? Need help with Jett's AM dose

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PJ Brown

PJ Brown

Member Since 2016
Hi Everyone,

Immediate issue: Jett's #s were very low for him this morning, and I don't know whether I should give him a reduced dose of 1 or 1.5 units. See his spreadsheet. I've read SLGS and TR information, and I'm not sure that I understand the difference. For the past year, I have been using SLGS to dose.

Jett's BG is still very high with 2 units of Levemir twice a day. I will do a curve this weekend. I have no idea if he needs more insulin or less. That is another thread....

Thanks for your help!

Patti and Jett
 
Those are actually really good numbers. If you can monitor I would not give a reduce his dose. You need to find the dose that brings and keeps his numbers in the blues and upper greens.
 
DebG said:
Those are actually really good numbers. If you can monitor I would not give a reduce his dose. You need to find the dose that brings and keeps his numbers in the blues and upper greens.
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Thanks, Deb. I gave him canned food and will monitor. By monitor, do you mean continue to test him every 2 hours?

Patti
 
I see the three numbers 162, 145 and 159 were those AMPS 162? +what? for the 145 and 159?
Have you considered changing the food to canned Fancy Feast or another low carb wet food? I am wondering if the foods are too high carb and that is why the numbers are so high?
Are you able to now test during the night?
 
To monitor would be to test at +2 or +3 to see where the cycle is heading if the number is close to the AMPS# you could have an active cycle. Levemier usually onsets around +4 to +5 for most kitties and then even can nadair late in the cycle . You don't need to lower the dose till he earns it by hitting the number 90 or lower.
Do you have Medium carb and high carb food on hand? As well as Karo syrup, honey and or maple syrup and lots of test strips? I'm concerned with all those high numbers? Is Jett s health good other than the Diabetes? Those numbers are too high. These numbers in the 1oo's are awesome!!!! Let's hope Jett will start to see these more often.
 
DebG said:
I see the three numbers 162, 145 and 159 were those AMPS 162? +what? for the 145 and 159?
Have you considered changing the food to canned Fancy Feast or another low carb wet food? I am wondering if the foods are too high carb and that is why the numbers are so high?
Are you able to now test during the night?
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Thanks, Deb. The 162, 145, 159 tests were 15 mins a part this morning. I have tried Weruva canned food (Fowl Ball) which is really low carb and still had huge swings and high values. I think I am going to try a low carb food again because the high BG #s are so concerning that I have to try something. I go to the pet store to buy the Fancy Feast and there are so many flavors that I can't seem to find the low carb ones.

He is eating well, so I am going to give him the 2 units now.
Thanks!
Patti
 
Hi PJ! I'm a newbie here with diabetes, but I can tell you that the Pates or Classic Fancy Feast are the low carb ones.
 
The Classic ones are the low carbs I feed raw to my kitty but keep the Fancy Feast Chicken ones on hand as Fritz is carb sensitive.
I have never heard of the monitor your testing with. I know a lot of the beans are using Relion Micro or Relion Confirm.
I'd get a +2 or +3 and depending on the number if rising get a +6 and +9.
It is not necessary to feed the vet recommended foods.
I'll be around off and on the computer I'd be happy to peek in on Jett a little later and see how it's going. Those are awesome numbers!!!!!!
 
DebG said:
The Classic ones are the low carbs I feed raw to my kitty but keep the Fancy Feast Chicken ones on hand as Fritz is carb sensitive.
I have never heard of the monitor your testing with. I know a lot of the beans are using Relion Micro or Relion Confirm.
I'd get a +2 or +3 and depending on the number if rising get a +6 and +9.
It is not necessary to feed the vet recommended foods.
I'll be around off and on the computer I'd be happy to peek in on Jett a little later and see how it's going. Those are awesome numbers!!!!!!
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Thank you, Deb! I will post his +2 and +4 tests. I was feeding him Weruva canned exclusively (no dry) until he was hospitalized in October 2016 for 10 days and the vet put him on the RC Glycobalance canned and dry. Can you believe it? I was SOOOO disappointed to get my kitty back addicted to dry food. :(
 
Patti I hope I didnt direct you wrong in the 2u dose. I'm use to TR not SLGS. make sure and get tests today. I'm here to help if you need help.
 
I have used Levemir for two kitties for the last 2 years. In both cases I found that the onset didn't occur until around +4 or +5 and often the nadir would be anywhere from +8-+12. There is a good chance the preshot was the nadir from the previous cycle and it will take some time before the onset of the new shot.

:bighug::bighug:
 
Tuxedo Mom said:
I have used Levemir for two kitties for the last 2 years. In both cases I found that the onset didn't occur until around +4 or +5 and often the nadir would be anywhere from +8-+12. There is a good chance the preshot was the nadir from the previous cycle and it will take some time before the onset of the new shot.

:bighug::bighug:
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Thank you Deb and Mary Ann! Jett's BG is on its way up. +2 test is 434. He is howling for dry food :(
 
PJ Brown said:
Thank you Deb and Mary Ann! Jett's BG is on its way up. +2 test is 434. He is howling for dry food :(
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There is something causing the higher numbers. That dry food is what we call kitty crack. Do you have freeze dried chicken treats? Bonita flakes and I also buy freeze dried salmo. As long as Jetts not allergic to seafood. How are Jetts teeth? Any other health issues? You might find feeding scanned good and no dry the numbers will drop if there isn't another health issue. Be careful to monitor if you change foods. :bighug: His numbers can still come down today as onset happens +4 to +5. Come on Jett work the juice. Thank you for posting:)
 
PJ Brown said:
Thank you Deb and Mary Ann! Jett's BG is on its way up. +2 test is 434. He is howling for dry food :(
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Sounds like it was a late nadir with the Levemir. Because Levemir does tend to have a much later nadir than Lantus it might be a good idea to get some later readings...maybe around +8 or so. I found with one of my Levemir kitties that the onset wasn't until +5 and quite often she would have her nadir at +8 or later. It is possible Jett may have dropped even lower towards the end of the cycle and was actually on his way back up at preshot, which would account for the big jump in the +2 reading. I would still try and get a later reading on this cycle so you get a better picture how Jett responds with Levemir and whether he may clear the bouce quickly or not.

It is a real shame the vet got Jett back on dry food. :mad:
 
Hi Mary Ann and Deb - Jett's +4 test was 443. I'm in a rush to get to a yoga class, so I will post again in a few hours. Thanks so much!!

Patti + Jett
 
Hello - Jett's +8 test was 432 and +11 was 517. I'm not sure I can stay up for a +4 test, but I will set an alarm to see if he has a low number at +8. Do the #s today tell me anything in terms of dosing?
Thanks!
Patti + Jett
 
Those numbers are way too high. There is something not right. It's not good for Jett to always be in these numbers.
 
Patti it's late and with the holiday not sure when @Wendy&Neko will be able to respond but let's see if she can help to see why Jetts nu.bers are so high and how you might be able to get them lower
 
It is possible that Jett had a lower reading the other night which would have caused a bounce into higher numbers. Getting a mid cycle test in the PM cycle would help to fill in some missing pieces. Jett has always been a bouncy kitty, but I agree that he spends too much time in high numbers. When was the last time you had a full blood panel and check done? Just wondering if there are some underlying medical issues that are making it hard to get regulation.


ETA With Levemir, my personal experiences are that there is very little effect until +4 and the greater effects don't show until +7 or later, so getting some later testings in might be useful to determine the onset and nadir timing,
 
I agree with the others, getting night time data will help fill in the picture. It looks like he went lower the night before last and is bouncing. Try drinking a large glass of water before bed and test him when you get up. Or if you get up even an hour before AMPS, it is a good time to test with Levemir, so you can see if he is going down or coming up to preshot.

Good luck getting rid of the dry food. That will make a difference. If you can't get rid of dry, there are lower carb options out there.

Has Jett been to the vet lately? Just wondering how his teeth and gums are. Needing a dental can make it hard to regulate.
 
Hi there - well, I didn't get up early this morning to do a test and his AMPS was "hi" :banghead: I will get some tests in tonight. Thank you for the support and encouragement.

Jett was at the vet in February for a full blood panel, which is when the vet made the switch from Lantus to Levemir. His kidney values were high, so he and his CKD brother receive 100 ml of Normosol-R subq every other day. At that time, the vet wanted to get his kidney values in better range before doing a dental. Back when he was hospitalized in October on the same day my husband went to the ER for emergency surgery, the vet gave me a $3,000+ estimate to determine what was wrong and cause of the high BG. The estimate included an MRI, CT, ultrasound, various blood tests, and dental. I was so overwhelmed. I did not know what test/procedure to prioritize over the others. I've asked about acromegaly several times and the vet dismisses it as rare, but I seem to see quite a few kitties with this diagnosis on the FDMB.

I welcome all suggestions and encouragement. I want to help him so much. It will be one year since his diagnosis on July 6th. I truly can't believe we've kept each other alive for a whole year. Jett is a very sensitive kitty and still grieving my husband and looking for him. All of these issues were stress induced by my husband's illness and death.

Thanks for your help @DebG @Wendy&Neko @Tuxedo Mom
Patti
 
Jett is indeed proving to be a difficult patient.

As far as high dose conditions such as acromegaly, IAA and Cushing's, most people do not test for them until they have reached 5 units twice daily with little or no response. You are very correct that acro is not as rare as was once thought. It is estimated that 1 in 4 kitties can develop acro. IAA is another condition seen much more, probably because of people having the testing done. Even Cushing's is considered a rare condition, but I have seen a fair number in my researching over the last 2 1/2 years. At this point I wouldn't worry about testing for any of these conditions.

If you have a full report of the blood work and other testing that was done in February, could you fill out the "Labs" tab on your spreadsheet. There are some very experienced members that can help interpret the results. As far as the dental...unless the kidney results are dire or Jett has a heart condition, having a dental done can be helpful both for kidney and diabetes problems.

Also, I know your vet got Jett started back on dry food when he stayed at there :mad::mad:. If you can work on trying to wean him off the dry food, that could make a big difference in the glucose levels. You may also want to keep a chart of what type of food you are feeding and the times you feed it. You could list this in the comments section on the far right of the spreadsheet. Getting some mid and later cycle tests will also be very useful.

You and Jett have had such a hard time and trying to get Jett more regulated would I am sure, be a relief for both of you. :bighug::bighug::bighug:
 
You and Jett have been through a lot this year. :bighug::bighug::bighug: I am glad you both were there for each other.

Your vet's quote to find the cause of the high numbers is crazy. I have no idea why an MRI or CT scan would be needed at this point and those two would be the vast majority of the $3000 quote. There is some validity to worrying about anesthesia if kidney values are high. Getting those numbers in the Labs tab will help us help you. As for "high dose" conditions, we typically testing after cats get to six units per shot, though the research that found one in four diabetic cats has acromegaly, found acrocats with doses as low as one unit and an average of seven. At this point, unless there were other signs of acromegaly, I wouldn't worry about those tests.
 
Tuxedo Mom said:
Jett is indeed proving to be a difficult patient.

If you have a full report of the blood work and other testing that was done in February, could you fill out the "Labs" tab on your spreadsheet. There are some very experienced members that can help interpret the results. As far as the dental...unless the kidney results are dire or Jett has a heart condition, having a dental done can be helpful both for kidney and diabetes problems."

I checked in the Labs section of Jett's spreadsheet and his Feb 2017 blood tests are in there. @DebG @Tuxedo Mom @Wendy&Neko Thanks for taking a look - there are 4 separate tests, so you can see a trend and his high #s.

Happy 4th!
Patti
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