Finally got my SS uploaded- Yeah! Question - AMPS now 115 / PMPS 112

Status
Not open for further replies.
TigzMom

TigzMom

Member Since 2015
Hi all
I finally figured out how to upload my SS. Whew! Okay, so I've lowered Tiggy's Lantus from 2 units (x 2) to 1.75 (x 2). His AMPS today was 115 and his PMPS today was 112. He's eating okay. But, I had to give him a little bit more of the Gerber baby food meat (mixed into his Tiki Cat canned meat) in order to get him to eat more. [I couldn't find the no carb Beachnut baby food meat at the store]. I also went to the vets and gave a copy of Tiggy's spreadsheet to the vets along with the blood glucose curve I did for him at home on 4/24/15 (as the vet wanted me to bring Tigz in for that). The vet was super impressed with Tiggy's progress, in addition to being VERY impressed with the spreadsheet. I made sure to give credit to the great folks here for all the fantastic help / support as well as the creation of the spreadsheet and all the other resources.

I figured I'd do another glucose curve tomorrow to make sure Tiggy was stabilizing on this dose. Any thoughts on Tigz progress? Are these AMPS / PMPS levels okay? I think I'm doing okay, but I am not experienced enough with all this. It's great getting the "ok" from the vet, but I guess I just need re-assurance from folks who have a lot more experience regarding this.
thanks so much!
 
I would get some mid-cyucle BG since the 1 3/4 units is quite high for a preshot of 115/112. Also, you got low (66/50) BGs on the 25th
 
Interesting. But Tiggy's BG was originally at 421, so I figured this was going in the right direction.
This morning's AMPS was 77, so I didn't give insulin. He did eat, so I'll recheck his BG but am concerned about giving him his 1.75 units this AM regardless.
 
I would likely give only one unit this evening. It depends on how Tiggy is eating and the PS BG. Could be the Tiggly is on the road of going OTJ (no insulin required)
 
Nice work on the spreadsheet - that makes it a whole lot easier to look at Tiggy's numbers! :) As you're fairly new to all this, skipping with a preshot of 77 is absolutely the right thing to do. :) You'll find as you get more experience, and more data on how Tiggy reacts to shooting a low number, that you'll reach the point where you'll shoot anything above 50 as shooting low tends to help a cat to stay in green numbers - you won't see the same drop in numbers when they start green that you would with a higher pre-shot - but that needs time and data to be safe. :) As far as reducing the dose is concerned, it looks as though you've already taken a reduction when he got to 50 on 4/25 which was fine. Lantus dosing is based on the nadir, not the pre-shot number and we usually only reduce by 0.25 of a unit at a time. I can't see anything on your signature saying which of the Lantus protocols you're following. If you're on SLGS then he has earned a reduction to 1.5 from going under 90. If you're following TR then he needs to go under 50 to earn a reduction so he hasn't actually earned the reduction from 1.75 to 1.5 just yet (though I think he's on his way to getting there).
 
The vet called back as I left her a msg. She is very happy with these numbers. She said that if Tiggy's PMPS numbers were below 170, that he should not have his PM inj either and if his numbers continued to stay between the 60-170 range, he could be kept OTJ. She thought his diet has greatly helped. Fingers crossed!
 
170 is a little outside the "normal" range that we'd generally use for classing a cat as OTJ (normal numbers for a cat are around 40-120) but as always, the decision is yours. :) Good luck to you and beautiful Tiggy if you decide to go with the OTJ trial! :) BTW my first cat was called Tiggy too - I still miss her even though she's been gone for almost 20 years now.
 
Ahh, OK - sorry, I didn't realize no-one from the Lantus sub-forum had passed the links on to you. It's likely not something your vet will be all that aware of but we have 2 main protocols that we use here for Lantus. The links are here, together with the link for shooting low numbers. :)

http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/

http://www.felinediabetes.com/FDMB/threads/lantus-levemir-tight-regulation-protocol.1581/

http://www.felinediabetes.com/FDMB/...regulation-shooting-handling-low-numbers.147/

There is also an explanation on both the protocols of what we would usually class as remission, or OTJ.
 
Is it? I wasn't sure. I asked her where his numbers needed to be to get him off the insulin. All she said is 60-170, but that 170 is just at the low-end of high.
The BG should be below that. If that makes sense.
I certainly feel confident on the info provided here, so I will work toward the 40-120 with Tiggy just to make sure he's healthy. Thanks for the feedback! Much appreciated!
 
Thank you so much for the links. Still pretty new to this so gets confusing. No offense to my vets (I do like them), but people here are VERY knowledgeable RE: feline diabetes. You're all diabetes health educators of the feline world! Love you all!
 
My vet knew nothing about either protocol (and in the main I really like our vet too - they just aren't all the way up to speed on Feline Diabetes). The Tight Regulation protocol has certainly been published on some veterinary information websites but my vet was concerned that she'd never heard of it, knew nothing about it etc, etc. The Start Low Go Slow is, I think, less widely published but it does still work. They wanted me to have a "target" number for Rosa of 180 which I'm sure was too high for her ever to be off insulin - you can see on her ss how long she hung around in numbers below that but still needing a little insulin support for quite a few weeks to get her into normal numbers without her shots. It seems that a lot of vets get us to aim a little higher because they're not used to people home testing the way we do and knowing what to do if a cat does go under 50.

You are very, very welcome for the links and information - I'm sorry I hadn't realized no-one had linked them for you earlier as, although it's a lot of information to take in, understanding what you're trying to achieve and why makes it a whole lot easier to work towards where you want Tiggy to be! :)
 
Thanks again! Where did the start low-go-slow, and the tight regulation protocol come from? Human diabetes patients? Or numerous feline diabetes studies that the vets just isn't aware of?
 
The Tight Regulation is from a study at the University of Queensland. I think this is the original information from the University website. As you can see, the initial study group was fairly small, but the number of people here (and elsewhere) who have been able to use it effectively to get their cats regulated or even OTJ speaks for itself! :)

http://www.uq.edu.au/vetschool/content/ccah/diabetesinfo/link4.pdf

The Start Low Go Slow is, I think, an adaptation of the Tight Regulation that was figured out by people here for anyone who can't test as much or needs more of a "safety" zone for their cat for whatever reason (someone please correct me on this if I'm wrong).
 
Tight Regulation is based on a study by Kirsten Roomp of the Diabetes Katzen message board and Dr Rand of the University of Queensland. It was a collaboration with members of that message board .
 
Status
Not open for further replies.
Back
Top