? 11/4 Killa AMPS 167, +2 86 (Need some advise)

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willow & killa

willow & killa

Member Since 2011
Good morning!
Killa's spreadsheet is up to date (starting on line 62) and I was wondering if someone could take a look at it and point me into the right direction. AMPS numbers have been higher than PMPS numbers and have often been skipping the PM shot fearful that i can't watch and test him throughout the night.
(Is this an indication i should drop down to .5 units 2 times a day or stick with what I'm doing?) btw: these are the lowest numbers he's at in the AM

Killa has been in remission for quite a few years so I'm a bit rusty on all of this. trying to relearn as much as i can. He's been healthy and doing well up until a few weeks ago after he had a dental and 2 vaccines, he became very sick and now I'm fighting to get his numbers back down. Im hopefully i can get him back into remission.
Thank you for your help.
 
I'm sorry the vet visit set Killa back, hope you can get him back in remission.

Take my advice with a grain of salt, I've only been at this since September, but just wanted to give you a response until others chime in. Which protocol are you following? Are you using a human meter or the AlphaTRAK? If you are doing TR, you wouldn't reduce the dose until the number goes below 50 (human monitor) or 80 STRIKE THAT, below 68 with AlphaTRAK. If you're using SLGS, the rules are different and I don't know them at all. If you could put some info in your signature like what monitor you use, what method you're following and some other basic things, it would help others to answer your questions.
 
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Thank you for your reply and recommendation. I'll post this info. I am using an Alphatrak. Not sure what you mean by which protocol? guess I've forgotten more than i thought. where would i find info on the different protocols? thanks
 
disregard my question about the protocol info, i just figured it out. Missed that there were two different protocols
 
Approaches to Regulation

Many here choose one of two methods to hopefully achieve regulation: Tight Regulation Protocol with Lantus or Levemir or a less intense method with fewer blood glucose tests required called Start Low, Go Slow (SLGS).

Both approaches were created and developed by laypersons using human meters. Reference numbers given for blood glucose numbers are from blood glucose meters calibrated for human use.

As of this writing, the Tight Regulation Protocol with Lantus or Levemir for Diabetic Cats is the only published protocol we know of for use with Lantus or Levemir. This approach was created by laypersons from the German-Katzen Group and was eventually published several years later.

The TR protocol is the same, but presented in different formats here:
Many Lantus and Levemir users in this forum have been successful following a somewhat modified version of the Tight Regulation Protocol for years. These "general" guidelines are based on anecdotal evidence and personal experiences of laypersons frequenting this Insulin Support Group.

If the Tight Regulation Protocol isn't the right fit for you, the FDMB's Start Low, Go Slow Method (SLGS) offers an alternative method for regulation. SLGS offers caregivers a less intensive approach to managing their cat's glucose levels.

Guidelines listed for each of these approaches are not intended to portray the ONLY way you can use Lantus and Levemir insulins. The guidelines on this website suggest how to best use Lantus or Levemir when following one or the other of the protocols mentioned above. Be aware there are other feline diabetes message boards on the web using different dosing methods/protocols successfully.

Once you have learned the onset, peak/nadir, and duration of the insulin in your cat by collecting data from spot checks and curves you'll want to be sure to read Lantus & Levemir: Shooting & Handling Low Numbers if you're following the Tight Regulation Protocol.

Here is the sticky I pullled this from:

http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/

The links in what I pasted should work, so you can pop over to the TR or SLGS sticky from here and see more about them in detail. I can't pick a method for you, obviously, it's whatever works best for you, but from what I've seen, people that feed dry food have to do SLGS and people that maybe can't test as much do SLGS. TR is a bit more involved, but has some great remission percentages behind it. If it's been awhile for you, and you were here before, you probably? did TR? As I understand it, that used to be the only protocol here.
 
Thank you! I didn't realize there were two protocols. the one I had learned and followed years ago and now is the tight regulation protocol. I was a also using a human meter in 2011 and now using an alphatrak. Ill continue to do my research :)
 
willow & killa said:
oh no! really?!
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It's fine, it's not an emergent need, it will just make it easier for you to see the "action" number (possible hypo conditions) by highlighting it bright green. As long as you know below 80 STRIKE THAT, below 68 is your number on AlphaTRAK, right now it looks like it's set up for below 50 for a human meter (makes sense since you had one the last time).
 
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willow & killa said:
this is why I LOVE this group. my vet had me switch meters and hasn't informed me that its any different than a human meter :(
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I started with the AlphaTRAK as well, I think it generally reads higher than human meters, but the really big difference is the cost of the strips. $50 for 50 on the AlphaTRAK. I think I made a car payments worth (a cheap car, but a car) of investment in AlphaTRAK strips the first month! :blackeye: I use my AT very occasionally to compare how close it reads with my human meter, but it's pretty much a paperweight.
 
Below 68 if the earned reduction number when following TR on an AT. It’s advised to be pretty aggressive if you can monitor if a cat has come out of remission to get back into remission.
 
tiffmaxee said:
Below 68 if the earned reduction number when following TR on an AT. It’s advised to be pretty aggressive if you can monitor if a cat has come out of remission to get back into remission.
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She's right, ignore what I said about 80, it's 68
 
so this group recommends using human meters? Im so annoyed, my vet said human meters weren't as accurate on cats so we bought an AT and you're right the strips are so expensive.
No I'm not good with spread sheets at all.
I will watch and work towards 68. thanks! seems so scary to work with numbers so low. I panicked today when it was in the 80's.
 
willow & killa said:
so this group recommends using human meters? Im so annoyed, my vet said human meters weren't as accurate on cats so we bought an AT and you're right the strips are so expensive.
No I'm not good with spread sheets at all.
I will watch and work towards 68. thanks! seems so scary to work with numbers so low. I panicked today when it was in the 80's.
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The human meters are recommended because the TR protocol was written using human meters (it's less confusing to follow it if you use human meters too). And yes, it's scary. Asia just started getting some low numbers (how's 47 for a freak out number)! But it does get easier and less stressful once you get an idea what they do and you know how they respond to food when you need to bring them up. I'm still not quite there yet, but I felt much better shooting an 83 last night than I did the first time her preshot number was green just a couple days before. This board is so amazing and supportive! Asia would be a diabetic mess right now without it.
 
Toebeans said:
The human meters are recommended because the TR protocol was written using human meters (it's less confusing to follow it if you use human meters too). And yes, it's scary. Asia just started getting some low numbers (how's 47 for a freak out number)! But it does get easier and less stressful once you get an idea what they do and you know how they respond to food when you need to bring them up. I'm still not quite there yet, but I felt much better shooting an 83 last night than I did the first time her preshot number was green just a couple days before. This board is so amazing and supportive! Asia would be a diabetic mess right now without it.
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okay that makes since. I may consider going back to the other meter.
Wow! 47! good for you. Keep it up! Asia is adorable by the way :)
 
I’m sorry your little guy came out of remission and I hope you can get him back. There is a lot of new info for you to read in the stickys.

@Toebeans and Willow: Actually there aren’t two protocols. The only “protocol” is tight regulation. Start Low Go Slow is just a method/approach developed in this forum based on the knowledge gathered within. We try to be sure and stress this when we can so people understand some of the differences.

Insofar as the SS, you are using the old one that was corrupted. Some people who have been around a bit haven’t had any issues but others are so we are trying to get everyone over to the new one. I can do a new one for you, copy any data you have, and then link your old SS just so it’s all in one place. I’ll send you a private message so check your inbox. We have different SSs now depending on whether someone is using an AT or human meter so let me know which one you want; however, even if you choose the AT SS for now, it’s easy for me to go back later, if you switch, and reformat that one for you for a human meter so everything is on one SS.

Killa is already looking pretty good so with a little insulin support, he might get back right to the Falls. While we usually tell the caregiver of a kitty coming out of remission that they want to be aggressive (as getting them back to remission a second time can be more of a challenge), you also want a dose that you can shoot every 12 hours because skipping shots and shooting reduced doses at night isn’t helping his depot and it’s why his AMPS and daytime cycles are generally higher.

Is there any reason why you can’t test at night.....even a +2 and before bed would be very helpful. He’s definitely at shootable numbers at PMPS as long as you can test some. He looks like he generally prefers to be flatter which is excellent! He’s also recovering quickly from the skipped shots and BCSs.

If you can’t test at night, you might want to back the dose down a bit so you can shoot the same dose twice a day but, honestly, I never recommend shooting and not testing....it’s just not a good idea. We’ve recently seen two long-term diabetics, who were very stable at the same dose for months and had experienced caregivers, hypo. One of them didn’t make it :(

If he were mine, in an effort to get him back into remission quickly, I’d shoot the 1u and stay on top of the testing because a little extra time and testing on your part now might help get him right back into remission.

We are sorry you have to be back but let’s hope it’s not for long and he can start enjoying his condo at the Falls again soon!

And I agree....Asia is absolutely adorable.
 
@Marje and Gracie thank you for your help and support! I am going to stick with the AT for now and will probably get a new human meter in the near future. is there one that this group likes best? I will email you the info you requested, I soooo appreciate the help. I tried today without success.

that is heartbreaking about the kitty going into hypo, i can't imagine what they must have going through :(
I can certainly test for a few hours after his PM shot, I guess my concern is that I was told by my vet not to dose or only give 1/2 if its under 150 and knowing his lowest numbers are around +5, +6 which i will be asleep during this time and may miss it. can you remind me what is the lowest PS number is in which i would not give him a dose? think i may feel better giving 1/2, 2 times a day but i'll give this a try.

both times over the past 6 years kills has come out of remission seemed to be medicine/illness/stress related. the first time a vet accidentally gave him a corticosteroid shot and this time he became very ill following a regular dental and 2 vaccines which i requested not to have but my husband was talked into them by the vet tech. he's 14 and 100% indoor cat, i don't see the need...oh well
thanks again for your help!
 
willow & killa said:
@Marje and Gracie thank you for your help and support! I am going to stick with the AT for now and will probably get a new human meter in the near future. is there one that this group likes best? I will email you the info you requested, I soooo appreciate the help. I tried today without success.

that is heartbreaking about the kitty going into hypo, i can't imagine what they must have going through :(
I can certainly test for a few hours after his PM shot, I guess my concern is that I was told by my vet not to dose or only give 1/2 if its under 150 and knowing his lowest numbers are around +5, +6 which i will be asleep during this time and may miss it. can you remind me what is the lowest PS number is in which i would not give him a dose? think i may feel better giving 1/2, 2 times a day but i'll give this a try.

both times over the past 6 years kills has come out of remission seemed to be medicine/illness/stress related. the first time a vet accidentally gave him a corticosteroid shot and this time he became very ill following a regular dental and 2 vaccines which i requested not to have but my husband was talked into them by the vet tech. he's 14 and 100% indoor cat, i don't see the need...oh well
thanks again for your help!
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Thanks for sending me the info and I will do the SS as soon as I get back from an appt so you will ave it later tonight.

Vets are really cautious with good reason.....they won’t be available if kitty goes low. We don’t shoot under 68 on the AT and 50 on a human meter. I might suggest you just start trying to shoot the blue numbers at this dose with a consistent dose and see how it goes. If you get a green number, stall without feeding and ask for help. There’s almost always someone around to help you through shooting lower. Heck...even if you get a blue number and need help...don’t feed him but post and just ask if someone can stay with you but be sure you make the subject line something that catches attention like “stalling need help pls”.

What many do is get a before bed test and then go to bed and get up around nadir and test and the next go back to be done unless kitty is lower. We all become very efficient at sleep testing. I always kept all testing supplies by my bed and Gracie at my pillow and it took me less time to test her than to make a night trip to the WC.:p
 
Great advise, this helps. I'll give it a try
I thought eating would increase his numbers...NO? if he's eating small amounts of food throughout the day, will this decrease or increase his numbers? we use to only feed 2 meals but since he got sick his appetite hasn't been great so we've been giving him food when he's hungry. trying to get him back on track.
enjoy your weekend!
 
Especially with the longer acting insulins like Lantus and Levemir, feeding during the cycle is much easier on the body. Lantus takes about 2-4 hours before onset. ...Levemir take about 4-6 hours. Once the insulin is in the system it helps to deal with food in between shots. Many human diabetes use a fast acting insulin at meal time and a longer acting insulin such as Lantus/Levemir. Human diabetics normally eat 3 meals each day with numerous snacks in between. In my experiences with 2 FD kitties, numerous feedings work best for them. With some kitties feeding after the nadir (lowest reading) can shorten the effects of the insulin. There is a lot of trial and error involved in figuring out the best feeding schedule for your own kitty.
 
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