12/26 Basic AMPS 138 Dosing and bloodwork question

Basic's Mom

Basic's Mom

Member Since 2023
Previous dosing post:
https://felinediabetes.com/FDMB/thr...33-11-5-124-pmps-137-175.284774/#post-3134612

Yesterday's numbers:
12/25 AMPS 198 +5 202
PMPS 242 +5.5 87 +6 84 +7 83 +89

Base earned another reduction, but I was wondering if a few people could look over his SS. I may be viewing this wrong, but with his recent patterns, should I have given him a reduction this morning? 83 isn't far from 90. I also feel that he has room to improve with his numbers on that dose.

I didn't want to stall his shot this morning, waiting on advice regarding his morning dose (to reduce or not), so I proceeded. If you wouldn't give your cat a reduction with these numbers, please advise.

Moving forward, is it safe for me to lower this reduction threshold? I had planned on holding this dose for more that 7 days because his numbers were the best they've been since diagnosis with that dose (we still have room for improvement).

Also, his appt on the 8th is at 9am. He will be full then. Is this bad, for bloodwork? I know now to schedule the appt as late in the day as possible. They didn't say he needed to fast for any tests, but I've read the bloodwork is more accurate when they haven't eaten prior to withdrawal.

Thank you
 
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Since you are following SLGS, anytime you get a number under 90 you would reduce for next shot. As you may have seen, there are instances where caregivers who follow SLGS choose to lower the reduction point and hopefully if/when they do so, they have a good understanding of how their cat responds to insulin and carbs.

From my point of view, changing the reduction threshold should not be undertaken lightly by a caregiver, since there are inherently risks in doing so. That is one of the reasons why I try and offer some guidance when I see the topic of making adjustments to SLGS, particularly when a caregiver perhaps has not gathered enough data on how the insulin is working or how carb sensitive the cat is. If a caregiver can't answer these questions, IMHO, they shouldn't be personalizing SLGS:

-How much of a food bump does kitty usually get after their main meal?
-How easy is it to bring your kitty up when the numbers are lower? What carbs does it take, how carb sensitive is he?
- do you feel you have a good idea of when your kitty onsets, nadirs and how much duration they get on a certain dose?
- what is the reason for needing to modify the general guideline?

So far, Basic has gone up to 4u and there was a reduction on Dec. 19th which held. I would take the reduction and see how he goes.

As for your question regarding lab work, I don’t believe whether the cat had been fasted or not is a consideration for standard blood tests. I usually get the senior panel. Actually getting a vetty visit as early as possible helps with urinalysis, especially if you are watching kidney values and other indicators for CKD, since the urine is most concentrated in the morning.

Just my 2 Canadian cents for what they are worth.
 
Christie & Maverick said:
-How much of a food bump does kitty usually get after their main meal?
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He gets an additional tablespoon at +1 and +3. I tried only giving additional at +1 and +2, but he isn't having it.
Christie & Maverick said:
-How easy is it to bring your kitty up when the numbers are lower? What carbs does it take, how carb sensitive is he?
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He's very sensitive to carbs. While I haven't had to give him med or high carbs in a situation that is concerning, I have confidence his numbers would shot up.
Christie & Maverick said:
- do you feel you have a good idea of when your kitty onsets, nadirs and how much duration they get on a certain dose?
Click to expand...
I do feel I have a good understanding of the first part, but not the latter part.
Christie & Maverick said:
- what is the reason for needing to modify the general guideline?
Click to expand...
I don't feel he is in danger on this dose nor do I feel like his numbers were great on this dose a week or so ago. His numbers were still too high on the dose I just had to reduce.
Christie & Maverick said:
As for your question regarding lab work, I don’t believe whether the cat had been fasted or not is a consideration for standard blood tests. I usually get the senior panel. Actually getting a vetty visit as early as possible helps with urinalysis, especially if you are watching kidney values and other indicators for CKD, since the urine is most concentrated in the morning.

Just my 2 Canadian cents for what they are worth.
Click to expand...
He is having a senior panel done. His previous vet wouldn't allow me to give him the supplement for his liver because of how hard he was to pill. She explained that in order to see if he needed the supplement, he would need to be fasting. I'm trying to prevent a follow up appointment a week or two after this appointment because he needed to be fasting.

I appreciate your Canadian two cents.

Thank you.
 
Thank you. He's had zoomies like crazy the few days and playing hard. Made me cry because I wasn't sure I'd ever see him happy again. I'm not sure if his cosequin has had enough time to build in his system or it is because his BG has been closer to normal range recently or a combination of both. Regardless of why, I'm very happy for my guy. I probably will continue to cry off and on as he improves. I wasn't sure I'd ever see it.
 
Isn't so wonderful when we see them have the zoomies ,start playing , just seeing them start to get back to their old selves .
Keep up the good work Basic ,you are making your momma very happy and all of us also :bighug::bighug::cat:
 
You are welcome, happy to offer some thoughts.
Basic's Mom said:
He is having a senior panel done. His previous vet wouldn't allow me to give him the supplement for his liver because of how hard he was to pill. She explained that in order to see if he needed the supplement, he would need to be fasting. I'm trying to prevent a follow up appointment a week or two after this appointment because he needed to be fasting.
Click to expand...

Thanks for clarifying :), I do recall fasting was necessary for fPLI tests to check for pancreatitis but I didn’t know about the need as it relates to checking liver function. I appreciate you not wanting to have to do a separate vetty visit, my Maverick hates going to the vet, it’s often a huge production. You’ve already tagged Suzanne and Marje, they likely have some further insight.


Basic's Mom said:
I don't feel he is in danger on this dose nor do I feel like his numbers were great on this dose a week or so ago. His numbers were still too high on the dose I just had to reduce.
Click to expand...

Following SLGS, he’s been getting into the right range overall, which is where preshots are around 300 mg/dl and nadirs are reaching 100 mg/dl, and where nadirs are in that 90mg/dl to 150 mg/dl range, so that’s good. I think to me, I’d still give the reduction a try. And as you continue to collect data and if you keep finding when you take a reduction under 90 but the reduction doesn’t hold, or if after you’ve tried a few reductions, and the overall BG ranges aren’t where you’d like them to be and you ultimately need to increase, then deciding based on those factors and considerations I originally mentioned, changing your reduction point might make sense. Even within the SLGS guideline it does say “let experience, data collected, knowledge of your cat and availability to monitor help in making the best decisions for your cat.”

Remind me again, since I’m fairly new to reading about Basic and haven’t gone too far back in his history, are you trying to slowly reduce the dry food? It looked from your SS that it’s periodically given but not daily? TR would be an option if Basic doesn't get dry food anymore.
 
Basic can't stand being at the vet and his numbers were off the charts every single time we went. I'll prevent as many visits as possible to reduce his stress levels.

Thanks for the detailed response. I am now glad I went ahead with the reduction. It does make sense for me to gather more data from these reductions before reducing the threshold.

Basic and Moonshine both are kibble addicts. I went in guns blazing and tried cutting them off cold turkey months ago. Basic refused to eat for 24 hours each time I tried this. Then, I start reducing the kibble and each time I got to an ⅛ of a cup he would stop eating again. With him having hepatic lipidosis, I get very concerned about him not consuming enough calories. Now, they both only get a tablespoon of kibble each morning. It is on the spreadsheet, to the far right, under the food column. It may say something like 10 pieces, but I just measured it out to tell you the amount. Dr. Elsey’s bothers both of them if they get much more than that. I'm fine with this set up for now. After this kibble is gone, I'm not sure what I'll do for her. He is loving the raw diet and I feel will adjust just fine. She is not liking the raw. She wants nothing to do with it after the EZ complete is mixed in. She ate just the meat mixed into her pate, but it was a very small amount.

Again, thank you for your time today. I appreciate you helping us.
 
Ah gotcha, saw the reference to the kibble, wasn’t sure if that was daily. Most definitely they need to eat, particularly too since Basic had previously ketones at diagnosis, so I understand you needing to make slow adjustments on the food.

Again, happy to offer thoughts, and if some things were useful for you, so much the better. I always try and hopefully explain properly my logic and rationale for consideration :). I hope some of the others you tagged come by to share their comments as well.
 
Sybil -
Given the amount of testing you do, is there a reason you haven't considered TR? If you were thinking of a lower reduction point, a switch to TR might be an option.

An alternative to some of the dry you're feeding might be air or freeze dried raw food. I know that ZiwiPeak has a low carb food air dried line. Stella and Chewy's does, as well but I'm not sure what the carb level is.

FWIW, I would have reduced this morning.
 
I haven't switched to TR because he still gets some kibble. It is a very small amount, but I just wasn't comfortable because of the rule regarding kibble. That's the only reason I haven't switched to that method.

He hasn't liked any of the freeze dried treats I've offered. I got a large bag of the salmon because I thought he was going to love it. I don't allow them to eat much fish at all, but he loves any I've ever offered. He will eat a rinsed sardine. She won't. He walks away everytime I offer the salmon. I may get a couple small bags of different proteins to try.

Thank you for telling me you would have done the same. I always second guess myself because of lack of experience and data.
 
Thank you. I'm hopeful we stay on this improvement train. My boy is slowly returning to me.

I hope you had a nice holiday. Thanks for always checking on him.
 
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