AMPS 128...didn't shoot

Recap:
Peyton's BG at vet a month ago 143
At the next vet a few days later BG 243
At our regular vet the next week BG 426 and continued to creep up. He spent all of last week at the vet on IV fluids (he's 4 years CRF) and getting his insulin regulated. Monday and Tuesday of that week he got Vetsulin and his BG went down. They did not give him insulin Wednesday or Thursday because his BG was 150 or less. Then in Friday it went back up to the mid 300's. This could have been from the food they were feeding him...royal canin renal lp.

I brought him home Friday and the vet suggested once a day Vetsulin at 1 unit. Saturday morning I didn't have test strips so I gave him the day off from ear sticking...probably not the best idea.

Sunday AMPS 148
1 unit Vetsulin
Fed Wellness can food in small amounts throughout the day and didn't retest.

Monday AMPS 134
1 unit Vetsulin
+4.5 BG 45 (fed slightly higher carb food)
+6 BG 53
Continued to feed slightly higher carb food throughout the day.
Called vet and he suggested insulin once a day, every other day which doesn't seem appropriate to me. I would think a reduction before skipping days?

Today:
Fed small amount of Wellness canned at 3:00 am
AMPS 128...didn't shoot
Should I have still shot a reduction at an almost normal BG level? It had been 24 hours since he had insulin and had eaten several small meals since then.
Thoughts/Advice?

He was on Lantus last summer and would have severe drops. He was in remission within a little over a month. I didn't think the Vetsulin would drop him like that.

Before his diabetes diagnosis this time he was being an extremely picky eater and I thought it was because of his CRF. He was mainly eating baked organic chicken. Do you think his body has been missing all the nutrients that were in the can foods and that is what has caused this? I would offer low carb can food but he wouldn't have anything to do with it so I baked him chicken and he would devour it. I'm just at a loss as to what has caused his diabetes to return.

My main question is...
At what BG do you not shoot? Was I right in not shooting this morning or should I decrease his dose? Looks like his BG is doing good even 24 hours after insulin. I'm at a loss a and I know I don't have that much data to look at.
I've tried to get in my spreadsheet and it keeps saying "loading" but won't come up. That's why I've had to write it on here.
Thank you all!!!

 

Yes, it is better to reduce does instead of skipping hosts.
Vetsulin does cause a rapid drop in BG compared to Lantus.
IWith your data I would not shoot Vetsulin below a GB of about 150. If over I would likely go with 1/2 unit. But it depends upon the specific BG.

 

@Larry and Kitties
Would you have shot 1/2 a dose at an AMPS of 128? I think I understand you saying you wouldn't shoot under 150 only over 150? I just want to double check in reading correctly.

What do you think about the vets suggestion of every other day insulin?

"If" his BG is above 150 this evening would you recommend 1/2 unit instead of 1 unit? That is if it's not too high.

Vets first recommendation was 1 unit once a day. Now he says 1 unit, once a day, every other day. Should I be shooting twice a day depending on his BG numbers? I know there is no 24-48 hour insulin.

I'm just wondering if he's truly diabetic Again. I guess if his BG starts to spike again then he is. I'll post later with his BG.
Thank you for your response!

 

Yes, based on your limited data I would shoot 1/2 unit if BG between 150 and 200. maybe a little more if higher than 200.

 

First up, Vetsulin is typically harsher than Lantus so the drops are to be expected. (Vetsulin works better for canine diabetics, but some cats do OK on it.)

I think it was a smart move not to give insulin this morning. 12o is the top end of the normal range as measured on a human meter. Doubly so because Peyton had eaten several times.

I'd suggest that you try testing him before a meal then testing at +1, +2 and +3. If the BG eventually lowers after the food, that would give us some idea of how Peyton's pancreas is doing (with the caveat that there is still probably some insulin in the depot).

I can access your 2014 spreadsheet fine from here. Try refreshing the tab in your browser.

Without a lot of data, the normal forum recommendation is not to give insulin if preshot is less than 200 (and also nadir has to be taken into account). As the volume of data builds, you can determine better when it is safe to lower the no-shoot number. As always, post if you're not sure what to do.

Re the CRF, are you a member of the support group on Tanya's Site? I don't think the baked chicken will supply all the nutrients Peyton needs. If you're not already a member, I'd recommend joining up. Saoirse was recently diagnosed with CKD and I've joined to learn how to help her. There are some very knowledgeable people there who might be able to advise on diet. Does Peyton take anything for nausea? Have you ever had Peyton tested for pancreatitis (Spec fPL)?

 

The 'every other day' recommendation does not make any sense to me. Normally, you want to give insulin twice a day, so your instinct to lower the dose in order to do that is absolutely correct. I've never used Vetsulin, but Larry's recommendation sounds like a good one.