05/03 Mom-mom AMPS 330,

Mom-mom was hi since the 30th of last month and on the first of this month, she started getting better, (I think) because I was started giving her the little cans of the Blue Wilderness (Salmon). On Thursday after her PM shot I went to Petco and bought the bigger cans of the EXACT food thinking it was more economical, then, all of a sudden her sugars were hi again, and most of the next day too (yesterday). So I went back to Petco and bought the LITTLE cans of Blue Wilderness again, this time in duck flavor too. Her numbers nailbite_smile have been steadily coming down. I really cant believe there is a difference between the small and the bigger cans, but there REALLY IS. Her numbers proved it. I just pray that it keeps going down until normal. This one I have to give my husband credit for, he figured it out. Usually he doesn't even get involved at ALL. :smile: :smile: :smile: :smile:
Even though she JUST ate, her AMPS was 330. I think the food is helping her. So instead of jumping to 1.00 I gave her 0.50. Was that right?

Laura --

Did you reduce Mom-mom's dose? Your SS reads that you gave 0.5u this morning. If anything, I think Mom-mom needs a dose increase.

Why do you think that she should have gone higher? Since I have been staying with the smaller cans of Blue Wilderness salmon and the duck, she has been in the 300ish. I thought she had alot better of a reading this morning, especially since she ate literally 3 minutes before the test. What are your thoughts?

Mom-Mom said:

Since I have been staying with the smaller cans of Blue Wilderness salmon and the duck, she has been in the 300ish.

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Is she getting enough to eat, though? While you don't want her to overeat, an unregulated diabetic may do better on about 50% more food. What can help so there isn't a huge food spike is feeding mini-means as Sienne does with Gabby.

What you want is a dose you can give every 12 hours safely, which controls the glucose into good numbers much of the time. Good numbers are below 150-200 mg/dL and she is not really there yet.

Why do you think that she should have gone higher?

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Maybe I wasn't clear. Let me try to explain. Mom-mom's numbers may be looking a little better. However, unless your cat is in closer to normal (i.e., 40 - 120) numbers, you want to increase the dose. If you take a look at the Tight Regulation Protocol sticky], these are the guidelines:

"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).
• Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
• Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose:

• Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
  if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
  when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
• After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
• After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

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I wasn't suggesting that Mom-mom's numbers went higher. I didn't know if you made a typo regarding the dose this morning. If you reduced the dose, there was no indication that the dose should have been reduced (i.e., her numbers didn't drop below 50). You also don't want to hold on to a dose overly long. The protocol indicated that if numbers are higher than 200, you want to evaluate the dose every 3 days/6 cycles. Mom-mom has been at the 0.75u dose for 7 days and nadirs have not been below 200. It's time to increase the dose to 1.0u.

BJM said:

Is she getting enough to eat, though? While you don't want her to overeat, an unregulated diabetic may do better on about 50% more food.

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I don't agree with BJ completely. Even with a cat that's not regulated, you don't want to go crazy with food. You may need to increase the number of calories your feeding if your kitty is losing weight which is definitely something that can be related to the diabetes. However, if your kitty isn't losing weight, increasing the calories can result in a cat that gains weight which makes managing the diabetes harder. You might want to take a look at this discussion on whether to feed your cat as much as she wants.

Well, I said "may" not will and "as much as", not exactly.
I did NOT say feed as much as the cat can eat.

The real point is that you should use the insulin to manage the glucose and aim to keep the incoming glucose somewhat consistent so they are in balance, not unintentionally starving the cat to make the insulin work. And those numbers do not look regulated to me, hence the suggestion she may need more food.

I would encourage weekly weight checks to make sure Mom-mom's weight is at a good level for her, using the body condition charts vets use.

When she was first diagnosed about a month and a half ago, she was about 2 pounds. She was like lifting a feather. Now, shes probably 6-7 pounds, and gaining every day. The LAST thing I would do is starve her for better numbers, she's like my child, shes spoiled rotten (believe me). She eats 2-3 small cans a day or 1 big and 1 small. I feed her in the am, around 8am, then again at 12:30, then again at 5:00, then right before her PMPS. I did reduce her shot, obviously it was a BIG mistake. Tonight I will do the 1.00 and continue until further notice from you guys. Is that going to be OK? I hope so. I hope I didn't mess up too bad. confused_cat

I didn't think you were starving her. The effect of too little insulin, however, means she may not be able to use all of what she eats, which risks weight loss and is why it can be OK to feed a little more. As Sienne noted, you don't feed an unlimited amount. And it can be very helpful to have a timed feeder to space out the food so she doesn't get too hungry and so her pancreas doesn't get hit by too much at once.

Keep going as best you can. Read over the protocol instructions until you really understand them. Look at how other folks are working with their cats on Lantus as there are always individiual adjustments to make for individual situations.

Hello Laura,

Perhaps I'm not the best adviser since I'm still learning and I'm a Levemir user, but I definitely would increase Mom Mom's dose to 1u based on the tight regulation protocol. She has been with nadirs greater than 200 for too long.

Have a great day!

I know I was supposed to do this yesterday but, I have so many things going on all at the same time, I forgot to raise her. Will do for her PMPS. I will set a reminder. Thank you sooo much everyone for staying on top of that confused_cat