11/29/14 Oz Dosing Question

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Ian & Oz

Ian & Oz

Member Since 2014
Hello,
Well I'm again trying to understand where Oz is at regarding his dose.
The past 7 days have been unpredictable again. I don't know if the numbers have somehow been food influenced even though I do my best to keep the others food away from him, so he won't eat too much. On the 25th & this morning I gave his AM shots 30 minutes late due to over sleeping, don't know if these have helped to throw him off. He's been at this dose about 18 days now, it was suggested to stay here for awhile when I last asked about his dose. It seemed like the dose was doing well but his numbers started drifting up again lately, don't know if any of you can make sense of his chart relating to his rising numbers. I'm wondering if it's time to go ahead & raise his dose to 2.75u.

Thank you for any help you may have
Ian
 
Hi Ian

It does look to me like he has fizzled a bit. First, I'd be sure it's not due to foods (higher carb than you thought). He's headed down today and I think I'd give him all day to see if he gets any green. If he doesn't, I think an increase to 2.75u is fine. Personally, I don't like to do increases at night because lately, that's when Gracie comes down. Oz tends to do the same so if you want to give him both cycles today and then raise him tomorrow morning if he gets no green, that's fine.

I'm glad you got a +6 last night; I was wondering where he might have gone 11/26 and 11/27 p.m. cycles because he was flat. Since it's Saturday, if you can get a +6 tonight, too, that would let us know for certain whether he's coming down into green closer to nadir. Sometimes cats shift their patterns.

Have a great day! I'm hoping for green for him!
 
Thank you Marje!
I'll watch him the rest of the day/night & probably raise the dose in the morning.
I double checked the canned food he's been getting with Dr. Lisa Piersons list & it's all been 9 carbs & lower.
The only other thing I can think of is, that he's eating someone elses food & I'm not catching it, or the times I'm feeding him aren't right for his particular cycle. I haven't really changed his feeding much. Could this still possibly be that he's not at the right dose yet?

Thanks again
Ian
 
Depending on how carb sensitive he is, the 9% might require that he have a little more insulin. Some cats do much better with the 9/10% foods because it helps to keep them from diving. But that also could mean he needs a bit more insulin.

When he's getting nice green nadirs and back to back cycles wth green nadirs again, he's where you want him even if the green is framed by blue. He was doing that on this dose for a while. I don't know why cats just suddenly seem to need more insulin but it can happen. Important motto for LL: "don't get attached to a dose". ;-) If he needs more insulin, he does. You might not know why.

But, first, you eliminate the obvious things like old or compromised pen, contraband, any health issues, etc. Then you just adjust the dose to get him back to where you had him.
 
Marje,
Is there always a certain dose that will work for a particular cat?
What I mean is, I raised his dose by .25u & his levels started to come down, then it seemed to stop working as well, so I raised his dose by another .25u & the same thing happened, three different times. I'm wondering if you can go in this circle forever, raising the dose with no limit or if there will be a limit for all cats, where the dose will actually/finally keep working.

Ian
 
Having punkin with acromegaly, i can say that yes, there is always a dose that works for a cat.

Oz doesn't have a high dose - i don't mean that. But with appropriate dosing you can get every cat into good numbers. Take a look at Cobb's spreadsheet here. He can be our teaching cat for the moment. :-D

Cobb has iaa - insulin auto-antibodies, a condition in which his body makes antibodies to the insulin that's injected and binds the insulin so it can't do it's work. That means that Suzanne had to increase the dose aggressively to get enough insulin in there to get by the antibodies to bring his blood sugar down. He got up to a high of 31u per shot before the iaa "broke" meaning his body has reduced/stopped making antibodies.

His situation is different because there is a specific known reason for him needing more insulin - but look at the spreadsheet and notice when his dose was at 31u and then started decreasing.

Another kitty's spreadsheet that might be helpful for you to look at is Max's. Max isn't a high dose kitty but he has some ongoing pancreatitis, which can make a kitty more difficult to regulate. Elise took his dose up to a fat 2.5 and then worked to keep him from earning a reduction by going below 50. She gave him carbs to smooth out his drops and hold up his nadirs. Doing that for even a few cycles can sometimes bring down the higher numbers that surround the green nadirs.

I looked at Oz's ss and am not seeing any notes about starting new insulin pens/vials. I usually put that in the comments section and then bolded it in red. Sometimes when you see numbers trending up, it can be helpful to know if the insulin is old.

It is very common to need to increase until you hit The Dose that is just right for that particular cat. You'll get there.

Hope all that is helpful - My fingers are crossed that the 2.75 is going to get him back into consistent greens. :-D
 
Hi Julie,
Is Cobb on Lantus or a different insulin?
Our insulin is about 3 months old, kept refrigerated, with the exception of maybe 3 times when it had been left out.
I have asked on here before & checked elsewhere if there should be any problem with it being left out & the general answer was no, so hopefully the insulin isn't the problem, especially since it's not easy to afford. We bought a bottle of Lantus for $200 +.
Are there any signs of pancreatitis? Is it something that has to be found by a vet?

Thank You
Ian
 
Cobb started on lantus and is now on levemir which has been fantastic for him.

Usually if a cat has not had a good response to lantus within six months, you could switch him to levemir. It's a really good insulin (I use it for Gracie).

Here is A Primer on Pancreatitis I did which has tons of info. I think you'd know if he had pancreatitis symptoms.
 
thanks to marje for answering! the main point is that yes, there is a dose that will work for oz. Increasing methodically will get you to that point.

I agree that typically, leaving the insulin out briefly here and there isn't going to wreck it. It's more likely that he just needs that little bit more insulin.
 
I also wanted to add this from Tilly's webpage:
Cats are extremely variable in terms of the maximum dose they end up requiring: they have ranged from 0.5 IU to 10.0 IU BID in the German forum, with most cats lying between 1.0 IU and 5.0 IU BID.
Click to expand...
 
Thanks Marje,
I'm hoping what's happening at the moment is just the new dose wonkiness stuff, his pre shot numbers have been higher on the last two cycles & he doesn't seem to be going as low.
 
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