539 AMPS Score

@Marje & Gracie, @Panic, @JanetNJ Susie had the worst test this morning (AMPS @539) since she was diagnosed. She has not had a "blue" number in three days. I am increasing her insulin (Vetsulin) back up to 1.25 units. I don't know what else to do as she has been backsliding. Maybe the increase in carbs (6.09% and 7.95%) the last day did not help. Maybe the increase in food is affecting her too. Any advice would be appreciated. In the meantime I will just feed her the FF Classic Pate and skip the Publix Pate. Thank you.

 

Black numbers usually indicate bouncing - I imagine she dropped lower than you realize last night.

 

If I thought she was going to go low I would have made it a point to get up and test at some point last night. She hasn't had a low number in several days. Thank you for the information!

 

I think it's a good call

 

Weren't you the one telling me that if I didn't think her numbers were going to go low than there was no need to get up in the middle of the night to test? Look at her numbers. Who would have thought that she was going to go low? Nonetheless, I will set my alarm clock for midnight, tonight, to test her blood. Hard to do with numbers so high, an 89-year old Mom I look after for all day long at home and a sleep problem when I get up in the middle of the night. Honestly, if I thought she was going to go low I would make it a priority but none of her numbers have led to thinking she was going to tank in the middle of the night.

 

I mean I think raising to 1.25 is a good call. You can certainly get up if you want to. I usually do a quick test before bed, and unless it's lower then I expected, that's it.

 

The concern with "going low" at night is hypoglycemia (roughly 50mg/dL or less with a human meter)...I very much doubt she came close to that.

Elizabeth is referring to a bounce, meaning the numbers dropped more or faster than Susie is used to and her body "overreacted". There's really nothing you can do to prevent or treat that, and chances are even if you did test middle of the night it would have been around 100. A 1U dose seems to drop her by 100-150 points it seems.

I'm not sure I would have shot 1.25U tonight. If a 1U dose at 255 caused a bounce, I'd expect a 1.25U dose at 244 to possibly do the same. Additionally, in the past 1.25U has taken her down significantly, and into the greens when she had a lower PS reading.

I'd recommend a +5 test tonight, I'm not sure where midnight puts you. If she's in the green, you'll want a +6 to see if she's still dropping. You'll want to test til you see her rising by 10-20 points.

 

I do want to add that you're doing a great job so far. I know it's overwhelming and you have guidance from the vet vs different opinions here, and sometimes it's hard to make heads or tails of what to do in a given situation.

I personally am just more conservative about shooting when I can't test, especially at new doses. So I choose to err on the side of caution, and wait til a day I know I can test.

Unfortunately it just takes time, data, and a bit of trial and error to figure out what you're comfortable with (and many pairs of patience pants).

 

When I first tested her AMPS this morning it said "HI". I retested and got 448. I did get up at +5.5 last night and tested. She was at 226. I don't think she is going to low at night but I don't understand why she is all of a sudden bouncing so much unless it is the additional food I have been feeding. Thank you, Janet. I appreciate the support.

 

Thanks. I did test last night at +5.5 and she got 226. I'm not sure what to do now. Keep her at 1.25 units or go back to 1 unit. She was doing better at the 1.25 units but did get a 74 so I was told to go back to the 1 unit. I just can't seem to manage her diabetes. She is up and then down. Ideally, I would like to shoot a 1.25 after AMPS and a 1 after PMPS so I don't have to worry about getting up during the night but I guess that comes with the territory/disease. Thanks for your input.

 

Have you noticed a difference between the Vetsulin and the Lantus with Mr. Kitty? Did he do better with the Vetsulin? I see you made the switch and that is what I am planning on doing (by March) but wonder if I should stay with the Vetsulin longer.

 

Honestly, this is just how it goes sometimes! Frustrating for sure, but everything you're seeing is pretty normal.

Since she apparently didn't go too low last night, I'd hold the 1.25U dose. I'm actually a bit surprised at such a small difference between PMPS and the +5.5. The recommendation for Vetsulin is to hold for at least 5 days unless she drops below 90 again, so do the mid-cycle spot checks when you can. Then a curve after those 5 days, and decide whether to increase or decrease.

I will say her big drops every now and then so make me a bit cautious...so although last night was ok, the next time you have a lower PS and shoot might have different results. If you can at least make sure she has food available in the +4 to +7 timeframe that will help.

As for Mr Kitty, I'm not seeing any difference yet. He was just one of those cats that did well on Vetsulin at the start, but I was a bit concerned about how harsh it would be over time. Right now I suspect I have glucose toxicity to break through, so I probably won't see any improvement until I hit 4U or more. Then hopefully we hit a breakthrough dose, and I can start doing reductions.

 

I do wonder if the +5.5 might be a weird effect of the bounce. Bounces usually don't clear so quickly, it's possible something residual (so to speak) kept her higher.

 

Will stay with the 1.25 units to see how she does over the next few days. She did well when she was on this dose before. Right now I am giving her one 3oz can of Fancy Feast right after AMPS/PMPS and 1/2 can around +5, +6 during the day and 1/2 can before I go to bed at night which is about 2 hours after she has had her pre-shot meal at night. I am usually in bed around 7:30 at night. I noticed that since I have started feeding her more her numbers have gone up. I'm thrilled that she can have more food though as she is always hungry. I just have to get the dosage right now. I'll have to look up the glucose toxicity as I don't know what that is. Good luck with Mr. Kitty. Love the tuxedos and the blacks. Actually, love ALL cats - no matter the color.

 

You too!

And yes, it's more important that she eat to maintain weight right now. When Mr Kitty was regulated, he was eating about a full 5.5oz can less each day. As her numbers get better over time you'll likely see her appetite decrease to a more "normal" amount.

 

My vet wants her down to 10 lbs which I think is too much. She just put on .14 lbs since last I weighed her but she is getting more food than she was in the beginning. My vet first told me only to feed twice a day - 12 hours apart. A couple weeks later I told him she was really, really hungry and, after free feeding since I had her, I wanted her to have more food. He agreed that maybe she should have more. Confusing. One of the wonderful reasons I found this site. Consistency.