? 5/1/17 Sprocket,AMPS/302,+2.75/273,+4.75/286.PMPS/319, +2.25/262, +4.6/239

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Hey Darnell--

Darnell & Sprocket said:
http://www.felinediabetes.com/FDMB/...-222-4-5-266-carbs-on-bg.177213/#post-1952632

He was doing good going into mid 100s. Why does he go up now?
When do we see a level dose? When do we stop increasing?
What do I look for as signs he is at right dose?
Does this just keep happening?
I need to know where the light is?
Getting very frustrated.
Click to expand...

I hear your frustration. This is a hard road, no question about it! And it's even harder with a DKA kitty like Sprocket-- some of the rules we have to make it easier to make dose decisions in less-complicated cases are sometimes put aside for a DKA kitty, so it's hard to give you the hard-and-fast answers to some of these questions. I will give you my two cents, though:

1. Why is he going up? One possibility is just, insulin needs change, and he needs a bit more now than he did a few weeks ago. I think this is quite likely. The other possibility is that he's got something else bothering him that is elevating his numbers. You've been taking such good care of him, though, I doubt he has any of the usual suspects like dental issues going on. I think he probably just needs a bit more insulin.

2. When do we see a level dose? When do we stop increasing? What do I look for as signs he is at the right dose? Lantus is dosed based on the nadirs. Eventually, we want to see a diabetic kitty with nadirs in (dark) green numbers-- between 50-100. You'll want to work up to that, but at the least, in the short term I think you should be shooting for getting him into the lower blues pretty regularly. The thing about the 3.5U dose is, he's really only gotten a good nadir once in the past few weeks, on 4/24. I think it's time to start thinking about another increase to try to get him to his "good dose".

That said, his relatively flat yellow numbers today suggest to me that he may be in a little bounce today, and that bounce may be going to break soon. So that's why I only say to "start thinking about" an increase-- I do think Sprocket needs a bit more juice, but I wouldn't increase until a cycle when you are ready to do a lot of monitoring (just in case). But don't wait too long-- the more he hangs out in the yellows, the more used to those numbers his body gets and the harder it will be to shake him out of them.
 
Nan & Amber said:
Hey Darnell--



I hear your frustration. This is a hard road, no question about it! And it's even harder with a DKA kitty like Sprocket-- some of the rules we have to make it easier to make dose decisions in less-complicated cases are sometimes put aside for a DKA kitty, so it's hard to give you the hard-and-fast answers to some of these questions. I will give you my two cents, though:

1. Why is he going up? One possibility is just, insulin needs change, and he needs a bit more now than he did a few weeks ago. I think this is quite likely. The other possibility is that he's got something else bothering him that is elevating his numbers. You've been taking such good care of him, though, I doubt he has any of the usual suspects like dental issues going on. I think he probably just needs a bit more insulin.

2. When do we see a level dose? When do we stop increasing? What do I look for as signs he is at the right dose? Lantus is dosed based on the nadirs. Eventually, we want to see a diabetic kitty with nadirs in (dark) green numbers-- between 50-100. You'll want to work up to that, but at the least, in the short term I think you should be shooting for getting him into the lower blues pretty regularly. The thing about the 3.5U dose is, he's really only gotten a good nadir once in the past few weeks, on 4/24. I think it's time to start thinking about another increase to try to get him to his "good dose".

That said, his relatively flat yellow numbers today suggest to me that he may be in a little bounce today, and that bounce may be going to break soon. So that's why I only say to "start thinking about" an increase-- I do think Sprocket needs a bit more juice, but I wouldn't increase until a cycle when you are ready to do a lot of monitoring (just in case). But don't wait too long-- the more he hangs out in the yellows, the more used to those numbers his body gets and the harder it will be to shake him out of them.
Click to expand...

On 4/24 he went in dark green because he was nauseous that morning n would not eat. I gave him ondansetron at almost +2 and he ate but he was still dropping while food was getting in his system.

I am gonna do the increase but i got appta every day till thurs so I will start wed am with increase n hope he wont go low till after 3rd cycle. Last increase he went low 5th cycle.
 
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