4/17 Penny AMPS 401 Glucose toxicity

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Robyn and Penny

Robyn and Penny

Member Since 2013
Hey everybody!! So after trying everything else I've finally settled into acceptance that I may be dealing with a case of glucose toxicity. Besides Penny drinking and peeing a lot and her lousy numbers, she is doing great. I never mark when I do ketone tests (dk why..I always forget) but they are negative, obviously, unless otherwise noted. If I get even a "trace" I'd be rushing her right to the vet anyway.

I guess I'm looking for those who have experience with this. I was gonna keep increasing .25u every 4 days (8 cycles) till I break it. I can't bring myself to be more aggressive than that if she's (knock on wood) not in DKA. Yes, I know I need to get up overnight and get more tests, especially since she seems to be highest in the morning. Anybody with experience on breaking through that glass floor who can weigh in or keep an eye on us?
 
It looks like you've been increasing with more regularity. At this point, just keep increasing after every 6 cycles/3 days. Eventually, you'll break through to better numbers. There's no way to predict when this will occur.
 
Even though Purrdy's numbers were blue, he was stuck there with some sort of weird glucose toxicity thing going on (usually they get stuck in much higher numbers), you can see in his spreadsheet that from 2/25 we did several back to back 3 day increases to break through it. The way to break it is to be aggressive in your dose increases. You should also give full .25 increases rather than fattening up the dose. With her nadirs being so close to 300 I would be tempted to give a one off .5 increase on the next one - see what others think. And yes you will need to test more so you can be on top of any changes, things may change very suddenly.
 
I agree it doesn't take much for glucose toxicity to set in. If I slack off on keeping Neko in good numbers, it takes less than a week before she gets used to higher numbers, so I have to keep on top of increases.

I'm not sure what protocol you are following, we have either TR or SLGS here. There are no guidelines for relaxed TR. If you do decide to do more frequent increases, I'd strongly encourage getting some spot checks in at night. Often cats will go lower at night than during the day. A before bed check is a great one.
 
I was doing TR but her numbers kept going up as the insulin went up and I think some wonkiness was happening with the gabapentin, so as she was tapering off of that I was being safe rather than sorry b/c I talked to Mel and when her Autumn went off of gabapentin, she bottomed out. I've talked to a few people from here whose cats starting doing a whole lot of bouncing with regular .25u dose increases so they ease them up by fattening the dose rather than following TR, so I tried that for a while but I'm anxious to at least get her under renal threshold so I abandoned that idea. So I'm following TR at this point but don't like to increase at night so I was gonna do every 4 days, so tomorrow she would get an increase. I won't be home much of the day Sunday so gonna do the .25u rather than take a chance on a half unit increase when I can't be here to monitor.

Penny was only on insulin for 6 weeks before she went OTJ the first time, so I'm pretty inexperienced with dosing and when problems arise so this is my first time dealing with this and didn't even know anything about it till a few weeks ago when somebody posted info for me on here about it.

I said I have to get more nighttime numbers. She has not been an easy test since coming out of remission so I'm trying to get data without torturing her. Plus, she's on a weight loss plan and her reward for testing is raw chicken so I really try to watch her with that since I use raw chicken for her exercise up and down the steps 20X per day. Chicken is the only thing that motivates her besides live bugs lol
 
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