? HeLP AMPS so low, Don't know what dose to give?

Griffin is being switched to wet food, slowly. This week he gets 2 meals dry food and 2 meals wet food. He loves the wet food!

This morning his AMPS is 11.9, I retested to make sure and it was 12.4 . I don't know how to decide how much of a shot to give him. He normally gets 3units.
My roommate is home to watch him but to do BG tests.

Yesterday he had a GB of 11.1 retested 11.8 so I withheld his insulin. (I was at work all day). at +1 (right before I had to leave for work he was 16. I still felt this was too low for me to comfortably give him his shot.

He missed his lunch as well and by 4pm was stalking anyone that moved.

Got home early did a BG at +9.5 (4:30pm) he is 27.3. I tested him again at +11.5 (6:30pm) 27.3 and feed and give him shot then (30mins early).

He was nice and low for the rest of the night.

I have also posted in the main area!

 

Moe. I'm tagging Alexi to get another set of eyes on Griffin as she uses Caninsulin too and has more experience than me.
@Alexi can you have a look at Griffin's SS and offer any advice about this morning as well as going forward. I'm not sure what to suggest to Moe as Griffin seem to be at his lowest much later than expected.

 

Retest 20mins later 12.5

My gut tells me I want to give him a reduced shot - 1.5units(maybe) so he doesn't hit 28 again or have to miss lunch.

 

I would miss his AM dose. That higher number last night was no surprise given he had not had insulin for 24 hours but the dose needs to come down, so you are able to give insulin twice a day instead of skipping shots. He is getting a great response to the food switch but don't do any more changes in his food regime until he is back on track with his dose. You could try a 2 unit dose this evening if you can monitor a +2 and a +5 as the minimum, if not then try a 1.5 and get a +2 reading. What you are looking for is a small drop in numbers by +2. I won't be around later today but what you are aiming for is to get those AMPS and PMPS numbers evened up without giving too big a drop and we can work out a dose going forwards.

 

Agreed.

Mo, if you are finding that you're having to skip shots because the preshot is too low then reducing the dose may even that out. And being able to give two shots a day will enable there to be insulin in Griffin's system for more of the time.

You may continue to see the numbers come down as the dry food is removed from Griffin's diet...
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Thanks @Alexi

If I skip the AM dose, should I skip his lunch around +6 / +7?

He gets super cranky and hard to test when he is hungry.

 

No need to skip his food. Keep things as consistent as possible as that will keep your data consistent. The stress of not getting his meal could just raise his BG more.

 

@MrWorfMen's Mom you are Griffin's new best friend, lol. He loves his food.

 

Mo, your gut 'might' be right, but at this point (while removing dry food) it's probably best to err on the side of caution; especially if there is nobody to monitor Griffin's BG...

In a nutshell, if you see a 'lower than expected' preshot, you have several options:

1) Skipping the shot. This is the safest option. But the downside is that you may see higher numbers later. (And this might not be an option for a kitty with a history of ketones or DKA.)
2) Stalling. Waiting for a little while - without feeding - to see if the BG rises to a shootable number on it's own.
3) Giving a reduced shot. This may be a slightly reduced dose, or half of the normal dose, or even a teensy weensy 'token' dose. But the first time you try this it would be good to be able to monitor the BG to get some data about what happens in that instance.

This is just one shot, so please don't worry. You'll get Griffin back on track very soon.

Eliz

 

Todays plan :

Skip AM Shot, feed lunch as per usual, Reduce PM shot to 2 and test at +2 & +5

Thanks Everyone

 

As an aside, I always feel so much better once I have a plan. You're doing really well with Griffin.

 

Morning Everyone,

Yesterdays plan did not quite woke out and normally it would be the feline's fault but the human completely owns this one .

I miss set the alarm for the PM +5 reading (midnight) I was exhausted when I went to bed (crazy day at work). So I missed what happened in his level drop on 2 units.

Would have slept through my second alarm too but that is feeding time and Griffin is the worlds best clock when it comes to food.

His reading this morning is 25 - much higher that the last two days (which I believe is what we wanted so I don't have to skip his shot).
I am going to go with the same routine and a 2unit shot this morning unless there is a reason I shouldn't.

@Alexi & @MrWorfMen's Mom wanted to let you know what happen after the "plan"

 

I think that sticking to the plan outlined by Alexi (above) is the way to go. If you can get those +2 and +5 readings today you'd have good info on where to go from there.

 

I'm I agreement. You want to find the dose that is going to give you two shootable pre-shot readings so stick with the 2u for a couple of cycles. And don't beat yourself up about missing a reading. We've all slept through a test alarm from time to time so just try again tonight. If getting a +5 is difficult during the week (you do need your ZZZZ's too!) then try for a +4. All data helps. You want to know how low a dose is taking Griffin so while that 25 this morning may look disappointing after the past 2 days, it looks like he likely got a good drop from the 2u last night so I'd stick with it.

Are you using the Caninsulin pen or sryinges to give Griffin his shot? Syringes give you the ability to finesse doses by 0.25u whereas the pen only allows for 0.5u dose changes and as time goes by and his numbers improve, syringes will give you more choice of dose when using a sliding dosing scale. Just something to think about.

 

Thanks for the encouragement and making sure we take care of ourselves as well. I should be able to get the +2 & +5 tonight.

I know the whole point of this is to get Griffin's BG to a consistent level that isn't harming him and allowing for me to give two shots a day (while ultimately hoping for remission) but I must admit that I was a little relieved to see a number this morning that I knew how to handle (no panic, this morning)

I am using needles u-40 to go with his syringe. Thinking that I may want to grab some U-100 for when we get to the point of doing .25u or .75u.

Is it preferable to increase by .25 than by .5?

 

Increasing in 0.25u when doses are low as in Griffin's case is ideal. Some kitties can be effected by miniscule dose changes while others do Ok with half units so if you can make 0.25u changes, it gives you that extra bit of control and gives you more options when it comes to finding that ideal dose for two shots per day. It's up to you whether you use u40 or u100 syringes. There are u40 syringes with half unit markings so you can eyeball quarter unit doses pretty consistently whereas you need a conversion chart to use the u100. It comes down to personal preference really.

 

Linda, I was just writing a comment and saw that 'someone else had just posted'. ....You said pretty much what I would have said, but faster, and far more succinctly!!! You are my 'internet angel', haha!
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