2/2 - Xander | 1.5u too high, 1.25u too low. Dose help please?

Brianna & Xander

Brianna & Xander

Very Active Member
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Hey everyone,

It's been a few days! After my last post I decreased Xander's dose to 1.25 units because he was going <90 on 1.5.

For the past few cycles, his numbers have all been flat and high (even hitting the 400+ range for the first time in a while :( ). I decided to increase back up to 1.5 as of last night.

He definitely seems to be feeling better as of this morning but his AMPS is 72 (now 10 minutes pre-shot he's at 65), which I imagine means I shouldn't shoot at all. Again. I'm so tired of having to skip doses and wait for the high numbers to come back down.

Just wondering what I should be doing if 1.25 seems to have almost literally no effect but 1.5 brings him below 90. Does this mean it's not possible for me to follow SLGS and I have to switch to TR?

For reference, it's currently 8:08 AM and I have to give him his next dose (if any) at 8:30.

Please help? I appreciate all of you.

ETA: I shot 1 unit. I've given 1 unit for safety in the past when he was hovering around 150, but I have no evidence for how he responds at lower numbers. Skipping always makes it worse though, so I'm trying this and I guess we'll see what happens. Hopefully this doesn't turn into a very scary, bad day lol
 
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I think TR would help but that means no dry food. You would feed lc wet unless dropping too low and you need to intervene with mc or hc. You mentioned you need to feed some mc and if that’s because he’s dropping it’s fine with TR. It’s one of the tools we use to keep them surfing normal numbers. With SLGS you don’t shoot under 90. With TR that number is 50.
 
tiffmaxee said:
I think TR would help but that means no dry food. You would feed lc wet unless dropping too low and you need to intervene with mc or hc. You mentioned you need to feed some mc and if that’s because he’s dropping it’s fine with TR. It’s one of the tools we use to keep them surfing normal numbers. With SLGS you don’t shoot under 90. With TR that number is 50.
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The idea of TR is very scary to me, but if it seems like that's the only real option (given that he seems to be between dosages) I guess that's what I'll have to do.

I feed LC wet entirely (until he's in the low 50s, then I've given a tsp or 2 of HC - I've been using the Fancy Feast Grilled in Gravy for that). I had been leaving dry food out for him to graze on but I haven't done that in about 8 days, so it's been at least that long since he's had any dry food at all.

You think TR is the way to go?

He's been in the 50s-60s since his last dose and he just seems like he doesn't feel well. I don't know if maybe some cats do better above 70 or what, but he's not himself when he's this low even though it's not technically "hypo."
 
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I think when not used to normal bg a cat might not feel as good in lower bg. Max got into the 30’s more than once but not had a symptomatic hypo. Cats new to fd do go back and forth in dose often. You don’t need to switch methods but if you continue to follow please take reductions and don’t shoot if under 90. You would reduce now to .75 if you continue with SLGS.
 
tiffmaxee said:
I think when not used to normal bg a cat might not feel as good in lower bg. Max got into the 30’s more than once but not had a symptomatic hypo. Cats new to fd do go back and forth in dose often. You don’t need to switch methods but if you continue to follow please take reductions and don’t shoot if under 90. You would reduce now to .75 if you continue with SLGS.
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He didn't dip under 90 at the 1.25 dose, just the 1.5. But on the 1.25 he was staying in the high 300s and even 400s for the most part. It seems like 1.25 isn't nearly enough but 1.5 is too much (if he goes under 90). I'm just not sure how to handle that. (I only gave 1 unit today because he was under 90 from the 1.5 at +12.)
 
Sorry, I think I'm not being clear. I had been giving him 1.25 and it wasn't effective, so I went back up to 1.5 last night. He only went back under 90 after the 1.5 dose. The 1 unit from this morning was just so that I could at least see how his body responded to shooting low, not an intentional permanent decrease.

So:
At 1.25 units he stays flat between 300-400.
At 1.5 units he goes under 90.

If I were to now decrease to 1 it seems like it would just be even worse than 1.25. I hope that makes sense.
 
Hi Brianna, it seems his numbers are all over the place because you keep changing doses. With SLGS you want to keep a dose for a week then evaluate how it’s doing for him and only increase if his nadirs aren’t in the right range.

When you go up and down end dose, every few doses, you can’t tell what The dose is doing.

And since you have recently cut out dry food, that can have an effect also on his numbers.

It seems like he might be doing OK on the 1.25 dose but you would need to leave him there for about a week unless he goes under 90 and then take a reduction.
Have you read the instructions on how to follow SLG as closely?
I hope this helps (please see link below) :bighug:
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
 
Staci & Ivy said:
Hi Brianna, it seems his numbers are all over the place because you keep changing doses. With SLGS you want to keep a dose for a week then evaluate how it’s doing for him and only increase if his nadirs aren’t in the right range.

When you go up and down end dose, every few doses, you can’t tell what The dose is doing.

And since you have recently cut out dry food, that can have an effect also on his numbers.

It seems like he might be doing OK on the 1.25 dose but you would need to leave him there for about a week unless he goes under 90 and then take a reduction.
Have you read the instructions on how to follow SLG as closely?
I hope this helps (please see link below) :bighug:
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
Click to expand...

Thank you so much for your response!

So it's possible that he would've started going into better numbers with the 1.25? I just started to worry seeing so much of the high 300-400 numbers again; I didn't want to risk DKA by letting him sit at 1.25 if it wasn't enough. The last 2 cycles of 1.25 I did seemed like they had no effect whatsoever and I didn't know if that would actually change with more time.

I have heard the instructions, but thank you for the link! I look it over again almost every day too. I wasn't sure if the "hold the dose for 1 week" was meant for the initial dose or if it applied to every dose change.

So I should go back down to 1.25 and hold for the full 7 days, even if he stays in the red? I just want to make sure I'm doing the right thing. I hate feeling so lost.
 
Let me see if I can clarify. With SLGS you don’t increase sooner than every 7 days. He never should have gone up to 1.5. It takes time for the depot to adjust to a decrease or increase. I missed that you gave 1.5 last night which was why I thought you needed to decrease to 1.0 as I was looking on my phone. A higher dose can effect the next 4 or more doses due to the depot. So give 1.25 more time. You might not need another full 7 days since he only got 1.5 once. If possible please ask first dosing advice before increasing.

Have you read this sticky?
https://felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/
 
tiffmaxee said:
Let me see if I can clarify. With SLGS you don’t increase sooner than every 7 days. He never should have gone up to 1.5. It takes time for the depot to adjust to a decrease or increase. I missed that you gave 1.5 last night which was why I thought you needed to decrease to 1.0 as I was looking on my phone. A higher dose can effect the next 4 or more doses due to the depot. So give 1.25 more time. You might not need another full 7 days since he only got 1.5 once. If possible please ask first dosing advice before increasing.

Have you read this sticky?
https://felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/
Click to expand...

Sorry to have been confusing! :)

I'll go back to 1.25 tonight and give it more time. Hoping you're right that maybe I don't need the full 7 days to see a positive change. Knowing I possibly messed it all up and have to start over is so discouraging.

Thanks for the advice again.

ETA: Yes I have read the sticky! :)
 
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Good luck with the 1.25 units dose. (and patience :p)

Are you home testing him for ketones, especially if it's a concern? Has he ever seen ketones? It's a good idea to test for ketones when they are in high numbers.
 
Brianna & Xander said:
Sorry to have been confusing! :)

I'll go back to 1.25 tonight and give it more time. Hoping you're right that maybe I don't need the full 7 days to see a positive change. Knowing I possibly messed it all up and have to start over is so discouraging.

Thanks for the advice again.
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Good luck with the 1.25 unit dose!
Doses are changed based on how low a dose is taking your cat. (Try to ignore the bounces, while I understand it’s hard). But yes, pay attention due to the DKA issue.

It’s really critical about how low the dose does or doesn’t take him. :)
 
Wendy&Neko said:
Good luck with the 1.25 units dose. (and patience :p)

Are you home testing him for ketones, especially if it's a concern? Has he ever seen ketones? It's a good idea to test for ketones when they are in high numbers.
Click to expand...

No history of ketones, but no, I haven't been checking for them at home. I guess I'll have to get some strips!
 
Staci & Ivy said:
Good luck with the 1.25 unit dose!
Doses are changed based on how low a dose is taking your cat. (Try to ignore the bounces, while I understand it’s hard). But yes, pay attention due to the DKA issue.

It’s really critical about how low the dose does or doesn’t take him. :)
Click to expand...

I guess that's what I'm worried about, that the dose won't take him any lower than it has. But I'll retry the 1.25 tonight. Thanks again!
 
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