Very reactive to dose changes. Can’t seem to find the perfect dose.

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Pudge, Jan 11, 2019.

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  1. Pudge

    Pudge Member

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    Nov 25, 2018
    Pudge has been back on the juice since November. Our numbers are constantly a rainbow. I am following the SLGS method and I have reiterated to my partner that we need to be doing more than just AMPS and PMPS tests. AT2 Strips are very expensive for me as I just graduated university.
    I have tried to hold doses a little longer than suggested just because pudge seems to be very volatile and reacts to very small changes.
    Lately we have tried just him eating fancy feast classics and then just weruva and BFF for a week at a time, neither of which seemed to make a big difference. Where do we go from here? Just keep trying to get more day and night tests in and keep following SLGS?
    I know it’s a marathon not a race and maybe I’m just looking for reassurance that we are doing things okay. I feel like a bad kitty mama as I can’t get him regulated and we are always in purple or reds and I worry about what that could do to him long term :(.
     
  2. majandra

    majandra Well-Known Member

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    Oct 11, 2018
    Can you pick up a human meter? The pharmacy will fill out a voucher for a free meter if you buy strips. That would help a bit on cost.
    Have you tried any of the presidents choice extra meaty cans? The plain chicken is quite low carb, and good price. The oceanfish and tuna is also a good price and can be bought in large cans. Both of those are about 2%.

    Hang in there, things will get better. Someone with more experience on the insulin side of things will reply soon
     
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  3. Pudge

    Pudge Member

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    Nov 25, 2018
    Thank you! I did get a human meter when he was first diagnosed while waiting to get the AT2. I ran out of strips though. I see you have the freestyle lite meter too, do you remember by chance how much the strips were?
     
  4. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    I have a Freestyle Lite meter too. All strips are expensive in Canada but not like AT strips. A vial of 50 of those was $100 from my vet. Full price for FS Lite strips at Shoppers Drug Mart (and a Rexall near me) is $80 for 100. They might be a little cheaper at other pharmacies so I'd call around. You should be able to get a free FS Lite meter when you buy your first 100 strips.

    Re Shoppers: if you have a senior friend or relative they can buy the strips for you on Seniors' Day (Thursdays in Ontario) for a 20% discount, no tax and you can earn Optimum points. I save up Optimum points and buy my strips on Seniors' Day (yeah - old! ;)) and have been able to get them cheaply or almost free.
     
  5. majandra

    majandra Well-Known Member

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    Oct 11, 2018
    I pay about 75 from Independent. Walmart was I think a buck more. Costco is not cheaper than regular pharmacies
     
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  6. Amina&M'row

    Amina&M'row Member

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    Jan 2, 2019
    I got a Relion "Prime" meter for $9.00 at Walmart recently. Strips are also cheap. Take a deep breath....all will be well....deep breath....and you sure have a cute kitty there!
     
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  7. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    Aug 5, 2016
    Yo put 1.Of in the dose that means you are giving a bit more than 1unit but less tha 1.25?

    With lantus you need to try and give the same dose morning and night to allow the depot to form properly and I is ok to follow the SLGS protocol but with that one you need to make a curve once a week that would help a lot to try and figure what's going on

    And remember that with diabetes patience is important you are doing a very good job taking care of him
     
  8. Dusty Bones

    Dusty Bones Member

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    Oct 20, 2013
    Was he off the juice for a while? Do you know what caused him to fall off the wagon? You're doing all you can and I'm sure he appreciates it, it's just one of those things where he could suddenly be OTJ again for no special reason. :coffee::bighug::cat:
     
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  9. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Can you get freestyle insulinx strips by you? They are cheaper and work in the alpha
     
  10. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Try not to get discouraged. It is always a bit harder when they come out of remission but really the SS is not too bad!
    I see you are giving different doses for the AM and PM shot.....Lantus works best if you stick to the same dose for both times of the day. Lantus is a depot insulin and if you keep chopping and changing the dose you will mess up the depot......
    So decide on a dose and try and stick with it for at least 3 days unless the BSL drops too low,in which case you would reduce the dose.
    Bron
     
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  11. Pudge

    Pudge Member

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    Nov 25, 2018
    Thank you everyone! He was off the juice until November, the vet thinks possible chronic pancreatitis is why he went into remission so quickly after his diagnosis and why he came back out but we are still unsure.
    We have been doing 1 fat unit in the evening and 1.25u during the day. The reason for this is 1 fat unit never brought him down enough during the day but 1.25u does. But, during the evening 1.25u has put him hypo on more than one occasion and 1 fat unit hasn’t. It’s not ideal but it seems to be making his numbers better. How much would this affect the insulin depot?
    We have tried 1u, 1 fat unit, 1.25u, and 1.5u and have held the dose unless numbers told us not too.
     
  12. majandra

    majandra Well-Known Member

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    Oct 11, 2018
    Do you have more mid cycle data than is on your spreadsheet?
     
  13. majandra

    majandra Well-Known Member

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    Oct 11, 2018
    If it were my cat, I would pick the dose that didn't cause any hypos, stay with it a few days, and get some extra tests in. At least a +2 day and night.
    It is great that you are getting the +4 quite often, but I don't think you have enough data to show that +4 is nadir for Pudge. If strip cost is an issue, you could try varying your test each cycle, if you are limited to only one extra test per cycle. **Does anyone else think that sounds logical?
    Are you still using the AT2 with AT2 strips?
    I apologize if I sound pushy on the testing- there is just so much that can happen in 12 hours, and I am a worrier. I do understand that there are reasons that more tests just can't be done!
     
  14. Pudge

    Pudge Member

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    Nov 25, 2018
    Yes I have a few more mid cycle numbers too add in but mostly just evenings. I don’t think +4 is his nadir it’s just the latest reading I can get before work. His feeder also goes off at +4 and +8 so I am limited to what tests I can get without food influencing his numbers.
    I am still using AT2, I found some reasonably priced on eBay and have 400 coming in the next few weeks so once I receive those I will be able to get more than one mid day test in. For now I am limited to one a day with how many strips I have left.
     
  15. majandra

    majandra Well-Known Member

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    Oct 11, 2018
    You don't need to limit your tests to be not food influenced. In fact, it is good to know how food affects him! I hope you get your strips soon. I can imagine how much worry you can have there.
     
  16. Pudge

    Pudge Member

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    Nov 25, 2018
    I did not know that! Thank you! I will start tracking some food influenced numbers as well.
     
  17. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    Aug 5, 2016
    Yes the only ones that have to be not food influenced are the pre shoots and that is for safety reasons, the rest you want to know how is he doing on his normal day and that includes food, meds, exercise etc
     
  18. Tiffany Rekasi

    Tiffany Rekasi New Member

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    Jan 29, 2019
    I have the AT2 and there are 3rd party strips that are compatible with this glucometer. I bought them on amazon. I not tried them yet though but have seen reviews that they work
     
  19. majandra

    majandra Well-Known Member

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    Oct 11, 2018
    @Pudge
    How is he doing? I don't see anything after the 28th. You may want to start a thread in the Lantus forum, or update your title since he is now reacting VERY well to insulin.
     
  20. Pudge

    Pudge Member

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    Nov 25, 2018
    I thought we were just starting to do better and then on the 28th his PMPS was 5 so I only gave 0.5u and we seem to have lost some progress again. My strips still aren’t here so I am trying to be conservative with testing still :(. That’s a good idea, I will post on the Lantus forum. The vet prescribed buprenorphine that I will pick up today and she said if it is chronic pancreatitis that is causing his rainbow of numbers it may help him feel a bit better?
     
  21. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Yes, bupe can be very helpful for the pain of pancreatitis. You might have to tinker with the dose a bit once you see how loopy he is with the prescribed dose. It comes as a liquid suspension that you squirt into the cheek pouch. It gets absorbed by the mucous membrane in the mouth. Warning: it tastes bad so there might be some kitty drama, drooling, etc. Don't worry if you think it didn't all get in there. Some will be absorbed.
     
  22. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    Aug 5, 2016
    Yes do post in there and you may want to review the Lantus protocols, that are in the stikys there, it is not helping him that you are changing doses so often and that you are not giving him the same dose AM and PM, Lantus needs consistency

    For example on the 25th he got to 3 and instead of decreasing the dose you actually gave him 1.25 the next morning versus the 1 he had had

    I get it he is very sensitive to insulin and insulin changes, Babu was too, he actually was a mini dose cat and I had to make changes in 0.1 units not in the normal 0.25 , that may be your case but still you need to find a dose you can give both AM and PM and try to keep it unless he goes under 90
     
    Last edited: Jan 30, 2019
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  23. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    My guy is very insulin sensitive too. I've learned that consistency is key - no frequent dose changes, no big dose changes.
     
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  24. Molly and Sammy

    Molly and Sammy Member

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    Sep 1, 2018
    Insulinx strips work on the Alphtrack and are currently $50 per 100 on Amazon. I've had two months of good results with these strips.
     
  25. Pudge

    Pudge Member

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    Nov 25, 2018
    thank you!
     
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