How old is your bottle of insulin? Are you varying the injection site?
I just rechecked the spreadsheet and had noted on the 19th of April that I started a new bottle of insulin that morning. I am rotating left to right on the sides in various areas, however the area is now getting to be troublesome due to the spreading skin condition. It is becoming so bad, that I have been causing blood from the injection site(s). Small amount, but this wasn't happening so often in the past.
It seems that the insulin isn't the issue. I wonder if her skin issue is affecting its absorption - just guessing. I'm assuming that tests for high dose conditions like acromegaly or anti insulin antibodies aren't available where you are. I'm grasping at straws. She's on a lot of meds and has several other medical issues that might well be complicating things.
You assumed correctly in that neither test is available here or, according to the vet, anywhere in Japan. Stated that the test would have to go to the U. S. I did not bother with asking the cost. Really at a loss as to what to do. Appreciate your suggestions and support.
I have been considering changing to another insulin. Have asked the vet about Lantus which they can obtain. I have to plead total ignorance here. I see a forum for Lantus(Glargine)/Levemir(Detemir) and haven't a clue what to ask for. Thought I should be giving current insulin type six months. Not sure yet. With all that is going on with her now feel perhaps haven't given it a fair shot and changing now may not work out either until the skin and other problems are resolved. Really feel stuck and pretty darned dumb at the moment.
Lantus has a good track record with kitties. It's action is quite different from PoZinc's. I suggest you go to that forum and read the yellow stickies to learn about it - might help you decide.
Thank you for the candid response. Not sure what to do anymore.
Not sure what to do anymore. Appreciate the information and time you spent. I may just turn the process completely over to the vet since I am being told here by them via my spouse that I don't know the little points and didn't go to vet school.
Thank you so much for that observation. I have a lot to remember but I think I was raising doses as she was bouncing and then getting stuck in higher numbers and to preclude glucose toxicity I was increasing dosage. in all honesty I never thought about moving back down afterwards at that time. Recently I have been wondering the same thing but figured I was just grasping at straws looking for a solution. You are more than likely right about the vet but I have them and others teaming up now and I’ve become tired of the arguments. Her loss of hair and skin condition worsening leads them to now think of Cushings. They want to test for that. Can too much insulin cause her current condition? Would like to hear your thoughts on that and dose decreases.
Cushings is worth testing for. It can make regulation much more difficult:
Thank you. Would you or anyone else also please review the spreadsheet. Has the Somogyi Overswing come into play here at any time? Does she have to go below 65 before this is a factor or can just a rapid drop cause this?
Our view of bouncing is that BG doesn't have to drop low to get it going. Bg merely has to drop at a faster rate than usual or into numbers that, although still high, are lower than recent numbers. Vets get caught up in the notion of Somogyi rebound but many caretakers here have SS data that supports a broader definition.
I had already decided to have the test performed however the test they are doing is 50/50 at best. My understanding in the past in regards to Cushing’s is that if creatinine levels are normal it is not Cushing’s but I’m probably wrong about that also. Every blood test performed in the past has shown her right about middle or thereabouts. I have also read that this can be caused by a tumor or steroid overuse. I suspect her diabetes is from steroids and this would now follow. Can’t discuss with anyone here as they take everything as an attack or interference. Thanks for the thoughts, means a lot.
). Hopefully the blood test will reveal something helpful. Please let us know when you get the results. 
Thank you. I’m still gathering my thoughts as I just don’t even know where to begin.
First and foremost - I am sincerely and deeply sorry for your loss. Though much time has gone by, we will never forget. I have lost 20 felines over the past 12 years and each one breaks my heart a little more.From looking at your spreadsheet at would appear that there may be other factors at work besides the diabetes. You mentioned that you were going to have the IAA and IGF-1 tests run which is a good idea.
I had a Cushing's kitty who passed away last year after 2 1/2 years with diabetes. He was PDH which is caused by a tumour on the pituitary gland. Cushing's can also be caused by a tumour on the adrenal gland (ADH) or iatrogenic which is caused from steroid use. My Tuxie's numbers were extremely volatile and could go from extreme highs to extreme lows all within the same cycle. He eventually got up to 6 units twice a day but was never even close to being regulated.
Cyshing's kitties often will have thin skin,prone to easy tearing, fur loss, and a pot-bellied appearance ( my Tuxie always looked like he was pregnant). The easiset test is the UCCR (urine cortisol creatinine ratio). This is done by collecting a urine sample AT HOME so there is no stress involved and having your vet send to an outside lab such as IDEXX for testing. There are IDEXX labs in Japan so this shouldn't be a problem. If the test comes back positive or borderline then other tests are necessary to determine which type of Cushing's it is.
Iatrogenic Cushing's (caused by steroid use) often can reverse itself once steroids are removed. PDH (pituuitary based) Cushing's has been treated with some success with trilostane (vetoryl). Kitties on this drug must be tested regularly, especially at the beginning, to make sure the dose is not too high. Too high a dose can cause Addison's syndrome which can be life tjreatening. ADH (afrenal based) can be treated by removing the tumour or adrenak gland although the surgery has higher risks.
Since you are having the IAA and acro tests done it wouldn't hurt to also do the UCCR test to rule out Cushing's. Current veterinarina literature says that Cushing's is rar in kitties. However it is my opinion that Cushing's in more prevalent than believed and is under diagnosed. If you need more information on Cushing's I will try to help you.
ETA Another useful test is an ultrasound done by a board certified technician. Cushing's kitties will often showing an enlarged pancreas, liver and adrenals. If both adrenals are enlarged then Cushing's is usually the PDH (pituitary) type. Of only one adrenal is enlarged then it is most likely ADH.
ETA I am including links to Tuxie's early spreadsheets. They were done in sections originally but these are the early ones after he was diagnosed with diabetes. I was using the AT2 pet meter.
https://docs.google.com/spreadsheets/d/1zjLCy1Y3LgvEsa3TU22TfmUUru9Ekr55QBrfBUpRO1Q/edit#gid=5
https://docs.google.com/spreadsheets/d/1eL-wdSvWyV5Z4ZIeSYbEP0WupKTcb4NuvahUQdVUcS8/edit#gid=5
