dosage recommendation? 6/19 Julian AMPS 64

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Lucy and Julian

Lucy and Julian

Member Since 2011
Just gave Julian him AMPS test and it was 64. This is by far the lowest he has been since getting home!
The day before yesterday his vet raised the dose of Lantus to 4 units, and I cut out his dry DM and started to feed him on a schedule, and his numbers are plummeting. He usually gets his AM shot now, at 6:30am. I'm going to call his vet at 8 and see what he recommends doing, but does anyone here have advice too? I'm still so new to this, and so far his numbers have all been 241+ when I've given him insulin.
Yesterday his numbers were:
AMPS 502 (he had dry food approx 2.5 hours before AMPS)
+5 413
+6 355
+9 277
PMPS 341
+4 278

this is my post from yesterday: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=45758
 
DO NOT GIVE INSULIN THIS MORNING. Welcome to LL. I'm running out the door but someone will be along shortly. Again, do not shoot this number OKAY?
 
Been waiting to leave for your reply. Please read the stickies at the top of the page. Tell us a little about Julian and his health, age, weight, etc. Set up a spreadsheet. Where are you located, (city, state)? Some will be along shortly. Glad you did not shoot this.
 
Good morning Lucy!

I'm teaching thing morning (work!) so I have only a few minutes. The link to your SS isn't working. Make sure you have the permissions set properly. The should be set for anyone having the link to be able to access Julian's spreadsheet.

I would be extremely cautious about raising Julius' dose when removing dry food. It's very likely that you're seeing the effect that dry food has been having on his numbers. Now that you're feeding low carb, you'll see a difference (and yes, it can be a huge difference). You may need to start at a much lower dose in order to give insulin twice a day. I would get another test in 30 - 60 min. If you are going to rely on your vet for dosing help, you can re-test in an hour.
 
I just changed it so it says anyone with a link can view it :smile:
I will re test in 30 min (+2) and I'll post his numbers! I'm expecting it will have gone up a bit from the food he got this morning.
He is such a handsome man!


I'm really excited to see what an effect regulating his diet has! And it makes me relieved I decided to suck it up and test at home :thumbup
 

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good morning!

it will be interesting to see where Julian's number go today. What this tells us is that 4 units is too much insulin, for right now. Your vet has been extremely aggressive with dosing, and with a diet change too, I wouldn't be surprised if Julian starts earning dose reductions very quickly. Please be sure your hypo toolkit is well stocked. Do you have high carb wet food (like Fancy Feast with gravy) on hand? And some syrup and lots of test strips? You won't need them today since you didn't shoot, but it would be a good time to stock up for the future.

ps. I still can't access your spreasheet.
 
How is the link working now? I think I figured it out... I didnt copy+paste the new url into my signature. Whoops!
Just re tested the little dude-
+2 142

He is getting so good at the pokes!
I agree- I think he is on way too high of a dose, and I'm calling the vet to see what he says about his low numbers :-D

His antibiotics are almost done, just two more days on the horrible Clindamycin drops and the Orbax, nine more days of the liver support Denamarin.
 
Keep up the great work!! Removing the dry food from his diet will work wonders!!!! That alone may make an enormous difference in his #'s. It baffles me that vets still recommend it! I'm excited to watch your progress!
 
Re: dosage recommendation? 6/19 Julian AMPS 64 +2 142

ack... I just realized today is Sunday... and the vet is closed on Sunday.....
I will continue to test him until I go to work at 2 (which will be +8) I have a break at 6 to come home and retest and feed him, and give him insulin if necessary, but then I'll be gone again till 10:30 (+4.5)
Do you guys have suggestions? If his numbers continue to rise, should I let them until his next scheduled injection time?
 
I wouldn't give insulin in the middle of the day unless you are able to keep that shot time as your new schedule. Remember that whenever you shoot, your next shot will be due 12 hours after that one. So yes, if you skip this morning then you would need to wait until your shot time tonight (or at least close to it) to give insulin tonight.
 
Thank you for the advice! I hope for Julian's sake I get all of this understood soon, altho I do feel like I have learned a lot in 2 weeks. Its really scary, but I'm glad to see him improving... that does wonders alleviating my stress. I think I cried every day the first week he was home.
But we are staying positive now!!!
 
Hi Lucy, You are doing fine. It's a good thing that you skipped the shot. I was able to access your spreadsheet both before and after you tinkered with the link, so I guess everyone else can see it now, too.

Your plan for today sounds fine. Continue to test Julian until you leave for work. Do not give a shot until your next scheduled shot time (which would be at +12--6 P.M. your time). If you can get home a bit before shot time, you should test and post the number and ask for dosing advice in your subject line. The very knowledgeable dosing experts here will want to see what the number is before you shoot. So, wait for advice from an expert (Libby, Sienne, Jill, Laurie) before shooting, because they may recommend that you reduce the dose.

Hang in there!

Ella & Rusty
 
Good call on not shooting this morning. The fact that there is nearly always someone here is one of many reasons to get advice here, there is often too much of a delay if you go to the vet. Did he know you were changing foods when he told you to increase? Getting rid of high carb foods makes a huge difference. We really try to change just one thing at a time.
 
Lucy: good job today. You have gotten a lot of good advice so I will only add that you are doing great and so is Julian. Just let us know any time you need help. The good thing is that Julian can't hypo if he hasn't had insulin and he was coming up so hopefully he will give you a number you can shoot tonight and get back on track.
 
Hi Lucy,

I've been alerted to your condo here on Lantus by another concerned board member. We are concerned because 4U is a huge dose of a very good insulin and you are seeing numbers which are very typical of overdose. Yes, OVERDOSE.

Those numbers would be any of the 500s you've seen and the 400s. Then this AM he had a preshot of 64. Please read the pet diabetes wiki on Somogyi Rebound. http://petdiabetes.wikia.com/wiki/Rebound It can be particularly confusing on the longer acting insulins, but I see it all too often, especially with new users.

It is counterproductive to the best use of Lantus or Levemir to begin with too high of dose. Too high of beginning dose is anything above 1U. Julian was begun at 3U. Oddly enough, he had better numbers in the beginning of insulin treatment than after a few days on 3U. That's because 3U is too high to begin at, not because it stopped working and he suddenly needed more. Insulin is unlike other medicine, being a hormone it often takes a minimal amount to see results. It's not fighting bacteria like antibiotics, it's merely doing the job that a stressed out pancreas is unable or having difficulty doing. Also, being a hormone, the cat's weight has little to do with insulin's effectiveness at different doses.

But for tonight, we noticed that you gave 4U again. Yes, his preshot was high, but it's high because of rebound off the 64. Because he's getting so much insulin he could very easily drop to hypo numbers tonight. Please monitor him at least every 2 hours.

Was that 4U given this evening about 6PM? I hope you see this when you get home. Please test him ASAP and you can always post on the Health section if he goes low. I hope he doesn't, but am really concerned so please test him.

Sorry for the intrusion LL folks, I know I don't normally reply here, but this is the 3rd cat I've seen this month coming to FDMB being given more insulin than necessary and I have to speak up. Luckily the owners are hometesting and we can see the effects of too much insulin fairly easily.
 
just saw your posts-
I'm frustrated with my vet, stressed out about his numbers, and I've had a serious lack of sleep thing going on since the start of the month.
Whew.
When I called his vet, he asked me to put a small amount of dry food down for him throughout the day. (1/8th of a cup) He also told me to do another day regulation tomorrow (I have it off from work) and he would advise about decreasing the dose. I don't feel comfortable giving him dry food again, and Julian has been crying constantly for the grazing food he used to have. Which is not doing anything for my already shot nerves, or sleeping situation.
I don't know what to do and I am SO OVERWHELMED.
 
I'll start a new post, too, but his PMPS is 193, and I have no idea how much insulin I should give him. I just fed him, as well.
 
What you're feeling is COMPLETELY NORMAL at the beginning. We have all been there! It totally sucks to go thru it - but so worth it when you start to see the results.

Absolutely, positively do not give any dry food! Period. It will send his #'s right back up.

You have such a high probability to get him off insulin when you start this process sooner rather than later. I got Gizzy off insulin within 2 months when he was first diagnosed and let me tell you all the sleepless nights are soooooo worth it when that happens! After he went into remission I got lazy and started giving him a little dry food again here and there because I felt sorry for him. Wouldn't you know - #'s went sky high again! Luckily he went right back down. That was all the proof I needed - the dry food has been gone ever since. I fed Fancy Feast CLASSIC from that point on. Now I give them raw food from a specialty pet food store, but the Fancy Feast works just great too! I also boil a couple chicken breasts and give him little pieces throughout the day as treats. Julian's hunger will subside when his #'s come down. Get him on a new schedule. I usually feed him at shot time and then again around +2 and +4. Then he goes until the next shot time. That seems to work out pretty well. They are such creatures of habit, so you have to create a new routine....typically within a few days they get it! :mrgreen:

Your vet sounds like mine. She started me out on 4u of Lantus and feeding Dry D/M cat food!!!! You have to stand your ground! I actually turned my vet onto the feline diabetes site so she could read about the protocol - she was skeptical at first, but once she started seeing the results she couldn't deny that it works! I hope through me, they have changed their procedures a bit. If there were only two things I could tell you, they would be to (1) get him off dry food asap and (2) home test before you shoot the insulin.

Stick with it! It's so overwhelming, but do the best you can. You'll make mistakes here and there, that's OK! You'll learn as you go!!

I know you both can do it. GO JULIAN GO! :RAHCAT
 
Definitely start a new post so the more experienced folks can guide you on dosing. Put something like "dosing help needed" in your subject line too!
 
Thank you for the hurrahs! I totally needed them :-D
Yeah, my little man isn't going to get dry food ever again. an average 200 point drop was ALL I NEEDED to "see the light"
I've been feeding him Friskies Turkey and Giblets Classic Pate wet food, and I work at Whole Foods...and have a few friends in the meat department who may be willing to give me extra cuts of chicken for a discount... so maybe I can give him little boiled snackies between his food times.
 
BTW - 193 is a great # so early in the game!! I'm starting to see "blue" #'s - that means you guys are definitely doing something right!! Keep at it!
 
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