Re: 8/5 Harley ---AMPS 414 How to decide on advice
Your vet is probably thinking about Somogyi rebound. We usually don’t see that here in LL because we work up to doses gradually so we know we have not passed the right dose. In your case, I suppose it is possible because as far as I can tell, you may not have worked up to your dose according to protocol. However, once glucose toxicity sets in (when the cat gets used to being in high numbers), usually the only way to break through the high numbers is by increasing the dose until a breakthrough is reached. Once the breakthrough happens, the cat may require a number of fast dose reductions. But just sitting on a dose that isn’t working, or reducing the dose, usually won’t cause a breakthrough and will just let the cat get even more used to high numbers. That is how a lot of cats end up on very high doses, then suddenly needing a lot of dose reductions.
Whoever suggested going down to 6 units might have been looking at the 39 he hit on 6.5 units. Sometimes reductions of 0.5 units work in higher dose cats so it was worth a try. He hasn’t gotten back to that range, though, so the reduction hasn’t stuck and he needs to go back up in dose to try to get back to green and get rid of red.
Personally, I also don’t see the logic in letting a ketone-prone cat sit in high numbers, I think you need to be more aggressive than some other people.
Have you thought about getting a Precision Xtra meter? It can check blood ketones and will alert you to potential problems earlier than a urine test (and might be easier than stalking the litterbox).
