What seems to be overlooked is that Oliver was not started on low dose, was not tested or curved during those first few days of treatment and was not tested much thereafter. He was fed dry food. His dose increases were based on occasional spotchecks. He has never been given the opportunity to see what would have happened at lower doses with any consistency. Every time the dose is raised, the numbers stay flat or go up. This is what rebound looks like and the only way to treat it is less insulin and giving the system time to clear out which can take up to a week.
My point is, and always has been, that the important first steps in treating Oliver were not followed per Tilly or any protocol. That is how chronic rebound begins. Raising the dose every few days compounds it. When the protocol says that the dose can be increased every 2 or 3 days, it is presuming that one is starting from the beginning, not after the cat has possibly been in rebound for a month. The concept of "shooting through rebound" does not apply to a cat who's been experiencing it chronically for a long time.
Furthermore, the protocol states: "Many cats will occasionally react to an increased dose with increased BGs - within the first 2 to 3 days after an increase, usually lasting for less than 24 hours. Nobody really knows what the reason for this phenomenon is (perhaps a "panicky liver"?) - hold the dose and ignore the fluctuations." Therefore it is not logical to raise the dose yet again if the cat is still reacting to the previous increase. Being too focused on the numbers usually ends up making things more complicated than they need be. Hammering the cat down to celebrate all the pretty colors is just as hard on his system as underdosing and since it's not producing much response it should be apparent that it's not working.
Yes, he's a big cat. So what? I took an even bigger cat last weekend, >18 lbs. and not obese. He was on 6 units bid of Lantus at the shelter - per vet - and has not needed a drop of insulin since he arrived here. According to his records, he was tested fairly regularly in his previous home and ran high and flat so the vet just kept raising the dose. Oliver had much less testing.
Girlcat said:
i totally ,wholeheartedly agree with yu carolynn.i dont feel that oliver is being overdosed,in fact i feel the opposite is the case.i feel oliver is in need of increase and is not getting enough on the basal dose. gayle....its very easy to get overwhelmed by different voices of opinions,some who (i feel) dont have any experience to advise yu so.as one who has been there and still is.....u are not overdosing your cat.(((((hugs))))
We who are concerned for Oliver have been at this for years and with multiple diabetic cats. Every cat is different, every situation unique, and we've had to learn to deal with them. For me it always paid off to just start over, which is what should have been done with Oliver. I have cared for eight rescue diabetics - four have gone into remission and one is getting close - so do tell me, what is your definition of experience?
