10/25 Archie AMPS 66---- Need advise

Hi Everyone! New to the group and not sure where I belong yet. My baby was diagnosed with diabetes about a year ago. We have been on Vetsulin 3.5u twice daily. We had never been told to home test, which I was leary about, but figured that if that is what the vet told me, it was normal and ok (I know now it isn't and should have trusted my gut)---so I have recently been researching more about diabetes, home testing, and different insulins. I was strongly considering switching to Lantus because of the better control. My cat will only graze so my concern was the intermediate action of the Vetsulin. My plan was to eventually talk to the vet and do my own curves at home and dose/treat him myself if he wasn't on board. Well, the other day my husband dropped the (BRAND NEW) vial of Vetsulin and it shattered. I decided it was time to take the plunge. A friend of mine had 5 Lantus pens from her son that she gave me for free (he has been swithced to NPH and they exprie 2019). I got all of my supplies for the curve---glucometer, lancets, test strips, spreadsheet to track it, karo, 100u syringes, and pens. His AMPS today was 66. He hasn't had vetsulin in 2 days at this point. I held the shot and now I don't really know where to go from here. He is 16lbs. (7.25kg). From what I researched the starting dose of Lantus is 0.25u per kg so I was planning on starting him at 1.5 (which I know is a little lower than the recommended dose, but I also read to just start with 1u somewhere else). I am going to keep checking him throughout the day today and see what happens. I just don't know what to do from here. This was definitely not one of the scenarios I had ran through in my mind when researching and planning. I am really glad that vial broke though and I feel justified in starting the curve and home testing. Any advise or experience would be greatly appreciated. I am not really comfortable consulting the vet at this point.

Jamie

 

Hi Jaime and welcome!
I have no experience with Vetsulin so I'm not sure what you're starting dose should be on Lantus with the AMPS of 66. I know once more experienced eyes see this they'll probably suggest a 1 u or less starting dose. My concern is Archie is at 66 this morning and hasn't had insulin in 2 days which is surprising.
In the meantime can you get your spreadsheet set up? Gathering test data is crucial for dosing advise in the future. I'll go grab the sticky link and post it for you. be right back...

 

Hi Jamie - Welcome. I'm sure more experienced people will respond shortly - they will have specific guidance in switching from Vetsulin to Lantus. To make the most of their guidance. Please clarify:
Did you give any insulin today - if yes, how much?
What type of meter are you using (human or pet)?
Can you say more about the food Archie eats - any dry? Any recent change in food?

 

Below are the links to get started. Lots of info in the stickies. It is overwhelming at first. Nobody absorbs it all in one shot. I still re-read stickies. You'll want to set up your signature too. If you don't get too many responses now you will later, its usually quiet mid day...well depending on your time zone


Spreadsheet set up

Lantus & Levemir the basics

 

I think getting a day or two's worth of tests in is a good idea before starting Lantus. Oddly enough there was a similar situation and the kitty never needed to start Lantus..paws crossed for you too.

In the meantime you'll want to read both protocols and decide which one you'd like to follow Start Low Go Slow or Tight Regulation (TR) . Each has different dosing methods as well as suggested starting dose. Also add if your kitty is eating wet food or if there is kibble on board.

 

UPDATE--- No insulin given today. Fasting BG was 66. Rechecked at 2 hours and was 58. We have tried every kind of food under the sun. He is VERY picky. We tried what seems like every variety of canned food and he turned his nose up at every one. My favorites were the FF flaked or grilled (?)---we tried everything without gravy and even some of the gravy ones but no carbs over 13. He just wont eat it. Dry food he is also picky with---he does not like any of the "diet" foods. He basically will only eat the crappy junk food. When we would get him the better foods (like evo or hills) he would hardly touch it. The vet had us switch back to whatever we could get into him. (probably will be researching that now too). So as for now, he is eating Purina One (which again, I know it's crappy but he has to eat and I'm not spending a ton of money on food that he just won't touch). No recent food changes. He has been pretty consistent with this. Most of our food changes were last fall when he was diagnosed. And we ended up pretty much back where we started. Meter is the walmart brand (prime model).

 

So I guess my main question is, when do I consider that this could be remission??

 

Is that wet or dry....just curious. I had a very picky kibble addict so no judgment..just wanting to know in case you need to start insulin. If dry, SLGS is the protocol you'll need to follow.

I'd test for a few day at what would be your preshot time...if he's under 100, no need to test again until next preshot time. If he's over 100 at preshot, then feed, test again 3 hours after to see if his numbers come back down under 100 on his own.

Since Vetsulin is an "in and out" insulin there is no depot to consider...meaning lets see what he does the next few days. Typically we suggest testing like that in a trial for 14 days...then it's officially off the juice.

 

Dry

That sounds good though. That's what I was thinking. It I was t sure if I needed to continue testing throughout the day or not. One more question...how struck should I be with feeding schedule during this trial period and then after as well?
I guess I will just see what tomorrow brings! Thank you everyone!

 

I'd keep the same feeding schedule you have been. It's also wise to not feed 2 hours before "preshot"

 

If there's no insulin on board, I wouldn't over poke

 

Feeding several small meals is easier on the newly healing pancreas. Perfect if he's a grazer.

Test at what would be you regular AM and PM shot times and if less than 100, you are done testing for the day. If he's above 100, test again 3 hours later to see ifmfood brought him down.

Paws crossed he's done.