Mikey AMP 343 +5 215 PMPS 357

Mikey’sDad

Mikey’sDad

Member Since 2021
Mikey has been at 1unit for 6 days. He has mostly flatlined in the 235 range. I did notice that today and one other day his morning reading was in the 343 and then 5 hours went to 214 and then at his night shot was 357. Is this kind of fluctuation normal. I have started a signature (thanks) of course I will test him tonight.

My vet wants him to stay on 1 unit until Thursday another 6 days. Thoughts.? I was thinking he needed a higher dose?
His ears seem a bit crusty from the pricks.do you folks use any healing meds for ears?
 
Hi Tom,

Here is your last post for continuity (we ask all members to cut and paste the URL from their last post so we can review before addressing the new day's concerns): https://www.felinediabetes.com/FDMB/threads/high-pre-shot-number-today.252278/#post-2846381

I use a cotton gauze pad to stop the bleeding and prevent scabbing. If you hold the pad underneath the ear when you are poking him, you can fold it over his ear when you're done and hold it there for 10 seconds and that should stop the crustiness. I don't use any ointments, though some people use a little coconut oil for healing and preventing bruising.

Fluctuations in BGs are normal for a cat who isn't regulated. Since Mikey is on dry food, you would need to follow the SLGS dosing method. Have you read the Dosing Methods sticky yet? https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/. Essentially you would only be able to increase his dose every 7 days after doing a curve, which means testing every 2 hours for 12 hours or every 3 hours for 18 hours (more or less). What we want to see is how the cat is doing over the course of a day to see how low the dose takes the cat. You can do that tomorrow since it will be your 7th day on this dose of 1 unit.

Do you have half unit markings on your syringes? I assume that you do since you started on .5 units of Lantus. We increase by .25 unit increments. You would have to aim the plunger so that it's halfway between the two lines.

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PerfumedCatMom said:
Hi Tom,

Here is your last post for continuity (we ask all members to cut and paste the URL from their last post so we can review before addressing the new day's concerns): https://www.felinediabetes.com/FDMB/threads/high-pre-shot-number-today.252278/#post-2846381

I use a cotton gauze pad to stop the bleeding and prevent scabbing. If you hold the pad underneath the ear when you are poking him, you can fold it over his ear when you're done and hold it there for 10 seconds and that should stop the crustiness. I don't use any ointments, though some people use a little coconut oil for healing and preventing bruising.

Fluctuations in BGs are normal for a cat who isn't regulated. Since Mikey is on dry food, you would need to follow the SLGS dosing method. Have you read the Dosing Methods sticky yet? https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/. Essentially you would only be able to increase his dose every 7 days after doing a curve, which means testing every 2 hours for 12 hours or every 3 hours for 18 hours (more or less). What we want to see is how the cat is doing over the course of a day to see how low the dose takes the cat. You can do that tomorrow since it will be your 7th day on this dose of 1 unit.

Do you have half unit markings on your syringes? I assume that you do since you started on .5 units of Lantus. We increase by .25 unit increments. You would have to aim the plunger so that it's halfway between the two lines.

View attachment 62483
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Actually, Mikey has pretty much stopped the dry food- He eats Only FF Pate and flaked

The vet wants me to do a curve, and loves the spreadsheet idea and we will decide on a day when we talk on Thursday to do a curve. I am a senior living alone, riddled with doctors appointments and commitments every day, so I have to have a day to be home all day.
She may want to do the .25 increment.
Vaseline seems to help a bit, as I use that on his ear before the shot. Coconut oil sounds like a good idea

I need to be patient as it has only been 3 weeks since this insulin journey. Patience is not one of my attributes
 
Hi Tom,

Did you give Mikey insulin on the night of 9/2? The SS doesn't show anything for that night.
You don't need to take Mikey to the vet to do the curve. In fact, curves done at the vet can give inflated numbers on account of stress.

Tomorrow (9/4) is Day 7 on this dose. Would it be possible for you to do a curve at home? That is, test him every 2 or 3 hours?

You don't want to hold doses too long. We recommend doing a curve once a week and evaluating the dose based on that.
 
Bandit's Mom said:
Hi Tom,

Did you give Mikey insulin on the night of 9/2? The SS doesn't show anything for that night.
You don't need to take Mikey to the vet to do the curve. In fact, curves done at the vet can give inflated numbers on account of stress.

Tomorrow (9/4) is Day 7 on this dose. Would it be possible for you to do a curve at home? That is, test him every 2 or 3 hours?

You don't want to hold doses too long. We recommend doing a curve once a week and evaluating the dose based on that.
Click to expand...
I will do the curve on 9-5 as Saturday i am not home consistently. Sunday I will be around all day.
Today’s morning shot was bad- the needle went right thru. I didn’t feel liquid, but wondering if he got complete shot.
I goofed on 9- 2 evening shot and fed him before I got BG
Thanks
 
A little nervous about poking him so many times for the curve. Won’t his little ears be sore? I hope he doesn’t hate me
 
Thomas said:
A little nervous about poking him so many times for the curve. Won’t his little ears be sore? I hope he doesn’t hate me
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Does he look like he is uncomfortable with the pokes? Most cats do not mind it and it's not painful. They get used to the routine and a low carb treat after a poke helps as well!

With the spot checks you are getting every day, you don't really need a curve.

I also think he needs more insulin. You have held this dose a week now. He is newly diagnosed and you don't want to lose momentum by holding doses too long.
You can take him up to 1.25U tomorrow morning.
 
Bandit's Mom said:
Does he look like he is uncomfortable with the pokes? Most cats do not mind it and it's not painful. They get used to the routine and a low carb treat after a poke helps as well!

With the spot checks you are getting every day, you don't really need a curve.

I also think he needs more insulin. You have held this dose a week now. He is newly diagnosed and you don't want to lose momentum by holding doses too long.
You can take him up to 1.25U tomorrow morning.
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I saw your note after I went to bed. I was going to start the curve today as originally suggested and gave him his 1 unit already. This morning he went up to 425. He has never been that high. Should I continue the curve or go to 1.25 tonight

He doesn’t mind the pricks
 
Thomas said:
Should I continue the curve or go to 1.25 tonight
Click to expand...
Yup! That's quite a bounce - probably from yesterdays lower numbers. If he continues to stay high today (on account of bouncing), a curve might not make sense because you will get flat high numbers. You could get a +3 and take it from there.

A curve is usually for people who follow cannot test very much every day (often not more than the preshot tests). The aim of a curve is the same as that of spot checks - to identify how low the dose is taking the cat - so that dose adjustments can be made.

I see that you are getting the mid-cycle tests almost every day. Do I remember right that Mikey is no longer on dry food? If so, you can follow TR and increase his dose more often than once a week.
 
Bandit's Mom said:
Yup! That's quite a bounce - probably from yesterdays lower numbers. If he continues to stay high today (on account of bouncing), a curve might not make sense because you will get flat high numbers. You could get a +3 and take it from there.

A curve is usually for people who follow cannot test very much every day (often not more than the preshot tests). The aim of a curve is the same as that of spot checks - to identify how low the dose is taking the cat - so that dose adjustments can be made.

I see that you are getting the mid-cycle tests almost every day. Do I remember right that Mikey is no longer on dry food? If so, you can follow TR and increase his dose more often than once a week.
Click to expand...
Pretty much stopped dry food. I guess I will not do the curve, take his midday reading and increase to 1.25 tonight. What is TR ? ( I am horrible with all these acronyms!
Why would lower numbers encourage a bounce. In his brief diabetic history he never had a 400 reading ? thanks
 
Thomas said:
Pretty much stopped dry food. I guess I will not do the curve, take his midday reading and increase to 1.25 tonight. What is TR ? ( I am horrible with all these acronyms!
Why would lower numbers encourage a bounce. In his brief diabetic history he never had a 400 reading ? thanks
Click to expand...
We follow 2 dosing protocols here - SLGS (Start Low Go Slow) and TR (Tight Regulation)

SLGS: You hold a dose for 7 days (unless a reduction is earned). You decrease the dose when the BG falls below 90. The aim of this protocol is to keep the cat in the 90-150 range. This is more suited for caregivers who can't test as much as TR requires. You do a weekly curve with SLGS.

TR is a more aggressive protocol with increases as often as every 3-5 days. Reductions are earned when the BG falls below 50. The aim is to keep the cat in the range of 50-100 (which is the normal BG range for cats). To follow TR, you would need to get at least one more test per cycle in addition to the pre-shot one i.e. 2 tests per cycle or 4 tests per day. You would also need to be feeding only LC canned food and no dry food.

You can read more about them here:
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". Usually, a bounce will clear kitty's system within 3 days (6 cycles).
 
Bandit's Mom said:
We follow 2 dosing protocols here - SLGS (Start Low Go Slow) and TR (Tight Regulation)

SLGS: You hold a dose for 7 days (unless a reduction is earned). You decrease the dose when the BG falls below 90. The aim of this protocol is to keep the cat in the 90-150 range. This is more suited for caregivers who can't test as much as TR requires. You do a weekly curve with SLGS.

TR is a more aggressive protocol with increases as often as every 3-5 days. Reductions are earned when the BG falls below 50. The aim is to keep the cat in the range of 50-100 (which is the normal BG range for cats). To follow TR, you would need to get at least one more test per cycle in addition to the pre-shot one i.e. 2 tests per cycle or 4 tests per day. You would also need to be feeding only LC canned food and no dry food.

You can read more about them here:
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". Usually, a bounce will clear kitty's system within 3 days (6 cycles).
Click to expand...
 
Btw, could you please start a new thread for today? We ask members to start a new thread every day so that they don't get too long to read!

The thread title nomenclature is:
<Date> - <Kitty's Name> - <AMPS/PMPS number and any other BG numbers you may have for the day> - <Question, if any>

For e.g.
9/5 - Mikey - AMPS 425 - Do I increase tonight? (Or do I do curve today? etc - only if you have a question).

Thanks :-)
 
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