Lowest AMPS, I've ever seen for Melty. Do I shoot?

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MeltyCat

MeltyCat

Member Since 2015
Melty has been running high lately, and I'm planning on picking up u100 needles to up his dose to .60u.

However, he's throwing me a curveball this morning at 15.3. This is the lowest AMPS he's ever had. Need some guidance. I won't be around after 8:30, so am considering skipping or giving a BCS dose.

Any help would be greatly appreciated.
 
Hi Nikki. I am not experienced with caninsulin so can't give dosing advice as to what you should do. Hopefully others with experience will reply to your message soon. I just wanted to say I know that feeling of anxiety when you get a lower than usual pre-dose blood glucose level and don't know what to do.
 
Hay Nikki I may not have knowledge of cainsulin but I do with Novalin and both are fast acting and very harsh! Huggles and breath you will make it through this... when was his last BG test and what where the numbers???
 
Hi Nikki?
Did you give the shot? And if so, what dose did you give?

When you get a lower than expected preshot number you have several options available, depending on the data you've collected so far and your ability to test after having given the shot. Usually, folks consider the following options:

1.You can 'stall'; ie, wait, without feeding, to see if the blood glucose rises to level where you're more comfortable giving the shot.
2.You can give a reduced dose, or even a teensy token dose.
3.You can skip the shot.

You may wish to see this from the FDMB FAQ's:

Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?

A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
Below 150 mg/dl (8.3 mmol/L), don't give insulin. Between 150 and 200 (8.3-11.1 mmol/L), you have three options: a.) give nothing; b.) give a token dose (10-25% of the usual dose); c.) feed as usual, test in a couple of hours, and make a decision based on that value. Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
In all cases, if you are reducing or eliminating insulin, it's wise to check for ketones in the urine. Above the normal pre-shot value, give the usual dose, but if the pre-shot value is consistently elevated, it's a good idea to schedule a full glucose curve to see whether a change in dose or insulin is appropriate. In most cases, the target "peak" value should not be below 100 mg/dl (5.6 mmol/L), and for some cats it might be higher. Keep in mind that these are general guidelines, and they should be personalized to your own cat's reactions to insulin. If your experience is that your cat does not became hypoglycemic with a dose which is close to her usual, then your experience should be your guide.
http://www.felinediabetes.com/fdmb-faq.htm#glucose

Just going to have a closer look at Melty's numbers.... Back soon...
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Hi again, Nikki,
Just looked at Melty's SS.

I would certainly suggest reducing the dose, just to be on the safe side. The amount of the reduction would depend on your ability to test after the shot.
(Is there any history of ketones?)

How long are you going to be around for?
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Thank you all for the replies! I fed a bit more and tested again in 1/2 hour. He was at 16.5 by then (Still lower than his usual AMPS, but not by much)

I decided to reduce the dose anyways, since I won't be home to monitor. Gave .25u, tested again an hour later and he was at 15.8, so not dropping too fast for comfort.
 
After reading that it looks super confusing, so here's a summary:

6:30am - fed usual wet meal
7:00am - AMPS 15.3 (gave a bit more food)
7:30am - retest at 16.5 - gave .25u of insulin
8:30am - 15.8

Phil will be checking on him periodically throughout the day, but won't be able to test.
(Melty has suddenly decided that he DOES NOT want Phil testing him, which is a huge disappointment, but not worth the stress to both of them to try to make it happen)
 
Glad you've got things under control, Nikki.

Re the hiccup with Phil testing Melty, for the immediate future try getting Phil to take Melty to his test station and just give him a treat and fusses - no test. The counter conditioning may help Melty associate the activity with yummy things, not pointy things. Hopefully Melty will settle down and then Phil will be able to help with the testing again.
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Good Morning Aine :)

Thank for the tips. I'm sure Phil will have no issue giving Melty some treats to try to re-acclimate him to the testing.
(I have a feeling that testing stresses Phil out and Melty can pick up on that, so I've been sort of having him watch me test)
 
I think you may have identified the problem. I went through a period of increased anxiety about testing Saoirse, and she was much less settled as a consequence. The anxiety can also make one clumsy with the tests, so it becomes a vicious circle. The way I solved the problem was to force myself to speak to her in a really upbeat fashion, praising and praising her. I still felt carp myself but Saoirse did better. Eventually it got easy for us both again, and my technique improved. Fake it till ya make it! It works. :)
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Critter Mom said:
Fake it till ya make it! It works. :)
Click to expand...
I can relate to this for sure! haha.

I'm going to find one of our 4 year olds mismatched socks and fill with rice for Phil as well. Melty has notoriously chilly ears and Phil generally doesn't have 5-10 minutes to sit with him and rub his ears the way I do to warm them up, so I think that is part of the problem. Too many pricks! If I can get the test on the first prick, Melty makes almost zero fuss about it. I think you are right that it will just take some patience, and some time/scritches. :)

Give Saoirse some scritches for me. Hope you are her are both doing well.
<3
 
Nikki. I feel your uneasiness when you get a number that's lower than expected. In my experience with Radar lately there have been lots of times when I wasn't sure what to do because of a number I didn't expect. I looked at Meltys ss and am thinking if you can do a few more tests, maybe this weekend, you can find out more about what's going on between shots. I certainly found that more information was very valuable. Hang in there, Nikki.
 
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