Peeks 9/12 Dosing help!

Good morning, Peekas AMPS, the first at 256, the 2nd at 213. We have been giving 2u of Vetsulin. These numbers are lower than any AMPS we’ve gotten, are we good to proceed with normal dosage, or should we wait a bit?

After getting a couple of tests and her getting into her food bowl a little bit, the numbers went up to 300.

 

Edit: Gave Peeka her normal dose, an extra bit of her food, and a Purebite. I know I probably could or should have stalled a bit, but I accidentally left her food bowl up on the counter top where I had left her and by the time I got back from posting, she was already well into her food. Thankfully, I’ll be home till a bit later today to get some good tests in and keep an eye on her!

 

Looking at SS. BRB...


Mogs
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Glad she has an appetite this morning!

Do you have lots of supplies (test strips, high-carb food, honey)? If not, the time to pop out and get some is now-- Vetsulin will start working very soon.

Hopefully today will be calm, though. Hear that, Peeka? No drama, please!

 

Just picked up a new set of 100 the other day. I have an unopened box of lancing devices, plenty of high carb foods as well. I’m definitely prepared, but hoping I won’t need to be.

 

If it helps, the numbers I got after she had a little bit of food in her were in the 300s

 

Great! Her going back up to 300 probably means today will be uneventful, but it's always good to be stocked up! Our kitties seem to have a sixth sense for when strips are getting low, it's a holiday, there's a snowstorm raging outside, etc...

 

Very hopeful for an uneventful day. It’ll be just what the doctor ordered! I’ll probably head out and get one more box of strips as my back up and that’ll be my break glass in case of emergency set. We still have another hour for her +2, and she was eating the little bit of food I gave her pretty well earlier.

 

+2 Update: Peeka is at 200

 

Hmmm, can you feed a small LC snack? The drop isn't unexpected on Vetsulin, but let's see if we can slow her down a little.

I see your message was almost 40mins ago now, so you can also just wait until you test at +3 and see where she is then. I would definitely test at +3.

 

Hi again, Peter.

I see you've given the normal dose. (Sorry for not getting back to you earlier. Had things to do here and I saw that Nan was helping you.)

For future reference, FDMB recommends a 'no-shoot' limit of 200mg/dL (human meter) for cats who don't have much data. Looking at the available data in Peeka's spreadsheet the nadirs you have caught have been in an OK range for the current dose [ETA: thus far].

To help Peeka's neuropathy, you're going to need to get her BG into a better range. There's no way around this. Looking at Peeka's data, it seems that you need to consider increasing her dose (and there may need to be further weekly dose adjustments - see the FDMB Vetsulin Guide). I'm tagging @Deb & Wink and @Panic to ask them to have a look at Peeka's data tomorrow if they're online and perhaps suggest a dose adjustment for you. Please can you make sure that you get a PMPS test tonight because they will need that information in order to help you - doubly so because Peeka's AMPS was lower than usual today.

As you've seen from today, PS tests can be lower than you expect. This is why it is critical to get both AMPS and PMPS tests every day. It only takes a couple of minutes before each dose is due to make sure it's safe to administer. Also many cats run lower on one of the cycles (most commonly PM but not always). This is why it's so important to test enough to catch nadirs on both cycles.

In order to start gradually increasing Peeka's insulin dose to get her into better numbers and help her neuropathy then, for her safety, tests need to be grabbed on each cycle for AMPS, PMPS and nadir (typically somewhere between +3 and +6 on each cycle for Vetsulin). Tests after +6 for this insulin will typically only throw light on when the dose is wearing off but they can also catch unusually late nadirs and also times when lower numbers may run right the way through to the next preshot time. The better her range, the more critical to Peeka's safety that the tests are done, especially with the likes of Vetsulin where there can be such a big difference between PS and nadir BG levels.


Mogs
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Been giving her some Purebites after each shot just to make sure we stay in good range. +3 came back at 196.

 

Thanks for your response Mogs, I understand that getting her BG into better range is priority #1. I just feel the discouragement some days and want to give her a magic pill to get better, even though I know that’s out of the question. I suppose more than anything, I just want some assurance some days that we are on the right track and that we are not completely hopeless.

I’m going to try everything I can to get the PMPS tonight. I work, unfortunately. My wife still isn’t too keen on the idea of doing the shots herself. She is terrified of needles and blood, and the thought of actually administering the shot is stressful for her, and with her being pregnant, I am trying to mitigate that stress as much as possible.

Would it be beneficial to try and get tests from +2-+6 when possible? Almost like a mini curve when possible?

 

This sounds like an excellent idea to me, at least. Are you thinking +2, +4, +6 (with more testing if numbers warrant, like today)?

On the nighttime schedule, I'm glad you are able to get some midcycle tests at least.

Something else you might want to look into is the Libre (apologies if this has been talked about before, I have not been on recently and am not caught up on everyone's threads yet). It's a sensor embedded in a patch that gets glued to the cat's skin, so you can read BG with a separate reader any time you want, without pokes or blood.

The catches: it's expensive (not sure but I've heard maybe around $65?) and short-lived (14 days, in theory), and doesn't work well on a lot of cats. The big problem is that the patch is just hard to glue onto a cat and have it stick and not get removed by an annoyed kitty. But when they work, they can be really really helpful in situations like this.

 

Any tests you can get are valuable, Peter.

Please be assured that I do understand how busy your schedule is but in order to help people here I have a duty of care to kitties and their caregivers. That includes the need to provide caregivers with information important to their kitties' safety. I would be doing Peeka and yourself a great wrong were I to do otherwise. It is for you to decide what to do with the information.


Mogs
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During the PM cycles, I can definitely get these numbers during the weekday. I work a 2nd job Thurs-Sun, so during the night, I may only be able to get a +5 or a +6. But Sun-Wed I can obtain those numbers to help fill in the blanks.

This was actually going to be our first option. Our vet bought a couple, and Peeka was going to be his first try with them, but when he saw how large the needle was, he didn’t feel comfortable using it on her. I understand some vets don’t have much experience with FD, but I’ve always felt that our vet has been willing to learn more about how to better treat it, including having me send Peeka’s spreadsheet over for him to look at. He has done a fair amount of outside research as well.

 

I know you do, and that’s why I’m glad to have found this group. It’s just a personal struggle to get that additional help when I need it. Under normal circumstances, I’d be able to do any and every tests necessary for the PM. I’m just in an incredibly busy season in my life at the moment.

 

Huh, that's interesting, I don't think I've heard that before (I have no personal experience with these things, so I haven't seen one myself). I know we've had several cats around here using them (with varying degrees of success).

Your vet sounds like a keeper!

 

Peeka +4 is 169

 

Turning into a nice cycle today!

 

I will gladly take this over the alternative, that is for sure! Hoping we don’t bounce and this may be the new normal. Get some more testing for a possible dosage increase tomorrow, and hope to stay in these numbers!

 

Peeka +7 272

 

Peter you are ROCKIN this. You may get down but the fact that you keep getting back up and TCOB is what this "dance" takes!
So glad you found this forum!
j