I don't see a post for today, so am responding to your previous posts questions: the
link to that discussion is here. We include those links for continuity.
I’m so nervous about getting a number under 50 and then having to worry about a hypo episode! I’m not sure I’m comfortable with teetering on the edge like that! Can I do a decrease in dose if I get a number under 80? And is the process the same as increasing? Like every six cycles I would decrease when we get there of course! I’m just wondering how long he will need to be on these high doses, so I can plan ahead and not run out of insulin. When he was on 3 units for so long, I knew exactly how long the pen would last and could plan ahead when to refill
If you can monitor, have plenty of high carb food and syrup/karo, and plenty of test strips, then you can learn to manage low numbers. Going below 50 does not necessarily mean hypo symptoms. Some non diabetic cats test in the 40's, we just don't want a cat on insulin that low as it gives no margin. If you are nervous about Cashmere being in numbers below 80, maybe SLGS is as better dosing method for you. SLGS has reduction if a cat goes below 90. But it also means holding a dose for 7 days before increasing. Under TR, reductions are earned by going below a reduction point, they are not time based. That part is up to the cat. At this point, I think a good first goal for you is to try to get Cashmere to spend as much time as possible under renal threshold, which means more blues and the odd upper green. Yesterday's cycle was great in that respect.
As for how long he will be on higher doses, again, that is not something you can predict. It would be useful to know why he needs as much insulin as he did. Part of the reason is
glucose toxicity - he's been stuck in high numbers for a long time. So his body is used to them and will take more insulin to get out of those numbers. Once the glucose toxicity breaks, the dose needs will come down. There are other reasons that cause insulin resistance too. Once cats get to 6 units per dose, we suggest they think about getting them tested for acromegaly and IAA. Acromegaly is a condition caused by a benign tumour on the pituitary sending out excess growth hormone. One in four diabetic cats has this condition. IAA (insulin auto antibodies) is like the cat's body reacting to the injected insulin, it's less common, those some cats, like my girl, have both.
A housekeeping note. We like to do just one post a day, due to the number of cats here. It also helps if you have your cat's name and the day's date on your subject line. Update that subject line (edit title from first post of the thread) when you've got a new question or concern or it has been answered. Many of us scan the subjects to see who needs help, and it lets us identify who needs help now.
