Tessie Lou's AMPS 388

Hi everyone,
Even though I've posted before about my newly diagnosed Tessie Lou, I wanted to start a new post now that I have her spreadsheet, profile, and avatar :smile: done. My new vet is wonderful, and because her AMPS have been high, new vet increased night dose to 1.4 from 1.0 two days ago. Yesterday's AMPS was a nice 290, but this morning, it was 388. I'm confused by that, although I know it takes awhile for a new dose to "settle in." Also, when I gave her shot last night, it seemed like I might have injected into her skin a bit, so I'm not sure if she got all the insulin? I'm going to do a spot check about 1pm.

Any thoughts?

Sandy

 

Hi, Sandy...

Just want to let you know some of us are around and reading your posts. Please don't feel abandoned

Starting a new post is a good idea every day . Format [Kitty's name] [current date] AMPS [PS #] [unit(s) shot] TESSIE Lou 1/9 AMPS 388 1.0u

I'm not qualified to give you an interpertation of Tessies's numbers. It's sometime quiet here on week end mornings. Some folks are west coasters. Someone qualified will be along before your next dose. Just keep checking back.

I must say, you're doing a really great job at this! Congrats on the new vet. Always makes this way easier when your vet is on board with you. (mine just called this morning to discuss Bud's ss... I put permission on the SS for her to access it)

I went back and reread your older post and have a question: What's the staus of the food? Are you still doing some dry with the LC? I think the folks that come in with advice will want to know this.

LC food is best fo *all* kitties, FD or civies. The lower the carbs, the better. I have a list of 6 SophistiCats (Petsmart <50 cents a can) if you want it.

Take care. I'm sure someone will be in this afternoon that can give you some qualified opinions.

you really *are* doing a wonderful job :smile:

 

Couple thoughts:

Shooting) It looks like you might be using the U100 needles. I'm assuming they are the "short needle" kind or 5/16". When you use those puch the needle in all the way up to the hilt. Then when you give the insulin make sure to push the plunger and do not pull the barrel.

Food) How are you feeding? Timed feeding or free feeding? Are there any difference in the way you feed during the day and night? Ideally you want to make sure they are eating the same amount during the day and night and in a way that hopefully is 'smoothest' or resembling of grazing. For "hoover" kitties if you have one - we often recommend timed feeders - especially at night. But if your kittiy does not have a hoover problem then no need.

I used to put down a weighed amount of food twice per day [sometimes more] and add water. The point is that I knew H was eating the same amount during the day as night or relatively how much different he was eating during the day or night. If you add water to the wet food then it helps it from getting the crusties. It should be much softer but not soupy.

Your day tests look like you are getting a bit of a U curve [which is good] even though the PMPSs are lower.

 

Re: Tessie Lou's AMPS 388 on 1/9/11

Gator, yes, I am using U100, 5/16". Will be sure to get it pushed all the way in. Thanks. Food: She is on 100% Purina DM canned. I weigh her food and give her between 2-2.5 oz, at 9am/1pm/5pm/9pm, then no food all night. She in not nocturnal. She usually sleeps in the same spot all night. She is indeed a hover kitty, if that means will eat anything and everything available. I will look into timed feeder for her at night. Can you recommend any? Otherwise, DH is up at 4am every day, and could start giving her some food then?

Question: If insulin goes into skin, and not under it, does it not work?
Thanks,

 

Re: Tessie Lou 1/9 AMPS 388 1unit

I appreciate the encouragement, Beth. I will start using the format you suggest, too. I answered the food question in my post to Gator that follows. I will probably switch her to a less expensive food down the road, but since I just got her transitioned from dry, I don't want to introduce too many changes at once.

Thanks again. It looks like Bud might be weaning himself off the ProZinc? You are already down to small doses. I'm a newbie, but his SS looks promising to me!

 

Great job getting everything up! And home testing. You are SO lucky to have a vet you can work with! I am not expert enough to talk about your numbers---but I have found that you have to wait awhile and study patterns, rather than being concerned about any particular number. Good luck and keep asking questions!
Oh===forgot to say that Tessie Lou is adorable.

 

Re: Tessie Lou's AMPS 388 on 1/9/11

LOL I'm getting good at this whole sleuthing problems thing if I do say so myself :mrgreen: OK now that I'm done patting my self on the back... :roll:

IMHO the reason the numbers are different during the night and day is because the feeding is uneven.

According to Small Animal Clinical Nutrition, normal cats should eat 10-20 small meals throughout the day and night. If you have a hoover kitty then IMHO the objective should be to approximate that as closely as possible [unless you are tying to influence the curve with food]. But of course you will have top limit the caloric intake. I think the five feedings during the day is fine, but the no feeding at night is not optimal. Nancy is out of town if I recall. But I know she likes a 5 position one - I think she recommended it to Claudia? Claudia is user Charliemeow - and you can PM her. Maybe Claudia can comment on that? It might be from here??:
http://www.drsfostersmith.com Nancy's Cody is a bit of a safe cracking expert and there is one I know she likes that Cody cannot get into. Also if you don't get any input here you can post in Health about timed feeders and I'm sure you will get many responses.

ANYTHING you can do to even out the food including rustling her up at night.

I've also wondered in other cases of this if the high morning numbers are from "stress" over not having food at night. But I have no proof of that - just more of a question I have wondered about. I know when I don't eat, I get a little stressed. :smile:

You know how cats are fans of routine... I would hope that she might get trained to the "click" of the feeder and get up on her own to feed at night after a while?

Hopefully if you get the feeding evened out then you can even out the insulin doses too. The upping to 1.4u at night concerned me a little [just a little not a huge amount ;-) ] just that you are not testing at night so you really don't know what's going on there. If you did make increases like that then I would make sure to get some mid-cycle tests at least the first couple cycles to make sure that dose will be OK.

 

Could she be in hover mode because of the diabetes? Maybe she'll even out when she gets regulated.

 

I have the 5- slot spinning feeder and we love it! I've had it for about 6 YEARS now and I've never had to change the batteries yet! We got it originally to feed my Hoover Charlie at night and while we go out of town. But it would be great for someone who works and isn't able to set out food thruout the day. For his night feeding, we got a great tip from the folks here to put an ice cube in with the wet food in the spinner so it doesn't get dry and crusty before it feeds him. Charlie has tried his hardest to break into it, and at his biggest he was 20 pounds, but never succeeded. There are claw marks all over it, but he hasn't figured it out! ;-) knock on wood. I got mine at petsmart.

 

Interesting #s!!! Is just leaving food out for her at night an option? Or will someone else just scarf it before she has a chance? I am a fan of free-feeding, and if that won't work, then I like what you are doing with the smaller meals throughout the day, and if the timed feeder works out for you, that is cool too.

I'm hesitant too on the 1.4 at night without any nadir readings. What comes to mind to me is that you either have something going on that is driving up her #s overnight (mystery dawn phenomenon, or one of the ideas others have suggested), or you have a situation where she is going lower overnight from the dose off a lower PS, and then you are seeing a little possible rebound/liver training or something by morning. Hard to say for sure without more data - the solution for the 1st would be a higher dose for the PM cycle, where the solution for the 2nd would be a lower dose at the PM cycle. The one +3 reading you have makes me lean towards the 1st, but I probably would have gone with 1.2 rather than 1.4, and try to do some more data collection if possible at night (I know that's a pain!).

Her #s a pretty good overall though, so that is really nice to see!

 

I'm going to order that feeder right away--thanks! Yes, she will qickly figure out the "click means food" thing, especially since her ottoman is not that far from the kitchen and her food bowl. ;-) She is always very worked up in the morning to be fed, so it wouldn't surprise me if the stress drives her number up. When she and T.J. were free fed dry, the bowl was always empty by morning, but I never knew if it was her or nocturnal T.J. doing all the scarfing. Luckily, T.J. has decided he doesn't care for Purina DM, and he is NOT a hoover cat. He would rather play than eat anytime!

I am still puzzled about this morning's 388 after getting the nice 290 the morning after the first 1.4 night dose. I'll give the 1.4 again tonight and see what we have in the a.m. I stayed up until 2am this morning getting my spreadsheet, profile, etc. figured out (I'm slow, but persistent), so I don't think I can stay up again tonight to do a spot check. I will try to stay up til 11 or 12 and give her another feeding before bed though. Then, my DH can give her some more at 4am. We'll see if that makes a difference.

I'll report back in the morning! Thanks and enjoy the rest of the weekend everyone.
Sandy

 

Sounds like a plan. BTW, the profile and spreadsheet look great - good job!

Whenever you can, get a number around +6. It will tell us a lot about how the insulin is working.

 

Slow AND persistent is a good mindset for treating the DM. :smile:

We often say here that this is a marathon and not a sprint.

 

If you freeze small portions of food in an ice cube tray, even without a feeder, you can leave one out when you go to bed and probably not have to get up to feed at 4am.

 

You probably will never know for sure - there are several reasons, and without having several data points it can be hard to draw a solid conclusion. Sometimes when you raise the dose you get a "wow factor" on the first cycle of that dose, but then their body adjusts and doesn't give you the same good #s after that. So that could be it, or it could be just the "wonky factor", where #s are different one day to the next for mystery reasons. Or could be the second night she saw a green nadir and her liver reacted to that a little and threw a higher PS the next morning. Hard to say really.

After tearing out a lot of hair along the way :lol: I've discovered that sometimes the #s are just the #s. If you are lucky you can figure it out with reasonable certainty, but a lot of times you can't. There is a fair amount of trial and error and data collection, and often you will see cats get regulated once there is enough experimenting & data to really know what doses work and what don't. Typically it takes a few weeks to sort all that out, and longer for cats that need more insulin, as it takes longer to build up to their doses.