1/2 Tibby AMPS 360 +6 359. Too much insulin?

Hi Amy, as Wendy pointed out yesterday, it looks like Tibby needs more insulin. I don't think it's a case of him getting too much insulin.
A cat's insulin needs change and a dose that worked a week ago could be too much or too little this week. Our job is to to take the dose up and down with the numbers.

Were you able to get any tests last night?

TR would be the best route to get Tibby to his optimal dose. You don't want him staying at high numbers longer than needed.
 
Amy&Tibby said:
His numbers have not been good since upping his doses during the TR trials. I'm thinking of working them back down again and going back to SLGS. It seems like I went past a good dose.

I'm been doing a brief trial of TR for the past week, but I think I'll go back to SLGS asap.

https://www.felinediabetes.com/FDMB...ould-i-increase-the-dose.240847/#post-2710411
Click to expand...
This is his second cycle on an increased dose and likely new dose wonkiness. It’s very common for the BG to increase, especially on the second day after a dose increase. This is why we hold doses and allow the depot to build.

You have slowly and methodically increased the dose. What you are referring to by dropping the dose back is called a “rebound” check and the only time I have ever seen it work is with a few cats that were grossly overdosed by vets raising the dose 1u at a time. Doing a rebound check can also leave him at higher BGs longer and thus result in glucose toxicity. That, in turn, requires more insulin to break through. I linked Henry’s SS yesterday. That is an example of a rebound check and you can see how long it left Henry in high numbers.

While I’m sure you wouldn’t intend to go back to that extreme, following SLGS is more for the caregiver than the cat. FD is a marathon not a sprint and it’s important to be patient. There could be other things at play here and Tibby’s dose may need to continue to be increased.
 
Bandit's Mom said:
Hi Amy, as Wendy pointed out yesterday, it looks like Tibby needs more insulin. I don't think it's a case of him getting too much insulin.
A cat's insulin needs change and a dose that worked a week ago could be too much or too little this week. Our job is to to take the dose up and down with the numbers.

Were you able to get any tests last night?

TR would be the best route to get Tibby to his optimal dose. You don't want him staying at high numbers longer than needed.
Click to expand...

I only got the one test before bed. I'm trying to get ready to be back in school Monday, and waking up in the night won't be an option, so I'm at least getting the before bed test. I'm assuming I'll have to do a curve twice a week to get proper data on his nadirs.
 
What is the latest you can test at night? Do you have an auto feeder? I don’t think Tibby is getting too much insulin from what I see. Just think she likely hasn’t hit the magic dose. Perhaps when the NDW ends this dose will be it. Fingers and paws crossed it is.
 
No, Tibby is not getting too much insulin. The only things that can cause a cat to be on too much insulin is (1) starting at too high a dose, (2) increasing by too large amounts so you bypass a good dose, (3) not testing enough to know what sort of nadirs the cat is getting. And if a cat is on too much insulin, at some point they will dive down to the lows to show you it's too much insulin. Tibby was started at 1 unit - a good starting dose. You've been increasing by 0.25 unit increments which is perfect. Your testing has been enough to show he's not diving into the lowlands, and in fact mid blues seems to be as low as he got on 4.25 units. Therefore, not too high a dose.

You are not alone in wondering this, I am sure almost every caregiver has the same worry. :bighug: You wouldn't be such a good pet parent without it.

The thing about insulin, it's not a drug, it's a hormone. So it's not like you give a little bit more and the numbers get a little better. You have to have faith in the dosing methods (which hundreds and hundreds of cats have followed), and keep increasing until you get to that breakthrough dose. Tibby's not there yet. He did do a fairly brisk drop last night between his PMPS and +2, so there is probably an element of bounce in today's numbers too.
 
I have to agree. Tibby's dose is just fine.

However, you really haven't done an adequate TR trial. You were at 4.0u for 13 cycles, 4.25 for 8 cycles, and 4.5 for 3 cycles. With TR, you would have been raising the cycle every 6 cycles. Based on how you've been raising the doses, it's some amalgam of SLGS and TR. Marje's point about new dose wonkiness is also well taken.

You've mentioned using kibble as treats. Just how many "treats" are we talking about? Frankly, one or two pieces of kibble can cause a considerable rise in numbers if your cat is carb sensitive.

If you have been relying on the FB group for dosing advice, I would strongly urge against doing so. You have no idea what insulin the people giving you advice are using, they do not have access you Tibby's SS and you can't see their SS to have any gauge of their knowledge base. And, most importantly, dosing advice is not supposed to be dispensed on FB because of the overall inexperience of most of the people there and the lack of spreadsheets. It's dangerous.
 
I've been doing SLGS until 12/26 when people here suggested I give TR a try. I marked that on the spreadsheet in orange. I then stopped the kibble treats on 12/26 as well. So I'll keep the trial going a bit longer and see what happens, but I don't have high hopes that I can manage it well and work unless I do curves twice a week.

I don't get actual dosing advice on FB, just broader discussions.
 
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