? Numbers question

[NadineTheodore]

I've upped Theodore's dose and while I don't anticipate instant results, I am just puzzled why I am not seeing more of a dent in his numbers...What am I doing wrong here? Can I do something differently or better?

We've increased the dose to 3.5 and his glucose is higher prior to shot than when I started. He seems more tired/sleepy with the 3-3.5 units as well but it's his first 24 hours. He's eating and drinking fine.

I am just stressed as vet said per his weight 3.5 units will be the max he should be doing. he's 14lbs. He was 16lbs before diabetes, went down to 13.5 DKA and I got him up to 14-14.3lbs but still seems thin and his back I can feel the bones. (muscle wasted).

I know dry food was mentioned as a no no but it helps his bowl movement, last time I removed it he ended up needing enema and ended up DKA. I limit the dry food to only when I feed him at night and mix with wet.

 

[Sienne and Gabby (GA)]

First, the numbers.... It helps to think about the depot. With Lantus, it takes a few cycles for the depot to catch up with a change in dose. With a cat that has gotten a dose reduction, it means that the next cycle or two may also involve lower numbers and even look like another dose reduction may be needed. With an increase in dose, it will take several cycles to see the results from the increase. The only time you see a more immediate response is if you are using a faster acting insulin (e.g., Vetsulin or Humulin N). So, be patient!!

There is not "maximum" dose of insulin. The dose of insulin is the dose your cat needs to get numbers where you want them. Take a look at other people's spreadsheets. You'll see a range. We even tell members that if a cat's dose gets to 6.0u, they need to get their cat tested for a high dose condition. In other words, we see cats that are getting more than 3.5u.

If your cat is underweight, the easy answer is give Theo more food. It sounds like you're tracking his weight. That's a great idea. Also, remember that carbs are not the same as calories. He needs more calories, not more carbs.

Dr. Elseys, if that's what you're still using, is lower in carbs and should be fine. The issue with dry food is that it's typically high in carbs. I'd urge you to consider, though, that Theo may do better if you're adding water to his food. If he was constipated without dry food, he may need more moisture (add water or add Miralax and more water). If he needs fiber, canned pumpkin (not pie filling) or squash baby food are both good for fiber. There is alway psyllium husk that adds fiber, as well. As long as you're using a low carb food like Dr. Elseys, you should be OK. The other issue with dry food is that you're limited to using SLGS for your dosing method.

 

[NadineTheodore]

First, the numbers.... It helps to think about the depot. With Lantus, it takes a few cycles for the depot to catch up with a change in dose. With a cat that has gotten a dose reduction, it means that the next cycle or two may also involve lower numbers and even look like another dose reduction may be needed. With an increase in dose, it will take several cycles to see the results from the increase. The only time you see a more immediate response is if you are using a faster acting insulin (e.g., Vetsulin or Humulin N). So, be patient!!

There is not "maximum" dose of insulin. The dose of insulin is the dose your cat needs to get numbers where you want them. Take a look at other people's spreadsheets. You'll see a range. We even tell members that if a cat's dose gets to 6.0u, they need to get their cat tested for a high dose condition. In other words, we see cats that are getting more than 3.5u.

If your cat is underweight, the easy answer is give Theo more food. It sounds like you're tracking his weight. That's a great idea. Also, remember that carbs are not the same as calories. He needs more calories, not more carbs.

Dr. Elseys, if that's what you're still using, is lower in carbs and should be fine. The issue with dry food is that it's typically high in carbs. I'd urge you to consider, though, that Theo may do better if you're adding water to his food. If he was constipated without dry food, he may need more moisture (add water or add Miralax and more water). If he needs fiber, canned pumpkin (not pie filling) or squash baby food are both good for fiber. There is alway psyllium husk that adds fiber, as well. As long as you're using a low carb food like Dr. Elseys, you should be OK. The other issue with dry food is that you're limited to using SLGS for your dosing method.

Thank you, I will get the psyllium husk today and see if that helps. My poor boy is on miralax (restoralax in Canada) and cisapride already. He's a complicated one Likes to keep mum on edge

 

[Sienne and Gabby (GA)]

It sounds like he may have a slow gut. I would try the baby food squash or pumpkin first. It's pretty neutral and contains moisture. The psyllium may be a much bigger gun and be more than what your kitty can handle.

 

[NadineTheodore]

It sounds like he may have a slow gut. I would try the baby food squash or pumpkin first. It's pretty neutral and contains moisture. The psyllium may be a much bigger gun and be more than what your kitty can handle.

Oh he's complicated! This all started when he got a tooth infection back in October 21' (he was a stray with broken teeth, found him in 2019), anyways they put him on antibiotics which gave him horrible diarrhea. When he went in they highly suggested doing a full dental extraction but kept him on antibiotics until close to his surgery. Now I really question why that was. We tried a lot of different antibiotics and all diarrhea. Didn't matter if he had them with food, probiotics. The only one that was okay was clavamox. Metronitizol, tylosin, antirobe were all HORRIBLE for him.

After his dental surgery they said NO dry food, that's when he started straining. They suggested another dry food (royal canid high fibre) to help and miralax but still strained and pooped in the worst places when he did. His surgery was December 16, 2021 and by April 2022 he had been diagnosed with megacolon. I wish they took a more aggressive approach sooner. In any case I am with a different vet now and he is doing really well with Megacolon, now we just have his diabetes to worry about. I suspect the diabetes was due to wet treats since I hide his restoralax in those.

 

[Sienne and Gabby (GA)]

It sounds like you're doing a great job with Theo! We frequently tell members, "Know thy cat." It sounds like. you know Theo.