04/05/2022 Dose Evaluation. Increase or decrease?

On day 5 of 1.25 units. Her BGs from March 27-April 2 had lots of blues and a couple of greens with 1.00 unit. On 1.00 unit she got these low numbers the first day I increased from .75 units to 1.00 unit. I'm just wondering if 1.25 units is too high and if a decrease back to 1.00 unit is a good idea or something in between .75 and 1.00 unit? Or Should I go ahead and give Princess another dose increase?

 

On day 5 of 1.25 units. Her BGs from March 27-April 2 had lots of blues and a couple of greens with 1.00 unit. On 1.00 unit she got these low numbers the first day I increased from .75 units to 1.00 unit. I'm just wondering if 1.25 units is too high and if a decrease back to 1.00 unit is a good idea or something in between .75 and 1.00 unit? Or Should I go ahead and give Princess another dose increase?

 

Here’s your previous post. I’m going to read and will be back.
https://felinediabetes.com/FDMB/thr...-3-17-3-7-18-8-need-help.261617/#post-2934236

 

With TR you want to see green nadirs and hope to eventually see bg 50-90 on a human meter. Princess was never to low and didn’t earn a decrease when you decreased her dose. She needs more juice. Please increase to 1.50. You should have increased on 4/4. That was 10 cycles since you saw green. If you don’t increase when needed she will just need more and more insulin. With TR reductions are taken if the bg goes under 50.

 

I never decreased her dose. I was asking if the dose was too high. Yesterday I had to take Princess to the vet because I suspected she might have a UTI so the last thing on my mind was increasing her dose. Unfortunately the vet could not get a urine sample and so sent me home with a urine sample kit. On 4/4 I was on SLGS. Then 5 days ago I switched to TR because another Admin suggested it.

 

Her dose is not too high. It is too low. If too high her bg would fall under 50. It hasn’t. With DKA in the and a possible infection she could go dka again.

 

She has no history of DKA but I hear what you're saying. I will start her on 1.50 units tomorrow. Thank you.

 

If her dose was too high you would have caught a low number somewhere in the last few days.

@tiffmaxee sign says no DKA history?

I think what's probably confusing to you is that she saw green at the lower dose, but is high at this dose. Few possible reasons, one is possible UTI. For now I would increase because as Elise said it puts her at higher risk of DKA, when the results come back then you can think about proactively lowering the dose before starting antibiotics if that makes you more comfortable...but usually we would still wait for a drop below 50.

The other thing is glucose toxicity. When they are still relatively unregulated like Princess is, they're used to the higher numbers. So her body still considers those normal - and the longer she stays in higher numbers, the toxicity sets in and keeps her higher.

 

Oh, I misread. I saw DKA but not no.

 

A cat's insulin needs can and do change. A dose that was good last week can be too much or too little this week. Our job is to follow the number.

She is good for an increase. With TR, you can increase as often as 3 days. You can take her up to 1.5U tomorrow.

 

I was abit fuzzy on TR but it is now much clearer, thank you. I appreciate your help.