10/27 Tibbs amps 411- question

[tibbs5]

Hi everyone
Just a quick question. I know that Tibbs will need to go up in insulin after tomorrow. He's got 1 more day at 1.75 and that will be 6 cycles i believe.
I just want to understand how do you tell the difference if the high numbers that you see are from too much insulin or not enough?
If the preshots and the nadirs are high, how do you tell the difference between too much and too little insulin? Do i understand correctly that they both present with the same symptoms or is there a definitive way to tell one from the other. Thanks so much. This way i will know what to look for.
hope everyone is doing ok.
sending hugs and healing to everyone.

 

[Wendy&Neko]

Hi Nadine - this is another reason that getting at least one mid cycle check is important. Right now I just see red preshots but I don't know what's happening in the middle of the cycle. He could be going lower, higher, or staying flat. By the way, Neko's first deduction earned (below 50) she started the cycle at 420. She's also earned reductions from the 470's and then zoomed back up at the end of the cycle. The mid cycle check doesn't have to be at +6, you can do anything from a +2/3 to a +7/8 and it'll give us a better picture of what is happening. I don't think you should increase until you've got 3 or so mid cycle checks in a row at 1.75U.

I'm inclined to think that Tibbs is high because he's not getting enough insulin. You've been stepping up the dose in small increments. Cats generally get overdose when they've gone up in large steps like one unit increases and pass a good dose, or been started on too high a dose. Neither of those cases applies to Tibbs. Another reason cats can get on too high a dose is if they don't do spot nadir checks and see how low the dose is taking the cat.

 

[Marje and Gracie]

Hi Nadine

I had done a detailed post for you and lost it :evil:

I wish I could tell you what about a SS strikes me when I think a cat is OD because not all OD cats drop at sometime during the cycle. Some are just high and flat. Perhaps it is just looking at hundreds of SSs and there is something that just stands out that a cat is OD. I don't think this applies to Tibbs.

I agree with Wendy that Tibbs just looks like he needs more insulin. When the CG takes the dose up according to the TR protocol or the Start Low Go Slow Approach, it is almost impossible to OD them. I can't remember the last time I saw a cat that was OD when they've been taken up slowly and incrementally.

A few things I am seeing:

--doses are being held too long. I'd follow the protocol and raise every six cycles if he doesn't do more than he has been.

--a few more tests would help.

I hope the ketones are gone and more good numbers are around the corner.

 

[tibbs5]

thank you both for explaining this to me. i have the next 2 days off so i will def get more mid cycle tests done. his ketones are negative now. i am going to keep increasing and hope i start to see some good numbers. thanks for your help.

 

[Michelle and Mannie (GA)]

Hi Nadine. I agree with the others, fwiw. Mid cycle test are so important, as they will tell you what is happening with that dose. The only thing I will add is related to my experience with my kitty. I discovered after many a roller coaster ride with dosing changes, per protocol, that if I backed off just a day or two Mannie would process the change better. He was just slow to get his BG's in line. But again, this was Mannie, and until you can say for sure that this is the case with Tibbs, I'd follow whichever protocol works for you, TR of SLGS. Good luck!