? 1/23 Pudge dose and other quality questions.. AMPS 202 +3.5 205

[kitten68]

1/22/26 Prev Thread Pudgles

..well we’ve been managing ok. winding down and exhausted after everything.. happy on other side.. but his sugar numbers now could be lots better.. he needs more. i read that when u see nadirs under 100, u wait 5 days.. and before id just wait 3 days.. which i was told was ok too (minimum tho right hut?..) idk.. but i read that???? so i stayed w that this time and hes 200s today and not going down much.. i thought maybe was bouncing…. ok to increase tonite???

and now.. im just noticing that hes having a little bit of urinary incontinence.. a little bit has been on the floor today.. very small, but there, like where he was resting and napping.. i checked him and he was also a little bit wet.. hes been putting up w crap healthwise, bathroom frequently, and hes tough.. but now w a high sugar (for him), im not surprised to see that.. or is it just the other stuff? These together im sure dont help.. will it hopefully get better tho? esp after we get a handle on numbers?.. now i regret not increasing after 3 days…. Sigh. UTI possible?.. but hes on something already. idk.

hes due for some fluids today.. give? assume so..

my poor cat. eating ok tho.. i thought hes been feeling better. enjoyed his heating pad earlier this morning. he also went potty (2) more yesterday!! A good amount.. i figured he’d had some relief.. sigh.

@Wendy&Neko @Suzanne & Darcy @tiffmaxee @Staci & Ivy @Mary & Jude @Tyleete @Jswick8991 ..


any and everyones good thoughts/advice appreciated..

 

[Allie & Gen]

Aww, poor Pudge. It's always something, isn't it, buddy? As usual, I don't know anything useful about his health issues (in this case, no clue what incontinence might be related to), but I hope someone else here does. You two deserve a break!

Dosing advice is not my wheelhouse, but here's a direct quote from the TR section of the Dosing Methods post:

Increasing the dose:

• Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
  • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
  • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
• Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
• Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.

In the 4.5 days you've had him on the current dose, he's had one cycle with a nadir under 100; the rest are under 200. I'm not sure that the "hold the dose for at least 10 cycles" applies in your circumstances; this is where we need someone with more expertise, especially as I'm not entirely clear why the dose was reduced originally (presumably this had to do with some of his other health problems, since I'm not seeing any numbers low enough for an earned reduction according to the dosing method)?

Good luck. Try not to fret too much about his BG? It's not super high, and given everything else he has going on, I think it's impressive how regulated he is! Whatever the next steps are with dosing, this doesn't seem like an area for pessimism. Hang in there.

 

[Wendy&Neko]

I'm going to quote a different part of the TR protocol Sticky:

If an attempted reduction fails, go right back up to the last good dose as soon as you see kitty's numbers trending upwards. You don't have to hold the reduced dose for a certain number of cycles before taking the dose right back up. The guidelines listed under the topic "Increasing the dose" do not apply to a failed reduction.

Pudge didn't earn any of the reductions from 2.0 units down to 1.0 units. You can consider 1.0 a temporary dose due to medical reasons and go right back up. He needs more insulin and I'd do more than a 0.25 unit increase. On Sunday, Bhooma suggested 1.5 units. If you don't want to go all the way back to where he last earned a reduction, you could start at 1.5. Though I suspect he'll need more.

 

[Staci & Ivy]

1/22/26 Prev Thread Pudgles

..well we’ve been managing ok. winding down and exhausted after everything.. happy on other side.. but his sugar numbers now could be lots better.. he needs more. i read that when u see nadirs under 100, u wait 5 days.. and before id just wait 3 days.. which i was told was ok too (minimum tho right hut?..) idk.. but i read that???? so i stayed w that this time and hes 200s today and not going down much.. i thought maybe was bouncing…. ok to increase tonite???

and now.. im just noticing that hes having a little bit of urinary incontinence.. a little bit has been on the floor today.. very small, but there, like where he was resting and napping.. i checked him and he was also a little bit wet.. hes been putting up w crap healthwise, bathroom frequently, and hes tough.. but now w a high sugar (for him), im not surprised to see that.. or is it just the other stuff? These together im sure dont help.. will it hopefully get better tho? esp after we get a handle on numbers?.. now i regret not increasing after 3 days…. Sigh. UTI possible?.. but hes on something already. idk.

hes due for some fluids today.. give? assume so..

my poor cat. eating ok tho.. i thought hes been feeling better. enjoyed his heating pad earlier this morning. he also went potty (2) more yesterday!! A good amount.. i figured he’d had some relief.. sigh.

@Wendy&Neko @Suzanne & Darcy @tiffmaxee @Staci & Ivy @Mary & Jude @Tyleete @Jswick8991 ..


any and everyones good thoughts/advice appreciated..

I’m glad to see Pudge is doing better. And so glad he’s pooped!!

Hopefully an increase in insulin will help the urine drops. I’m not familiar with that.
Maybe it is from being too high for him??
He’s used to being much lower (BG)
I hope you get some definitive answers soon.

I hope the fluids continue to make him feel much better.
Glad he’s enjoying the warm blanket.
Stay warm! We send hugs your way

 

[kitten68]

I'm going to quote a different part of the TR protocol Sticky:

Pudge didn't earn any of the reductions from 2.0 units down to 1.0 units. You can consider 1.0 a temporary dose due to medical reasons and go right back up. He needs more insulin and I'd do more than a 0.25 unit increase. On Sunday, Bhooma suggested 1.5 units. If you don't want to go all the way back to where he last earned a reduction, you could start at 1.5. Though I suspect he'll need more.

that's been exactly it.. was going slowly. but out of time I'd say.. and I asked from before.. wasn't sure or clear on what was said; think you told me to choose. right.. yeah. but now he needs to go back up.. last good dose was 1.5, can just go back there???.. I'm a little scared to do it.. but I hate these 200s.. don't need to be?

thanks for saying can do more than .25 increase.. I want his cells tip top as much as possible rn.. :/

 

[kitten68]

Aww, poor Pudge. It's always something, isn't it, buddy? As usual, I don't know anything useful about his health issues (in this case, no clue what incontinence might be related to), but I hope someone else here does. You two deserve a break!

Dosing advice is not my wheelhouse, but here's a direct quote from the TR section of the Dosing Methods post:

In the 4.5 days you've had him on the current dose, he's had one cycle with a nadir under 100; the rest are under 200. I'm not sure that the "hold the dose for at least 10 cycles" applies in your circumstances; this is where we need someone with more expertise, especially as I'm not entirely clear why the dose was reduced originally (presumably this had to do with some of his other health problems, since I'm not seeing any numbers low enough for an earned reduction according to the dosing method)?

Good luck. Try not to fret too much about his BG? It's not super high, and given everything else he has going on, I think it's impressive how regulated he is! Whatever the next steps are with dosing, this doesn't seem like an area for pessimism. Hang in there.

of course I read it wrong.. its when you FIRST start seeing them. good god.. smh. my fault now..
we're exhausted. (thanks for this!! )

ugh.. thanks for the encouragement honestly.

 

[kitten68]

I'm going to quote a different part of the TR protocol Sticky:

Pudge didn't earn any of the reductions from 2.0 units down to 1.0 units. You can consider 1.0 a temporary dose due to medical reasons and go right back up. He needs more insulin and I'd do more than a 0.25 unit increase. On Sunday, Bhooma suggested 1.5 units. If you don't want to go all the way back to where he last earned a reduction, you could start at 1.5. Though I suspect he'll need more.

also.. of course when I went looking to see where that was.. didn't find it. and I read things. wrong. this is stressful.. sigh. thanks

 

[kitten68]

that's been exactly it.. was going slowly. but out of time I'd say.. and I asked from before.. wasn't sure or clear on what was said; think you told me to choose. right.. yeah. but now he needs to go back up.. last good dose was 1.5, can just go back there???.. I'm a little scared to do it.. but I hate these 200s.. don't need to be?

thanks for saying can do more than .25 increase.. I want his cells tip top as much as possible rn.. :/

it's still ok too even tho its been like 10 days? its true due to medical reasons tho.. and we were adjusting to things..

 

[kitten68]

I’m glad to see Pudge is doing better. And so glad he’s pooped!!

Hopefully an increase in insulin will help the urine drops. I’m not familiar with that.
Maybe it is from being too high for him??
He’s used to being much lower (BG)
I hope you get some definitive answers soon.

I hope the fluids continue to make him feel much better.
Glad he’s enjoying the warm blanket.
Stay warm! We send hugs your way

he went some more today too!! yayyy
yeah..maybe UTI. or just strain from everything.. idk. he certainly was..

ooh! w his BG high like it is (for us).. is giving fluids ok still? I don't want to stress him more.. but like him to feel better.
sorry if stupid question..
HUGS!!!

 

[Staci & Ivy]

he went some more today too!! yayyy
yeah..maybe UTI. or just strain from everything.. idk. he certainly was..

ooh! w his BG high like it is (for us).. is giving fluids ok still? I don't want to stress him more.. but like him to feel better.
sorry if stupid question..
HUGS!!!

Fluids are good for him. It will help his overall condition

 

[kitten68]

::Update::
So.. his poor numbers are stinky (for us.. and certainly want him as strong as possible rn). I didn't increase when should've.. my fault. I misread something.. also wasn't sure if bouncing (??) cuz those greens surprised me. :/ at that lower dose..

so okay to go right back to 1.5? (was last good one..) its been 10 days?..
he's doing better also; not seeing much more w the potty situation.. he also went to the bathroom more!

from here, maintenance routine? I was thinking 1/8-1/4 tsp a day.. (MiraLax)

also, w his numbers like this, ok to give fluids? sorry if a stupid question.. he could use some. @Suzanne & Darcy

ugh.

@Wendy&Neko @Suzanne & Darcy @Bandit's Mom @tiffmaxee @Staci & Ivy

 

[tiffmaxee]

If it were me I would go up to 1.25 even though 1.5 was the last good dose as it’s been awhile since he was in 1.5 with lots of skips but others might disagree.

 

[Wendy&Neko]

BG numbers are not a factor for whether or not go give fluids. Do try to give them in a separate location from the insulin shot. Some cats go down with fluids, so I gave fluids in the last half of the cycle when numbers were rising anyway.

 

[Suzanne & Darcy]

::Update::
So.. his poor numbers are stinky (for us.. and certainly want him as strong as possible rn). I didn't increase when should've.. my fault. I misread something.. also wasn't sure if bouncing (??) cuz those greens surprised me. :/ at that lower dose..

so okay to go right back to 1.5? (was last good one..) its been 10 days?..
he's doing better also; not seeing much more w the potty situation.. he also went to the bathroom more!

from here, maintenance routine? I was thinking 1/8-1/4 tsp a day.. (MiraLax)

also, w his numbers like this, ok to give fluids? sorry if a stupid question.. he could use some. @Suzanne & Darcy

ugh.

@Wendy&Neko @Suzanne & Darcy @Bandit's Mom @tiffmaxee @Staci & Ivy

Yes. He needs the fluids! Give them. I would give them, and I would try to do them a couple hours before or after insulin. This is what I did with my own Diabetic cat, Darcy, when he developed kidney disease.

 

[kitten68]

::Update 2::
I really wanted to try going to last good dose.. but was also suggested and feel like I need to be conservative if possible rn while we still iron out some things to maybe just up a bit then go.. (dose is one jump to the last good one..) I appreciate the advice so much for the future .. I wish I could honestly.. but im scared w all these other things going on too rn.. and ill probably come back anyway to ask haha.. I am also terrified going back to TR that I'm hoping to maybe catch a pattern with the Mirataz (while he's on it..) cuz I am terrified of him possibly going off his food when lower numbers hit.. that'd be a disaster. :/ (any thoughts? .. appreciated..)

I'm struggling w tiredness rn.. its probably emotional too. doing best..

did not know about the fluids affecting BG!! that's one good thing to know because I was considering giving them tonite but not w the shot so close.. guess ill have to hold off til tmw to have a good time???...... afternoon sometime.. or if im able I'll do it later tonite.. ugh.

I changed the location of his shot.. is it okay its on the tummy near his upper leg? cause that's where I've been putting em.. :/ could this be affecting his numbers too?.. I tried finding a good spot w the kitty diagram on the site here.. cuz of the fluids..

 

[Jswick8991]

I’m sorry I’ve been MIA all day. Definitely keep doing his fluids. Is he struggling to pee at all? Or is he just randomly leaking.

 

[Staci & Ivy]

::Update 2::
I really wanted to try going to last good dose.. but was also suggested and feel like I need to be conservative if possible rn while we still iron out some things to maybe just up a bit then go.. (dose is one jump to the last good one..) I appreciate the advice so much for the future .. I wish I could honestly.. but im scared w all these other things going on too rn.. and ill probably come back anyway to ask haha.. I am also terrified going back to TR that I'm hoping to maybe catch a pattern with the Mirataz (while he's on it..) cuz I am terrified of him possibly going off his food when lower numbers hit.. that'd be a disaster. :/ (any thoughts? .. appreciated..)

I'm struggling w tiredness rn.. its probably emotional too. doing best..

did not know about the fluids affecting BG!! that's one good thing to know because I was considering giving them tonite but not w the shot so close.. guess ill have to hold off til tmw to have a good time???...... afternoon sometime.. or if im able I'll do it later tonite.. ugh.

I changed the location of his shot.. is it okay its on the tummy near his upper leg? cause that's where I've been putting em.. :/ could this be affecting his numbers too?.. I tried finding a good spot w the kitty diagram on the site here.. cuz of the fluids..

So maybe try 1.25 units as Elise suggested, see how he does. You can always go up if needed.

I’m unsure of whether location on his tummy will alter BG.
But I’ve read that lots of things can, such as absorption, etc. so perhaps that could be true.

I think caution is a good idea with so many variables. His BG will guide you if he can use more.

And his eating well is key to keeping him safe.

 

[kitten68]

I’m sorry I’ve been MIA all day. Definitely keep doing his fluids. Is he struggling to pee at all? Or is he just randomly leaking.

i havent seen much since.. hes doing ok. hes still going its his BG now.. and definitely will. just.. im hearing they affect BG so trying to figure a good time.. fitting in everything properly…. ….

 

[kitten68]

So maybe try 1.25 units as Elise suggested, see how he does. You can always go up if needed.

I’m unsure of whether location on his tummy will alter BG.
But I’ve read that lots of things can, such as absorption, etc. so perhaps that could be true.

I think caution is a good idea with so many variables. His BG will guide you if he can use more.

And his eating well is key to keeping him safe.

tysmmmmm man.. id like to do the whole.. but im trying to figure out his eating/medicine, thats the foundation to everything.. i been up half the night now.. trying to make sure he eats enough at these numbers. he also got more Mirataz.. (i feel stupid.. needed to increase earlier…. Ugh. like we always do..)

did end up doing the 1.25.. also because its nighttime.. :/ id rather do increases in AM.. just in case.. so im awake .. but might keep 1.25 for a little.. it is helping.

yeah.. more or less on the flank, on the tummy, near the top of his little leg.. im just gonna do it there frm now on..

 

[Tyleete]

Fluids are only a bad thing if they have a heart problem, so far that I know. I've been doing fluids for more years than I care to remember, but no one's an expert. I've got a cat right now that's going through a lot (not Nico), and I double checked with the vet that giving twice a week is ok. And it is. I'm giving her between 70-100ml twice a week. And I see her perk up a bit after each time. Nothing drastic, but I see it, so I know it's helpful to her. And she even is one of my better drinkers too.
As for the Mirataz, I've learned a trick recently with her. She's on chemo once weekly, so there's a couple said she's not feeling it, besides the cancer itself effecting her appetite. I've found it helpful to give her all her anti nausea and the Mirataz meds twice daily. It just means I take everything and halve the dose. But it actually seems to help her better. Getting a half dose of the Mirataz in the am & then on, seems to keep her eating better throughout the day. Verses just eating everything part of the day, then just picking at it the other half.
You said your sweety's already on something? Antibiotic-wise, when talking about a possible uti? Sorry that I don't remember. But if she is on a need for something else, doesn't necessarily mean it will fight a uti. There's bacterial and viral issues, and needs specifically meant for each. And even in their own categories, there's broad spectrum and then more specialized ones. So if having another issue that the original med wasn't meant to address, might not fix it. Just tossing that out there on case it wasn't previously. I only read halfway through this, as I'm running around stupid with the cats lately.
All the advice given seems spot on, and I definitely would go up to that 1.5 again, but if you wait a few days, will probably be fine too. But you do know that 1.5 was safe and better, so I wouldn't have any worries about that.
And please stop admonishing yourself for what you could've/should've done. Every single one of us makes mistakes. We're only human. Yours isn't, but even if we make a fatal mistake? As long as we can learn from them, that's all that matters. I do rescue, and am left with the sick and elderly no one wants to adopt. My husband calls them our Permanent residents, I call them family. I've lost many over the years, 4 just in a 7mo timeframe the other year. And once I can get over the heartache of their loss, I keep going by telling myself.... I'll do better next time. I'll learn from this, and the next with (insert illness), will fair better because of it.
So chin up! Just learn from whatever you feel was a mistake and do the best you can moving forward. Your baby's counting on you. Keep up the good work.

 

[kitten68]

Yes. He needs the fluids! Give them. I would give them, and I would try to do them a couple hours before or after insulin. This is what I did with my own Diabetic cat, Darcy, when he developed kidney disease.

I didn't get a chance to yesterday.. but did so today! it went really nicely.. least there's that. yay. those Terumo needles are a miracle.. and I hope im just getting maybe a bit better at it. thing is, I'm trying to fit everything in extra we need to do rn and its a lot... I have things to do too and errands and work.. he got fluids around 7 and shot time is around 8:40/8:45 tonite.... that ok?

 

[kitten68]

Fluids are only a bad thing if they have a heart problem, so far that I know. I've been doing fluids for more years than I care to remember, but no one's an expert. I've got a cat right now that's going through a lot (not Nico), and I double checked with the vet that giving twice a week is ok. And it is. I'm giving her between 70-100ml twice a week. And I see her perk up a bit after each time. Nothing drastic, but I see it, so I know it's helpful to her. And she even is one of my better drinkers too.
As for the Mirataz, I've learned a trick recently with her. She's on chemo once weekly, so there's a couple said she's not feeling it, besides the cancer itself effecting her appetite. I've found it helpful to give her all her anti nausea and the Mirataz meds twice daily. It just means I take everything and halve the dose. But it actually seems to help her better. Getting a half dose of the Mirataz in the am & then on, seems to keep her eating better throughout the day. Verses just eating everything part of the day, then just picking at it the other half.
You said your sweety's already on something? Antibiotic-wise, when talking about a possible uti? Sorry that I don't remember. But if she is on a need for something else, doesn't necessarily mean it will fight a uti. There's bacterial and viral issues, and needs specifically meant for each. And even in their own categories, there's broad spectrum and then more specialized ones. So if having another issue that the original med wasn't meant to address, might not fix it. Just tossing that out there on case it wasn't previously. I only read halfway through this, as I'm running around stupid with the cats lately.
All the advice given seems spot on, and I definitely would go up to that 1.5 again, but if you wait a few days, will probably be fine too. But you do know that 1.5 was safe and better, so I wouldn't have any worries about that.
And please stop admonishing yourself for what you could've/should've done. Every single one of us makes mistakes. We're only human. Yours isn't, but even if we make a fatal mistake? As long as we can learn from them, that's all that matters. I do rescue, and am left with the sick and elderly no one wants to adopt. My husband calls them our Permanent residents, I call them family. I've lost many over the years, 4 just in a 7mo timeframe the other year. And once I can get over the heartache of their loss, I keep going by telling myself.... I'll do better next time. I'll learn from this, and the next with (insert illness), will fair better because of it.
So chin up! Just learn from whatever you feel was a mistake and do the best you can moving forward. Your baby's counting on you. Keep up the good work.

tysm for this!! means a lot.. I appreciate being able to be in this place with u and everyone so much.. thank you. I'm hard on myself cuz my kitty is really my family.. its just us now. one day I might talk about things, but its been really painful.. and its just us. so when he isn't well it hurts me. but I do do my best! I just gave fluids btw and it went great!!! the Terumo needles, and maybe im just better at it now.. yay. I have to give the shot tho in like 1 hr and 40-45 min.. I hope that's enough time. he's also feeling better BG wise!! its awful when the numbers are high.. I could tell he felt terrible. im so sorry about your babies.. u doing god's good work!! honestly.. im just trying to fit everything in w my one kitty.. im so sorry about the cancer.