Cassie 9/16-17 -- TID -- dose advice, please!

Status
Not open for further replies.
bookw0rm

bookw0rm

Very Active Member
9/15 AMPS 441, .6u (+8)
MDPS 409, .6u (+8)
PMPS 442, .6u (+8)
+5 300
9/16 AMPS 469, .6u (+8)

We've been at the increased dose of .6u tid for almost a week now, and the numbers are getting worse. Here's average numbers:
For .4 u: AMPS 382, +5 239, MDPS 334,5, +5 270.75, PMPS 355.3, +5 333
For .6 u: AMPS 405, +5 352, MDPS 404.6, +5 293.33, PMPS 423, +5 361.5

Keep in mind I didn't +5 for every cycle--this is the average of the numbers I did have.
Overall, .4 PS 357, +5 281; .6 PS 411, +5 336

Obviously he was getting better numbers overall with .4. I increased because he'd gone into higher numbers and wasn't coming back down. I know .6 isn't working. The question is, do I go up, or back down? I have yet to find a "good" dose for Cass. He does have a clean bill of health right now. They never did any invasive testing, which, from what I understand, is the only way to definitively diagnose things like pancreaitis, IBD, etc, but from the tests they did when he was DKA, they saw no signs of anything other than a UTI that's cleaned up. I don't know why .4 stopped working, and I don't know whether to increase or decrease.

He is currently eating EVO dry. He wouldn't eat wet at all after the DKA and I figured this was a better option than than the high carb dry he was eating before. There have been no signs of ketones since he came home. The vet says he's a "brittle diabetic" who may never be regulated--but I'm not ready to give up yet. I won't make any changes until I get a full curve on him at .6 (either tonight or tomorrow), but I need to do something this weekend. SS is up-to-date. Suggestions?
 
Re: Cassie 9/16 -- TID -- dose advice, please!

Brittle Diabetic???? If there is such a thing, throw my Kitty in that group! She had DKA, has Pancreatits, arthritic and who knows what else. It took me 5 months of trial and error (mostly error) to get her in any numbers that were respectable. My vet had given me the talk...insulin resistance..might never be able to help her. And, you know what--I do think she is insulin resistant to some extent--but, after 7 months she finally has settled down and remains pretty much in a constant acceptable area. My goals for Kitty are not as lofty as some people's, simply because Kitty is 16 years old and her "long term" probably isn't as "long term" as most cats here. But, it took a lot of time, testing, and patience to find a dosing pattern that would work.

Okay...so, I don't think there is anything to a "Brittle Diabetic" that can be regulated to some extent!

I would reduce to .5 and see what happens. BE SURE to continue to check for ketones. One of the biggest players in DKA is insufficient insulin supply. So, anytime you have a cat that is prone to having ketones, you must be very careful when reducing insulin. TEST, TEST, TEST! If the .5 doesn't give you some decent numbers, then you can begin to increase. If you don't try the .5 and begin increasing with poor results, you will always have the .5 in the back of your mind. So--I would give the .5 a shot.

Truly, I don't blame you for continuing to feed the dry if that is all Cassie will eat. But, as long as the dry is in the picture it will remain hard to achieve regulation.

Good Luck! Don't Give Up!
 
Re: Cassie 9/16 -- TID -- dose advice, please!

kse said:
Truly, I don't blame you for continuing to feed the dry if that is all Cassie will eat. But, as long as the dry is in the picture it will remain hard to achieve regulation.

Good Luck! Don't Give Up!
Click to expand...

I realize that there may be problems with the dry. I was hoping to get him somewhat stable (and back up to a good weight) before I start tinkering with his food again. I'm not planning on giving up--Cass is my "baby" of 11. (His brother is 13). I should have at least a couple of good years left with him.

I will probably go to the .5 next, just to see. Like I said, I want to get a curve on the .6 to see if anything's going on I've missed. Of course, sometimes I wonder if I should just chuck it all and go back to 1 u bid for a while.
 
Re: Cassie 9/16 -- TID -- dose advice, please!

Looking at both ss's Cassie did better on the lower doses around .4u for both bid and tid. I would try the lower dose and see what happens, test for ketones daily.
 
Re: Cassie 9/16 -- TID -- dose advice, please!

Mdpd 385, .6u (+8)
+2 385

Got my postal scale. Now I need to figure out how to get the boys to hold still while they're weighed... First attempt says Cass was 10 lb 9 oz, but that's over half a pound more than the vet said Tues, so I need to try again. May have to resort to locking them in the carrier.
 
Re: Cassie 9/16 -- TID -- dose advice, please!

Lisa,
Sorry, after getting up at 4:30 this morning, I'm finding there are too many kitties and numbers to keep track of! Just refresh my brain...
When you decided to go with TID vs. BID, was that due to concern that the insulin wasn't lasting 12 hours?

Carl
 
Re: Cassie 9/16 -- TID -- dose advice, please!

+4 371

Figures. I decided to do a curve & it's one of his flat ones.

Carl: yes, I went tid because he'd nadir at +5 and then shoot up higher.than he started if I waited the full 12 hours. When we went tid, his #s went down & stayed there for about 4 days. He had ps's under 300. He threw a wonky low at +8 one night, and wrnt back up in the 350-475 range and I can't get him.down.
 
Re: Cassie 9/16 -- TID -- dose advice, please!

flat is okay. all numbers tell us something....we just have to figure out what they are trying to tell us.
carl
 
Re: Cassie 9/16 -- TID -- dose advice, please!

OK, so he apparently is feeling like it's Flat Friday....

hmmmm
 
Re: Cassie 9/16 -- TID -- dose advice, please!

Actually, he tends to have flat cycles in the afternoon & evening. The onlu really good drops he's had (none lately) have been in the morning. I probably should have waited to do the.curve-this was the first chance since going to .6u.

Pmps 335, .6u (+8)
 
Re: Cassie 9/16 -- TID -- dose advice, please!

Amps 323, .6u (+8)

I am planning to change doses tomorrow, so he throws two decent preshots in a row--after a high flat cycle. Guess we'll see how today plays out before deciding.
 
Not bad---TID curves are normally a little flat. Let's hope he hangs out in this range for 3 more hours and gives you another good preshot!
 
Okay, I agree I was hoping for a yellow or low pink---but, still not bad. Remember the Reds!
 
And this is why it is very helpful to have someone who's been doing the TID dance for a while like Kim has. I would have hoped for a bigger curve, but Kim has experienced flatter curves being the "norm" with TID, and that is terrific knowledge to have within the group! Now, how to get the flatter curve "lower" overall? Maybe I should look at kitty's TID more closely. Was/is Wendy dancing TID too? I'm looking for as many as possible other TID sources to get clues from....
Carl
 
Nancy and Payne dose TID, BUT Payne is even more complex than Kitty. But, from her SS it appears they too experience flat curves.

I need to update Kitty's SS....she has had a good couple of days with preshots in the mid 200s. I will update it shortly to give you another source to reference.
 
From my understanding of what "brittle diabetic" means Cassie doesn't fit that profile.
My grandpa was termed a brittle diabetic by his doctor and the way it was described to us was someone who had had uncontrolled diabetes for a long time that was not regulated and had wide swings from high to low numbers.
 
Pmps 366, .6u (+8)

So should I drop to .5u tomorrow or stay at .6 longer? Been at this dose a week, & did better at .4, at least at first. I can monitor closely tomorrow but not necessarily during the week.
 
Try it if you want too. There is nothing to lose, you can always go back to .6 if you don't like the results.

Today's preshots haven't looked bad.
 
Status
Not open for further replies.
Back
Top