7/3 Zorro AMPS 365 +3 468 +6 331 Increasing dose this PM

[Zorro's mom]

@Wendy&Neko @Bron and Sheba Please don't feel obligated to respond due to me tagging you. If possible I would just like some opinions from any experienced Levemir users on whether I should increase Zorro's dose with 0.25u or 0.5u this evening. I am starting to feel a bit panicked by the increasing numbers of pinks, reds and blacks on his SS.

I've updated his US SS. For the sake of speed I didn't specify half hours or 15 mins. with the test results (eg. +5.5) as on the World SS but it gives a pretty accurate idea of how things were going a few weeks ago and how things have been going "backwards" since I started TR with 12/12 dosing on a lower dose on 06/26/2019.

The reason why I decreased his dose was that I expected Zorro's bg to improve after his dental extractions and since he is now mainly on raw food whereas before he was on 10% carbs FF. However it is not going as I had hoped. Is there the slightest possibility that his dose is too high? I am too scared to do a rebound check based on his high numbers and feel that I should try an increase first.

Background info:
http://www.felinediabetes.com/FDMB/...ro-caninsulin-to-levemir.213420/#post-2399717

http://www.felinediabetes.com/FDMB/threads/zorro-pmps-hi-4-412.216328/#post-2399760

 

[Bron and Sheba (GA)]

Hi Maritsa
Have you decided if you are going to follow the TR or the SLGS method yet? You are testing enough to do the TR and it will allow you to increase the dose more quickly if necessary. When you decide can you put it in your Signature please.
As you have some nadirs between 200 and 300 I would increase by 0.25 units, hold the dose for 6 cycles and see how he goes.
I see you mention blood has cleared from his urine in the remarks column. Is this an ongoing problem? It could be FLUTD which could possibly be contributing to the higher numbers if he is experiencing pain from it. Google FLUTD and see what you think. Sheba had FLUTD and used to get blood in her urine. No infection. I used to give her extra fluids, tried to remove stress ( it used to flare if there was a change such as visitors staying in the house etc) a feliway collar (or similar collar, different brand) and I gave her a medication which supported the bladder wall. The name escapes me at the moment. I’ll try and remember.

 

[Wendy&Neko]

I am glad you increased the dose. As Bron said, I would hold this dose for six cycles now, unless he earns a reduction. As for reducing, we only do it when the cat shows us reduction numbers, not in anticipation of seeing them. Yesterday I talked about doing reductions under 40 for long term diabetics. An alternate method that some people use, if their cat does not hold reductions well, is to hold for three times under 50, on separate days.

You can intervene with food if you see him dropping fast. At this point, your goal should be to try to get him to spend as much time in green, without earning a reduction. That means maximizing the insulin, but still being safe. This post on using food to manipulate the curve may be of interest. Note that Jill has Lev specific times later in the post. You had feeding times listed on your previous post, but it is best to list them in + times after the shot. One that food experiments take time.

Another thing you may with to experiment with at some point is the amount of carbs you feed. I too fed raw, but it was 3-4% carbs. Some cats do better with some carbs in their diet, another post to read http://www.felinediabetes.com/FDMB/threads/feeding-lowest-zero-carb-vs-lower-carb-foods.144220/ Some of the Weruva foods are low phosphorus and low carbs, and might be better than the Fancy Feast for Zorro.

As for insulin duration, it gets better when you are at a dose that is giving better numbers. Right now you need to get Zorro used to green, then longer stretches of those green normal numbers. That will slow the bouncing, as will slowing his major dives p, that also cause bounces. If his onset is +3, then food a bit before that may slow the drops.