12/29 Aiden AMPS- 337, Curve Day

Hey all! We are working on a curve today that I am hoping I'll be able to get a good 14/16 hours of data for. However, Aiden is in an awful mood today...I barely just got his +6- and I didn't make it away without some new scratches! Anyhow, today's curve is currently as follows: AMPS- 337, +2 394, +4 291, +6 303. Today he has had half a can of Friskies and about half-3/4 can of Friskies.

I am hoping that adding the link for our chart into my signature worked, but just in case, I'll be including a link to his Lantus chart, as well as his previous chart when he was on Vetsulin. I know last time I read that somebody mentioned I could keep it on one chart...however, I've already got so much info on this new chart, and it helps me to clearly see 'These are his numbers on Vetsulin, these are his numbers on Lantus'.

Aiden was on Vetsulin from the end of July through the beginning of November. He started Lantus on November 6. My concern is that his numbers are not dropping in the way I expected. As you can see on his Vetsulin chart, there were several curve days that included better numbers (blue/green). There were also a few cases of lower numbers at AMPS/PMPS. That has not happened at all since he has been on Lantus. I am afraid I've made a mistake by switching to Lantus.

Is the case simply that he has not had long enough to "adjust" to Lantus, even though it has been close to two months since starting it? Or that perhaps the dose is not high enough? His diet is still the same (Friskies and Fancy Feast mainly, with 9lives here and there). He has only gotten one or two fur shots since starting Lantus, so I know that can't be making it too 'off'. And we stick to shooting between 5:45-6:00, typically going for the 5:50-5:55 mark.

Vetsulin spreadsheet: https://docs.google.com/spreadsheets/d/1XCFRoDGK3u4XauZ9QloAChjTxvLkr4f0RKh4102e43s/edit?usp=sharing

Lantus spreadsheet (Current): https://docs.google.com/spreadsheets/d/1JUe-MbbaXu4dqRsAMOlH00sfjTaaQpMQWOxm445aJcg/edit?usp=sharing

 

Hi Elizabeth. You might be holding the dose too long and not getting any mid cycle tests to see how low the dose is taking Aiden. You don’t say what dosing method you are following but if SLGS you need to get a curve every 7 days. It’s also helpful to get a +2 each cycle that you can. If it’s lower than the preshot another test later in the cycle is a good idea to try and catch the nadir. Cats often drop lower at night so a before bed test is a good idea and if lower than the PMPS I would set an alarm for somewhere between +6-9 to see what’s happening.

With TR you would be increasing the dose every 3 days if the numbers suggest that.


Please read the sticky at the top of this forum on dosing methods. I don’t think you are giving lantus a proper chance the way you are dosing. Without catching the nadir too much insulin can look like too little if he is bouncing.

It’s often helpful to feed three small meals during the first half of the cycle. Many use auto feeders at night and when they aren’t home.

I hope this is helpful.

 

I guess I'm not really following a dosing method? I won't say it's impossible for me to get a curve every 7 days...but between Aiden's hurt leg and his aggression, I space out his curves as much as possible to not further irritate him. The days where I have not completed a curve are either due to life events happening or just the simple fact of Aiden not cooperating. The last test I'm usually able to get would be at the +2 mark after PMPS, as we go to bed early. I have heard people mention that cats drop lower at night, but why is that? Is it because they usually don't have access to food? I give Aiden food before going to bed- some mornings when I wake up his bowl is completely empty, other times there are scraps, and sometimes there are spoonfuls. I typically know when he has an empty bowl, however, as he wakes me up with throwing up...

Going back to a previous topic, I'm not really sure why it matters about the curve once a week as far as dosing advice goes. Perhaps you could help me understand better or direct me to somewhere so that I can understand better? If the insulin is not old, his body should be responding to the dose in pretty much the same way after a few days of his body getting "Used to" the new dose, right? Or am I just completely misunderstanding.

I'll go look into the sticky on dosing methods, maybe that will help me to understand. Because the sentence following your suggestion to do so just makes no sense at all to me

Also, I do feed 3 or occasionally four meals during the day. Typically half a can of Friskies or a whole Fancy Feast in the morning, the same amount around 12-1, and the same amount in the evening. I will say he usually doesn't eat all of this and is left with a few spoonfuls of food by dinner, though sometimes he does eat it all (which is where the fourth meal comes in). He gets a snack of a similar amount right before we go to bed, which I understand could be causing the bouncing, though an autofeeder isn't really in our budget right now.

 

Okay so! Based upon my reading, it looks like I'm not 100% following the SLGS method, but I am much closer to that than the TR dosing. In regards to my curve today, does that mean if my nadir is over 150 that I should increase the dose by .25? Am I supposed to stay up all night and keep trying to test? I'm honestly worried that I won't be able to get another reading today due to Aiden's behavior, but I'm going to at minimum try to get through +2 after PMPS. Thank you for your help and sorry for my confusion and lack of knowledge.

 

I have updated his curve (I got through +4 after PMPS, yay!!) if you want to check it out. Based on my reading of SLGS, that means I should bump up .25 U yes?

 

Yes, I would bump up to 2.25. Good job and good luck with the increase.