? MALACHAI AMPS +320-Need help how to test today

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Deena and Malby

Deena and Malby

Member Since 2016
Hello,
Malachai's AMPS WAS +320. It's still high but I have never seen it this low in the AM except for one other time (which someone here thought he may have bounced over those dates?)
I'm still trying to regulate Malachai, understand his numbers better and learn about bouncing from everyone here...
Should I test differently today with an AMPS +320 or just do a regular mid-day and PMPS?
Might have just been an "off" test strip but again, not used to seeing low numbers (for him) in the AM so wondering if this means something??
Thank you!


http://www.felinediabetes.com/FDMB/...e-should-i-increase-dose.180515/#post-1998831
 
Hi! With this being his lowest AMPS to date, I would test again at +2 and +3 to see if his numbers go down or up. If they are the same or lower as AMPS, that means he would have an active cycle. Active cycles mean you need to keep a closer eye on him to be sure he's not dropping too far. Congrats on the lowest AMPS to date!! :)
 
Mandy & Rex said:
Hi! With this being his lowest AMPS to date, I would test again at +2 and +3 to see if his numbers go down or up. If they are the same or lower as AMPS, that means he would have an active cycle. Active cycles mean you need to keep a closer eye on him to be sure he's not dropping too far. Congrats on the lowest AMPS to date!! :)
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Hi Mandy,
Actually he's had a lower AMPS (299), but it's rare to not see him in the 400's or even 500's for pre-shots so I'm still celebrating
Unfortunately, at +1 he snuck in a few bites of his brothers high carb food (CRF cat)....He only got a little but should I still test at +2 now? Not sure how much the HC food will affect his +2? I'll test at +3 for sure.
Can you explain an active cycle more? Why would it be lower on some days that others? Is an active cycle good or bad?
Thanks!!!!
 
This is from a sticky:

Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

An active Levemir cycle will have an onset at approximately +4 and a nadir around +8 - +10. However, please keep in mind every cat is different (ECID). Data collection will offer you a better picture of YOUR cat's response to either of these insulins.
 
I would go ahead and test at +2 anyway because if he somehow dropped even though he had a few bites of HC, that means you need to watch him. Rex would tell me if he was going to have an active cycle at either +2 or +3; it was never the same each time. Plus, if you notice Malachai is dropping way too fast, you want to feed the curve so the drop isn't too drastic to try and prevent a bounce. Active cycles could lead to reductions so in my view, they are good. Are you practicing TR or SLGS?
 
SLGS.
Reached out to this forum last week to try and get some help on getting him regulated and understanding his numbers. I was encouraged to start getting more pretests in so everyone could see what was happening and offer better advice.
He was diagnosed 7 months ago. Originally on Vetsulin but I switched him to Lantus about 3 1/2 months ago. They started him on 1unit but he's at 3.75 now and I still haven't seen him in any low numbers.
I'll throw a party once I catch him in the blue!!!
Again, I'm still trying to learn about everything (active cycles, bouncing) but it's good to know that active cycles can lead to reductions.
I'll post his +2 here in 15 minutes.
Depending on those numbers, would love to know when/if I should snack him to prevent him from bouncing...if that's the case.
 
Mandy & Rex said:
I would go ahead and test at +2 anyway because if he somehow dropped even though he had a few bites of HC, that means you need to watch him. Rex would tell me if he was going to have an active cycle at either +2 or +3; it was never the same each time. Plus, if you notice Malachai is dropping way too fast, you want to feed the curve so the drop isn't too drastic to try and prevent a bounce. Active cycles could lead to reductions so in my view, they are good. Are you practicing TR or SLGS?
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Also, looking at his spreadsheet, even though I don't have many pre-tests and +2's data, the ones I DO have show him lower at +2 than his pre-shot which would suggest an active cycle right!??!
 
Looking at the SS, it doesn't look like Malachai has bounced yet. They all look like typical cycles with nadirs around +5 to +7. The active cycles you are asking about - yes. With him being in higher numbers and not seeming to bounce, I wouldn't worry too much about feeding the curve until he gets into yellows and blues.

Is there a reason why you cannot get a PS (pre-shot) number every time? I encourage you to work on that more. :bighug:
 
Hi there,
Usually when I'm not testing (in the PM) it's because I'm not home and my husband is giving shots. Not testing in the AM is beacuse Malachai is so stressed (physco) for food, it's hard to keep him still. My husband isn't comfortable with taking his BG yet. I know once Malachai is in the lower numbers for safety reasons he's just going to have to man up and do it. I travel a lot for work (sometimes 10+ days at a time), so it definitely stressses me out worrying about him when I'm gone.
Again, I'm still learning here, why are we testing the +3 now? Seems like he is in safe numbers and I should try and test him at his Nadir? Again....learning :) Thanks!!
 
Deena Traina said:
Hi there,
Usually when I'm not testing (in the PM) it's because I'm not home and my husband is giving shots. Not testing in the AM is beacuse Malachai is so stressed (physco) for food, it's hard to keep him still. My husband isn't comfortable with taking his BG yet. I know once Malachai is in the lower numbers for safety reasons he's just going to have to man up and do it. I travel a lot for work (sometimes 10+ days at a time), so it definitely stressses me out worrying about him when I'm gone.
Again, I'm still learning here, why are we testing the +3 now? Seems like he is in safe numbers and I should try and test him at his Nadir? Again....learning :) Thanks!!
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+3 will not be food influenced. AMPS and +2 were almost the same with the 20% variance with the meter. If there isn't much difference, then you can wait and get a +9 just to fill in that row a little more. :)

Have you tried giving Malachai a treat to settle him a little so you can get an AMPS? Or have you tried to check while he's eating?

That's hard when you have to travel a lot for work. That's great your DH is willing to do the BG once you get into lower numbers.
 
Yeah I usually have to test him in the AM while feeding him so he stays still (I mix a teaspoon of his food with water). But sometimes, he's so frantic and hungry, he'll lick it up in a second before or I can test him or just shake his head profusively (won't let me get to his ear).
I'll try and go back a few times to get more food and test again but sometimes I just don't have any luck and don't want too much food in him influencing his AMPS number.
Going to test his +3 right now....
 
All right. I just saw the +3. You can take a break and grab a +9 like I suggested if you are around. I will pop in on you in a few hours. :)
 
AMPS-320
+2 363 (possibly higher due to HC)
+3 343

Thoughts?
I'd still like to test him at his Nadir today to see how low he goes. Sometimes when he starts the day low (low for him), he just stays there all day, like he might just coast in the mid-300's all day and never drop lower? It's so confusing! I'm hoping that doesn't happen today and that I can actually catch him in the yellow which technically should happen given his AMPS number....
 
If you want to test at nadir, that's your choice. I was just giving a suggestion of checking at +9 if you wanted to take a break for a few hours. If you do not see any blues for 2 more days, do another increase to 4 units. :bighug:
 
Yeah I 've only seen him in the yellow a handful of times. Never seen him in the blue at all! I'm sure he'd be fine with an increase! Just wish I could get him down!!!
Thanks for your help this morning!!! Appreciate everyone on this site for always being there!!!
 
Mandy & Rex said:
If you want to test at nadir, that's your choice. I was just giving a suggestion of checking at +9 if you wanted to take a break for a few hours. If you do not see any blues for 2 more days, do another increase to 4 units. :bighug:
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I really don't understand why his numbers are just staying flat!? 320-363-343-324???? I would have expected to see him in the 200's today with a AMPS OF 320. I just understand why I can't get him in the yellow and why he didn't go lower today? Any ideas?? I'm so frustrated
 
Deena Traina said:
I really don't understand why his numbers are just staying flat!? 320-363-343-324???? I would have expected to see him in the 200's today with a AMPS OF 320. I just understand why I can't get him in the yellow and why he didn't go lower today? Any ideas?? I'm so frustrated
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Lantus does give you a flat cycle. You just haven't found the breakthrough dose yet. If you look at Rex's SS, you can see he was staying flat in the high numbers before I found the magic number. I do think you're getting close!
 
Mandy & Rex said:
Lantus does give you a flat cycle. You just haven't found the breakthrough dose yet. If you look at Rex's SS, you can see he was staying flat in the high numbers before I found the magic number. I do think you're getting close!
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Gosh I hope we're close! It just worries me as last month he was double dosed at 6units!!! While I did give him a little HC food (as suggested by the great folk here who walked me through that day), he never went below 259! On 6units!
While I know his body might have just gone into self defense mode to keep him safe, I am just worried he's a high dose cat or something else is going on. Crossing my fingers he'll start going down though!
 
Deena Traina said:
I am just worried he's a high dose cat or something else is going on.
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Cats need as much insulin as they need. As long as you have the data to say it's safe to do so, keep increasing as per the dosing guidelines. You WILL find a dose that moves him, whatever that dose is for Malachai. :bighug: If you are worried about other conditions, have you talked about that with the vet or had recent bloodwork done?
 
Wendy&Neko said:
Cats need as much insulin as they need. As long as you have the data to say it's safe to do so, keep increasing as per the dosing guidelines. You WILL find a dose that moves him, whatever that dose is for Malachai. :bighug: If you are worried about other conditions, have you talked about that with the vet or had recent bloodwork done?
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Hi,
Yes all blood work is recent and urinalysis as well. I check for ketones on a regular and he looks good :)
PMPS was +354. That's the lowest it's ever been so I'm hoping for low numbers again tmrw with his AMPS.
Most likely I'll move him up to 4units soon.
 
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