Help! Dosing advice for Fatty (repost from PZ forum)

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Looks to me like Sir Fats will need another dose increase soon. Maybe in a couple more cycles. Not seeing any blues for him since 2/11/21 (11/2/21 in your date format) when you reduced the dose.

Alana & Fatty said:
So true! Blessed to have enough water for both of us. Are you in Texas? Either way, hope you are staying safe and well!
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In the northeast, in Massachusetts, where we are getting another round of the frozen stuff (snow) over the next 2 days.
 
Ah yes -- I am in southern Ontario and we seem to be getting more snow within the past two weeks than we've had in years!

I'm not sure if this counts as a bounce or not, but yesterday AM when I increased is dose to 2.0, he went into the reds and then into the blacks this morning. His +8.25 was better (227 or 12.6) so I'm hoping he just needs a bit of time to settle down before doing another dose increase. There must be a dose that works him ... right?
 
So kind of you to ask, thank you! :cat:

We will have to wait until Monday for his labs because they are going out of house, but the vet said he looks great and his weight is stable, so those are good things.

She checked his BG at +11 and it was freaking 11.something, so low 200s, way lower than it was. And at the vet, which is possibly stressful (though she said he was cool as a cucumber)? HUH? She said I could drop his dose down to 1.5U given that reading, but by the time I got home and checked again, it was up a bit more. And whenever I drop his dose he goes way higher, so I forged ahead with 2.0 and at +7, it hasn't dropped him down too much, but at least we're in the yellows for now.
 
Well folks, I am profoundly confused.

I'm inclined to keep him at 2.0U for the next two days (for a total of 5 days, 10 cycles) to see if anything settles. Looking back through his spreadsheet, I see that his current 6-cycle dose at 2.0 is the longest I've held anything, and the first few seem to be all over the place after an adjustment up or down, so maybe this is worth a shot.

The high "nadirs" (if we can call them that) seem to warrant a dose increase, but looking back, it almost looks like his nadirs were lower on 1.75U (though still high).

:banghead::banghead::banghead::banghead::banghead:
 
Might be a good idea. He may just be a very bouncy cat, and holding the dose a bit longer helps get him used to lower numbers? Or it really is the food throwing everything out if whack, though if it's consistent amounts/ratios/times that's a bit surprising to me
 
Even if I would have a more clear indication of how to adjust the dose after two more days, I'd take that as a win. I'm blending his food (one 5.5oz can high carb to two 3oz cans lower carb) to make sure it's the exact same every time, but his spreadsheet still looks confusing as heck to me!
 
Wondering ... I’ve been trying so damn hard to figure out Sir Fatty’s BG for weeks now, as you are well aware. What do you think of this plan:

What if, instead of trying to do a slow transition between foods while also trying to navigate his dosing (the drop still has me freaked, and the HIs do too), I try to do a full reset and try (beg, plead, pray) to give him only the lower carb renal food? He ate a few pieces quite happily this morning. It’s the same kind he was on in the fall at 1.0U but they’ve done a tiny formula tweak, so maybe that’s enough of a change for him. I would give no insulin for maybe a day to see if he would take to it, then add insulin back in? Is that crazy? I’m at a loss here.

Hopefully our vet will call tonight but while she is excellent with kidney stuff, I feel like you wonderful wondrous wonders know more about dosing.

If this is dumb/risky, please — don’t hold back!
 
Hi again Janet, he's early stage 3 (values were almost up to stage 4 a month ago, so I'm still on eggshells). I made a note of the Weruva foods you mentioned on another post of mine a few weeks' back, but I still haven't been able to find them. Now that some pet stores near me are opening up again I will go and try to track down a few kinds in person.

May I ask, if I were to try one of these low carb foods, would you suggest withholding insulin for a day/a few days? He seems to be super sensitive to carbs and I don't want to overdose him (again).
 
Alana & Fatty said:
I would give no insulin for maybe a day to see if he would take to it, then add insulin back in? Is that crazy? I’m at a loss here.
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It sounds like Sir Fatty is the one you have to beg, plead, pray with to get him to eat only the lower renal food. It's really up to him if your proposed plan would work. Go ahead and try it. If it doesn't work, you go back to how you were doing the food transition before.

Alana & Fatty said:
If this is dumb/risky, please — don’t hold back!
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Life is not without risks Alana.

The risk with stopping insulin altogether, would be from the formation of ketones, especially if Sir Fatty isn't eating enough. That would be my main concern, him not eating enough.

Ketones form when there is not enough food and/or not enough insulin and/or there is an infection/inflammation of some kind. The cat burns up there own fat and then muscle tissue, and that produces the toxic byproduct of ketones.

You already tested him for ketones yesterday. So try for a ketone test every day.
 
Reds and blacks ... poor Fats. Considering giving him 1.0U tonight as the PZ dosing sticky recommends that as the starting dose if not on a low carb wet food diet and the new renal food is still 20% carbs. He was on 1.0U with this food before but it didn't have the higher carb "topper."
 
For some reason I didn't see this reply earlier this week... Sorry for the delay. I get weruva through chewy.com, but some pet stores sell them. Are you in the United States?
In your case I might not reduce the dose since he's still high.... Just keep a close eye.
 
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