5/30 - Buddy - AMPS 172 +4/68 +5/90 PMPS 102

So I can clearly say now Buddy's numbers are clearly trending up since Monday, from low 100's to upper 100's. Trying to decide if we can go back to 0.25, will test him at +6 for sure.

Also not eating great per say. He's eating Wellness OK, sometimes Tiki, mostly turned his nose up at Weruva. Any other food suggestions folks have had success at? He's clearly still hoping the prescription kibble is coming back (its not)

Thanks and have a great day.

 

Hi there,

Your last post for continuity: https://www.felinediabetes.com/FDMB/threads/5-29-buddy-amps-138-pmps-151.247964/#post-2797053

It does look like Buddy needs an increase but we could help you better with all of your questions if you could

1. Fill in details for your signature: Your name (if you want to be referred to as such), your cat's name (Buddy, obvs), age of your cat, the date of your cat's diabetes diagnosis, the kind of food being fed (LC wet food), the kind of meter you are using (AlphaTrak), any other known conditions, and the protocol you are following.
2. Pick a protocol. Here's the Dosing Methods sticky for you to read through. With SLGS, you hold doses for 7 days and reduce doses at 90. At the end of those 7 days, you do a curve to figure out where the cat is going midcyle. Without those midcycle numbers showing how low the dose is taking the cat, members here can't advise you on what to do with much confidence. With TR, you can hold a dose up to 10 cycles and then make a decision to increase, but doses are always reduced at 68 (on an AlphaTrak, 50 on a human meter). TR will get you a greater chance of remission but it is more aggressive and requires more testing. Which leads me to...
3. Do more mid-cycle tests. You're doing a great job at tracking Buddy's preshot numbers, but aren't that concerned with those but what you really need to do is track those nadirs, the lowest number the cat sees once Lantus has had a chance to take effect after a shot, usually 3-6 hours afterwards. I understand you have family obligations, so maybe SLGS would be good for you right now, and once you start seeing more greens you can switch to TR to fast track him towards remission.

My cats never liked the Weruva with the shredded chicken. They liked the BFF Pates in pouches that have tuna in them more. Have you tried those? They aren't that expensive and low carb.

If your cat was eating kibble before, he is getting more water from his wet food now and that might be reason he's urinating more.

 

Thank you. I’ll try to update my profile later today.

 

I see you've increased his dose to .25. I'd watch him today, as you've essentially doubled his dose from .1.

 

Thanks, I actually changed my mind before doing it and ended up dong 0.1 (i fixed the spreadshetet). Gonna take some mid day numbers, and if he doesn't go low I may try 0.25 tomorrow and watch him close.

 

Also congrats on Ruby, you're doing so good

 

Thanks! It's been a long 9 months but Ruby's doing great diabetes-wise with all of the help I get from everyone here. Remission is in the cards for Buddy, too. You do need to be methodical about it though, hence my encouragement to you to pick a protocol.

 

I agree with Katherine about testing (and the other items she mentioned, as well). Lantus dosing is based on the lowest number in the cycle. You're getting tests during many of the AM cycles. Without any PM cycle tests, you're missing half of Buddy's data. Many cats experience lower numbers at night so you could be missing dose reductions. At the very least, you need to get a "before bed" test every night. We recommend getting a minimum of 4 tests every day: tests at AMPS and PMPS as well as at least one dest during both the AM and PM cycles.

Not only does picking a dosing method allow you to have guidelines to help you with decision making, it also allows us to know how to best offer input.

 

I really appreciate all the input here and going to do my best.

Just did a little over +4 and buddy is at 68!!! and only gave him 0.1 units this AM.

 

This is why we don't increase based on preshot numbers. Please feed him a teaspoon of food (if you have higher carb food, like 10-15%, that would be better) and test again in a half hour to see if his numbers move up. He's potentially a few more hours away from nadir and so might drop more.

Glad you decided not to increase this morning. Tagging @Sienne and Gabby (GA) and @tiffmaxee to see if they have an idea of how you should proceed.

 

Yes thank you good lesson, will give him some food now.

 

You're welcome, Andy. And do keep the title thread updated with new numbers as you test so we can keep up with your progress. This is all good, we just want Buddy to be safe.

 

Hi, Andy. You have some really good people here advising you. I don't know where you live (US?) but my Susie likes the Fancy Feast Classic Pates. The highest carb level is 3%. The lowest is 0%. You should also have some medium carb food (10% - 15%) and high carb food (16% and up) available for when Buddy gets low. For some reason I cannot pull up his spreadsheet today but I know I have in the past. Good luck with your boy.

By the way, this is not important but we love to see pictures of the kitties. If you have one of your boy please add it.

 

+5 at 90. maybe food pulled him back up

 

Very good! Test again in one hour and don't feed to make sure he's heading up without the assistance of food.

 

Tagging @Wendy&Neko here for dosing advice for this evening. If you're following TR, Buddy didn't technically earn a reduction because he didn't drop below 68, the reduction number for AlphaTrak.

 

Good catch on that 68 and getting him up a little higher. As others have said, he may or may not have earned a dose reduction, depending on which dosing method you are following. Without that information, we can't properly help advice you. BTW, it's a well known phenomenon that threatening a dose increase causes them to dive.

 

I 'm on board with Wendy. In addition to knowing which dosing method you're following, are you still using a pet-specific meter?

The challenge is that if you're using a pet meter and following TR, below 68 is the reduction point. The reduction point with a human meter is below 50. However, aside from the nadir, much of Buddy's pre-shot numbers are really not low enough for me to suggest that you stop insulin.. The other factor is the one I mentioned previously, you need PM data.

There is a way to give a lower dose, or "some" insulin. You push really hard on the plunger of the syringe, Insert the syringe into the insulin and release the pressure on the plunger. You will likely draw up about a drop of insulin.

If you fed high carb food at +4, you might want to put a note in the comments on your SS.

 

Unfortunately a lot came up today and I couldn't do more testing this afternoon (impossible to do by myself with him, he's a little wild), just kept checking on him.

I am using the pet specific meter, but i'm thinking of getting a human meter. Doing some side by sides and eventually converting over to human only when the AT strips run out. Is the Relion Prime the one most folks here buy?

Are there examples of other cats here that had higher AMPS/PMPS but really low NADIRS on very small doses?

 

Many people in the US use the Relion. The strips are among the least expensive around. You will make yourself crazy trying to compare meters. Many have tried and gray hair is the result. Pick a meter and don't look back!

 

Thanks that makes it easy.

PMPS 102. Wow, good number, but didn't expect that. Right now im thinking we'lll try to do one drop tonight, then get a +3, if that number is low i'll stay up and keep feeding him myself.