Dosing help needed!

Mrs B. Thomas Mom

Mrs B. Thomas Mom

Member Since 2021
Hello. Thomas has just come off a large bounce over the weekend. The AMPS this morning is 100. Is that too low for the normal 1 unit shot?
 
Just got a 2nd amps, post feeding of 141 You think I should skip or reduce his shot? He's due right now.
 
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How long since the last test and has he eaten since then?

The challenge is that without being able to test, we would not be able to give dosing advice or even ask you to shoot a low pre-shot. I know testing can take a lot of practice initially. Are you using a lancing device or just freehanding with a lancet? Warming the ear or massaging it to increase blood flow?
 
Bandit's Mom said:
How long since the last test and has he eaten since then?

The challenge is that without being able to test, we would not be able to give dosing advice or even ask you to shoot a low pre-shot. I know testing can take a lot of practice initially. Are you using a lancing device or just freehanding with a lancet? Warming the ear or massaging it to increase blood flow?
Click to expand...
Just got a 141 30 minutes after eating.
 
Ok thanks. Sorry for the hand holding. I'm a bit gun shy after the weekend's highs and lows. Yes I'll try to get several tests today throughout the day.
 
My gut tells me to skip the am shot. Does it cause problems if you skip?
Bandit's Mom said:
Not at all! Happy to help! :)

All of this can be pretty overwhelming when you are first starting out. :)
Click to expand...

It sure is. I love my guy so much. He's improving a great deal. I'm determined to get this rythm down pat so I can keep him healthy. I'm so annoyed at my vet. They said there is no need to test...now I'm obsessed with knowing his numbers. Just wish I didn't have to poke his ears. He's tolerate about 3 pokes. After that he gets testy . Going to get better at this. I must!!
 
Hi and welcome. I personally won't suggest that someone shoot if they may not be able to test.:) yes, it will disrupt his insulin depot. Also the cycle count starts over after a skip.
The vet who diagnosed butters also dismissed home testing. He refused to help me with it. We've gone through three more vets since then, but her current vet is very supportive. I've been managing her diabetes with help from members here since the start, and honestly she otherwise would not be doing as well as she is.

So, all that to say don't be sorry for the hand holding, that's why we are all here and it's how we learn. I urge you to post a daily condo for Thomas if you are able.

A few observations from your spreadsheet:
-Is all of your BG data in your spreadsheet? If so, I recommend that, going forward, you always test at the very least before every insulin shot, so at AMPS and PMPS. That's the only way to know with certainty that it is safe to give Thomas insulin. Otherwise, you are basically shooting blind and that can be scary and unsafe, since there are threshold numbers we never shoot below: <90 is the cutoff for shooting when doing SLGS. <50 is the cutoff for TR.
-Also important is consistency in dose. You've been doing that for the most part, giving 1u.
-On SLGS, a reduction is earned if kitty drops <90. Thomas technically earned a reduction on 03/26 and the new dose would have been .75u. I'm not telling you to reduce; I'm just merely offering up an observation.
-The high numbers that you're seeing are very likely Thomas bouncing from a low number...you can see a clear bounce during the day on 03/26: he nadirs at 60 but then is 409 by PMPS. If I had to guess, I bet he was breaking his bounce last night and probably went lower. It would've been good to get a couple of tests in overnight:).
-There are no nighttime tests, so we have no clear picture as to what Thomas is getting up to overnight.

In addition to always getting an AMPS & PMPS, if you can get a +2 test for every cycle? A +2 is usually the "tell" for most cats on Lantus, in regards to what the cycle is going to be like:
If +2 is lower than preshot, it means he is likely going to have an active cycle and go even lower, so you'll want to get more tests in.
If +2 is higher than preshot, it is likely a good day to put away the lancet and take a poke break.
If +2 is similar to the preshot, then it will probably be a typical lantus cycle, with Thomas dipping to nadir and then coming back up. Good to get a midcycle test or two for these types of cycles.

Regarding testing issues, have you tried warming his ear first to help with testing (rice in a sock, and heat it) , and always giving a treat (food treat, brushing, whatever floats his boat)? Consistency is key. I always test butters in the exact same spot. She is treat motivated, so she will come trotting over when she hears me pop the lid on the test strip container. In the beginning, I'd treat her just for jumping onto the testing spot. I'd treat her for letting me hold her ear. And of course, I give her a treat for every test, whether I get enough blood or not.

We all stood where you are now. :bighug: So ask as many questions as you need.
 
He's tolerate about 3 pokes. After that he gets testy . Going to get better at this. I must!![/QUOTE said:
You are giving him a low-carb treat of some kind every time you poke his ear, right? That's important. But you will also get a lot better at getting the blood out more easily and more quickly. I always free handed. A lot of cats don't like the sound of a lancing device (not sure which you are using.) You boy is beautiful! So glad you are not listening to the vet about testing! You have already seen what you miss when not testing.
Click to expand...
 
Butters & Lyla said:
Hi and welcome. I personally won't suggest that someone shoot if they may not be able to test.:) yes, it will disrupt his insulin depot. Also the cycle count starts over after a skip.
The vet who diagnosed butters also dismissed home testing. He refused to help me with it. We've gone through three more vets since then, but her current vet is very supportive. I've been managing her diabetes with help from members here since the start, and honestly she otherwise would not be doing as well as she is.

So, all that to say don't be sorry for the hand holding, that's why we are all here and it's how we learn. I urge you to post a daily condo for Thomas if you are able.

A few observations from your spreadsheet:
-Is all of your BG data in your spreadsheet? If so, I recommend that, going forward, you always test at the very least before every insulin shot, so at AMPS and PMPS. That's the only way to know with certainty that it is safe to give Thomas insulin. Otherwise, you are basically shooting blind and that can be scary and unsafe, since there are threshold numbers we never shoot below: <90 is the cutoff for shooting when doing SLGS. <50 is the cutoff for TR.
-Also important is consistency in dose. You've been doing that for the most part, giving 1u.
-On SLGS, a reduction is earned if kitty drops <90. Thomas technically earned a reduction on 03/26 and the new dose would have been .75u. I'm not telling you to reduce; I'm just merely offering up an observation.
-The high numbers that you're seeing are very likely Thomas bouncing from a low number...you can see a clear bounce during the day on 03/26: he nadirs at 60 but then is 409 by PMPS. If I had to guess, I bet he was breaking his bounce last night and probably went lower. It would've been good to get a couple of tests in overnight:).
-There are no nighttime tests, so we have no clear picture as to what Thomas is getting up to overnight.

In addition to always getting an AMPS & PMPS, if you can get a +2 test for every cycle? A +2 is usually the "tell" for most cats on Lantus, in regards to what the cycle is going to be like:
If +2 is lower than preshot, it means he is likely going to have an active cycle and go even lower, so you'll want to get more tests in.
If +2 is higher than preshot, it is likely a good day to put away the lancet and take a poke break.
If +2 is similar to the preshot, then it will probably be a typical lantus cycle, with Thomas dipping to nadir and then coming back up. Good to get a midcycle test or two for these types of cycles.

Regarding testing issues, have you tried warming his ear first to help with testing (rice in a sock, and heat it) , and always giving a treat (food treat, brushing, whatever floats his boat)? Consistency is key. I always test butters in the exact same spot. She is treat motivated, so she will come trotting over when she hears me pop the lid on the test strip container. In the beginning, I'd treat her just for jumping onto the testing spot. I'd treat her for letting me hold her ear. And of course, I give her a treat for every test, whether I get enough blood or not.

We all stood where you are now. :bighug: So ask as many questions as you need.
Click to expand...

I messed him up on Friday 26th. It was curve day, as my vet asked me to do in order to not go in for a vet visit blood draw. For his am shot, I was talking to my husband when I drew up the insulin. I drew up 2 units, meaning to adjust to 1 unit. I then got distracted and gave the shot. I realized immediately after doing it I doubled his dose. When he dropped to 60 I panicked and gave him high carb rescue food. Which put his numbers through the roof.

I sadly was listening to my vet about testing, which is why I hadn't been doing any evening tests. It was more curiosity testing than anything. I won't do that anymore. I'm just stunned how blasé the vet is about treatment.

I decided to give Thomas his shot this morning and basically do a curve all day. I want to get a true read on him. Now that I have the spreadsheet figured out, and you guys to help me through it, I feel better armed. I just did a +2 test, and he's 120 which is higher than his AMPS thankfully!
 
Welcome. You have gotten lots of good advice from Bhooma and Lyla. Has he eaten since the amps? If so this bg is food influenced which is fine but no guarantee that it won’t be an active cycle. We actually suggest feeding mini meals throughout the first half of the cycle to avoid dropping too low.
 
tiffmaxee said:
Welcome. You have gotten lots of good advice from Bhooma and Lyla. Has he eaten since the amps? If so this bg is food influenced which is fine but no guarantee that it won’t be an active cycle. We actually suggest feeding mini meals throughout the first half of the cycle to avoid dropping too low.
Click to expand...
Yes he did eat. I do give mini meals, glad to hear that's a good thing to do!!
 
May i suggest that you put that 141 as your AMPS and maybe make a note that it was after feeding. I recommend you put the following in your AMPS cell: 100; 141@12.5.
See for ex:
upload_2021-3-29_18-14-14.png


Otherwise i want to assure you that all of us have passed thru testing horrors and it gets better, pretty quickly :) and don't be stressed about testing, our Chico is purring while we do it :)

It is frustrating to hear so many people complain about vets not recommending or even discourage testing... ours just didn't care :D

Otherwise you are doing a great job at testing. With newly diagnosed cats it is easier to turn it around (you can check Chico's spreadsheet), so you are lucky to have found the forum so early on :)
 

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Marina & Chico said:
May i suggest that you put that 141 as your AMPS and maybe make a note that it was after feeding. I recommend you put the following in your AMPS cell: 100; 141@12.5.
See for ex:
View attachment 60367

Otherwise i want to assure you that all of us have passed thru testing horrors and it gets better, pretty quickly :) and don't be stressed about testing, our Chico is purring while we do it :)

It is frustrating to hear so many people complain about vets not recommending or even discourage testing... ours just didn't care :D

Otherwise you are doing a great job at testing. With newly diagnosed cats it is easier to turn it around (you can check Chico's spreadsheet), so you are lucky to have found the forum so early on :)
Click to expand...
Thank you!! It's nice to have the support
 
Looks like Thomas is back to business. Might be worth getting another test soon. FWIW, in all likelihood the greens were due to the incorrect 2u dose given, which is why it made sense to me to hold the dose, and continue to test, including spot checks mid cycle especially at night. Others of course may have a different view.

Last night he was breaking the bounce, might have been interesting to see a before bed test.

If you are giving snacks, especially during more active cycles, it will help you and those checking his SS to note in the remarks what % carb you are feeding when and how much. It becomes more important when you need to intervene with higher carb food, since you then get a feel for how the carbs are influencing the cycle. As I said yesterday, this is part of the process in learning how your cat responds to insulin and carbs.

Lastly, we do have a guideline for posting here in the LBL subforum, since it can get quite busy, please have a read :)

https://www.felinediabetes.com/FDMB/threads/posting-guidelines-please-read.231511/
 
Christie & Maverick said:
Looks like Thomas is back to business. Might be worth getting another test soon. FWIW, in all likelihood the greens were due to the incorrect 2u dose given, which is why it made sense to me to hold the dose, and continue to test, including spot checks mid cycle especially at night. Others of course may have a different view.

Last night he was breaking the bounce, might have been interesting to see a before bed test.

If you are giving snacks, especially during more active cycles, it will help you and those checking his SS to note in the remarks what % carb you are feeding when and how much. It becomes more important when you need to intervene with higher carb food, since you then get a feel for how the carbs are influencing the cycle. As I said yesterday, this is part of the process in learning how your cat responds to insulin and carbs.

Lastly, we do have a guideline for posting here in the LBL subforum, since it can get quite busy, please have a read :)

https://www.felinediabetes.com/FDMB/threads/posting-guidelines-please-read.231511/
Click to expand...
I'll check that link out here shortly. I just tested him again +8 ~ 119. I'm so excited, today has been great so far. He's so active and bright eyed ❤.

I alternate feeding him Friskies pate and FF pate. I cut a serving in half of a Friskies can. Whole can if FF. I'll have to research how to get the carb content of those. A snack is usually chicken breast chunks, a treat when testing is chicken or freeze dried salmon.

He's one of my 8 cat tribe. I switched them all to pate to make sure he's not able to sneak bad stuff.
 
Mrs B. Thomas Mom said:
I'll check that link out here shortly. I just tested him again +8 ~ 119. I'm so excited, today has been great so far. He's so active and bright eyed ❤.

I alternate feeding him Friskies pate and FF pate. I cut a serving in half of a Friskies can. Whole can if FF. I'll have to research how to get the carb content of those. A snack is usually chicken breast chunks, a treat when testing is chicken or freeze dried salmon.

He's one of my 8 cat tribe. I switched them all to pate to make sure he's not able to sneak bad stuff.
Click to expand...
Here is a link for calculating carb content in food, just keep in mind that we are interested in caloric carb content :)
 
Here is a link to the food chart that most of us use for reference...
https://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

Usually people start off in the main forum, and provide a little introduction, so if I may ask, how was Thomas diagnosed? Was he showing symptoms of diabetes? Did the vet run any blood work and urinalysis, or fructosamine? If you have those results, that would be good to share.

Was the diet change from dry to wet food for your crew after Thomas' diagnosis?
 
Christie & Maverick said:
Here is a link to the food chart that most of us use for reference...
https://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

Usually people start off in the main forum, and provide a little introduction, so if I may ask, how was Thomas diagnosed? Was he showing symptoms of diabetes? Did the vet run any blood work and urinalysis, or fructosamine? If you have those results, that would be good to share.

Was the diet change from dry to wet food for your crew after Thomas' diagnosis?
Click to expand...
Sorry I didn't do an intro. I was in panic task mode,, so I didn't really read up on the does and don'ts

I'm a life long cat lady.. I have loved and taken care of around 80 cats betwen feral colonies, strays, rescues and mother cats with kittens we took in..

Thomas was born as a feral under my shed, and I've raised him for 12 years so far.. He has always been a giant cat. People thought he was a raccoon at first glance due to his size. Last November he started dropping weight, but acted normal. Then his thirst, appetite and pees were off the chart, yet he kept dropping weight. In December I had him at the Vet. They did bloodwork expecting thyroid issues, but found high BG levels. The vet had me switch from an all dry food diet to pate only. To see if we could regulate that way. Thomas had no issues with the switch. I have been feeding my tribe of 8 cats boiled chicken breast as a treat for the past few years. So I've continued that as well. I switched all of my cats to wet food, with only one (my 15 year old lady) who won't eat anything but dry food. All was going well, Thomas put weight back on and seemed to improve. Early March, he started dropping weight again, and suddenly stopped eating. Back to the Vet. He was dehydrated, high bg levels (700's), but no keytones or organ failure. They gave him fluids and we started Insulin the next day. Thankfully I work from home so I am able to keep an eye on him. My husband and son are my back up crew.
 
Wow, he sure is lucky to have you! It sounds like the diet change was good for a little while, but he needs some insulin support now. I had wondered about diagnosis and diet change also since there are a couple of ways we calculate/verify a good starting dose, depending on the dosing method being followed. One is based on the kitty's ideal weight (if following TR) and for SLGS a kitty on wet food only would usually have a starting dose of 0.5u, but given that he was in the 700s at diagnosis, I'm not so worried about you starting at 1u.

One of the things you'll notice is people here will do one post each day, with the subject line of date, kitty's name, and then AMPS and subsequent test numbers, so for example today, your subject title would be 30-Mar Thomas AMPS HI, + 5 357. It helps people who are scanning quickly in case someone needs help.

If you'd like to start a new post for today, and let us know how the rest of the evening goes, you certainly can. I see he went higher again after yesterday's blues, but looks like he's coming back down. I'm curious to see where he will be at PMPS.

Again, welcome to the subforum :)
 
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