6/28/2015 NORMAN AMPS 330 + 4 303 Dose increase this AM

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Cindywith4cutecats

Member Since 2014
Good Morning, Norman is out on the enclosed screen porch this morning watching some birds. He received his Lantus increase at 5 am this morning and actually didn't nag me until 9 am for his mid morning breakfast . We just did another dose increase to 1.75 units of Lantus. I sit and look at his SS and honestly since he went out of remission I see no change in his numbers despite the dose increase. Somewhere in the middle of each of dose increase I see hope that his BG will start lowering ... If you look back 06/18/2015 His numbers had been starting to really improve on 1 unit, we actually hit the high end of the blues. I don't understand it ??? I don't understand why he was hitting the blues and we have never been back there again ! I am so discouraged and so scared that we may never find a working dose. I leave for a trip July 29th and I am so scared. I almost wish I would have followed the dosing per kg of ideal weight instead of the start slow go slow....ggrrrr so hard to know,


previous condo from friday http://www.felinediabetes.com/FDMB/threads/6-26-2015-norman-amps-270-4-301-pmps-333-5-293.140082/
 
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Hi Cindy! Your post slipped to the bottom of today's posts - anytime you're not getting responses, feel free to bump the post up by adding a reply.

My understanding is that it's very common to have a cat that's come out of remission, end up having to go back up in dose to their highest dose. From the spreadsheet it looks like Norman had 3.0u in the beginning of his diabetes journey. He's just at 1.75u right now. I think you're on the right track now. You can switch to the TR Protocol. I think that would be a smart move. Holding a dose that isn't working just allows Glucose Toxicity to set in, and then in takes even more insulin to bring down the blood sugar.

If you want to do that, you'd hold a dose for 6 cycles and increase by 0.25u if his nadirs are over 200. From the Tight Reg page:

Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
I suspect everyone has phases that are very frustrating with the diabetes, especially when you're not seeing the response you're hoping for. I think if you march on with the dose, evaluate every 6 cycles and increase as above, you'll get him to a good dose and his blood sugar will come down.

As far as your trip goes, can your husband learn to test? Is he just giving shots? You've got a month to go - we can help you figure out a dose that will work for while you're gone if your husband can't test.

Hang in there!
 
This part of the diabetes journey can be frustrating. :bighug: It's not uncommon to see spreadsheets with constant increases and not a lot of movement until bang! kitty finally hits the good dose. Just keep plugging along doing the increases and re-evaluating.

By the way, how much does Norman weight?
 
Norman weighs 18 lbs ...now at one year of age he weighed 16 and typically a cat is not overweight there first year of life. Norman is going to be 10 years old this August so.....But I am posting a new CONDO we had a breakthrough finally
 
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