? Questions about MPM

JackieP

JackieP

Member
Based on the limited data I have so far, it seems like Mickey’s nadir is around the 3-4 hour mark… is that normal? by the time +6 rolls around he is usually back up. I really don’t know for sure if this is from food or if it’s really just that the insulin is already wearing off. I know this is important to know before considering a dose increase. I free-feed the first 10 hours of each cycle because we’re also managing hyperthyroid.

I read that it’s not advised to dose on a sliding scale because that can cause numbers to bounce, but also for low pre-shot numbers that it’s an option to reduce the dose. This confuses me.

At this point I don’t even know which method I’m following.

Should I be increasing to 0.5 or holding??
I’m using U40 syringes and eyeballing the dose the best I can currently.
 
This 0.25U looks lovely for him actually, I'd hold it for several more cycles (per MPM you hold a dose 5 days minimum when you see green, SLGS is a week).

SLGS you'd reduce below 90 but honestly he's doing so well right now, I'd either follow MPM (reduce below 50) OR modify SLGS to reduce below 60 or 70. It's really what you're comfortable with doing, the lower the reduction point usually the more testing you have to do.

Next time you get a preshot in the 90s and can monitor, try shooting the full 0.25U. The more you can get him in greens, the more his pancreas can heal. When you do that, please tag me so I can watch the cycle and see what happens.

Edit: also, yes the trends youre seeing are totally normal. He's actually doing almost the best I've ever seen a cat on ProZinc do, relatively flat
 
Thank you for the reply! That makes me feel better, I was getting discouraged to see so much blue the past few cycles and thinking maybe he’s supposed to be dipping lower.
Over time, would I expect preshot values to gradually get lower as the pancreas starts kicking into gear a little more? Had a few 90s since I started but didn’t feel comfortable shooting at that time, and I’m thinking I may have set his healing back a bit.
 
Nadirs are around 70 are perfect, unless you want to go full blown MPM. I really do think you have a decent shot at remission here, MPM may or may not be needed to get him there.

Yes preshots are the last numbers to come down, and usually AMPS actually is the last one to come down. It's scary to shoot those lose numbers! It's why we don't recommend it until you have data, and can stay around to monitor.

He seems to have done ok with the 0.1U you shot on the 25th, which is why I think full dose may also be ok in the 90 range...there is a gap between tests that night so it's hard to say for sure, but his nadir usually is right around +3.
 
FrostD said:
Nadirs are around 70 are perfect, unless you want to go full blown MPM. I really do think you have a decent shot at remission here, MPM may or may not be needed to get him there.

Yes preshots are the last numbers to come down, and usually AMPS actually is the last one to come down. It's scary to shoot those lose numbers! It's why we don't recommend it until you have data, and can stay around to monitor.

He seems to have done ok with the 0.1U you shot on the 25th, which is why I think full dose may also be ok in the 90 range...there is a gap between tests that night so it's hard to say for sure, but his nadir usually is right around +3.
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Yes, I set alarms every 2 hours that night that night to do checks and I still failed to wake up for the most important ones so mad at myself.

I appreciate the encouragement, obviously remission is the #1 goal…. Cutting out the carbs helped quite a bit right off the bat but he definitely still seems to need a little bit of help. The sooner the better as far as remission goes because I want to take him in for I-131 treatment for his thyroid but I don’t feel comfortable leaving him for 5 days and not being able to pay attention to his blood sugar myself. Might be an irrational fear but I’d be more okay with leaving him if he’s in remission.
 
Beautiful SS! Your sheet looks alot like mine did right before the otj trial. I went to the lowest possible carb point for his fancy feast pates and I think that's what got my guy into remission! If you can find a 0-1 carb option see how your BG checks go :)

0carb for me was fancy feast ocean whitefish and tuna pate :)
 
Katsallday said:
Beautiful SS! Your sheet looks alot like mine did right before the otj trial. I went to the lowest possible carb point for his fancy feast pates and I think that's what got my guy into remission! If you can find a 0-1 carb option see how your BG checks go :)

0carb for me was fancy feast ocean whitefish and tuna pate :)
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I can’t believe I didn’t think of trying to get his carbs a little lower! He eats a lot of Friskies pate right now(5ish%) and I JUST ordered a case of Dave’s from Chewy to try(3%) I’m going to pull up Dr. Lisa’s list and see what I can find at the store tomorrow that’s even lower.

Were you able to work back in the foods that weren’t 0 carb after he went into remission?
 
JackieP said:
I can’t believe I didn’t think of trying to get his carbs a little lower! He eats a lot of Friskies pate right now(5ish%) and I JUST ordered a case of Dave’s from Chewy to try(3%) I’m going to pull up Dr. Lisa’s list and see what I can find at the store tomorrow that’s even lower.

Were you able to work back in the foods that weren’t 0 carb after he went into remission?
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Just a note - be cautious when you do this. His numbers are low enough that a carb change may let him get too low.

I'm not too well versed on very low carb, so will tag @Sienne and Gabby (GA) for her thoughts. Something is sticking in my memory about cats perhaps needing at least some carbs, or diabetic cats sometimes actually doing better with some carbs vs none
 
My Tuna went otj using a 0 carb and 1 carb food 4 times a day every 6 hours with treats and constant testing. Now he's at 1-2 carbs 4x a day still. I was insane about testing and still test him daily. If you want to try and see what happens with a 0-1 carb food I'd recommend quitting your job to just monitor ;) at least that's what I did! Your baby is already on a very low dose with very good numbers at that dose there is a chance of hypo and you'll see that in my chart too. I always caught the hypo early because I was insane about testing and I got a feel for his trends. Now I know that my cat is different in the way that if he doesn't eat his blood sugar goes up so I feed him constantly low carbs and that's what keeps his numbers perfect.

But it looks like your baby is going otj quickly! I use fancy feast savory salmon pate in the orange can alot. 1% carb at 2am 8am 2pm 8pm without fail. If your feeding only 2x a day I'd say go a bit higher on the carb. But I'm not a vet and I'm new here still :)
 
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