? Yoshi 11/25 pm 428 increase doesn’t seem to be wking

[Stressedcatmom]

Happy Monday everyone,

I increased to 5U. This is the 6th cycle. I haven’t been posting because not much has been happening. He saw more blues and yellows on a lower dose.

Not sure if he’s hitting yellow or blue when I’m at wk or sleeping and this is a bounce.

Am I missing prime nadar time?

If anyone can look at SS, we would appreciate it.

 

[Penelope and Mačka]

I would say, keep on increasing... but yes, it's very frustrating. At 6 units, you can start to investigate acromegaly for example. I've seen kitties that had to go to 9 units, before decreasing fast.

 

[AmandaE]

I wonder if maybe Yosh has glucose toxicity? I agree, Yoshis numbers are high and your increases don’t seem to give much movement. One thing to consider is that if you’re consistently in these high numbers you might want to increase by 0.25u every 3 days (6cycles). I believe after a certain point you might be able to increase by 0.5u at a time. I don’t know a lot about it though. @Wendy&Neko @Sienne and Gabby (GA) would one of you have any insight into Yoshis numbers?

 

[Stressedcatmom]

I wonder if maybe Yosh has glucose toxicity? I agree, Yoshis numbers are high and your increases don’t seem to give much movement. One thing to consider is that if you’re consistently in these high numbers you might want to increase by 0.25u every 3 days (6cycles). I believe after a certain point you might be able to increase by 0.5u at a time. I don’t know a lot about it though. @Wendy&Neko @Sienne and Gabby (GA) would one of you have any insight into Yoshis numbers?

I’m sure he has some level of it. It has been mentioned before. I just don’t understand how he was in yellows and some blues and on the upswing after his dental but with subsequent increases, seems to be getting worse BG wise

 

[Sienne and Gabby (GA)]

I would encourage you to stop using skinny or fat doses. The only time those kind of micro-adjustments are indicated is if you are trying to zero in on a good dose. You're trying to get Yoshi below the 400s.

I'm tagging @Wendy&Neko. I'm thinking it might not be a bad idea to have Yoshi checked for acromegaly and insulin resistance. These are blood tests that are run out of Michigan State's veterinary lab.

It may be time to start increasing the dose by 0.5u but I'd like to have Wendy take a look.

 

[Stressedcatmom]

I would encourage you to stop using skinny or fat doses. The only time those kind of micro-adjustments are indicated is if you are trying to zero in on a good dose. You're trying to get Yoshi below the 400s.

I'm tagging @Wendy&Neko. I'm thinking it might not be a bad idea to have Yoshi checked for acromegaly and insulin resistance. These are blood tests that are run out of Michigan State's veterinary lab.

It may be time to start increasing the dose by 0.5u but I'd like to have Wendy take a look.

I heard that test is very expensive. Maybe I will get some bloodwork and a physical done. He has been constipated and drags his bum sometines. If I go to the vet by my moms house for the holiday, they have prozinc and I could Also discuss that.

I don’t understand why he was doing better on lower doses.

 

[Stressedcatmom]

I would encourage you to stop using skinny or fat doses. The only time those kind of micro-adjustments are indicated is if you are trying to zero in on a good dose. You're trying to get Yoshi below the 400s.

I'm tagging @Wendy&Neko. I'm thinking it might not be a bad idea to have Yoshi checked for acromegaly and insulin resistance. These are blood tests that are run out of Michigan State's veterinary lab.

It may be time to start increasing the dose by 0.5u but I'd like to have Wendy take a look.

I also remember you (or someone) telling me about skinny and fat doses. I haven’t done it since. I think I was used to the lingo and dosing strategy when he was on prozinc and was nearing remission. Wendy also cleared that up for me.

 

[Sienne and Gabby (GA)]

The tests themselves aren't that expensive. I believe the last time I looked, they were around $75 but, you have to pay for the blood draw and shipping. I suspect the shipping is what bumps up the cost.

If this is insulin resistance, antibodies interfere with insulin doing its job. You have to be very systematic with increases in order for the insulin to get ahead of the antibodies. Ultimately, the insulin breaks through the resistance. It can, however, take a while. With insulin resistance, it can be that lower doses look better because the antibodies haven't fully come into play. With acro, you're dealing with growth hormone influencing the numbers.

 

[Stressedcatmom]

The tests themselves aren't that expensive. I believe the last time I looked, they were around $75 but, you have to pay for the blood draw and shipping. I suspect the shipping is what bumps up the cost.

If this is insulin resistance, antibodies interfere with insulin doing its job. You have to be very systematic with increases in order for the insulin to get ahead of the antibodies. Ultimately, the insulin breaks through the resistance. It can, however, take a while. With insulin resistance, it can be that lower doses look better because the antibodies haven't fully come into play. With acro, you're dealing with growth hormone influencing the numbers.

Oh man nooooooooooooooooo

 

[Stressedcatmom]

Maybe an insulin switch? My friends dog seemed to be insulin resistant and the vet just switched the insulin and it started responding

 

[Wendy&Neko]

Maybe an insulin switch?

Nope, not yet, unless you notice Yoshi starting to react to the Lantus injections. Some cats react to the Lantus sting at higher doses. If he does, I'd suggest Levemir. Going to Prozinc would be going backwards. For higher dose cats, people switch from Prozinc to Levemir, not the other way around. From what I've seen, Levemir seems to have better duration.

As for the numbers, at this point, you just haven't reached a dose yet that will move him. Your focus should be on getting better blood sugar numbers. The number of the dose isn't as important. And yes, now that you are at 5.0 units, I would move to 0.5 unit increases.

And I think you are doing enough testing to know you aren't missing any lows. If it helps any, I had a lot of the same doubts early on that you are feeling now. I started seeing greens pop in at 3.5 units, but they'd vanish and come back again at much higher doses, then disappear. Very frustrating! It wasn't until I increased enough until the first reduction was earned that I saw some action.

If you are thinking bloodwork, I would prioritize both the IAA and IGF-1 (acromegaly) tests. If he's dragging his bum, I would get the vet to look at his anal sacs. If they are overfull, kitties will scoot their bums.

 

[Stressedcatmom]

Nope, not yet, unless you notice Yoshi starting to react to the Lantus injections. Some cats react to the Lantus sting at higher doses. If he does, I'd suggest Levemir. Going to Prozinc would be going backwards. For higher dose cats, people switch from Prozinc to Levemir, not the other way around. From what I've seen, Levemir seems to have better duration.

As for the numbers, at this point, you just haven't reached a dose yet that will move him. Your focus should be on getting better blood sugar numbers. The number of the dose isn't as important. And yes, now that you are at 5.0 units, I would move to 0.5 unit increases.

And I think you are doing enough testing to know you aren't missing any lows. If it helps any, I had a lot of the same doubts early on that you are feeling now. I started seeing greens pop in at 3.5 units, but they'd vanish and come back again at much higher doses, then disappear. Very frustrating! It wasn't until I increased enough until the first reduction was earned that I saw some action.

If you are thinking bloodwork, I would prioritize both the IAA and IGF-1 (acromegaly) tests. If he's dragging his bum, I would get the vet to look at his anal sacs. If they are overfull, kitties will scoot their bums.

So his dose would be 5 and a half units, correct? Tomorrow is my long day and I won’t be able to do mid cycle day tests. Then we are going to stay with my parents for the weekend. He likes to go lower at my moms house. I don’t know what it is. Maybe because he’s more active (2 other cats).

What is IAA?

 

[Wendy&Neko]

You can wait to increase until tomorrow night if that makes more sense for you.

IAA = insulin auto antibodies. Sienne talked about them in post 8. The one good thing about the antibodies is that they are self limiting and seem to go away after about a year. Neko had both that going on, and acromegaly, and likely some glucose toxicity.

 

[Stressedcatmom]

You can wait to increase until tomorrow night if that makes more sense for you.

IAA = insulin auto antibodies. Sienne talked about them in post 8. The one good thing about the antibodies is that they are self limiting and seem to go away after about a year. Neko had both that going on, and acromegaly, and likely some glucose toxicity.

Thank you @Wendy&Neko.

 

[Gill & George]

Hi just wondering if there is still dry food in the house??

I notice that that you occasionally catch him getting into it, might he be getting into it more than you think?

Could that be a reason why he goes lower at your parents? If there is no dry food there??

 

[Stressedcatmom]

Hi just wondering if there is still dry food in the house??

I notice that that you occasionally catch him getting into it, might he be getting into it more than you think?

Could that be a reason why he goes lower at your parents? If there is no dry food there??

Hi. No, no dry food here. He got into it at my moms last we visited because I left my civvies dry on the table where he could access. My civ has been staying w my mom since Halloween so I don’t drive him back and forth during the holidays (he loathes it)