? What does it look like when ‘too much insulin seems not enough ‘?

[fafa's mum]

We are a bit frustrated now and some suggestion is appreciated.

when we were at 5u, the best drop was roughly -216 , but since it was still not good enough, we increased to 5.25 u and now 5.5 u, the drop does not seem as good as when we were on 5u.

some people say ‘too much insulin might not seem enough’ does it look like our situation?

 

[Larry and Kitties]

Yes, maybe the dose is too high. Too high a dose can manifest itself by a high, relatively flat cure. With you increase in dose the PS changed little but there was less drop in BG.
How long has your lantus pen or vial been punctured?

 

[Lisa and Witn (GA)]

There are a couple of reason that may be why you are not seeing better readings. It is possible that you may have missed your optimal dose. What was your starting dose? If the dose is too high the body tries to protect itself from becoming hypoglycemic by producing extra glucose. One way to test this is to start over with 1 unit twice a day and gradually increase it over several weeks to find the dose that works best.

Another possible cause is that there may be another medical issue going on that requires high dose of insulin. One is Acromegaly. We do have a board for high dose kitties. You could post on that board and they can recommend what tests need to be done to see if your cat is insulin resistant.

 

[fafa's mum]

Yes, maybe the dose is too high. Too high a dose can manifest itself by a high, relatively flat cure. With you increase in dose the PS changed little but there was less drop in BG.
How long has your lantus pen or vial been punctured?

the lantus is under two months I think.

 

[fafa's mum]

There are a couple of reason that may be why you are not seeing better readings. It is possible that you may have missed your optimal dose. What was your starting dose? If the dose is too high the body tries to protect itself from becoming hypoglycemic by producing extra glucose. One way to test this is to start over with 1 unit twice a day and gradually increase it over several weeks to find the dose that works best.

Another possible cause is that there may be another medical issue going on that requires high dose of insulin. One is Acromegaly. We do have a board for high dose kitties. You could post on that board and they can recommend what tests need to be done to see if your cat is insulin resistant.

We did start with 1u and increased slowly.

vet did blood test (general onea)and it showed nothing else last time. but not sure what it covers though

 

[fafa's mum]

oh actually the best drop was when it was 4.5u.

should I go back to 4.5g to try?

 

[Wendy&Neko]

To me, this looks like a “not enough” insulin situation. Once kitties stay in high numbers for a while, glucose toxicity develops, and those high numbers feel like normal to them. You need to get to a higher dose to break through the toxicity.

It also helps to remember that insulin is a hormone, not a drug. It is very possible to have some occasional better numbers at a lower dose. Neko first saw green around 3.5 units, then didn’t earn a reduction until 8.75 units. I kept seeing glimpses of good numbers, then they disappeared. She had two high dose conditions, acromegaly and insulin auto antibodies.

I know you are following SLGS, but I think you need to move to 0.5 unit increases now unless you are seeing green. As a percentage of total dose, those 0.25 unit increases are too small. I would go to 6.0 units next. Going backwards in dose would hinder progress. If you choose to go back, and you hold the syringe, please test daily for ketones.

 

[fafa's mum]

To me, this looks like a “not enough” insulin situation. Once kitties stay in high numbers for a while, glucose toxicity develops, and those high numbers feel like normal to them. You need to get to a higher dose to break through the toxicity.

It also helps to remember that insulin is a hormone, not a drug. It is very possible to have some occasional better numbers at a lower dose. Neko first saw green around 3.5 units, then didn’t earn a reduction until 8.75 units. I kept seeing glimpses of good numbers, then they disappeared. She had two high dose conditions, acromegaly and insulin auto antibodies.

I know you are following SLGS, but I think you need to move to 0.5 unit increases now unless you are seeing green. As a percentage of total dose, those 0.25 unit increases are too small. I would go to 6.0 units next. Going backwards in dose would hinder progress. If you choose to go back, and you hold the syringe, please test daily for ketones.

Thanks very much for the information. That gives me confidence to increase without worrying too much.

Our vet will not be back to work until next Saturday and I will talk to her about any other health concerns then.

I will find a time to start the increase this week. I am too scared to give an increase without me being at home for the first few cycles, in case it goes too low.

We had the worst BG tonight at 511 at pmps...we gave the same 5.5u and got a drop down to 241 at +3. Not sure what will happen at +4. it was a big drop this time. so unpredictable.

 

[Wendy&Neko]

Big drops can also cause bounces. It can help slow them down if you feed a small meal around +2 or just before onset, so fresh carbs are on board when the insulin takes effect.