? AMPS: 375, +6 382, +9 352, 1.5Ul for Benny’s Dinnertime Dose?

[KatieL09797]

Hello again everyone, some updates on Benny and a question for tonight’s dosage.

This past Saturday my patience ran out for our specialists recommendation of 3Ul so I decided to start titrating Benny’s dosage down by .5Ul. Most of Saturday, Benny was zoned out, sleeping all day, very out of character for himself. Throughout the day he was testing from the high 300’s to the high 500’s. That night we gave him 2.5Ul. This was also his first day full on Fancy Feast Gourmet Naturals.

On Sunday, he was showing much better signs. Meowing for his breakfast, his eyes were brighter, and he was just so much more engaged throughout the day. I finally felt like I did something right so Sunday morning we titrated down further to 2.0Ul. His numbers were also soo much better than they have ever been, in the 100’s! Of course I worry about Somogyi but his behavior just felt so much more like himself all day.

This morning, Benny was still engaged but he usually is eager for breakfast. His numbers were back in the 300’s this morning and have been throughout the day. He has also been sleepy for most of the day. It feels like we are going back to his symptoms from the past couple of days.

Because of his behavior and his numbers today, I’m wondering if we should continue titrating down and try 1.5Ul tonight?

 

[Christie & Maverick]

Hi Katie- I think this is your last post, just linking for continuity. ? - Back in the 600's

What you may be seeing with the lower blood glucose is some benefit from the change to low carb food, and then because he’s not used to being in the lower blues, he bounces. Wendy posted some good info on that topic in your last post. Typically with long acting insulins like Lantus, you want to try and hold a dose for several days to allow the depot to build and in order to see what the dose can do.

While I understand perhaps your inclination to reduce from 3u, since the jump up from 2u to 3u would be more than what we would suggest here on the forum, I think I’d like to see how he does with 2u. It looks like he’s coming down a bit already from the pinks, so that could mean bounce breaking into tonight’s cycle from the blues yesterday.

**I see you’ve reduced to 1.5u, sorry I didn’t catch you in time.

 

[Wendy&Neko]

Have you managed to get a ketones test in today? You be testing daily (and recording results on the spreadsheet). Ketones can go from trace to high quite quickly. I get concerned when I see the words lethargic and high BG numbers and lowered dose in a cat so recently DKA. How is his appetite? Eating lots? A cat just out of DKA should be getting 1.5 times his normal calories. And that should include a second meal after the PM shot, maybe just before you go to bed?

With his history of DKA, I'd wait for his blood sugar numbers to prove his dose is too high, rather than anticipating that it might be.

Side note, Somogyi is not a thing. The original Somogyi study was done a long time ago, on humans, with fast acting insulins. And the study didn't even get published. For some reason the idea was transferred over to cats. There has since been research at U of Queensland showing that it doesn't exist for cats on gentle insulins (like Lantus) where cats are home blood tested and increases are done slowly as per TR.