the drop yesterday from 478 to 76 is certainly a rebound causing drop. how TOR-y is your TOR? 0.1 units?
hey don't get upset, regulation is a goal but it takes time and a lot of time in some cats. i was looking at your SS last night while i was here and was asking jill and libby and co about what was going on with you guys. i need some questions answered so i can try to help~
~is there blood work to look at? some puzzling things on SS as far as meds and such.
To me, TOR is 0.1 or less
I don't have a copy of the blood work but I know that there was nothing remarkable about it
~have you had an fPLI test done? i see shot of centrine on SS and flagyl but not reason why, was there vomiting?
I asked my vet(ex bf) jaime if he thought there was a chance that it was pancreatitis and he said no. The centrine and flagyl were for BOTH of my cats when they had a stomach virus type thing at the same time and they were both throwing up and vomiting.. My civie needed it a second time.
~have you had a urine C&S (via cysto, sterile means) done? what about x-rays to check for bladder stones? i am concerned about the labeling him as 'chronic cystitis' that i see on SS and then giving AB's for that? pain meds and fluids are the tx for cystitis. i need more info.
yes I had a C&S done about 2 months ago or less and there was no bacteria at the time. I don't really know whether the blood in his urine is caused by a small kidney stone that he has or whether or not it is cystitis. He does also get fluids. Plus he gets like 3-4 tablespoons of water per each bowl of food in his food bowl. Jaime has been very hesitant to give him bupe as he really doesn't believe that he is in pain and if he was he couldn't live on it(is what he said) He has been trying to see if S/O would break up the kidney stone(as an option and it is low carb, but it also contains corn flour and always raises Alex's sugar..I found this week. It did help my other cat who is is littermate and has the same stone).
~how long ago was that last thyroid test? they can change their hyper-t med needs in a short time frame and the last test might have been more of an ESS results than true value. (ESS = a few conditions that artificially lowers the thyroid test results). i saw on SS that he is on tapazole, he might have just lost thyroid regulation and is very hard to control BG's when that happens.
I was thinking that too because he is driving me crazy lately. His last test in December sometime I really should have charted it darn. It was after he was switched to the dose he is on now and his level was 4.2. There are days when he doesn't stop yowling and bothering me for food the whole whole day. Then when I'm getting it for him he's up on his hind legs(thank God) twirling like a ballerina waiting for it...I call him Mr. Happy Pants doing the Happy dance. Just now he spun like a top, it has variations. He eats like a horse and hasn't gained more than 1/2 lb in the 5 months since he was dx'd.His behavior toward me is getting better tahn it was. He was never nasty to me but at the time of dx and beyond he was much less affectionate and less social and less "Alex". he is becoming more "Alex" every day now, toward me. The affectionate social cat is returning. But he has become horribly aggressive toward his brother who he could not spend a second away from for 12 years. The hissing and growling and total aversion toward Jacky breaks my heart. He attacks him for no reason. Jackson who is twice his size tries to tiptoe around him but where he first wouldn't fight back, now he has had enough. It's very pleasant in my apartment.
That sounds like the result of thyroid, no?
But Alex has the heart condition and isn't a candidate for a lot of options and is a very bad patient and gets stressed out very easily.
oh wait i just read profile, i remember you guys from health on old board when you were on vetsulin! (from before i got sick, when i was around all day everyday). now some of the questions i have make sense.
you might not like what i have to suggest...a second opinion. your SS looks like health issues not dose issues (although i do have issues with dose, i understand why it was raised all those times because cat was throwing ketones, but awfully weird that so much lower doses gave green). sometimes a fresh set of eyes will pick up on what is wrong. cause something is wrong, something is being missed, a cat on such a dose of insulin
should not be throwing ketones all the time unless this is an acrocat or IAA cat, but your SS is not one of insulin resistance, it is one of bouncing.
He hasn't had ketone issues since back in December(until 2 days ago and that was because I gave a fur shot). Alex gets ketones very quickly, maybe only trace but he starts to smell acetone after 6 or more hours over 300. Maybe no one else would notice but I start sticking my head n his mouth because of my first awful experience when I let it go because I thought he got near bug spray and I ignored it for over 2 weeks. (I had been exterminated) 
Could he be IAA and have been blue and green for over a week on 2.5 units ? I don't know what threw him off. Maybe I was told too many things by too many people who were trying to help me. Maybe I switched foods too many times. Maybe I tried too much of a good thing. Maybe I didn't understand what the R was for. Maybe his thyroid. Maybe his stomach virus came into play or his kidney stone...I don't know. Maybe I should have gone to 2.75 and stayed until he leveled out. Maybe he needs to go up, reach a breakthrough dose and then go back down but he does respond to insulin. That appears to be clear. Don't you think so?
As for vets. Jaime was a feline only vet for years. it's true he's old school but he is a good vet. as for why i haven't gotten a second opinion. There are so many reasons that I can't explain here. They were valid before and they are more valid now but it doesn't mean I love my cat any less.
The things I can tell you about blood work
T4 4.2
albumin was a little high I don't remember number
creatonin was normal
sugar was 4 something that day but I knew it was
There was nothing else in in that he was concerned about
what do you think?
I think I thank you so much for this. you never met me and I am hurting. I think I need to PM you for what I need to say because it is personal
Thank you so much jojo
~jojo