6/24 Esca AMPS 407 - Repost from yesterday, dosing advice

Prev post: https://www.felinediabetes.com/FDMB...195-7-3-153-11-161-pmps-165-2-91-3-91.264980/

Didn’t get an answer to my original question, so I’m reposting because I’m so confused on what to do. His numbers looked SO good for a few days and now we’re going in the wrong direction fast. Is the .5u dose too high? Is it suddenly not enough and does he need an increase now?
.5 is dropping him quick still it seems, but now he’s bounced high this morning.

 

Sorry nobody got back to you. With SLGS a reduction is earned if the bg is ever under 90 so a reduction to .25 has been earned.

 

If you were following TR these would be good numbers. Cats bounce when their bg is lower than they are used to having. The more time in normal numbers the less bouncing and better chance of remission.

 

That 407 came out of nowhere!

This dose looks good for him, but only if you were following TR, like Elise pointed out. You are feeding canned food and testing enough - why not switch to TR? It is a more aggressive protocol and allows you to hold doses in which kitty can spend more time in normal numbers (50-100 mg/dl on a human meter).

 

Just to help a bit with what Elise wrote, here is a definition of what a bounce is:

• Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

I recommend going thru this sticky note https://www.felinediabetes.com/FDMB/threads/the-basics-new-to-the-group-start-here.18139/ , there is a lot of useful information

 

The plan was to start on TR today! My husband left for a week when we switched to Lantus. I wanted him to be home to help with extra testing - he just got home yesterday so the plan was to switch today. With these new numbers though, we didn’t know what to do. Although I feel like I was doing a combo of the two and was waiting for lower numbers to reduce!

It’s okay - I know y’all are super busy! I just felt it was best to repost


We did .5 this morning, should we do .25 tonight? Or stay at .5 because we want to switch to the TR.

What should we give tonight?

 

Stay with 0.5u since you are switching to TR. With TR, dose reductions are earned when the BG drops below 50 on a human meter (for cats who were diagnosed less than a year ago)

 

Thank you!
I’m hoping his numbers go back to normal soon, I’m so confused why they did this suddenly. We were getting so close to reducing!

I’ll keep holding and hope this is just a random spike that will correct itself!
Should I be concerned that he’s slowed down on eating or is it normal to see after some low numbers?

 

Also is it possible to see the higher numbers if this dose is too high and I should have reduced when he hit under 90?
I guess I’m partially confused with just holding for so long on TR with no adjustments lol. I’m going to dive into TR stickies tonight again though!

 

It might just be a random spike. His numbers have been looking good this last week. And it is indeed normal for their appetites to reduce once they start seeing lower/normal numbers. At higher numbers they can't process their food and are therefore always hungry. The excessive thirst and urination also reduces in lower numbers.

Yes, if a dose is too high it can look like the dose is too low - but only when you are not getting enough tests to see how low the dose is taking the cat. That is not true in your case. It is just a matter of him getting used to lower numbers. Once he does, the bouncing will reduce and you're already seeing evidence of that. I know it's very upsetting and alarming to see such a high number after days of lower numbers.

With TR you examine the dose every 3-5 days and increase if the nadirs are not in the range you want them to be. With nadirs in the high 60s, you do have room for an increase. See what he does today and we can take a call on increasing tomorrow.

@tiffmaxee

 

Thank you so much for all this information. Just when I think I’m getting a handle on it, he throws me a curve ball and I panic haha. We’ll stay the course! Unfortunately I’m not home today to get a bunch of mid day tests like usual, but I’ll monitor like normal over the weekend!

 

Wow, Esca! What's with all those angry reds??!! Curious to know what he did in the PM cycle?

If you are home and can monitor, you could look at an increase tomorrow morning. if he is clearing the bounce, you might want to hold off on the increase. Bounce clearing cycles have additional downward momentum and you do not want the increase adding to that.

 

Ah, not good! He’s been high all day

I just updated his spreadsheet with his days numbers. I’ll be home for a decent part of the day tomorrow and can monitor him if you think an increase would be a good idea. I’m not opposed to an increase - I dislike all that red! He did throw up once today too

I’ll be up for another hour to check him at +3 and will wake up to check either +5 or +6.

 

Looks like he is going to bounce tonight. So don't bother waking up for a +5 or +6.

You could increase tomorrow.

 

Ugh, I was hopeful to see more of a drop at +3, but alas he’s only come down by 7. So yes I’ll definitely skip the AM wake up.
I’ll increase .25 in the AM!