? 4/25 Maus, AMPS/529, +4/437when to increase dose?

https://felinediabetes.com/FDMB/threads/4-24-maus-amps-356-4-237-8-166-pmps-425-4-298.262441/

I went ahead and gave the normal 1.25 this morning, the beginning of day 7 at that dose.

I've been wondering how to decide between SLGS or other. I started slow by default, but wonder if I'm testing enough to move faster (one way or the other).

I prefer caution, but it is hard to watch pink & red day after day wondering if I'm going too slow.

A big hesitation is when I travel and during the summer when I'm not at home as much. My daughter will take over (she's been helping with testing & will learn to shoot but works 4/10's)

 

One thing for your consideration, you are not locked into a dosing method. You could pick TR now to get her into better numbers faster, then potentially switch when summer hits.

With either method, you would increase tomorrow by 0.25 units if you don’t see anything below 150 before then.

 

I cannot provide dose advice, but I will admit I am happy I went with TR.

I was in the same position you are, deciding between SLGS or change to TR. I was very nervous about TR because of how “aggressive” it can be. I also then started to find it disheartening to see the reds.

With TR at the beginning it can be nervous, but you learn your kitty very quickly and pick up on cues they give. For example I quickly learned habits Clyde has when he was dropping into lower numbers-but still always safe-so then I could test and feed accordingly. The people on this board are VERY good at what they do and will be around to support those times you shoot lower and lower. Just make sure you do have medium carb, high carb and syrup in the house at all times.

Two months ago the idea of shooting a 60 would have been BONKERS to me, but today I wouldn’t bat an eye.

It definitely is more demanding and you need the right tools on hand, but if you can commit to having someone around for the next few months until you figure out what works for your kitty, I would recommend it. Only if you have people around though; otherwise I would always preach better safe than sorry. Your spreadsheet definitely looks like you have the data to support you though

 

If she continues to test high all day is it bad to increase the PM jab to 1.5 or should I wait till morning?

 

I spoke with the vet today and she agreed that Maus can boost to 1.5 tomorrow morning and with the amount of testing I'm able to do, don't need to wait a week to make adjustments. We are all pleasantly surprised at how well Maus is taking all of this. Just 6 months ago I described her as half feral. Vet also prescribed something for the vomiting but I won't get into town until tomorrow. My brain likes changing one thing at a time, so that works for me.

I'm starting to read up on TR, beginning with the stickys on this page and have opened the Tilly's page. Do I need to be checking for ketones?

 

I can’t speak for the official protocols but when Clyde was unregulated I checked twice a week. Since he’s been regulated I check ~every week and a half, but he doesn’t have any history of ketones. If he had I probably would do once a week.

Most people use ketosticks - you can get them from any pharmacy for $10 a bottle and I think there are 100 tests per bottle.

 

With TR you can increase the dose as often as every 3 to 5 days depending on the numbers. Doses with nadirs below 200 are held for 5 days. It requires at least one mid-cycle test per cycle in addition to the preshot test - more if it is an active cycle.

What did the vet prescribe for the vomiting?

 

Thanks for the dosing info, I have a running list of notes to keep me from rereading entire docs (although that helps to some extent); post-its for my old brain

I believe she rx'd ondansetron, same as last time. It's worked really well in the past; should we consider something different? I can't pick it up before tomorrow.

 

Ondansetron is for nausea. She is already getting Famotidine, right? Stomach acid build-up is one cause for vomiting. Did the vet have anything to say about what was causing the vomiting?
Her kidney values okay? You said she tested negative for pancreatitis?

 

Yes, she's getting famotidine, but I'll stop when we start the other anti nausea. The barf is brown liquid, not the foamy stuff. For some reason, she generally does it overnight, so I rarely see it in action.

Kidney values good, didn't test specifically for pancreatitis that I know of but I could be wrong, it's been a bit of a blur. The link to all of her bloodwork is in my sig. The third visit end of March sent us down the diabetes path and here we are.

 

Does she get food/snacks at night? A long gap between meals causes acid build-up.

Her kidney values look good.

 

Welcome Susan and Maus! good luck with increase!

 

Susan, your story and how far you have come with Maus is one for the history books imo. I remember showing my wife a picture of gorgeous Maus, my wife has a soft spot for calicos and she was like AWWWWWWWWW and I told her about how Maus just comes and goes as she pleases, semi-feral, and how you were trying to wrap your head around doing BG tests on her and what a challenge it was. And now here you are considering TR! you are an awesome person I hope you know that.

 

I generally give her about 1/4 cup of raw before I go to bed, but nothing after. I've tried reducing and increasing that amount & it doesn't matter. It occurred to me this morning to get some low carb can & try that at night

 

What is the gap between the meal before bed and the morning meal?

 

@Hendrick Cuddleclaw Thank you for the kind words. As you know, this group has been a lifesaver (literally) giving me the confidence required to carry on with this but most of the credit goes to Artemis for allowing this to happen. She has her limits though & nail trims are spread over a couple days

 

6-8hrs The cats would normally go from a dinner feeding to morning with nothing in the middle but the FD has made her so hungry so I've been giving the bedtime snack. The vomiting started a couple months before I changed her feeding schedule and was the original reason we went to the vet in Dec. I also started feeding less food more often to avoid scarf & barf

 

Try giving a snack between bedtime and morning shot. See if that reduces the vomiting.