HELP - Samuka's Dosage Increase? Nadir 259 AMPS+8

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Marianne Lima

Marianne Lima

Member Since 2022
Previous thread: https://www.felinediabetes.com/FDMB...1-year-burnaby-bc-canada.278337/#post-3078958

Good morning guys,

Yesterday I've ran a BG curve on Samuka, and his nadir was on +8 259 (his BG increased from his AMPS, dropping at +8. I am currently giving him 4.75u of Lantus twice a day, and I would like your help if I should increase or maybe even decrease his dosage (he was doing well on 3u in September 2021, until the vet told us to give him only one shot of Lantus per day. Since that it has been very difficult to control his BG)?

Fact: Samuka never lost weight since we started his insulin treatment. He has been fluctuating between 17 to 18lbs even though his diet changed (way less calories than before - when he was free fed -; 85% wet food instead of high carb dry food before...), and he is doing OK with his water intake and pee times (way much better than before starting treatment). Is this something that we should consider?

Also, I have a few questions that the answers may be different than what the vet has been sharing with us:

1. Should I feed Samuka before or after his AMPS/PMPS test? After the test, give him the insulin shot, or feed him and give insulin after?
2. During the BG curve day, should I feed him only at AM/PM (2x per day only), or it is ok if he eats a bit of Fancy Feast; freeze dried chicken; a few kibbles of Dr. Elsey's (max. 10g)?
3. It would be a good idea to decrease his dosage and start increasing slowly after 1 week?
4. I am giving him 1 capsule of Metamucil per day, should I keep with this or maybe stop?

Thank you all for your support!
 
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I’m tagging a few more folks to get more eyes on it. I’d say increase but let’s see what the consensus is.

1. You withhold food for 2 hours prior to the pre shot tests. Then you test, feed and shoot in that order. You want no food onboard before so the test is not influenced by food and then you want food onboard in order to give him the insulin.
2. You can feed him normally when you do the curve just like any other days. Remember smaller meals throughout the day help to avoid big sugar spikes. The only time that you don’t feed before is for the pre shot tests so you can see if it’s safe to shoot. Did you only feed him twice when you did this last curve?
3. @Bron and Sheba (GA) @Wendy&Neko @Sienne and Gabby (GA) @tiffmaxee
4. What’s the Metamucil for? If you’re giving it to him daily, I’d add it to your signature so we can see all the meds he’s on there

:cat:
 
Ale & Bobo & Minnie (GA) said:
I’m tagging a few more folks to get more eyes on it. I’d say increase but let’s see what the consensus is.

1. You withhold food for 2 hours prior to the pre shot tests. Then you test, feed and shoot in that order. You want no food onboard before so the test is not influenced by food and then you want food onboard in order to give him the insulin.
2. You can feed him normally when you do the curve just like any other days. Remember smaller meals throughout the day help to avoid big sugar spikes. The only time that you don’t feed before is for the pre shot tests so you can see if it’s safe to shoot. Did you only feed him twice when you did this last curve?
3. @Bron and Sheba (GA) @Wendy&Neko @Sienne and Gabby (GA) @tiffmaxee
4. What’s the Metamucil for? If you’re giving it to him daily, I’d add it to your signature so we can see all the meds he’s on there

:cat:
Click to expand...
Thank you for your quick reply :D See below my responses:

1. Sounds great, thanks for clarifying! The vet guided us to first give him food, wait 20 minutes, then test the BG and give the shot. I am definitely following the correct order now.
2. During his last curve I did feed him more than 2 times (he had more wet food around AMPS +6.5, and small portions of freeze dried chicken through the day)
4. The vet asked us to give him Metamucil to see if it can help decreasing his BG (it look like it helped a bit). I am adding to the signature right now :)

Thank you!
 
Answers to your replies.
1. That's what people did with the old in and out insulins like Caninsulin. Your vet isn't up to date with Lantus. Note the "don't feed two hours before the shot" is guidelines for new people only. Once you learn how much of a bump in numbers he gets from food, you don't need to follow that rule, but do follow it for now. It's actually better to feed most of the food in the first half of the cycle anyway, when the insulin is strongest.
4. There are lots of extra ingredients in Metamucil that kitty doesn't need. You can buy pure psyllium husk powder in vitamin stores. Dose is 1/2-1 tsp per day, but start lower and work your way up.

Leaving to last #3, the question on dosing. It would be really helpful if you can get at least two tests per cycle, the preshot and one other per day and night. Many cats go lower at night, which means if you can get at least a +2 test or ideally later if you go to bed after that (the before bed test), it'll help us figure out how low he's going on this dose. Until then, I would stay with the current dose and just gather more data. I do suspect he actually needs more insulin, but 24 hours with at least 2 tests per cycle will help us figure that out.
 
Hi Marianne I just wanted to add that I have read it's not advised to use the Freestyle Lite test strips with the Alpha Trak Meter
When you do switch to the Freestyle Lite Meter ,I saw that in your previous post ,I would put that in your signature something like Freestyle Lite Meter as of ,put the date

Also note it on your Spreadsheet up top
It would be also better if you can put a blank line above the date you plan to switch and type Using Freestyle Lite Meter now and highlight it
Also the co!or coding would have to be changed up top just the last two to the far right since it's a human meter, we can have a member here do it for you
Just ask when you are ready :cat:
Oh can you add SLGS to your signature
@Marianne Lima
 
Wendy&Neko said:
Answers to your replies.
1. That's what people did with the old in and out insulins like Caninsulin. Your vet isn't up to date with Lantus. Note the "don't feed two hours before the shot" is guidelines for new people only. Once you learn how much of a bump in numbers he gets from food, you don't need to follow that rule, but do follow it for now. It's actually better to feed most of the food in the first half of the cycle anyway, when the insulin is strongest.
4. There are lots of extra ingredients in Metamucil that kitty doesn't need. You can buy pure psyllium husk powder in vitamin stores. Dose is 1/2-1 tsp per day, but start lower and work your way up.

Leaving to last #3, the question on dosing. It would be really helpful if you can get at least two tests per cycle, the preshot and one other per day and night. Many cats go lower at night, which means if you can get at least a +2 test or ideally later if you go to bed after that (the before bed test), it'll help us figure out how low he's going on this dose. Until then, I would stay with the current dose and just gather more data. I do suspect he actually needs more insulin, but 24 hours with at least 2 tests per cycle will help us figure that out.
Click to expand...
She only found us a few days ago and since then she’s increased the daily testings per our advice :)
 
Wendy&Neko said:
Answers to your replies.
1. That's what people did with the old in and out insulins like Caninsulin. Your vet isn't up to date with Lantus. Note the "don't feed two hours before the shot" is guidelines for new people only. Once you learn how much of a bump in numbers he gets from food, you don't need to follow that rule, but do follow it for now. It's actually better to feed most of the food in the first half of the cycle anyway, when the insulin is strongest.
4. There are lots of extra ingredients in Metamucil that kitty doesn't need. You can buy pure psyllium husk powder in vitamin stores. Dose is 1/2-1 tsp per day, but start lower and work your way up.

Leaving to last #3, the question on dosing. It would be really helpful if you can get at least two tests per cycle, the preshot and one other per day and night. Many cats go lower at night, which means if you can get at least a +2 test or ideally later if you go to bed after that (the before bed test), it'll help us figure out how low he's going on this dose. Until then, I would stay with the current dose and just gather more data. I do suspect he actually needs more insulin, but 24 hours with at least 2 tests per cycle will help us figure that out.
Click to expand...
Thank you for the clarifications :)
Sounds good, I will stop with Metamucil and buy the pure psyllium husk. Do you guys have a way to give the powder to the kitties? I tried sprinkling on his wet food, mixing with Churu, mixing with chicken... he just doesn't eat at all.

I started doing more tests per day only a week ago, but will definitely keep doing at least one test after AMPS and another before bed, after PMPS. I will maintain the 4.75u for now, and will keep testing his BG during the cycle. Yesterday and today I though weird that his AMPS test was lower than the 2nd test, but hopefully he will adjust.
 
Diane Tyler's Mom said:
Hi Marianne I just wanted to add that I have read it's not advised to use the Freestyle Lite test strips with the Alpha Trak Meter
When you do switch to the Freestyle Lite Meter ,I saw that in your previous post ,I would put that in your signature something like Freestyle Lite Meter as of ,put the date

Also note it on your Spreadsheet up top
It would be also better if you can put a blank line above the date you plan to switch and type Using Freestyle Lite Meter now and highlight it
Also the co!or coding would have to be changed up top just the last two to the far right since it's a human meter, we can have a member here do it for you
Just ask when you are ready :cat:
Oh can you add SLGS to your signature
@Marianne Lima
Click to expand...
Hello! thank you a lot for the information. I am going to the drug store today to buy the FreeStyle meter (just to confirm, is this the right one? https://www.londondrugs.com/freesty...3ODCimqo0jACYdjodqxoCrDEQAvD_BwE&gclsrc=aw.ds), and will add the blank line indicating the meter changes.
I will probably use the new meter either tonight or tomorrow morning, and it would be great to have help on the color changing. Thank you for all the support!
I am adding the SLGL to the signature right now :)
 
The husk has a little bit of a taste. A lot of folks will put it in small gel caps and pill them. I had luck with Minnie mixing it to baby food. She liked the baby food so much I guess she tasted it less when it was mixed with it. You just have to make sure it’s protein only baby food with no seasonings like onion and garlic added
 
Unfortunately, I don't think we can get all meat baby food in Canada. You could try making your own. Boil chicken in water and blend the chicken with the resulting stock. Or use turkey or meat he likes. Metamucil has flavourings added. So far I've just been mixing it in with food, do start with a really small amount and work your way up.
Ale & Bobo & Minnie (GA) said:
She only found us a few days ago and since then she’s increased the daily testings per our advice
Click to expand...
Except the last three nights. So I haven't seen any night data since the 4.75 unit depot was built.
 
Wendy&Neko said:
Unfortunately, I don't think we can get all meat baby food in Canada. You could try making your own. Boil chicken in water and blend the chicken with the resulting stock. Or use turkey or meat he likes. Metamucil has flavourings added. So far I've just been mixing it in with food, do start with a really small amount and work your way up.

Except the last three nights. So I haven't seen any night data since the 4.75 unit depot was built.
Click to expand...
I’ve also had luck with those lickable sticks like the ones from Inaba Churo and Nulo. Do you have those there?
 
Marianne Lima said:
Hello! thank you a lot for the information. I am going to the drug store today to buy the FreeStyle meter (just to confirm, is this the right one? https://www.londondrugs.com/freesty...3ODCimqo0jACYdjodqxoCrDEQAvD_BwE&gclsrc=aw.ds), and will add the blank line indicating the meter changes.
I will probably use the new meter either tonight or tomorrow morning, and it would be great to have help on the color changing. Thank you for all the support!
I am adding the SLGL to the signature right now :)
Click to expand...
Yes that's the correct meter :cat:
Let me know when you start using the Freestyle Lite meter and I will tag our members to change the color coding , draw the blank line to say you are using the Freestyle Lite Meter , fix the top of your SS where you have Alpha Trak and add it to your signature
By the way Samuka is a very handsome boy
@Marianne Lima
 
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Wendy&Neko said:
Unfortunately, I don't think we can get all meat baby food in Canada. You could try making your own. Boil chicken in water and blend the chicken with the resulting stock. Or use turkey or meat he likes. Metamucil has flavourings added. So far I've just been mixing it in with food, do start with a really small amount and work your way up.

Except the last three nights. So I haven't seen any night data since the 4.75 unit depot was built.
Click to expand...

I will give a try with the boiled chicken and stock, he liked to lick broths before :)

it was my fault that I didn't recorded the night test for 3 days. I didn't have strips enough and was waiting for the order to arrive, so I had to reduce the number of tests during the time (lesson learned).
 
Diane Tyler's Mom said:
Yes that's the correct meter :cat:
Let me know when you start using the Freestyle Lite meter and I will tag our members to change the color coding , draw the blank line to say you are using the Freestyle Lite Meter , fix the top of your SS where you have Alpha Trak and add it to your signature
By the way Samuka is a very handsome boy
@Marianne Lima
Click to expand...
This was great :) We used the meter this morning, and we got AMPS 185 (I tested with AlphaTrak, and the results were 248!). I've updated my signature, the blank strip, and the top of the SS - thank you a lot for your help, please let me know if is there anything that I should do to facilitate to understand what is going on with this boy :)
Thank you for the nice words :) Samuka loves to pose for photos, I will definitely start adding some nice shots here ;)
 
Marianne Lima said:
This was great :) We used the meter this morning, and we got AMPS 185 (I tested with AlphaTrak, and the results were 248!). I've updated my signature, the blank strip, and the top of the SS - thank you a lot for your help, please let me know if is there anything that I should do to facilitate to understand what is going on with this boy :)
Thank you for the nice words :) Samuka loves to pose for photos, I will definitely start adding some nice shots here ;)
Click to expand...
Great job, I'm going to tag our member Bhooma
@Bandit's Mom
Hi Bhooma can you please change the color codes on Marianne's SS she switched from the Alpha Trak to the Freestyle Lite human meter, she has already put a line on her SS stating Started Using Freestyle Lite Meter.
I don't know if you should note somewhere on her SS that she was as using the Alpha Trak ,what do you think ?
Thanks Bhooma :bighug::cat:
 
Diane Tyler's Mom said:
Great job, I'm going to tag our member Bhooma
@Bandit's Mom
Hi Bhooma can you please change the color codes on Marianne's SS she switched from the Alpha Trak to the Freestyle Lite human meter, she has already put a line on her SS stating Started Using Freestyle Lite Meter.
I don't know if you should note somewhere on her SS that she was as using the Alpha Trak ,what do you think ?
Thanks Bhooma :bighug::cat:
Click to expand...
Thank you a lot for your help! please let me know if is there any other information that you may find helpful - I've included some blood exams that Samuka had once he was diagnosed last year. I need to schedule an appointment to the vet, so she can ask for new exams (hopefully better results).

Thank you all, I really don't have word to express how glad I am to start interacting on this forum. I am hopeful again that this big boy's BG will finally start regulating :joyful:
 
Looks like he’ll be surfing the blues today but you never know. He could drop at around +6 still. Also, don’t be surprised if he bounces tomorrow from the lower numbers today. Maybe not, let’s see. Either way, great job!
 
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