2/17 "Getting upset" AMPS 401/+4 266/+6 354/+8 374/PMPS 408

Cookee

Cookee

Member Since 2022
Just keep adding insulin, and he just keeps dropping slightly then rebounding to terrible highs. I mean he's at 4.5u for these numbers and still no greens.

How many units are we gonna have to give??

This morning so far. at 5 units? These are worse numbers than he had at 3.5u?
Very confused.

AMPS 442
+5 351
 
Here’s I think your last post I think for continuity.
https://felinediabetes.com/FDMB/thr...0-5-414-what-am-i-seeing.259109/#post-2911719

Please add your method to the signature and spreadsheet. If you chose TR like your post says you are not following it. You need to increase every 6 cycles by .50 when the nadirs are over 300 which they are. Hopefully with this increase you will see better numbers. You haven’t reached the breakthrough dose yet.
 
Cookee said:
How many units are we gonna have to give??
Click to expand...
As many units as he needs to get into good numbers. I'm being serious. ECID or each cat is different is so true. We've seen cats on drops of insulin and some north of 60 units (though rare). Those that were on higher doses typically have a secondary endocrine condition that causes insulin resistance and the need for higher doses. Also, cats who are held too long on a dose that isn't working can build up glucose toxicity, meaning their bodies get used to higher numbers and thing of them as normal.

The choice of dosing protocol will influence who long it'll take you to get to a good dose for Cookee. And like most things cat, that "good dose" will still change over time.
 
Also remember insulin is a hormone not a medication. It takes the body a little while to "know" how to use the insulin you are giving. During this time like Wendy said glucose toxicity can become an issue by holding doses longer and it takes more to break through. I promise once you break through it will be like a light switch flips on:bighug: hang tight!:)
 
Ok, I am hampered by the fact that I am not home most days for long periods, and I am fearful of increasing his dose when I cannot be home to watch for signs of HypoG. I like to do dose increases only on a days when I can test his numbers throughout the day to see what's going on.
As an example, I work the next 5 days , 11 hour shifts with a 30 minute commute. My wife tries to get home during her inbetween hours, but she also has limited time.

Its very frustrating trying to do this the "right" way, when we cannot even be home to check BG numbers.
 
Coming from a previously-13U-cat, I understand the frustration, I do. Worry about what you can control.

There is no "right" way, just optimal, safe ways depending on a caregivers abilities and desires. It's true TR allows for quicker increases, but safety is the top priority. So if on SLGS it takes you a month or two longer to get to a good dose, you still have a live cat. Just keep an eye on ketones.

You have enough data to know/reasonably infer that he's nowhere near hypoglycemia, even on the days you can't test. If he drops lower on cycles you miss, it would eventually come out in the wash during the cycles you do (and/or we'd see some bouncing, unusual preshots ,etc.)

Other things you can (probably) control - nighttime tests, which you've been doing a good job of. You could consider increasing at night if you really want to watch the first cycle, and just plan to test every 3 hours or so. It may allow you to increase a few days sooner
 
Cookee said:
I like to do dose increases only on a days when I can test his numbers throughout the day to see what's going on.
Click to expand...
FYI, many cats wait until the 4th or 5th cycle after an increase to show a response, because of the depot. But some do on the first cycle. Your job is, as best you can, to figure out what Cookee likes to do, and plan accordingly. Know Thy Cat.
 
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