AMPS 276 adjust dose?

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by FrostD, May 31, 2020.

  1. FrostD

    FrostD Member

    Joined:
    May 27, 2020
    AMPS and PMPS have been 325-400. Only have one curve of data, with 75 pt drop at 2.5U.

    I pulled the dry food, and left him a can of wet overnight, he ate nearly all of it so that's the likely reason we're lower this morning.

    Just not sure if I should give full dose...
     
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  2. FrostD

    FrostD Member

    Joined:
    May 27, 2020
    Saw a reply and it disappeared...I ended up giving 2U, gut was telling me not to do full dose since I'm also pulling the dry during the day. I'll keep an eye on him, and try to get a few midcycle tests
     
  3. Oliver the Roman

    Oliver the Roman Member

    Joined:
    Mar 22, 2020
    Oh dear, the reading went up 4 hours after the injection? That's odd. Try to keep monitoring closely, and I hope more experienced people can step in to help you... @Deb & Wink ?? (she is my mentor and has been helping me greatly!)
     
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  4. Panic

    Panic Well-Known Member

    Joined:
    Apr 10, 2019
    Remember that meters are allowed a 20% variance. 276 and 314 are basically the same number.
     
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  5. FrostD

    FrostD Member

    Joined:
    May 27, 2020
    I only have two days worth of data, but I seem to be hitting nadir around 4 hr mark and not getting a significant change when you factor in the 20%.

    BUTTT we seem to be down about 100 pts just by doing the wet food, time will tell. He turns his nose up at the dry and is going to town on the wet, hopefully he doesn't make himself sick.
     
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  6. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Yeah! for Mr. Kitty liking the wet/canned food. That is half the battle sometimes, convincing a cat that wet food is edible.

    With not much data yet, and you switching Mr Kitty to low carb canned food, the numbers certainly can drop 100 basis points or more. So it's a good idea to drop the insulin dose as you are doing the food change. Like you did, from 2.5U to 2U of Vetsulin.

    You can always increase the dose, but once you have given the insulin, you can't take it back out.
    Did you print out the hypo instructions, and make up your hypo toolkit, just in case Mr. Kitty goes low?
    They are in the Health Links/FAQ's forum, in the index. Along with a lot of other documents.
    Be prepared isn't just the boy scout motto, it's ours too.
    Vetsulin (Caninsulin) often doesn't last more than 8-10 hours in a diabetic cat. But hoping that Mr. Kitty is an exception to that normal and he gets longer duration.
     
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  7. FrostD

    FrostD Member

    Joined:
    May 27, 2020
    Done, thanks!

    Quick question - AAHA guidelines specify 300 (renal threshold) as the max acceptable BG level for cats. As long as they stay under that with nadir of 80-150, sufficient duration, no clinical signs, they consider it controlled. But here the recommendation seems to be 200, why is that? Just based on the wealth of experience? (For the record, I don't think permanently operating a cat at or near the renal threshold is a good idea, just curious)
     
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  8. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Renal threshold is not 300 in diabetic cats. Renal threshold varies for different diabetic cats, but most cats will spill glucose into the urine at 180-200 mg/dL. Over the counter test strips are available, if you want to try seeing this renal threshold at home. Doesn't always have to be a urine sample run through lab equipment at the vet clinic.

    Excess glucose makes the kidneys work harder which you don't want. It provides a nutrient rich environment in the urinary tract, which is why diabetic cats are prone to frequent UTI's.

    Why do we say a BG of 200 at PRE_SHOT? Because that is a relatively safe BG level when people are new to home testing. That level gets lowered with more test data and knowing how YOUR cat reacts to the insulin. So you need to test to find out the onset, nadir, duration of insulin for YOUR cat. ECID. Every Cat is Different. You need to really come to understand how the insulin and food affects your Mr. Kitty.

    We definitely want to see nadirs lower than 200. You want nadirs that get your cat into normal BG ranges, which is 50-80 for most non-diabetic cats. For many diabetic cats, those ranges are still achievable.

    Depends on how much time and effort that people want to and are able to put into monitoring their cat.

    What is Regulation?

    As you can see, there are many degrees of regulation. Not all cats can achieve the various degrees or levels of regulation. You do the best you can, and the important thing is to get your cat feeling better and acting more normally, like their old self.
     
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