6-23 New Dose 400's :-(

[Bree&ZeddyBoy]

Is it possible that this is due to the new dose settling in? We had blues and yellows in the beginning and now aren't seeing any of that even with the increased dose. No ketones, no additional carb intake, he seems to be regressing...is this normal??

 

[Wendy&Neko]

Here is that link to your previous post here, for continuity: http://www.felinediabetes.com/FDMB/threads/6-22-lantus-dose-adjustment-advice-appreciated.231333/

There is a phenomenon we call NDW or New Dose Wonkiness here, where cats can temporarily go higher after an increase, likely due to the depot building again. It only lasts a couple cycles. It's also not uncommon for a cat to have a strong initial reaction to insulin, then have that wear off and you have to keep increasing.

 

[Bree&ZeddyBoy]

Hi Wendy&Neko - I have been told by some admins on the FDSG facebook page that we should actually reduce the dose to .75. I am so confused.

 

[Wendy&Neko]

I guess it depends who you want to listen too. We have a couple of dosing methods here that have been used for years by many cats. According to those methods, You would stay the course for the moment on this dose. He’s starting to get over NDW and numbers are coming down today.

I know there is at least one FB group out there whose ideas I don’t agree with. We often see people from there over here when the caregivers find they aren’t making progress. The idea of “resetting” or going back in dose very seldom works, just those cases where kitty was started on way too high a dose, increases were too large and/or the person wasn’t testing enough. I see no evidence any of those are true with Zed. There can also be real harm in going back too far in dose, especially if that kitty is prone to ketones. I have seen cats go into DKA from going backwards needlessly. At very best, the cat gets glucose toxicity, where they get used to higher numbers, and you end up needing an even higher dose to break through.

 

[Bree&ZeddyBoy]

Hi Wendy&Neko - thanks for the info - we got a 629 AMPS today - the highest he has ever been!! Is this the lack of depot from when we had him on a lower dose or is his pancreas freaking out from the higher dose??

 

[Wendy&Neko]

You got no tests last night, but after six cycles at 1.5 units, I suspect his 1.5 unit depot was full and starting to work. It's possible he went lower than he was used to again, so is bouncing now. Many cats go lower at night, which is why we suggest getting a test before bed, if you can. We determine how to change the dose based on how low it takes the cat, not those highs. Bouncing is perfectly normal (and annoying for us) for relatively newly diagnosed cats, and even some longer term diabetics.

 

[Bree&ZeddyBoy]

You got no tests last night, but after six cycles at 1.5 units, I suspect his 1.5 unit depot was full and starting to work. It's possible he went lower than he was used to again, so is bouncing now. Many cats go lower at night, which is why we suggest getting a test before bed, if you can. We determine how to change the dose based on how low it takes the cat, not those highs. Bouncing is perfectly normal (and annoying for us) for relatively newly diagnosed cats, and even some longer term diabetics.

Morning! We got a test at +5 last night and he sat in the 400s and was over 500 at AMPS. I don't think he is a night dropper. We are going up to 1.75 and will see where that settles in over the coming days and be sure to get more PM tests in.