01/15 Henry AMPS 119, need some advice on dosing.

I feel like I'm spamming this forum but you all have been so helpful. I could really use some advice on Henry's numbers. I'll link my previous posts but here's a quick summary:

- Henry dx 12/30/20
- Vet thinks could be steroid induced, intranasal dexamethasone stopped on 12/29/20 to treat a sinus growth, had been on it roughly 3 weeks
- Vet started him on 2 units BID
- Started home testing the next day, lowered dose
- Insulin has been sporadic for a combination of reasons; I didn't know what I was doing initially, he got into low numbers quickly, I was scared to shoot low numbers with no history, I work during the day so I was scared he'd go hypo when I wasn't home, I was feeding too close to preshot testing
- He was hanging mostly blue so I decided to start a drop dose BID to bring him down to green on 01/07/2021
- Dropped quickly after 1 drop shot, PMPS +3 was 2.9 (52) I freaked out and thought he was going hypo, fed high carb to get him up
- Decided not to dose further and monitor over the weekend, all dry completely removed. Last dry eaten was morning of 01/09/21 (save for 5 tiny pieces he snuck on 01/10.)

Which brings us to today. It's been 7 whole days with no insulin, 5 without dry food. He is eating LC Tiki canned/Nutro canned/Merrick canned (only the low carb ones). 4ish meals spaced throughout the day. His numbers are mostly green with some low blues thrown in. Trend I'm seeing is low blues for 2ish hours after feeding, green the rest of the time. Greens average 85-99.

Wondering where you all think I should go from here? Does it look like I can control his diabetes with diet, or should I drop dose to get him strictly in the greens? Removing the dry has made such a big difference, I'm getting greens in the morning for the first time.
****I've noticed I get greens at AMPS only if I feed him in the middle of the night. Last night I slept through my alarm, he's blue again this AM. Does anyone know why fasting overnight raises his BG? Is this even a thing that happens?

He is so borderline with the low blues and it's making me a little insane. I've been trying to wrap my head around his spreadsheet, but my data is very convoluted for the first 8 days due to sporadic/skipped shots, not keeping track of his mealtimes, giving food at the wrong time, and high carb food. I've waited until today to ask for advice as if a drop dose is recommended, I want to start tonight so I can be home with him to monitor. On weekdays I'm out of the house from 730-5.

@Gill & George I'm tagging you as I want to thank you for your lengthy detailed reply on my last post. Didn't want to respond there to bump an old post. I went with the wait and see approach you mentioned, definitely would love to know what you think now.

Thank you everyone!
Henry & Angela

https://felinediabetes.com/FDMB/thr...me-help-with-fine-dosing.241013/#post-2713434

https://felinediabetes.com/FDMB/thr...-should-i-be-drop-dosing.241133/#post-2715023

 

Continue feeding like you are and don’t give insulin. When you feed him, test 3-4 hours later. If the pancreas is working, the bg will be lower. Also if possible start feeding a +9 snack at each cycle. I think there’s a good chance Henry is going into remission. You are posting in the right place. Fingers and paws crossed.

 

Thanks for your response! I'll start testing 3-4 hours after food. I think I'm testing too much, especially right after food - then I stress myself out when I get blues.

Will do with the snacks. I think I'm going to buy an auto feeder for overnight snacks. I set multiple alarms and turn them off in my sleep when I'm really tired.

 

When people are on really tiny doses, or in your case, feeding a small meal around +8 or +9 can kick start his pancreas to create it's own insulin, and bringing the numbers down a few hours later. That's why those early AM feeds are giving him green nadirs. An autofeeder to do the same thing would be an excellent option so you can sleep.

 

Well he's doing better now, nice to see those mid blues disappear.
Have you got rid of the HC high in the house now? Is he getting any Dr Elseys LC?

I would try the regular snacks as Elise suggested, George went onto a schedule of main meal at ambg/pmbg, with snacks at +3 +6+9, that worked the best to keep his BG level. I tried 4hr intervals but that didn't work so well. The Auto feeder is a life saver, you get to sleep and go out

 

He has had nothing but low carb canned food for the past 5 days. I have a small bag of Dr Elsey's, but that is strictly reserved for my other boy Frankie who refuses canned food. Dry food addict is fed in a separate room, I sit with him and lock the dry food away as soon as he's finished. I've read Dr Lisa's guide on how to transition hardcore dry food addicts and I'm making my way through all her tips.

I studied your SS very closely, and modeled mine to look like George's because I was so impressed! I still have some work to do to make it more detailed. +3/+6/+9 will be doable with a feeder. Any idea how I can make sure canned food won't spoil if left there for hours?

I will keep monitoring his numbers. At what point would I need to restart insulin again? If he hits mid blues or higher I assume?