12/20 Tubbs AMPS 311 +3 254 +8 311

[Mandykins]

Need dosing help, spreadsheet is in my signature. I don't know if I should keep increasing by .25, or if there's something else going on. Is it possible I shot past her best dose? I've re-read the SLGS and think I should have been keeping the dosing at 1 week at a time, we've had a few issues here and there that could have affected her BG in the last few weeks, but now her numbers are still so high and today Tubbs' eating is slowing down. She's also been mopey today - not lethargic, but seems depressed - she usually loves snuggling up in a soft blanket, but when she's moping, she lays on the floor in various places.

She's drinking a lot of water still and has been since coming out of remission, still eating fully although noticeably slower than normal (she usually puts her head down and doesn't come back up until she's finished, whereas right now she's leaving, coming back, leaving, coming back), her stool has actually just in the last few days to a week become fully formed vs the soft serve semi-formed stool it's been for awhile, but considering how food driven she is, the slowdown concerns me (this happened about a month ago too but resolved after a few days).

UA is in progress, I'm picking up the pellets this week while I'm off on holidays, so just hoping for some direction in the meantime.

Please help, I have no idea what my next steps should be.

Previous thread with recent bloodwork here:
https://www.felinediabetes.com/FDMB/threads/12-15-tubbs-amps-326-5-182-7-254.271887/#post-3025462

 

[Wendy&Neko]

In my opinion, the next step is to try to get some night time tests. Many cats go lower at night. We decide how to change the dose based on how low it takes the cat. A before bed test, if at least 2-3 hours after the PM shot, can be very informative.

Next step is an increase. As per SLGS, you hold a dose 7 days, do a curve, then increase by 0.25 units if nadirs are not in the 90-149 range. You have held the dose longer than needed, done the equivalent of a curve, and what nadirs you have seen are all above 150.

Has the vet checked her mouth recently to see if she has dental issues? They cause many a cat to come out of remission and can make eating uncomfortable.

 

[Mandykins]

In my opinion, the next step is to try to get some night time tests. Many cats go lower at night. We decide how to change the dose based on how low it takes the cat. A before bed test, if at least 2-3 hours after the PM shot, can be very informative.

Next step is an increase. As per SLGS, you hold a dose 7 days, do a curve, then increase by 0.25 units if nadirs are not in the 90-149 range. You have held the dose longer than needed, done the equivalent of a curve, and what nadirs you have seen are all above 150.

Has the vet checked her mouth recently to see if she has dental issues? They cause many a cat to come out of remission and can make eating uncomfortable.

Thank you! I'm on holidays now and will take a few PM tests over the next few days - aiming for +5 since that seems to be her "new" nadir, but worst case will get some earlier ones in. I increased her tonight to 2.50 based on the SLGS method and your confirmation it makes sense; hopefully we're going in the right direction. I've seen some mention of "new dose wonkiness" so left this dose for awhile to make sure that wasn't the case. We did check her teeth at the vet when we did the blood test as I knew that was one thing that kicks kitties out of remission, and put her on antibiotics for it, so I don't think that's an ongoing concern.

We'll see how her numbers are tonight; thankfully I'll have the opportunity this week to do more mid-day and PM testing, and hopefully we can get to the right dose. The first time around was pretty quick and not challenging, so I'm coming back into this feeling like I know nothing since her BG seems to just keep going up when I increase her dose I'll post an update, but for now - the goal is more PM testing & get the UA done.

 

[Wendy&Neko]

New Dose Wonkiness only happens the first few cycles after an increase. Good luck with the increase.

The second time around, it is typically harder to get them to a good dose. Another reason not to delay any increase if needed.