Day 3-Lowered dose-still in 300's

[katieroc]

Hi Everyone,

It’s Day 3 of the dose lowering (from 3.5 u to 1 u) for Rui to see if his high numbers will begin to go down. I haven’t seen any change as yet. Is it too soon to see a change? Numbers are still high and flat. I happened to wake up at 1:30 last night and tested him: 331 at +6.5.

--Could he be insulin resistant?
--Maybe he should try a different insulin?
--Should I increase his current dose?
--Hold the dose?
--Am I not getting the sequence right: I test, fed and then shoot (all in about 30 min)?
--He’s not losing weight even on a low carb diet (I mix Purina DM and Tikicat, 50/50)
--Should I have the vet test his thyroid again? (Did test on either 9-5 or 10-3)
--Recent test for pancreatitis-neg (test on 10-16)
--Recent urine culture-neg (test on 10-3)
--Had shot of Covenia(?) a week ago in the event he had an infection

I have the information about nadirs and how much to increase/decrease based on that number. Unfortunately, his nadir is basically the same as his AM/PM PS which leaves me totally and utterly confused, baffled and frankly, deeply down in the dumps. These consistent high numbers have to be doing damage.

He does need to have his teeth cleaned. Spoke to the vet a few days ago and I think she will do it even though his numbers have not come down.

His numbers have been consistently high for weeks. I’m giving him insulin, but the numbers are like he’s not being treated at all.

I’m using the AlphaTrak2 which I know gives higher numbers. Maybe I should use the OneTouch, but I frequently get errors when I test.

His spreadsheet is updated.

 

[Larry and Kitties]

I myself would try no insulin for a couple of cycles but I would wait for other input.
If no change then I would change insulins. If change of up or down I would have to reassess what to do.

 

[zzyzzx]

If the Purina D/M is dry food, the carbs are still too high. Try Wysong Epigen instead if you are feeding dry food.

 

[katieroc]

Thanks Larry, zzyzzx.

He's on DM canned food.

 

[KPassa]

I'm thinking the reduction simply failed. Something obviously happened around the end of September to cause his numbers to flat-line. From your SS notes, it looks like health-wise he's checked out okay and the vet gave him antibiotics just in case there was an undetected infection? Any chance he's getting into some dry food somewhere (perhaps a dog's food)? Another possibility is a high-dose condition, specifically acromegaly, which can cause these sudden fluctuations in BGs like you're seeing.

 

[katieroc]

Hi KPassa. No. No chance he's getting any dry food or people food. His pmps is the highest it's ever been tonight. 384. I guess the dose reduction didn't work. I'm going to have to raise the dose tonight I guess. I'll have to talk to the vet about next steps. This is very disappointing and disheartening. I'm just an at a loss of what to do.

 

[MOS]

Hi, I'm sorry that I can't offer any advice. I feel like I don't know anything anymore. But I wanted you to know your not alone in how you feel; it really is so very disheartening. Reading your last post felt like I was reading my own. My girl had her highest reading ever last night as well. It was 383 and that was with her highest dose of Lantus thus far; 4 units. She was diagnosed around the first of September. She had better readings last month with a lower dose! It's so confusing. I feel like I'm failing her. I know it has and is doing damage because my poor baby is walking on her wrists. I never realized their front leg would even bend to that extent! She has to hobble and it's horrible to look at. They're so pitiful when they're sick. I think I'll try a fresh bottle and, if that doesn't work, then ask to try a different kind of insulin.

 

[BJM]

You might try using the Tight Regulation protocol to guide dosing from this point onwards.

And I'm wondering if he developed antibodies to the Lantus; it can happen. Dose wise, you're not at the point where we typically recommend testing for the high dose conditions, but it is very clear something has changed, so it might be worth testing for high dose condition. Have a read here and see if anything matches with your observations.