1/21 CRYSTAL - still stuck in the pink zone, dosing advice please?

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suki & crystal (GA)

suki & crystal (GA)

Member Since 2014
Hi everyone
didn't post yesterday, not much to say (don't know whether that's good or bad) but Crystal appears to be stuck in the mid 300's on her 4th cycle of 14.5u, so I'm still plugging away. She's been fairly quiet but eating okay and having lots of cuddles but get the feeling she feels a little off colour. Should I go ahead and increase tonight by 0.5u? thoughts please.

Suki & Crystal
 
I agree with Dyana.

However, I'm thinking you might want to consider increasing more than a half unit. When Cobb got to 14 units, we started increasing by a whole unit. I have an explainer on it from Julie or Wendy in one of my condos. I'll go look for it and post it for you to look at. A half unit increase may not even register since you're at such a high dose now.
 
Ok, so I couldn't find the explainer and it took me a minute to figure out the math. LOL

So, most cats increase at .25u. For a cat that is on 1 unit, that .25u increase is really a 25% increase in insulin. At 14 units, by increasing only a half, you'd only be giving Crystal 3.6% more insulin. Comparably -- not really that much of an increase. If you increase by 1 unit, it'll be more like a 7% increase. To hit that 25% increase, you'd be talking about increasing by 2.5 units, which I would NOT recommend. Some people, if they reach 20 units, they increase by 2 units at a time -- again, a 10% increase.

FWIW, we started using the R insulin when Cobb hit 14 units. The day I increased him to 14 was the first day I gave R. That's on the second tab of his spreadsheets.

Here's the thing about high dose cats that all of us who have them have learned. The protocol doesn't necessarily work for them. It gives us a good road map, but they will deviate off the path. High dose cats write their own rules. Boy do they write their own rules! You may not see any change at 15 units, but if you hit 16 units, it could be like a light turns on and they drop. ECID, I suppose. (Such a frustrating expression, isn't it?)

If Crystal were my cat, with her numbers, I would start increasing every 4 cycles by 1 unit until I see numbers under 200 and then reevaluate.

IF Crystal has IAA, you have to be aggressive in the dosing to get ahead of the antibodies. It is a PITA. Those little boogers are fierce. If you are aggressive, see progress, and then see a dose "go bad," without the IAA test, I think it would be safe to assume she has. Testing results are always nice because they back up a theory and can support your treatment plan, but they aren't the end all be all, IMHO.
 
Hi Dyana & Suzanne, thanks for your advice and confirmation on dosing. I too have read somewhere but can't remember where (but definately on this site) about a whole unit increase once you get over 10 units, the maths make sense and thanks for explaining it in detail. So, 15.5u tonight then and fingers crossed, 2 hours to go before shot at 6pm.

I've just heard back from the RVC (I'll post the full reply tomorrow under a new thread, RVC Update) but just to confirm that the RVC is unable to do an IAA test for me, so looks like I will just have to carry on without actually knowing whether Crystal has it or not.
 
We've all been there, Suki, at one time or another. You'll get there. You just need to continue to have patience, which I know is hard sometimes. If it makes you feel any better, Blackie's been diabetic for going on 5 years now. You just need to find what works for Crystal, and either stick with it for a bit, or change it up again. I know it's discouraging, and there'll be more times when you feel frustrated, anxious, upset, etc. Yep, we've all been there, more times than we can count, I'm sure. Once you find that magic something, hopefully you won't have to medicate Crystal for as long as I've been medicating Blackie. That's my wish for you both. :) Just hang in there... It'll come in due time.
 
Totally been there, Suki! That claw is hanging on for dear life, isn't it?

Any time you feel frustrated, anxious, upset or you just have NO IDEA what to do next, let us know! :smuggrin:
 
Angela & Suzanne, it's very reassuring to know so many people are supporting us and that you've all had the doubts, fears, ups and downs and eventually got there in the end. I keep telling Crystal to read the protocol but she likes to do it her way.
 
Hi Suki - Suzanne has given you some great advice on the dose, looks like it's time to step up to whole unit increases. At least you are increasing on the lines.

Interesting on the IAA testing at RVC. We have another member in England who posts periodically who said she had all the tests done on her kitty (neg for acro) but didn't give an IAA results so I suspected it might not be available there.

And this is for you. :bighug::bighug: Nothing about having a high dose kitty is easy. Those of us who've been there can relate to how you feel. You are doing a great job with Crystal. You will get to a good dose, it'll just take the time it takes. Feel free to vent your frustrations here. This board is a community and about more than just dosing. I found the support of others really helped me on my upward dosing journey. And make sure you are doing something for you too. I found exercise (hikes and rowing) really helped, some people do yoga. FD is stressful, high dose FD even more so and we get that.
 
Just given Crystal her increased dose and her dinner (and a large glass of wine for me). Pretty stressful day as I scratched the car badly on a low stone bollard and DH (is that the abbreviation for husband?) is furious, oh well.
Thanks for the hugs Wendy and the good personal advice, it does feel a bit like life is revolving around Crystal at the moment and perhaps I should take a step back and stop being so obsessed with her every move. I really couldn't do this without all the support received here. I'm sure you've heard that a million times from newbies but it really is the best place to be for FD.
 
Toby has see some blues and greens for awhile but always goes up again. We keep hoping we will find the right dose. I guess you probably do too. I worry about him going so high I won't be able to afford his insulin. Trying to take one day at a time. Am hoping when I can get back to the R it will make a difference. Keep in Touch, Peg and Toby
 
Hi Peg, I know what you mean, it has cost a small fortune so far, the test strips here are very expensive but I have managed to get some much cheaper on ebay but I wouldn't take any chances with insulin except from a reliable source. The increased dose seemed to have an immediate effect and dropped her down quite a bit, will monitor her most of the evening. Don't give up hope, we will get there eventually. Take care, check in with you tomorrow.
Suki
 
I'm feeling all those...frustrated, upset, no idea what to do, etc. We'll have one really good day, the next he doesn't want to eat. First it was pancreatitis, then diabetes, diarrhea, not eating again, etc. Yesterday was great, today not eating so no insulin. No keytones as far as I can tell. We were just at the vet a couple days ago too, they taught how to give fluids and he had his dose of that yesterday. Something else must be underlying all this.
 
Hi Susan, sorry to hear that you are having a tough time at the moment, are you new to this forum? I can't see any details or signature but you certainly have the right place for help, you only have to ask, there is such a wealth of experienced people happy to advise. Let me know if I can get someone to help you, unfortunately I'm very inexperienced but totally understand your frustration but don't go it alone.
 
Suzanne's exactly right about the dose increases. I did a couple of whole unit increases after we were past 10u, but i confess it made me super nervous. I know more now than I did then, and i've seen from a bazillion spreadsheets that skootching up in dose almost never works unless you're so close in dose that you're really just fine tuning. When you're not fine-tuning, i think it's better to bite the bullet and do at least 10% increases. I realized I had to think in terms of "getting on top" of the blood sugar. I spent an entire summer with punkin (2011), before the SRT, feeling like I could never catch up. I was running behind and his blood sugar was out of my control. At that point I should've been more aggressive, because it does seem that getting a cat into better control helps keep a lid on the dose increases. Every cat has a point, though, where the dose begins to work. Crystal has one too. That's why increasing every 4 cycles seems to be the trick - go up until suddenly you begin to see better BGs. I think at 15u you could go up by 1.5u and see what happens.

The protocol is a great starting point and it gives a roadmap to teach you the general plan - i think you just adjust the size of the increases and decreases to fit the high dose kitty's needs.

And yes, everyone finds things overwhelming at first. You just do the best you can and know you're acting out of love for Crystal. :bighug: She's lucky to have you.

bummer on the car! :arghh:

Susan, I hope you'll open a thread so we can get your little guy's story and give you a hand, if possible. There is a wealth of experience on FDMB not only with diabetic cats, but for lots of other issues too. Many diabetic cats have concurrent problems that others deal with. Sending you a big hug too!
 
@julie & punkin (ga) I didn't read you mail until this morning but many thanks for your continued encouragement and hugs). I must admit I felt a bit nervous going the whole unit but low and behold, she went down nearly straight away - some nice yellows for a change. I'll open a new thread today with the RVC update as well.
 
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