? CONFUSED!! AMPS is Normal but PMPS is High Readings

Jacque- Tiger & Jazz Man

Jacque- Tiger & Jazz Man

Member Since 2014
Previous Thread http://www.felinediabetes.com/FDMB/threads/help-with-tigers-lab-results.226293/#post-2537301. What a rollercoaster ride for my poor old man :arghh: blacks(a lot), reds, pinks and yellows. At least he is eating better and sorry but ya he is nibbling on dry..Nutro Sensitive and BB Kitten. Pee testing daily with One Step Vet 10...results are good except for glucose(of course). After 7 cycles of 5u's..Doc upped the units to 6 this morning's shoot. Also in case you haven't read the other threads, he is now on Clavomox for congestion and Prednisolone to help him to breath. Not as raspy sounding now. @Deb & Wink and @Chris & China (GA)
 
Tiger is not getting very good duration from the Vetsulin. Looks like the insulin poops out by +8 or +9.

He did have a nice day of yellows, but now he's back in blacks.:(

Hope the antibiotic can clear up his lungs, and then maybe the BG levels will start coming down after that.
 
Deb & Wink said:
Tiger is not getting very good duration from the Vetsulin. Looks like the insulin poops out by +8 or +9.

He did have a nice day of yellows, but now he's back in blacks.:(

Hope the antibiotic can clear up his lungs, and then maybe the BG levels will start coming down after that.
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Ya it does look that way...sometimes lol. At least the Vetsulin is doing something, Prozinc didn't even touch his bg's. Day 3 on Clavamox so should start kickin in good now.
 
Hi! This is my first time seeing Tiger (and I'm not a Vetsulin user), so forgive me if you've considered this already - but I'm wondering if it would be good to test for high-dose conditions at this point. There are some conditions which cause the need for higher doses of insulin - Acromegaly being one of them (which my Rocket has). Like Deb, I hope it's the infection that is driving up Tiger's numbers. Tagging @Wendy&Neko to see what she thinks.

There's a high dose section of the forums here, if you'd like to take a look :)

http://www.felinediabetes.com/FDMB/forums/acromegaly-iaa-cushings-cats.12/
 
Karen @Keskat&Rocket Tiger is still eating dry food, which would contribute to the need for higher doses. As does prednisolone and possible dodgy teeth. Not that dry and pred preclude acromegaly or insulin auto antibodies, but they will definitely mean a higher dose is needed. Good to hear his breathing is better. Did the vet have an explanation for it?

I agree with Deb, I don't think Vetsulin is a good choice for Tiget. And at his size of dose, Levemir is probably the better choice.
 
Jacque is very leery of using the L type insulins.

@Chris & China (GA) talked to her about the advantages of using Lantus, in a post over in our sister facebook group.
Jacque already has another cat Jazz Man, on Prozinc.
That is why she tried that insulin first, starting on 2/14/20. She self diagnosed her cat Tiger. No vet diagnosis at that time.

I questioned her on if her cat Tiger was actually diabetic, but she insisted he was. I then actually agreed with her bumping the dose of Prozinc up really, really fast, to get him out of the high BG levels, those black numbers. I'm still not convinced that her bottle of Prozinc is any good.

Then she got the Vetsulin from her vet and has tried that for the last 9 days. She started Tiger at a very high dose, increased really, really fast and expects very fast control of the BG numbers.

The problem with Vetsulin, is that it simply does not last the full 12 hours of the dosing cycle.

Jacque is also very scared of numbers in the yellow range or below. Afraid of hypos more than getting Tiger in
those lower, better BG ranges. Human diabetics feel dreadful, when their BG levels are that high.

Even Jazz Man, her other diabetic cat (on Prozinc) is likely above renal threshold most of the time, from what she has said.

It's her choice though. On making those insulin choices and dosing decisions.

Tiger has other medical issues, complicating the situation. Beyond his older senior age of 18. Plus, limited funds is a big concern for Jacque, as she has a lot of special needs cats she takes care of, besides the 2 diabetic cats.

"Between a rock and a hard place."
 
Wendy&Neko said:
Karen @Keskat&Rocket Tiger is still eating dry food, which would contribute to the need for higher doses. As does prednisolone and possible dodgy teeth. Not that dry and pred preclude acromegaly or insulin auto antibodies, but they will definitely mean a higher dose is needed. Good to hear his breathing is better. Did the vet have an explanation for it?

I agree with Deb, I don't think Vetsulin is a good choice for Tiget. And at his size of dose, Levemir is probably the better choice.
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He just started eating dry again this past week and only nibbling. Not eating the Nutro anymore, eating bb kitten. At this point I'm just thankful he is eating at all. He is eating canned pate..right now his choice is "I Love and You". Doc put him on the Vetsulin because it was faster working and unfortunately the draw back is its leaves fast too.
 
Deb & Wink said:
Jacque is very leery of using the L type insulins.

@Chris & China (GA) talked to her about the advantages of using Lantus, in a post over in our sister facebook group.
Jacque already has another cat Jazz Man, on Prozinc.
That is why she tried that insulin first, starting on 2/14/20. She self diagnosed her cat Tiger. No vet diagnosis at that time.

I questioned her on if her cat Tiger was actually diabetic, but she insisted he was. I then actually agreed with her bumping the dose of Prozinc up really, really fast, to get him out of the high BG levels, those black numbers. I'm still not convinced that her bottle of Prozinc is any good.

Then she got the Vetsulin from her vet and has tried that for the last 9 days. She started Tiger at a very high dose, increased really, really fast and expects very fast control of the BG numbers.

The problem with Vetsulin, is that it simply does not last the full 12 hours of the dosing cycle.

Jacque is also very scared of numbers in the yellow range or below. Afraid of hypos more than getting Tiger in
those lower, better BG ranges. Human diabetics feel dreadful, when their BG levels are that high.

Even Jazz Man, her other diabetic cat (on Prozinc) is likely above renal threshold most of the time, from what she has said.

It's her choice though. On making those insulin choices and dosing decisions.

Tiger has other medical issues, complicating the situation. Beyond his older senior age of 18. Plus, limited funds is a big concern for Jacque, as she has a lot of special needs cats she takes care of, besides the 2 diabetic cats.

"Between a rock and a hard place."
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@Chris & China (GA) guided me from the beginning. We did the 3 cycle a small units..it did nothing(from the one bottle). Switched to the other bottle and nothing either. If you take a look see at the numbers Doc just had me do the 4u's of Vetsulin for 4 cycles which was the same Units as the Prozinc. With the Doc's recommendations I've been upping the dose..not on my own. She wants 6 cycles so that's what I've been doing. I'm in constant contact with her..I even have her cell phone number.
And yes, I am a little worried about the "colors" when I see other members posts..they freak out too...so, I'm not the only one who freaks. I'm sure his pancreas and other organs are shot at the age of 18. I don't think the Pred is causing any "HI" readings he was just put on it on the 28th at Midnight. Antibiotics just this Monday. Most of bottles of insulin are donated to me by one of the rescues/shelters that I help out. Doc knows I have very little money and doesn't want to do any more bloodwork unless it's necessary. We are waiting to see if the Clavamox works. I checked Jazz Man today and his AMPS was 250 so I don't think the bottle I'm using now is bad. Before Tiger got sick I was actually planning on doing a 24 curve on Jazz. Jazz Man seems fine..nothing out of the ordinary so Tiger is top priority now.
Can't it take months to get a diabetic cat better results? His numbers have been so high for who knows how long which is why(what did you call it?) bouncing. Maybe with alittle luck no more bouncing. Take a look see at todays numbers..looking better.
 
I just saw a post about a cat having 80bg's and she is worried. Not sure why I don't have the right to be worried at 200. Especially since we still haven't gotten close to a Nadir yet.
 
Keskat&Rocket said:
Hi! This is my first time seeing Tiger (and I'm not a Vetsulin user), so forgive me if you've considered this already - but I'm wondering if it would be good to test for high-dose conditions at this point. There are some conditions which cause the need for higher doses of insulin - Acromegaly being one of them (which my Rocket has). Like Deb, I hope it's the infection that is driving up Tiger's numbers. Tagging @Wendy&Neko to see what she thinks.

There's a high dose section of the forums here, if you'd like to take a look :)

http://www.felinediabetes.com/FDMB/forums/acromegaly-iaa-cushings-cats.12/
Click to expand...
http://www.felinediabetes.com/FDMB/...-other-high-dose-conditions-what-we-know.375/ Just read through this..he doesn't fit the bill. None of the characteristics of a Acro cat. His breathing issues right now are caused by congestion. And his readings are finally starting to drop. Thanks for the heads up...I've been watching him closely for any out of the ordinary symptoms since he showed me he wasn't feeling good.
 
Jacque- Tiger & Jazz Man said:
Not sure why I don't have the right to be worried at 200.
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You have the right to be worried at any number you are getting.

What is it about the BG at 200 that makes you worried?

Back on 3/3/2020 PM cycle, Tiger had a nadir of 227 at +8. Was that worrisome to you Jacque? Would you be able to explain why, or why not?

Jacque- Tiger & Jazz Man said:
Especially since we still haven't gotten close to a Nadir yet.
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You have gotten to a nadir. For 3/6/2020, AMPS Tiger had a nadir of 342. It's not a very low nadir, but it's still the lowest point he achieved in that cycle.

So you said your vet has you increasing the dose every 6 cycles. Tonight's PMPS will be the 6th cycle on this 6U dose. What does the vet want you to raise the dose to then? 6.5 or 7 Units? Or something different?
 
Deb & Wink said:
You have the right to be worried at any number you are getting.

What is it about the BG at 200 that makes you worried?

Back on 3/3/2020 PM cycle, Tiger had a nadir of 227 at +8. Was that worrisome to you Jacque? Would you be able to explain why, or why not?

You have gotten to a nadir. For 3/6/2020, AMPS Tiger had a nadir of 342. It's not a very low nadir, but it's still the lowest point he achieved in that cycle.

So you said your vet has you increasing the dose every 6 cycles. Tonight's PMPS will be the 6th cycle on this 6U dose. What does the vet want you to raise the dose to then? 6.5 or 7 Units? Or something different?
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It's the huge number drops that freak me out. After that nice 227 he went HI again shortly after that. I am definitely starting to feel more optimistic since I'm getting better readings throughout the cycles. I'll call Doc in the morning and let her know his readings. Maybe we need to hold at this dose for awhile longer..Idk..whatcha think? His AM is at 11am and PM is 11pm..yes, I have a weird schedule. All I do is syringe feed, subq and medicate cats and dogs all day it seems. From the moment I wake up at 8am all the way until bedtime which is about 3am.
 
Jacque- Tiger & Jazz Man said:
It's the huge number drops that freak me out. After that nice 227 he went HI again shortly after that. I am definitely starting to feel more optimistic since I'm getting better readings throughout the cycles. I'll call Doc in the morning and let her know his readings. Maybe we need to hold at this dose for awhile longer..Idk..whatcha think? His AM is at 11am and PM is 11pm..yes, I have a weird schedule. All I do is syringe feed, subq and medicate cats and dogs all day it seems. From the moment I wake up at 8am all the way until bedtime which is about 3am.
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And of course his readings just now are waaay up again, insulin is wearing off. 554 +10
 
What really shocks me about the members here is that NO ONE has ever said anything rude, cruel or nasty to me. Some fb groups say hurtful comments like: if you can't afford the cats meds and doc visits you don't deserve to have them..and I'm like...I take in these cats and dogs that would have been euthanized by their "guardians" or thrown out the door to die alone and unloved...does this make me a bad guardian?
 
No, he's getting 12 Units total right now, for every 24 hour period.
6 Units in the AM. 6 Units in the PM.

To do the every 8 hour dosing, you'd want to keep the same 12 units, but split it over the 3 times a day versus the 2 times a day.
Divide the 12U by 3 and you get a 4U dose every 8 hours.
He'd still be getting the 12 units each 24 hours that way.

Just the dosing closer together would keep him from losing the duration. He might even get some overlap.

Would dosing 3 times a day even work with your schedule?
 
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If you do the every 8 hour dosing, it's going to be rough and mean more of a time commitment.

Starting that "every 8 dosing", you want to do a curve, checking the BG's every 2 hours.
If at +8, the numbers are still rising, (no longer falling), and the BG is above your no-shoot threshold, then give another shot.

Then wait 8 hours, test to be sure the numbers are still rising, (not falling), and BG is above your no-shoot threshold. Give another shot.

This is not used as a long term method, but could get the levels to stabilize in a few weeks.
Get your vet to "buy in" to doing this. You'll want their guidance.
 
Deb & Wink said:
No, he's getting 12 Units total right now, for every 24 hour period.
6 Units in the AM. 6 Units in the PM.

To do the every 8 hour dosing, you'd want to keep the same 12 units, but split it over the 3 times a day versus the 2 times a day.
Divide the 12U by 3 and you get a 4U dose every 8 hours.
He'd still be getting the 12 units each 24 hours that way.

Just the dosing closer together would keep him from losing the duration. He might even get some overlap.

Would dosing 3 times a day even work with your schedule?
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:facepalm::facepalm::facepalm::facepalm::facepalm:
 
Deb & Wink said:
If you do the every 8 hour dosing, it's going to be rough and mean more of a time commitment.

Starting that "every 8 dosing", you want to do a curve, checking the BG's every 2 hours.
If at +8, the numbers are still rising, (no longer falling), and the BG is above your no-shoot threshold, then give another shot.

Then wait 8 hours, test to be sure the numbers are still rising, (not falling), and BG is above your no-shoot threshold. Give another shot.

This is not used as a long term method, but could get the levels to stabilize in a few weeks.
Get your vet to "buy in" to doing this. You'll want their guidance.
Click to expand...
My schedule is all over the place..if it might work to stabilize him even a little..I'll make it work. I test all the time anyway lol..so that isn't a big deal. What would be my no shoot threshold be?? He doesn't have one :(. Or should I just shoot when rising at the 8hr mark?
 
So what is that? Yes or no? Or "Oh my god, I don't think I can handle doing a curve."

Do we need the 3 little monkeys?
images
 
My availability to guide you with this, this weekend is horrible.
I'm cat sitting 3 times a day this weekend. they are not short "gigs" either, at least 90 minutes each and one of them will be 2.5+ hours.

Damn.
 
Idk if it will be possible for me to get a big meal every 8 hours though. Every 12 is hard enough. Since he is free feeding dry BB Kitten should I NOT be concerned about the amount he eats if and when I do the 8hr shoots? The "if" is because not sure if Doc will be onboard with this yet.
 
Deb & Wink said:
Free feeding dry, but is he eating enough of the dry each day?

Will he eat any flavor of wet/canned/pouch food?
Even 1 ounce, which is only about a tablespoon would be enough.
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For sure on the canned. He eats way above that.. pate or delectable lickables..I just keep shoving in front of him and not give up. Eats at least 2 cans of 3oz pate at day before shoot time. And about 2 cups of dry inbetween.
 
Deb & Wink said:
Every color of the rainbow except the blues and greens which would be good to see.
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Ikr? 11th cycle so 5 days on the 6u. Still sounds nasally. Have an appt to take our breast cancer dog(Maxine) in this afternoon..she's scratching the tumors, limping and in pain. She's on Rimadyl 50mg right now. I'll see if doc wants to put Tiger on something else for the congestion.
 
Good luck with Maxine, the dog with cancer. Running a virtual small animal rescue like you are doing, with lots of special needs pets is tough.

Tiger simply isn't getting the duration he needs from the Vetsulin. And since that is the case, he will be in those higher black numbers for a good portion of the dosing cycle. Sorry to say, but I don't think that upping the dose of Vetsulin will improve the situation for him. You could try. Ask your vet first though what he/she thinks about doing that.

Are you sure you wouldn't reconsider the Lantus or Levimer? ;):joyful::p
 
Jacque- Tiger & Jazz Man said:
Just read through this..he doesn't fit the bill. None of the characteristics of a Acro cat.
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Just FYI, saw a research paper that says only 35% of acros showed symptoms on diagnosis. Neko had no physical signs, just a high dose and incredible hunger from the excess growth hormone (think growing teenage boys :rolleyes:). She did get up to five units of Caninsulin/Vetsulin and seeing blues before I switched to Lantus. But eating all low carb wet/raw.

You’ve got a lot on your hands. When I worked at the local shelter, we loved people like you.
 
Deb & Wink said:
How are you doing Jacque?
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Me? barely hanging on, had to get back on Xanax for my panic attacks. We had to put Maxine to sleep last week, she was suffering so much from the breast cancer. It spread to her lungs and the lymph nodes.
Just yesterday Fluffy another old cat(17) lost the use of her right leg, she's always had a problem with it..it turns inwards..also didn't eat or drink the whole day. Glucose is fine. She is weak though. Gave her B12, Zobaline, subq-d fluids and syringe fed(which she threw up). I have her in a huge dog carrier right now, don't want her to injure herself. Today she is eating better.
And Tiger?? Well just a few minutes ago I did his AMPS it was 102!!!!!!!!!! No insulin given. So proud of my old fart. His congestion is easing too, Doc put him on Lasix last week.
 
Jacque- Tiger & Jazz Man said:
Me? barely hanging on, had to get back on Xanax for my panic attacks. We had to put Maxine to sleep last week, she was suffering so much from the breast cancer. It spread to her lungs and the lymph nodes.
Just yesterday Fluffy another old cat(17) lost the use of her right leg, she's always had a problem with it..it turns inwards..also didn't eat or drink the whole day. Glucose is fine. She is weak though. Gave her B12, Zobaline, subq-d fluids and syringe fed(which she threw up). I have her in a huge dog carrier right now, don't want her to injure herself. Today she is eating better.
And Tiger?? Well just a few minutes ago I did his AMPS it was 102!!!!!!!!!! No insulin given. So proud of my old fart. His congestion is easing too, Doc put him on Lasix last week.
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@Chris & China (GA) suggested to check Tiger's glucose again in case bad strip. So, an hour after the 102 it's now 132
 
I'm saddened to hear that Maxine had to be put to sleep. But it was time. It's one of those so, so difficult decisions we are forced to make in life, when our pets health has declined and they are suffering. :bighug::bighug::bighug:

Fluffy cat being sick simply adds to your burdens. The shortages in cat food and supplies is scary.

I think it's time to reduce Tiger's dose anyway. That BG of 70 back on 3/15 PM cycle was a signal that the 7U is too much. Today could have been a "wonky test strip" or not enough blood on the test strip. From 7U to zero is a huge difference. No carryover or depot with Vetsulin, so no insulin for the day is safe. Tiger will be fine.

A lot of us are barely hanging on. Afraid that if we go out in public, we are risking our lives. Even getting packages delivered to my home is scary. I think to myself, "Is this package that just got dropped off safe to touch? Should I let it sit in the mudroom and open it in a few days?" Definitely wash my hands after, and don't touch anything that I don't have to.

Life will not be normal for some time I'm afraid. I'm glad it's spring at least, and we have the better weather and green growing things to look forward to. I'm "treasuring every day" and keeping in close email/phone contact with a few close friends daily. Our own little support network.
 
I agree with Deb. That 70 on an AT means business and you should reduce. Or was that 70 with the Contour? I'm a little confused by the comment on your spreadsheet header that you are using the AT sometimes and sometimes the Contour? Regardless, keeping Tiger safe so you don't have to go to the ER is a good thing.
 
I would have reduced the dose Jacque.
Not up past midnight to give you feedback. Usually not up past 9PM EDT.
 
Wendy&Neko said:
I agree with Deb. That 70 on an AT means business and you should reduce. Or was that 70 with the Contour? I'm a little confused by the comment on your spreadsheet header that you are using the AT sometimes and sometimes the Contour? Regardless, keeping Tiger safe so you don't have to go to the ER is a good thing.
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I need to edit my sig. Only using the Contour now. No strips for the AT.
 
Food differences between AM and PM?
Medication differences between the 2 cycles?
The 7U is way too much insulin, and Tiger is dropping even lower during the PM cycle and you aren't catching it?
 
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