Hi Ian!
Yes, I think you can increase his dose by 0.25u to 2.0u per shot.
From your comments here and on the spreadsheet, i'm thinking you think you gave a furshot because his numbers didn't move yesterday for several hours? Is that right? I think the reason his blood sugar was staying high is because he
bounced after hitting the green numbers on 10/11, then he cleared the bounce on 10/14. He probably was a little lower than 100 that afternoon and when you caught the 115 he was on his way back up at that point.
He bounced again from that point, and i think that was the cause of the solid pink day you saw yesterday.
Read the second post in the link I gave you above - it describes what bouncing is. It's really common and just part of this. Oz's body has gotten used to higher numbers and it is reacting to the lower ranges as though they are dangerous to him, when they aren't. The more time he spends in normal numbers (50-120) the more his body will "remember" that range as normal. I will say that overall he looks pretty good.
Even if you did have a furshot, you have enough days on the 1.75 to see that he can use a little more insulin. I"m looking at the
Tight Regulation Protocol yellow starred sticky and looking at the nadirs (low points) in each cycle that you have been seeing on the 1.75u dose. Mostly he's having nadirs in the 100's, so I've highlighted the part below that would apply to him at this time.
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.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
I saw a few days ago that you stalled for a while to see if he was coming up before you shot. If you are interested in TR, we encourage new people to go ahead and shoot everything over 150 unless your cat seems sick or isn't eating at all. Experienced people will shoot everything over 50 - but you want to work up to that. Learning to shoot low (which means shooting the regular dose into normal numbers) as soon as is safe is the path to getting a cat off of insulin. For now, go ahead and post if you have a preshot of less than 150 and someone will likely have you stall for 30 minutes without feeding, then shoot. We do encourage people to try to wrap their heads around the idea of shooting normal numbers as soon as they understand a little more about how their cat responds to insulin.
It's a good idea in general, for cats on Lantus & Levemir to re-evaluate the dose about every 6 cycles (3 days), look at the nadirs you've been seeing & compare to the guidelines above and decide if you should hold the dose a little longer or increase the dose. You do a great job of testing so it's pretty easy to see how he's reacting to the current dose. If you're interested, the idea of tight regulation is that if a cat's blood sugar is held between 50-120 on a human glucometer, the cat's pancreas has the potential to heal and begin producing insulin again. Cats are unique in their ability to do this. That stats are that over 90% of cats who get their blood sugar controlled in the first month after diagnosis can go off of insulin and become diet-controlled. The chances are best soon after diagnosis, but we've had cats go off of insulin even 2-3 years later. That's why there are so many people on TR - we don't know which cats will be able to do that, but it's a worthy goal for many people.
Glad to see you here! Please ask as many questions as you have - we're happy to help you learn what you need to know to help Oz.
