11/11/14 Oz Dosing Question

Status
Not open for further replies.
Ian & Oz

Ian & Oz

Member Since 2014
Hello,
Today will be 15 days that Oz has been on a dose of 2.25u.
There were three or four really good days & then he started to drift back up some, though not as high as he was.
I'm seeing this trend where he gets a new dose & it starts to work for him & then after two to four days it dosen't seem to work as well.
Does anyone know a reason for this or is this just "Every cat is different"?
Does it look like it's time to raise the dose another .25u?

Thank you for any help you may have.
Ian
 
Hi Ian!!

Great to see you and Oz back.

I don't know why they do this but I don't think it's uncommon. Gracie does it to me quite often. I think as long as you continue your great monitoring, I'd increase the dose. While, for some cats, we might just add a little fat, I think I'd try the 2.5u dose for Oz. You might find it's a bit too much because he is occasionally throwing a nice, green nadir but sometimes they just need a kickstart and you can reduce the dose again (see Gracie's SS of late; she wasn't doing much on 0.45u so I increased to 0.55u and she only lasted about 8 cycles and now she is doing better on 0.45u). I really wish I had an answer for you as to why they do this. I don't. I just don't get attached to a dose and figure if they need more insulin, they just do.
 
Hi Marje, good to hear from you!
This dose has given him the most, best numbers so far.
I've kept him here longer because of, like you said, he's had quite a few green numbers.
I do worry about raising the dose, because of the way the 2.25u dose was bringing his levels down so fast in the beginning.
If I were to raise the dose to 2.5u what would i look for when i needed to bring it back down & would i bring it back to the 2.25u dose?
What does it mean to "add a little fat" in this situation?

Ian
 
If he got below 50, you'd reduce back to 2.25u.

The other option is, as I said "adding a little fat". that means shooting a dose that is between 2.25u and 2.5u. You could also choose to do that. Newly dx cats usually respond better to the 0.25u increases but with work schedules, etc, if you are getting green nadirs, you might definitely elect to increase by just a tiny bit instead of the full 0.25u. That is definitely a reasonable option.
 
Ok, Thank you Marje.
I may be raising his dose to 2.5u this evening.
Drawing up somewhere between 2.25 & 2.5u seems a little tough to gauge.

Ian
 
Hi Ian

I have been advised by a number of different members that they do not rely on the markings on the syringes to get their dose as theses can be unreliable but they use a digital calliper and that way you not only get a consistent dose but you can also work out tiny increases and reductions.

I have not jet got around to using the ones I ordered as I have become used to using a metal ruler. I choose a needle that looked like the plunger and markings were accurate and then worked out where the doses feel on the ruler. Ie one unit equalled 2.5 mm, etc. then I used the metal ruler each time and used that to get a consistent dose.
 
Hi Ian!

I would encourage you to re-evaluate the dose more often than this. Most of his nadirs are in the blue 100's - which is pretty good, but not quite where you want them. There are some greens popping up, but by far, the majority of the numbers are in the 100's. Your goal, if you're going for remission, is to have most of the cycle under 100 and everything under 120. Looking at the guidelines below, I'd re-evaluate every 10 cycles - and ask the question: are the nadirs consistently where i want them to be? If the answer is no, then I'd go ahead and increase by 0.25u.

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.
Click to expand...

The reason for doing it fairly frequently, per the guidelines in the quote above, is for exactly the reason you've seen. If a dose is going to get him flattened and with constant nadirs in normal numbers, you'll have seen it by the 10 cycles. If MOST of them are there, but not all, then you could "fattening" his dose. If it hasn't done the trick in 10 cycles, he likely needs more insulin.

For whatever reason skootching up in doses doesn't seem to work very well in most cats unless you are really just fine-tuning and most of the cycle is already where you want it to be.

I'd go with the 0.25u increase for now.
 
While Dosing with Calipers is optional, I find it really can help with micro dosing. Not everyone uses them and cats can go into remission without the CG ever using them. But they really allow some great micro dosing consistently.
 
Last edited:
Thank you Marje, Julie & Phlika,
We've started the new 2.5u dose tonight.
Hoping this will get him to where he needs to be level wise.

Ian
 
I'm glad that you are increasing. I think perhaps one of the reasons Max didn't go into remission is that my vet didn't have me increase quickly enough. Well, that and the fact we thought he was and took him off for 3 weeks and that failed. Since then I've seen cats go up the dosing scale quickly and down quickly and then the are OTJ. Good luck with the increase.
 
Status
Not open for further replies.
Back
Top