8/10 Oscar amps 247 +7 286 frustrated yet again

[Kelly & Oscar]

We increased his dose per protocol a few cycles ago to 3.75u. Lately he seems to give me a somewhat decent drop in the evening, even with giving food for the first few hours after the shot. For some reason we are lucky to see any drop at all during the day, and most of the time see up to a 40pt rise. What gives? I don't understand at all. He got a string of great numbers for 2 days on 3u, but we have seen nothing close to that since. As each day goes on, I start thinking more and more that he may be an acro cat or insulin resistant. I know his dose right now does not suggest either yet, but I see the pattern. We'll give this dose another 2 cycles and then raise it to 4u.

 

[Kelly & Oscar]

On a slightly other note.... I currently have the following email typed up to send to our IM specialist. You guys obviously know we have continued to hometest, but she doesn't. Let me know what you think, and if I should add or subtract anything. I would really like to keep her on board with his treatment. Especially if I need to push for an acro/IAA test in the future.

Hi Dr. *******,

I did some spot checks on Oscar during this morning's cycle and he was running between 247 and 286. Maybe those lower numbers were temporary unfortunately. I did come across a new article from the Journal of the American Animal Hospital Association about diabetes treatment in cats/dogs. (http://www.aahanet.org/PublicDocuments/ ... elines.pdf) On the bottom of page 4 they mention that home monitoring of glucose levels is encouraged and ideal. Also, I found that the dosing protocol for Lantus and Levemir from the Veterinary School at the University of Queensland, Australia gives a dosing protocol for owners that monitor glucose levels at home. The study that lead to this protocol had all owners testing levels at home on a regular basis. (http://www.felinediabetes.com/Roomp_Ran ... otocol.pdf)

I do truly understand your concern with home testing, but I am becoming very uncomfortable with giving insulin blindly continually, especially based on the history of surprise glucose levels Oscar has given me before. I really hope that you can understand my wish to test his glucose before each shot and once in between at the very least. Since I plan on testing more often now, would it be safe to allow his numbers lower than 200? I am less likely to have a surprise hypoglycemic episode if I am testing at least 2 times a day, and I believe we might be able to do this safely. From my discussions with other diabetic cat owners, I have seen so many go into remission, and I am worried that this will not be a possibility for Oscar if we keep his numbers at or above 200 all the time.

Thank you for your continued help!
Kelly

 

[Pat+Raja+Shadow (GA)]

Hi Kelly....been looking back and I think I found your last post. Is this it?
viewtopic.php?f=9&t=21458&start=0&hilit=oscar
That might help for any of the experienced people who come by to give you a hand...
This is his 4thcycle on the 3.75u correct?
Do you feed snacks during both AM/PM cycles after shot time at all?
Maybe you can indicate what you are feeding and what your schedule is for the meals/snacks.
Hopefully someone will be along to give some thoughts....

 

[Kelly & Oscar]

Thank you for finding that. It has been a while since we rented a condo for him - his numbers just don't show anything different each day. I believe we are currently in the middle of the 4th cycle on this dose. I do give food, mostly at the beginning of the cycle. He usually eats 2-3oz at shot time. 1-2oz at +1, 1-2oz at +4, 1-2oz around +9, and then again at pm shot time. In the evening cycle he eats 2-3oz at shot time, 2-3oz at +3 and 1-2oz at +7. The am +4 and pm +7 are via an automatic feeder.

 

[Sienne and Gabby (GA)]

It's worth considering the possibility that Oscar is a high dose cat but he's not there yet by any means. Take a look at Randi/Max's spreadsheet. Max got up to 6.0u and then came speeding down the dose ladder. If he's insulin resistant, you're doing the right thing. It's going to take insulin to squish the numbers.

As far as the letter to your IM vet, my knee jerk reaction was, "Why bother." What if your vet takes an adamant, anti-home testing position? All it will do is create friction. At this point, what your vet doesn't know won't hurt her. You're not doing anything that could potentially harm Oscar. If you want, send her the Roomp & Rand article with an, "Oh gee. Look what I found! Wouldn't this be helpful for Oscar?" And then, see what kind of reaction you get.

 

[Kelly & Oscar]

It's worth considering the possibility that Oscar is a high dose cat but he's not there yet by any means. Take a look at Randi/Max's spreadsheet. Max got up to 6.0u and then came speeding down the dose ladder. If he's insulin resistant, you're doing the right thing. It's going to take insulin to squish the numbers.

As far as the letter to your IM vet, my knee jerk reaction was, "Why bother." What if your vet takes an adamant, anti-home testing position? All it will do is create friction. At this point, what your vet doesn't know won't hurt her. You're not doing anything that could potentially harm Oscar. If you want, send her the Roomp & Rand article with an, "Oh gee. Look what I found! Wouldn't this be helpful for Oscar?" And then, see what kind of reaction you get.

I'll pop over and take a look at the spreadsheet. Thank you for linking that for me!

As far as the IM vet - she doesn't know I have been testing, and she wants me to hold the 3u dose for 8 weeks and then rely on fructosamine tests after that. She will find out at some point that I am not doing what she is suggesting unfortunately. She is of the mindset that cats do not go into remission often and most cats do not give "nice" curves. This is due, I believe, to using insulins like Humulin and using an old protocol. We here prove that it can be done on a regular basis even. She also thinks that home testing is too stressful for a cat. (ha!) This is the only reason she gave me for not wanting me testing so often. If I can help another person by pushing the issue, and possibly even myself, then pissing her off may be worth it :lol: Worse comes to worst, I go at it alone with the help of the board like I was planning on doing anyway :mrgreen: