? 2/10/20, Chaz, curve day, amps 396, +8 421, highest ever reading

[Kelly & Chaz]

We need help please. 2 1/2 months on Lantus, SLGS. It seems the higher we go in dose, the higher his numbers are going. We have kept a very rigid schedule for feeding and shot times. All low carb canned food, several meals a day. I look back at Dec and Jan numbers and while not ideal, we had mostly blues and a few greens (.50 & .75). I don’t know what to do. I’m ready to just stop shooting for a while and start over again at the lowest dose. He just had a vet visit, no uti or other sign of infection. Vet thinks we haven’t hit the right dosage yet, meaning higher. This whole process seems futile, please help us .

 

[tiffmaxee]

A second remission is harder to achieve and I’d anything you need to be more rather than less aggressive sometimes. Any reason you aren’t doing TR? You test enough.

 

[Kelly & Chaz]

A second remission is harder to achieve and I’d anything you need to be more rather than less aggressive sometimes. Any reason you aren’t doing TR? You test enough.

Fear of hypo I suppose. Based on his early numbers on a low dose, I never expected to be where we are 2 months later. As I mentioned, his numbers have climbed with dosage increases. Can too much insulin cause this? Should I have stayed at .50 for longer back in December?

 

[Wendy&Neko]

Are you following a modified version of SLGS? I see a couple times when you got a number below 90 (Jan 11 and 20) and either did not reduce, or didn't hold the reduced dose for 7 cycles. Sorry, just trying to figure out what your dosing method is.

As for too much insulin, the answer is no. It's likely some glucose toxicity has set in and Chaz's body is getting used to higher numbers. That means increasing higher to get over it. At this point I would recommend following SLGS as its written. Hold each dose for 7 days, then evaluate it and decide if you need to increase. In the mean time if you see a below 90 at any time, reduce the dose by 0.25 units and hold 7 days again. So, unless you see a number between 90 and 149 tonight, you increase tomorrow. Note, some cats go high before they go low, so paws crossed you see some blue tonight.

The link to your last post here, for continuity.

 

[Kelly & Chaz]

I guess you could call it a modified version. I’m trying to follow it strictly, but I confess my impatience and concern over the upward trend in his numbers has gotten the best of me. One low in the middle of mostly 300s seems like a fluke - I wish I had tested again right away on those two low numbers. I did reduce a few days later, after you had advised me to do so. Then his numbers went right back up again. As you can see, he has had a pretty high flat curve today, not much dip for nadir, and that was at pmps. Maybe I should try and go to TR as mentioned above. I think we are just about at what the recommended starting dose would be if I figured it right? 14 lbs = 6.4 kg x 0.25U = 1.60u. We are just bumping up to 1.50 on SLGS. I just worry about the other potential complications of staying high with SLGS. So far he’s been ketone free, want to keep it that way. This is so frustrating!!!!
@Wendy&Neko

 

[Wendy&Neko]

If you did TR, you would stick with the existing dose. Well, actually you would increase it, as you evaluate the dose and increase the dose every 3 days if nadirs are above 200.

I did reduce a few days later, after you had advised me to do so. Then his numbers went right back up again.

That was probably him bouncing. That's a temporary condition that goes away in six cycles or less. It is his body dumping sugars to compensate for what to him are lower numbers than he is used to, or fast drops. If a kitty bounces, put on the patience pants and stay the course with dose.