Dose advice? - Nelson lost his AMPS spike today

Status
Not open for further replies.
Danny&Nelson

Danny&Nelson

Member Since 2012
Hi all ... i posted a while back. Nelson has been coming along ok (with a few wrinkles along the way) for the last 5 weeks. We seem to have settled on 2 1/2U x 2 per day (3 was too much, 2 was too little) and getting some nice numbers in the last 10-11 days, except for a predictable PMPS spike and sometimes an a.m. one as you can see from the SS. But today Nelson had no PMPS spike at all, it's been a nice flat line all the way through which i've never seen before with his numbers. So of course i'm fantasising that he's spontaneously decided to cure himself tonight! :smile: A bit premature i know, but it is odd if you look at the SS. 2 hours to go till the next PS check, we'll see. Danny.
 
Re: Nelson lost his AMPS spike today

He's been pretty good, eating well, mostly back to normal, maybe a little less energetic than before the whole thing happened. I just took his AMPS level and it was still on the flatline! So bizarre. Now i'm not sure if i should give him his shot or not. I'll wait another hour and see if it moves.

saimasmom said:
So glad to hear this great news about Nelson! How is he feeling?
Click to expand...
 
Re: Nelson lost his AMPS spike today

I suppose i should go ahead and give him his shot so long as he hasn't gone below say, 100 (u.s. numbers)? Still waiting another hour or so.
 
Re: Nelson lost his AMPS spike today

Danny, I am not experienced and can't offer advice on whether to shoot, but could you change your subject line to indicate you have a dosing question? You would do this by editing the first post of the thread, I believe. You can add the question mark icon or just say "Dosing question" in the subject line. Meanwhile I am hoping that by bumping this to the top, you will get some more eyes on it. Good luck!
 
Re: Nelson lost his AMPS spike today

Nice!! :thumbup :thumbup That flat line is just what we want to see!

This is a lower number than you usually shoot and it is sliding down but not fast and still within meter variance. If you will be around to monitor I think it is a good idea to shoot. It looks like you are starting to get some overlap in the cycles, which is a good thing. Hopefully the last dose will begin to wear off just as the new one starts to take effect.
 
Re: Nelson lost his AMPS spike today

I might just leave it as is since i'm not really worried or desperate for advice so much, i just was interested in the fact that for the first time he's had no spike. i'll test again in half an hour or so and if he's below say 160 or thereabouts i'll skip it and check again when i get up (going to bed in a while, i keep strange hours). i just spoke to the 24 hr vet hosp where he stayed for a while when this all started and that's the advice they gave. after all, i gave him his last shot when he was about 160 and he was fine after that but much lower than that i'd rather wait. the flatline in the normalish range is happening in the presence of insulin (so far), so of course its entirely possible that i withdraw the insulin and we go back to where we were (i.e. he spikes again). danny.

saimasmom said:
Danny, I am not experienced and can't offer advice on whether to shoot, but could you change your subject line to indicate you have a dosing question? You would do this by editing the first post of the thread, I believe. You can add the question mark icon or just say "Dosing question" in the subject line. Meanwhile I am hoping that by bumping this to the top, you will get some more eyes on it. Good luck!
Click to expand...
 
The flatline continues

Just tested 2 hrs after he was due for a shot at 4 am And he's 95 (5.3) .. I might squeeze in one more test before we go to sleep, seems unlikely it'll be high enough for a shot and we're going to bed in half an hour. Is spontaneous remission really too much to ask for?!? :-D
 
Re: Nelson lost his AMPS spike today

the short answer is yes. it doesn't work that way to go from 2.5u to zero. what you are seeing right now is lantus has a nice long duration and you're getting some overlap - it's the perfect time to shoot lower numbers and hold his overall BG numbers down.

i wouldn't call his numbers flat, but he isn't bouncing, and that's a good thing.

if you can be late 2 hrs with his shot tomorrow, i'd shoot now and then gradually work your way back to your regular time over several days.
 
Re: Nelson lost his AMPS spike today

Agree with Julie, you should shoot now if you can. It's better to give something (even a half dose) than nothing at all.
 
Re: Nelson lost his AMPS spike today

Thx Julie and others. I skipped the shot before seeing your suggestions of a lower dose one. We just got up and i tested him and he was 401 (22.3) which is sort of where he has been at lately before the pm shot, or even a bit lower, which is interesting as well after nearly 24 hours. I expected that if he would spike up it would go way up. So ... let's say i find myself in the same situation today or tomorrow or whenever, i wonder what a reasonable amount to inject would be (rather than as you say Julie, going from 2.5 to 0)? Any suggestions? I'm thinking maybe 1 or 1 1/2? I'm afraid i'm not quite ready to gird my loins for doing the tight protocol just yet, although i've read it and it looks do-able although potentially very tricky. Thanks. Danny.
 
very nice!

I see that Nelson hit a 50 last night. Did you retest after that? What number is he at now?

Rather than reducing by a whole lot, I would reduce by just a bit. If you reduce by too much, you risk losing all the progress you have made. He looks really good on this dose, but it is just a tad too much now. Usually we reduce by 0.25 units at a time, which would be 2.25u, but if you want to be more conservative you can go to 2u. Even though that dose wasn't enough for him before, it might be now.
 
hi danny! funny how this forum works and the cats and their stories get into our brains - or at least into mine! i woke up this morning nearly 2 hours ago (5am my time) and was trying to go back to sleep, but really thinking about your question and nelson. so thought i'd return to you this morning.

you asked if cats go into remission like that - but really the question we can answer is "do cats become diet-controlled?" that answer is absolutely. we have about one cat every week or two become diet controlled. We've been celebrating with Amy because Ruby's OTJ party has been this week. once a cat is diabetic, they remain diabetic but they may be able to become controlled with only a proper low-carb canned food diet. if they go back to eating a higher carb diet, they return to needing insulin. I'm unaware of any cat that has gone off of insulin while still eating dry food. perhaps it's happened, but i don't know of any. reducing the carb load allows the insulin dose to drop, the pancreas sputters back to life, and then some cats are able to go off. the dose they go off from is usually .25 or sometimes less, perhaps even .5u if the cat is very newly diagnosed, but i've never seen a cat still needing a larger dose go off.

in your situation yesterday, nelson is giving you signals that he's ready for an opportunity. having a cat stop bouncing is fantastic - and he was coasting along very nicely without bouncing. i just hate hate hate to say it more, because i know you've already heard it a hundred times & don't like to hear it, but dry food carbs are like giving him ice cream, candy and cake every day, increasing the insulin dose to compensate for those carbs, and then hoping he is going to do better. it's one of those truths that there is just no way around, and i don't know how to offer advice without including this every time - because it's that important.

if you decide you can move him off of the dry food, yes, he may be able to become diet-controlled. you won't know til you try it. if you want to make the move off of the dry food, do it gradually because he will not need as much insulin when he isn't getting so many carbs. you would increase the percentage of canned food and slowly decrease the percentage of dry food over the course of perhaps 4-5 days, monitoring for signs that the insulin needs are reducing. dry food carbs can stay 24 hrs or so in the body.

i agree with libby about the dosing. you're seeing progress - it's like gathering momentum and you don't want to lose it.
 
Danny --

Did you not shoot this morning? I think it would have been fine for you to have shot the 122. You have enough experience with testing and if you keep skipping when Nelson is in low blues, you're going to lose all of your momentum.
 
Yes i had to go out for a couple of hours and when i came back at +6 he was 50 (2.8) so i tested twice after that and made sure he ate some more (he ate before i left) and it came up a little. he seems fine. i've read that some cats are totally fine all the way down to 2 or even bit lower. i totally agree about the 2.25U, i was thinking about that earlier tonight. i'm going to really have to squint though with these needles, they don't even have half unit markings so i've been estimating the 2.5 (actually not that hard), but the 2.25 will be a challenge but do-able.

Libby and Lucy said:
very nice!

I see that Nelson hit a 50 last night. Did you retest after that? What number is he at now?

Rather than reducing by a whole lot, I would reduce by just a bit. If you reduce by too much, you risk losing all the progress you have made. He looks really good on this dose, but it is just a tad too much now. Usually we reduce by 0.25 units at a time, which would be 2.25u, but if you want to be more conservative you can go to 2u. Even though that dose wasn't enough for him before, it might be now.
Click to expand...
 
Hi, Nelson!!!

Binks started his journey with bouncing...
then one day he just stopped bouncing and began working his way down the dosing scale to OTJ :-D

here's hoping Nelson does the same for you!

We did have a brief 2 month return to insulin due to him getting kibble & HC canned food-
but he's nicely diet controlled again.

celi & binks
 
julie & punkin said:
but really the question we can answer is "do cats become diet-controlled?" that answer is absolutely.
Click to expand...

Well Nelson is pretty much on a raw meat and canned high protein diet now anyway, he gets very small amounts of the dry m/d, usually only when i want to bring his numbers up a bit. I've discovered some great new foods that it turns out he really likes, like kangaroo meat which i dice up small, it's very lean and nutritious plus a few of the loaf style Whiskas varieties with turkey/chicken, and the beef one with some gravy.

julie & punkin said:
in your situation yesterday, nelson is giving you signals that he's ready for an opportunity.
Click to expand...

Yes that's how i feel about it, that he's maybe on the verge of gaining some sort of control and it's just going to take a little more persistence. We're at about the 5 week point now. i get a bit worried about the lows dropping into the 50s and the fact that i actually have to sleep for a certain number of hours or else i'm not functional and i have no way of knowing how far down he's going while i sleep so as above i'm going to maybe drop down a little to 2.25 as of the next shot and see how that goes. the best i can do at this point for the sleep thing is to leave some food out for him to nibble at during those hours, and i usually wake up a bit early anyway, but still, anything could happen. then again i can't really live in perpetual fear mode :/
 
Yes, skipped entirely, won't be doing that again. Not that his spike before the next one was *that* bad but i'll have to decide on whether i give 1U or 1 1/2 in a similar situation next time. I was a bit iffy about it because i was about to go to bed an hour later (i sleep in the daytime). danny.

Sienne and Gabby said:
Danny --

Did you not shoot this morning? I think it would have been fine for you to have shot the 122. You have enough experience with testing and if you keep skipping when Nelson is in low blues, you're going to lose all of your momentum.
Click to expand...
 
in the early part of the diabetes dance a lot of what we are doing is learning about our own cat. you can just add last night's experience on to what you've learned - skipping a shot causes x to happen. it's all valuable information and there will no doubt be another point where you are faced with a similar situation, cuz these things do repeat themselves, and you'll have a better idea what you'd like to do to respond.

btw, the last food you mentioned "with gravy" - the gravy is what has a lot of carbs in it. that would be a good one to use when you're faced with low numbers and wanting to bring him up. if you see a number under 50, you give a teaspoon or so of the gravy from the food, wait 20-30 minutes for it to get in his system and then recheck. the goal is to keep him above 50 while not giving him so many carbs that he jumps too high. i think you probably have the link on "how to handle low numbers" - but if not, it's in one of the yellow starred stickies at the top of this forum. good to have that printed out just in case. it also tells you what to do when faced with a lower-than-you-expected number at preshot.

at some point when nelson hits green numbers, you might want to experiment and see if you can give nelson a little bit of low carb canned - like 2 teaspoons, to encourage him to surf there. the goal is to keep the cat is non-diabetic cat numbers, under 120 on a human glucometer, so that their pancreas will heal and begin working again. the longer he spends in those numbers, the greater the chance of healing his pancreas.

glad to hear the update on his food! i know that's been a tough one. you might want to make note on his ss when you give him any high carb - the gravy food or the crunchies - and see if you see a pattern of response after he eats them.
 
Vyktors Mum said:
I don't know of any whiskas loaf variety with gravy???
Click to expand...

No, the beef one is beef pieces with some gravy, which is good for when Nelson doesn't feel like eating because i know he'll always eat it and lick at the gravy.
 
Status
Not open for further replies.
Back
Top