6/3 Samba AMPS 233, +2 328, +7 288, +9.5 343, PMPS 287, +2 271, +4 204

[Sarah Mc]

http://www.felinediabetes.com/FDMB/...cept-them-moving-forward.175607/#post-1930849

I haven't posted on here in awhile but haven't seen any improvement in Samba... I've started using calipers, and I do feel that helps to give him more precise doses, but it definitely does not appear that we have hit a "breakthrough" dose yet. He is currently on 2.6 units BID, which might sound silly, but this is the highest dose he's ever been on (2.5 units before we started using the calipers used to make him crash into the 30s, so I am raising the dose really slowly). When I brought him up to 2.6 units on 5/23/17, he went below 50, so I reduced the dose to 2.55, but now he is back up to 2.6. We are looking at doing an increase to 2.65 units tomorrow night if his numbers stay the way that they are. Am I handling this all wrong? I feel that taking him up to 2.75 units like the protocol recommends would be dangerous, but maybe I am hurting his progress by doing such small dose increases/reductions (?)

Should I be posting daily even if I don't have a pressing question?
Thanks!!

 

[Sarah Mc]

Used the novaMax Plus blood ketone monitor for the first time to text his ketones, and the result was 0.4 mmol/L... looks like that is okay.

 

[rhiannon and shadow (GA)]

I do believe that you should be doing the increases in 0.25 u....

It's good if you could post daily.... especially if you want input.
By following the protocol, he would be more likely to progress downward as he needs to. The small increases may make him insulin resistant if you
hold the dose too long and are barely increasing.

0.25 u is aproximately 2 1/2 drops depending on which syringe you use.

 

[Wendy&Neko]

A cat's insulin needs can change over time. When we look at the spreadsheet for dosing suggestions, generally we'll only look back a couple of weeks in history. That's my long winded way of saying don't get too attached to a dose. And as Rhiannon said, it's better to move in 0.25 unit increments/decrements. When you got the below 50 on 5/24, I would have reduced by 0.25 units and done subsequent increases by the same amount. Smaller increases aren't that effective, unless you are on really small total doses, which you are not. Assuming the past is the past, try going ahead with 0.25 unit changes.

If you find over time that Samba isn't very good at holding reductions when he earns them, then you could try the technique of going to three drops below 50 (or one under 40), before a reduction is earned.

When are you feeding him now? I am wondering if some modification to his feeding schedule might help even things out. He does seem to do some large drops at times.

 

[Sarah Mc]

A cat's insulin needs can change over time. When we look at the spreadsheet for dosing suggestions, generally we'll only look back a couple of weeks in history. That's my long winded way of saying don't get too attached to a dose. And as Rhiannon said, it's better to move in 0.25 unit increments/decrements. When you got the below 50 on 5/24, I would have reduced by 0.25 units and done subsequent increases by the same amount. Smaller increases aren't that effective, unless you are on really small total doses, which you are not. Assuming the past is the past, try going ahead with 0.25 unit changes.

If you find over time that Samba isn't very good at holding reductions when he earns them, then you could try the technique of going to three drops below 50 (or one under 40), before a reduction is earned.

When are you feeding him now? I am wondering if some modification to his feeding schedule might help even things out. He does seem to do some large drops at times.

Thanks for this info. I think that I will try raising him to 2.75 units tomorrow night and try allowing him 3 drops in the 40s or 1 drop in the 30s before reducing the dose and see how that goes. I wouldn't be surprised if 2.75 units twice a day drops him in the 30s and brings him back to 2.5 units, which does not appear to be enough for him, but fingers crossed that it works...During the day, he gets 1.5oz of FF at AM shot followed by 1.5oz before I leave for work. He then gets 0.75oz through his timed feeder at +1, +3, +5 & +7. At night, he gets 1.5oz at his PM shot and each subsequent test to a total of 4.5oz (so at PM shot plus the next 2 testing times). I try to do all of the feeding within the first few hours of his cycle at night. Does that sound okay?