1/10 - Leo - should I hold dose

Susan Shropshire

Susan Shropshire

Member Since 2021
I increased him to 10 units and tonight was the 8th cycle. I have seen Higher #s the entire time on this dose. I was getting really good blues and now nothing close.

It seems he is bouncing since we were at 248 at the PMPS and now 311 at the +6 hour mark.

Is this dose maybe too much? Should I have maybe held the 9.5 longer to see if he came down further.

Also it seems when I increase his dose it makes him sick For a day or so after the increase. He was doing great and playing and then I increased the dose and it went down hill?
 
A cats insulin needs go up and down. A dose that was too high last week could be too little this week and vice versa. With the amount of testing you are doing, you need not worry about missing a good dose since you know how low he is going on the dose.

With yellow nadirs at 10U, you can increase in 6 cycles. For doses over 10U, increases are in multiples of 1U. So you can go up to 11U tomorrow morning.

Not sure @Wendy&Neko is around to confirm.

ETA: If he is not feeling well, that could be a reason for the higher numbers. When you say sick, what do you mean?

Link to your previous post:
https://www.felinediabetes.com/FDMB/threads/1-5-leo-115-11-need-advice-asap.257520/
 
Sorry to hear Leo has been vomitting. Any chance he has a food allergy? I kept a "vomit log". :p In it I tracked which proteins were fed and what days there were vomits and what they look like. That way I can see if there is a correlation to type of meat being fed.

You test enough to know if 10 units is too much insulin. You'd see lows if it was was too much. And you don't see him diving low. Since you increase by safe amounts, and test enough, it's not too much insulin. In a cat over 6 units, and definitely at 10 units, there is some underlying condition causing insulin resistance, like acromegaly and/or IAA. The nature of insulin resistance is that it can keep growing and you have to keep chasing after good numbers with higher doses. My mentor Julie (& punkin) said it was like chasing after a speeding train.

Doses with nothing but yellow nadirs mean you shouldn't hold a dose more than 6 cycles, and as Bhooma said, at this point it's a 1 unit increase. Think of the increase as 10-15% of the size of the dose.
 
Wendy&Neko said:
Sorry to hear Leo has been vomitting. Any chance he has a food allergy? I kept a "vomit log". :p In it I tracked which proteins were fed and what days there were vomits and what they look like. That way I can see if there is a correlation to type of meat being fed.

You test enough to know if 10 units is too much insulin. You'd see lows if it was was too much. And you don't see him diving low. Since you increase by safe amounts, and test enough, it's not too much insulin. In a cat over 6 units, and definitely at 10 units, there is some underlying condition causing insulin resistance, like acromegaly and/or IAA. The nature of insulin resistance is that it can keep growing and you have to keep chasing after good numbers with higher doses. My mentor Julie (& punkin) said it was like chasing after a speeding train.

Doses with nothing but yellow nadirs mean you shouldn't hold a dose more than 6 cycles, and as Bhooma said, at this point it's a 1 unit increase. Think of the increase as 10-15% of the size of the dose.
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I’m just wondering why I was seeing lower numbers and immediately after increasing they went up? It just seems the more I give him the more he needs. At the #s he had at 9.5 he was where the new vet says she is happy. Around 150 and under is what she likes to see for nadirs. We were really close to that and now we have gone back to 200s and 390s and no blues.
 
Wendy&Neko said:
Sorry to hear Leo has been vomitting. Any chance he has a food allergy? I kept a "vomit log". :p In it I tracked which proteins were fed and what days there were vomits and what they look like. That way I can see if there is a correlation to type of meat being fed.

You test enough to know if 10 units is too much insulin. You'd see lows if it was was too much. And you don't see him diving low. Since you increase by safe amounts, and test enough, it's not too much insulin. In a cat over 6 units, and definitely at 10 units, there is some underlying condition causing insulin resistance, like acromegaly and/or IAA. The nature of insulin resistance is that it can keep growing and you have to keep chasing after good numbers with higher doses. My mentor Julie (& punkin) said it was like chasing after a speeding train.

Doses with nothing but yellow nadirs mean you shouldn't hold a dose more than 6 cycles, and as Bhooma said, at this point it's a 1 unit increase. Think of the increase as 10-15% of the size of the dose.
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I forgot to mention he was allergy tested and has food allergies and he is on a food for his allergies.
 
Susan Shropshire said:
I forgot to mention he was allergy tested and has food allergies and he is on a food for his allergies.
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Is this a recent food change?
Susan Shropshire said:
I’m just wondering why I was seeing lower numbers and immediately after increasing they went up?
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It's the nature of some types of insulin resistance. With Neko I call it "the dose going stale". If you'd held the dose longer, you would also have seen the numbers go up.
 
Look at my spreadsheets. This is what my boy did a lot (especially prior to starting Cabergoline).

What kind of food is he eating now? How many carbs are init? This may be contributing to the higher numbers as well as feeling poorly, although I am inclined to think the higher numbers are making him feel down.
 
Suzanne & Darcy said:
Look at my spreadsheets. This is what my boy did a lot (especially prior to starting Cabergoline).

What kind of food is he eating now? How many carbs are init? This may be contributing to the higher numbers as well as feeling poorly, although I am inclined to think the higher numbers are making him feel down.
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It seems with you and Wendy that they needed “other” treatment to make a difference as well.

He has food allergies so he eats a certain can food that is 1% carb.

It was just weird that he was seeing great numbers the night before I increased his dose??? I could see if it had started back up but it just made it seem it correlated with the increase.
 
Susan Shropshire said:
It seems with you and Wendy that they needed “other” treatment to make a difference as well.

He has food allergies so he eats a certain can food that is 1% carb.

It was just weird that he was seeing great numbers the night before I increased his dose??? I could see if it had started back up but it just made it seem it correlated with the increase.
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Yes. I understand. I had the same observation in my kitty. Very frustrating indeed! Several time I received bad advice from people NOT ON THIS BOARD. I was told that I was giving too much insulin or hadn't held long enough or had "shot past his good dose." So I would do a decrease and it ended up being much worse than before and it just contributed to the overall glucose toxicity problem and he was firmly ensconced in high numbers. It was only when I truly began to follow the methods of this board and, most especially, Wendy, that I started to make any progress at all. Levemir was also very helpful at evening him out and removing a lot of the ups and downs. But yes, finally it took the Cabergoline to get him into really good numbers with reduced insulin requirements. I believe he was headed for remission when he was taken out by complications from kidney disease.
 
Susan Shropshire said:
He has food allergies so he eats a certain can food that is 1% carb.
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I was just wondering about this canned food also because I have a cat with food allergies and I just don't know what to feed her. I was considering trying the hydrolyzed protein diets (she's not diabetic) but none of the other foods that I've tried have been helpful.
 
Suzanne & Darcy said:
I was just wondering about this canned food also because I have a cat with food allergies and I just don't know what to feed her. I was considering trying the hydrolyzed protein diets (she's not diabetic) but none of the other foods that I've tried have been helpful.
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It has been a struggle finding a for for Leo. He is allergic to beef, pork, & all fish except Salmon. Anything with meat by products is out for him. That is really hard. He is eating Purina beyond organic chicken and carrot. I talked to the company and was told it was .9% carbs.
https://www.chewy.com/purina-beyond-high-protein-organic/dp/279316
 
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