250ish are very hard on kidneys and other organs. It looks like you've stopped giving R for the most part, but he's still very high. I would continue to be aggressive with his dosing until you get him into normal numbers, 50-120.
 
Was Charlie tested for acromegaly and IAA? I ask because the attachment in your signature is called Acro Test, but shows only the negative result of 4 for IGF-1 .
Is Charlie's Insulin autoantibodies test result still pending?

With Charlie being ketone/DKA prone, I think you need to be fast tracking his dosing, holding a dose for only FIVE shots, then upping the dose. When you get something like the 139 at shot time, it's good to test again to double check, hold back food, and test again in 30min…. if rising, you could go with a half dose.

You may find that the odd time, with acros at least, you will get some odd 'good' number out of the blue, but it's most times nothing except maybe a hint that you MAY be getting close to your dose. Dose increases will be full units once you reach a dose of 10u until you are getting better numbers, maybe in the 200s for most of your cycles.

If Charlie is found to be IAA positive, you are going to need to be much more aggressive and push for numbers under 50, or your dose will just keep rising. If the 2nd test was not done, you may want to have a draw sent in.
The ketone/DKA issue is a big concern as I know of another person with an IAA cat who had the same issues, was at dosing around 10u+, but she's got her IAA cat down to a dose of 1u or less at times. You will need numbers under 40 to earn your decreases.

You will gain more courage with the more data you gather. With curves, you will see when YOUR cat has lowest numbers and where. One of my cats was lowest around +10-+12, so his numbers at shot time were usually low and I could go with a full dose.
Many times you will find that even a partial shot is safe, especially for a 139, but it is always better to side with safety…. just be prepared for the bounce. We have all done it - get a number lower than usual and we react by jumping back and skipping, then we learn that maybe we would have been OK with a partial shot.
 
A few of us were looking up a low IGF-1 and there may well be another issue…… dwarfism may well explain your low IGF-1 result of 4 so while acromegaly may not be Charlie's problem, a diff pituitary disorder should be considered.
 
Hi there :cool:

Was wondering how you two were getting along. . .

:!: I see you shot 8uL at +16 (from last nights shot) a 4 hour stall. The safe way to get back to schedule is shooting 30min early once every 24 hours or 15min early each cycle until you reach your desired shot time. overlapping more could result in unexpected lows.
If he goes way high you it may be safe take an hour back if you can commit to testing on the overnight. Depends on the numbers.

That weight gain is fabulous news - \M/
EllieKozak said:
He was up to 9 units for a few days, but I switched him back to 8 for his last 2 shots due to a "reasonable" pm/am/ps numbers.
Click to expand...
Remember, Lantus dosing is based primarily on nadir. Also keep in mind with Lantus you are shooting at a BG number 3 hours or so down the road, when onset occurs not at the PS number.
EllieKozak said:
No clue as to why it is as low as it is, nothing has changed.
Click to expand...
A good number of clues are likely to be found in the PM cycles - particularly the the hours between PM+5 and PM+11. . .
Throwing you an AMPS of 139 is a huge change. The weight gain is also a huge change. Charlie is changing for the better :thumbup

Did you have him tested for IAA yet?
My BK, the cat nobody, including yours truly thought would ever get regulated, just celebrated 5 years OTJ! - unbelievable. Living proof that it can happen.
IAA sucks, no two ways about it, however there is a silver lining to the dark cloud of IAA - it's self limiting The day comes, generally 9mos to a year after it starts, when antibody production stops and insulin sensitivity returns. And when it does - reductions happen - fast and furious in leaps and bounds! Never a question of 'if' you should reduce when IAA breaks, more a matter of how much.
So while you are waiting for the return of insulin sensitivity (which will happen regardless of how much insulin you shoot or what BGs are), the goal is to try and keep a kitty ideally in the healing range Julie mentioned, 50-120, for as much time as possible. Anywhere in that range works - 105 is just as healing as 55 - it's all good. Overall under the renal threshold (250ish) is desired to give the kidneys a break. Also while you are waiting try to address any other health issues.

When BKs IAA broke, I was left with a long term diabetic that still had less that ideal numbers and a dose that although half of what it had previously been was still in the 'big gulper' zone. So it was then time to address what in his case was fueling the high BGs- infection caused by his gingivitis and many resorptive lesions.

It was a long road and a whole lotta work (and a whole lotta $$$). But it sure did pay off. :cool:
 
Hi Ellie,

I was just rereading your post from yesterday and wanted to say that you don't need to feel badly about skipping the shot and then shooting 4 hours later. So much of what you're doing still at this stage is gathering information. It is worthwhile to note that he went really high 4 hours after the blue amps - that tidbit of information may be handy another time when you're faced with a blue amps and considering your options. Don't feel badly about it. If you had to run out after +12, it would've been a mistake to shoot the 139 - a new low at amps for him - and then leave. You made the right choice given the circumstances. The time to practice shooting low is when you can monitor afterwards, until you are confident that you know how he'll respond to it.

The way to record what happened yesterday and help you get his ss back in order is to use the amps column like this

amps
+12=139
+16=409

then in the amps dose column record your 8uL and 1uR

The 333, which i think you got 4 hours after you shot, would then go in the +4 column. You're always measuring time from whenever you did shoot. There may be some time in the future that you want to look back and see how he handled things when you had to do x or y (like yesterday when you had to delay his shot) and it will be helpful if you can see what happened.

It's hard having a cat that's not fitting neatly into the program! I had one too - just persist and things will improve. :YMHUG:

Hope you're having a good day!
 
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