4/21 CARTER AMPS 429, +4 556, +6 428, +9 494, PMPS: 441, +5.5 306

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Erica & Carter

Erica & Carter

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Hi all,

Yesterday's thread.

Carter is starting off at 429, similar to yesterday's AMPS. Maybe he can reach the low 300s today!

Before bed last night around +3.5 he had gone from 300s to 520. Though I know Lantus can usually start taking affect around the +2 or +3 mark, would that spike just be influenced by food still? Is that common?

I'm tweaking my food schedule a bit (still 4x a day) but making sure I get it set so there is no food after the Nadir, so from +6- to the next PS of every cycle . I read that helps because if you add food to the time where the insulin is at it's weakest it can prevent it from working to it's full potential.

Though my auto feeders arrived yesterday, I forgot to buy batteries! So I'll have to implement tomorrow. The pet fountain is all set up and while Simon and Odin are a little cautious, Carter started drinking out of it this morning, so 1/3 in 12 hours isn't bad!

Hot spot is smaller and looks like it's healing as long as he doesn't keep getting it moist by licking!

I'll have some questions about tomorrow's AM dose later depending on today Nadir so stay tuned for that! :D
 
Could be food in part, though it's a bit of a hike if he is only getting wet LC, and that doesn't appear to have happened in previous cycles.

Do all your cats get Low Carb? Could he have got into some contraband?
Glad the hot spot is getting smaller.
 
Gill & George said:
Could be food in part, though it's a bit of a hike if he is only getting wet LC, and that doesn't appear to have happened in previous cycles.

Do all your cats get Low Carb? Could he have got into some contraband?
Glad the hot spot is getting smaller.
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Yes they all get LC, rotation of Tiki Cat and BFF. Only other thing they get are the Whole Life freeze-dried turkey treats. I don't think he could have gotten into anything? There's nothing around dry-food wise I donated everything, and my dog's food is kept locked up. It's possible he found some crumbs or something on the floor of some type of food but that's the only thing I could think of.
 
Cats can be bouncy. It looks like Carter started to come down and then bounced back up. I hope he heads down today and the hot spot heals. Sending prayers.
 
Mm now that I think of it, my other boys were finishing off a random can of Merrick I had (not their favourite, but I wanted to use it up) and it's possible Carter could have snuck some of that. I've been watching them eat because I had a couple cans of Merrick I had been trying to get rid before I started using the auto feeders because the Merrick is 6% carbs as opposed to the 0%-3% he's been eating. So maybe he's just carb sensitive?
 
I know he has to stay at 1u for 6 full cycles so the soonest I can up his dose would be tomorrow AM but I'm just worried about him being steady in the 500s...
 
I think it's a bounce, as well. The 79 a few days ago coupled with the skipped shot have probably propelled the numbers upward. In addition, the Lantus depot is still forming. You may not see much of a response until the depot has stabilized.

Actually, when starting Lantus, you hold the initial dose for at least 5 days.
 
Sienne and Gabby (GA) said:
I think it's a bounce, as well. The 79 a few days ago coupled with the skipped shot have probably propelled the numbers upward. In addition, the Lantus depot is still forming. You may not see much of a response until the depot has stabilized.

Actually, when starting Lantus, you hold the initial dose for at least 5 days.
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Oh okay. @Chris & China had said the earliest I could increase would be tomorrow morning? I assume based off this:

GENERAL GUIDELINES:
  • Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).

I'm confused now lol is he technicially on a high curve? or periodically high? His starting dose for 1u what based off advise from here because my vet wanted to do 2 units and safe to say I don't really trust her dosing advise after the 4 units of Vetsulin she started him out on. But he's a big boy, almost 15-17 pounds, so I didn't expect the 1u would probably be our final number either.
 
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Carter just went on the attack again... noticed it might have to with food. Poor Kya doesn't understand why her buddy is acting like this. Even when the food is put up, he usually acts like that after a feeding (after his plus +4) so maybe he's being food aggressive? He doesn't attack the other cats though, I don't get it.
 
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The earliest you would increase is usually 6 cycles with a bounce. Does Carter have a history of DKA or ketones?

I would be inclined to increase since I think Carter is under dose. Usually, when switching from any insulin (other than Levemir) to Lantus, you switch at the same dose. I suspect that 1.0u is too little insulin given that you were starting to see better numbers at 3.0u of Vetsulin. This is not so much a situation as noted in the TR guidelines as it is fast-tracking because you started at too low of a dose.

However, are you planning on following Tight Regulation? If not and you're planning on using Start Low Go Slow, you need to hold this dose for a week.



 
Sienne and Gabby (GA) said:
The earliest you would increase is usually 6 cycles with a bounce. Does Carter have a history of DKA or ketones?

I would be inclined to increase since I think Carter is under dose. Usually, when switching from any insulin (other than Levemir) to Lantus, you switch at the same dose. I suspect that 1.0u is too little insulin given that you were starting to see better numbers at 3.0u of Vetsulin. This is not so much a situation as noted in the TR guidelines as it is fast-tracking because you started at too low of a dose.

However, are you planning on following Tight Regulation? If not and you're planning on using Start Low Go Slow, you need to hold this dose for a week.


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He does not have a history of DKA or ketones, though I've been grabbing urine test the past week to check just to be safe since he's been pretty high overall.

I am doing TR, yes.

So then it would in fact be fine to increase tomorrow (4/22) morning by .5 if his Nadir for today is still above 300? But if it's below 300, to increase by .25? I doubt his AMPS tomorrow will be cause for a stall, I just want to know ahead of time that my increased dose tomorrow (under the above circumstances) will be justified.

Then, if I increase, I hold that dose for 3-5 days and then reassess from there?
 
Just to clarify I'm doing the +3, +6, +9 but I took a nap and slept an extra hour due to myself not feeling so good, so my 3+ became a +4.
 
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Erica & Carter said:
So then it would in fact be fine to increase tomorrow (4/22) morning by .5 if his Nadir for today is still above 300? But if it's below 300, to increase by .25? I doubt his AMPS tomorrow will be cause for a stall, I just want to know ahead of time that my increased dose tomorrow (under the above circumstances) will be justified
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Yes, the reason we all discussed increasing after only 3 days (instead of the usual 5 to fill the depot) is because of the high, flat curves, as well as the fact that he was on 3U of Vetsulin when you switched to Lantus and by dropping back to only 1 unit, you probably dropped too much.

If he doesn't make a major move tonight on his PM dose, I think you could safely increase to 1.5 tomorrow morning (unless of course he throws you a curve and by some miracle he's under 150 in the morning!)

Erica & Carter said:
Then, if I increase, I hold that dose for 3-5 days and then reassess from there?
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Yes, you'd hold the dose for at least 6 cycles (3 days) and re-access then. That's one of the good points about TR instead of SLGS....you can adjust the dose more frequently in response to the numbers you're getting instead of holding them for a full week when they're not getting the numbers we want to see
 
Chris & China said:
Yes, the reason we all discussed increasing after only 3 days (instead of the usual 5 to fill the depot) is because of the high, flat curves, as well as the fact that he was on 3U of Vetsulin when you switched to Lantus and by dropping back to only 1 unit, you probably dropped too much.

If he doesn't make a major move tonight on his PM dose, I think you could safely increase to 1.5 tomorrow morning (unless of course he throws you a curve and by some miracle he's under 150 in the morning!)



Yes, you'd hold the dose for at least 6 cycles (3 days) and re-access then. That's one of the good points about TR instead of SLGS....you can adjust the dose more frequently in response to the numbers you're getting instead of holding them for a full week when they're not getting the numbers we want to see
Click to expand...

Alrighty we go from there then! :)
 
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