10/22 dumpling AMPS 639/ PMPS 453, consistent high BG, please advise

[Dumpling0407]

Hi all,

Dumpling has been following TR with a steady does increase, however the pass 2 weeks he has not been responding to does increases well. Wonder why would he be under 400 first 2 days after dose increases, but can not last.

Dose is at 4.75u and based on TR guidelines, will be increasing to 5.25 tomorrow if dumpling is not showing numbers under 300. Spreadsheet have both alphaTrak 2 & libre readings, dose adjusted based on AlphaTrak 2 readings which is taken at AMPS, PMPS and PMPS +4.

Can he be an acro cat? Would he need acromegaly at some point? Dumpling is not showing improvement in BG level with dose increase despite religiously feeding only wet high protein food, and close monitoring & caring.

Really not sure if there is anything wrong with what I am doing and frustrated with consistent high numbers.
Could someone please take a look at the spreadsheet and advise what to do?
Thank you in advance! Any input is appreciated

https://docs.google.com/spreadsheets/d/1zz_oHYTl2Fdnq1bGV5bz_BokiknnFnDre-F_m_fIzlw/edit?usp=sharing

 

[Sienne and Gabby (GA)]

Just so I understand, you're using your AT meter for your pre-shot tests and using the Libre for your other tests? We generally don't suggest using different meters because it may make you crazy!! The AT is calibrated differently than the Libre and typically produces lower values. All of that aside, I think you're going to need to keep increasing Dumpling's dose. It doesn't look like you've been doing anything wrong. You just haven't gotten to a good dose for your cat.

Given that the next dose increase will put Dumpling over 5.0u, your thoughts about getting him tested for both acromegaly and insulin auto-antibodies is on target. I'm going to tag @Wendy&Neko so she can take a look at Dumpling's spreadsheet.

 

[Dumpling0407]

Just so I understand, you're using your AT meter for your pre-shot tests and using the Libre for your other tests? We generally don't suggest using different meters because it may make you crazy!! The AT is calibrated differently than the Libre and typically produces lower values. All of that aside, I think you're going to need to keep increasing Dumpling's dose. It doesn't look like you've been doing anything wrong. You just haven't gotten to a good dose for your cat.

Given that the next dose increase will put Dumpling over 5.0u, your thoughts about getting him tested for both acromegaly and insulin auto-antibodies is on target. I'm going to tag @Wendy&Neko so she can take a look at Dumpling's spreadsheet.

Thanks @Sienne and Gabby (GA) for the suggestion . We are using Libre to monitor dumpling's BG trend just in case if it goes too high or too low so we can be aware of that. As you mentioned, should we get him test for both acromegaly and insulin auto-antibodies once we give him 5.25u or should we wait to see what his reaction for the increase?
Thanks again!

 

[Wendy&Neko]

Typically we wait until a cat gets until 6 units before suggesting testing for the two conditions. And yes, test for both, my girl had both. Knowing what you are dealing with, if either is positive, can impact dosing decisions.

 

[Dumpling0407]

Typically we wait until a cat gets until 6 units before suggesting testing for the two conditions. And yes, test for both, my girl had both. Knowing what you are dealing with, if either is positive, can impact dosing decisions.

Thanks @Wendy&Neko for the suggestion, I will follow the TR guidelines to increase the unit and hopefully dumpling can gets some lower numbers