12/21 Mallie AMPS 245 +2 202, +4 103, +6 86, +7 97 +8 99, +10 81, PMPS 103

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by mom23seniors, Dec 21, 2019.

  1. mom23seniors

    mom23seniors Member

    Joined:
    Dec 7, 2019
    Mallie’s amps were not as high as I had anticipated with it being 24 hours from her 1.1u given yesterday morning after the fur shot Thursday night.
    I’ll be able to be home to check her every two hours today to see how this 0.5u works.
     
    Last edited: Dec 21, 2019
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  2. mom23seniors

    mom23seniors Member

    Joined:
    Dec 7, 2019
    I didn’t do a shot tonight. I don’t feel comfortable giving her any when she’s in the high-normal range, even though I know she’s going to go higher as she digests her dinner.
    Maybe Mallie needs 0.25u twice a day if this keeps up and not 0.5u.
     
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  3. nslade001

    nslade001 Well-Known Member

    Joined:
    Nov 12, 2018
    Hi there, good job with the testing today :)

    If you're following SLGS, you actually earned a reduction today with that 4.8 (reduction earned if kitty goes below 5.0). So, Mallie's new dose would be 0.25U twice daily.

    Here's a link to both protocols :)

    Without data, SLGS says not to give insulin with a preshot below 8.3, so you were right not to shoot. However, I would also post and ask for advice in this situation, because Mallie is giving beautiful low preshots before you have had a chance to gather the data! And there may be some hints or tips from experienced members who have been there or seen this type of pattern. The next few days may be a bit slower with responses as we're hitting holidays. I'd recommend asking *before* the preshots hit, with a question mark and clear "help please, need advice with dosing, low preshot" type title, and maybe tagging someone if you see someone more experienced on board. Hopefully the reduction will give you a bit of room with her numbers lol.

    With love, Nikki
     
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  4. nslade001

    nslade001 Well-Known Member

    Joined:
    Nov 12, 2018
    I know you may have mentioned this before, but could you refresh me with your feeding schedule for Mallie? Thanks! With love, Nikki
     
  5. mom23seniors

    mom23seniors Member

    Joined:
    Dec 7, 2019
    I feed her (and her brothers) 1 can of FF each every 12 hours, usually 6am/6pm. Mallie has been eating about half before walking away, and will sometimes go back to it after an hour or two if Tony hasn’t gobbled it up.
     
  6. mom23seniors

    mom23seniors Member

    Joined:
    Dec 7, 2019
    If her AMPS tomorrow morning is similar to today’s, I’ll stay with the 0.5u. I’ll be home for most of the day (aside from a few errands) so I’ll be able to monitor her, especially between the +5, +6, +7 times. I have to work Monday so I won’t be able to do any daytime monitoring then. I’m thinking that Tuesday would be the best day for me to try the lower dose-I’ll be home all day making cheesecakes :)
     
  7. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    I think you should reduce to 0.25 units tomorrow morning. 0.5 units, with several missed shots before so hardly any depot, brought her below 90. Maybe with a 0.25 unit dose you will be able to shoot twice a day.
     
  8. nslade001

    nslade001 Well-Known Member

    Joined:
    Nov 12, 2018
    Reductions are given as a safety measure; they are not randomly picked numbers. People who follow TR have a lower reduction number than SLGS because as a general rule, they are able to test more often and have more data on how their cat responds to insulin. While at the moment you can test more frequently (which is awesome, because more testing = more data on the SS, and more knowledge/safety) you still really don't have any data on how she will respond to a consistent dose. What you *do* have is data that shows that, as @Wendy&Neko said, *without* a depot and with several missed shots, 0.5 U brought her too low on the SLGS protocol. She has earned a reduction because 0.5U is too high a dose for her now, knowing what we now.

    (Looking back at her Dec 13 pm cycle she got 1 U, then two consistent 0.5 U doses on the 14th, and earned a reduction by preshot in the am on the 15th when she was at 4.6. Most likely she dropped even lower during the night of the 14th, since she seems to nadir around +6ish, so that 4.6 was after she'd been climbing a while.)

    If you shoot 0.5U twice daily now, she'll most likely earn another reduction in a day or so (go below 5) but more concerning she may go too low (under 2.7). Mallie's already shown she can drop hard and fast lol. Of course, she's your cat, it's your call :) Just be prepared to watch closely the next few days and nights as her depot builds.

    Likely, a consistent 0.25U will give her safer shooting numbers twice daily, allowing twice daily dosing with no skipped shots (so her depot can stabilize).

    Regarding feeding: Many (most?) cats on Lantus do better with more smaller meals fed through the day. It's a matter of trying to get the carbs into her while the insulin is working, but (again as a general rule, but not always) not after nadir. So instead of giving her a big meal at preshot, it would be a good idea to try to give Mallie maybe 1/2 can at preshot, then maybe 1/4 can at/around onset (+2 or +3) and another 1/4 can around +5 or +6 when she's about to hit/hitting nadir. This will help to keep her "surfing" the greens instead of dropping into deeper numbers, and then having a harder time to get her numbers up in time for preshot.

    (Feeding twice a day is meant for other types of insulin such as caninsulin, which cause a fast and early dramatic drop in blood sugar but have no lasting effect, rather than the long-acting insulins like Lantus).

    Also, if you keep notes on when/how much you feed (I'm talking her regular LC food) you'll get a better idea how she responds to carbs (some spike on LC, some need HC just to budge) so you'll have a better idea how/what to feed when you *need* to bring her up. More data is always great.

    With love, Nikki
     
  9. mom23seniors

    mom23seniors Member

    Joined:
    Dec 7, 2019
    [/USER][/QUOTE]

    Feeding throughout the day does not work for my schedule as during the work week I am gone from the house for 11 hours a day. I’m not sure even a timed feeder would help, as Mallie still might not necessarily be the one to get the food. Her brother Tony is on long term (palative) dose of prednisolone so his appetite is insatiable. (And yes, I have checked his bg since Mallie’s diagnosis and luckily he shows no signs of diabetes)

    I had thought about making notes as to which food variety I’m giving her when to see how it affects her numbers.

    With her amps of 142 (7.9) I’m going to give her 0.25u today and monitor.
     
    Last edited: Dec 22, 2019
  10. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    You can buy feeders that only open for chips on collars. Or we have had people do creative things like make boxes only the skinnier cat can get into, if the diabetic is the skinny one. Or buy his and hers feeders that go off at the same time in different parts of the house.
     
  11. mom23seniors

    mom23seniors Member

    Joined:
    Dec 7, 2019
    The feeders with microchips on collars would be a good fix I think. Ill look into where abouts I can get them here in Canada if needed.
     

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