dose advice Does Mouse need an increase?

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Mouse & Me

Mouse & Me

Member Since 2016
If an increase is called for, how much? fat3.5? 3.75? 4.0?
Her numbers are high, but she is getting a definite Nadir, which moves...last three days, it was +10, then +8, today, +6.
 
Hello and welcome. Can you tell me a little bit about you and Mouse. Which method are you following for dosing, Tight Regulation Protocol or the Start Low Go Slow Method? Our answers about dosing depends on how you answer that. It'll help us help you if you have that answer (TR or SLGS) in your signature block.

It looks like Mouse likes to bounce, as do most newish cats. One thing I'll note is that you were a little quick to increase here to 3.5 units on March 10th. She had gotten down to 60 on the AT on the night of the 7th. Bounces can take up to 6 cycles to resolve, so I would have held the dose at 3.25 units for at least another day. However, since you did increase, I would keep holding the current dose since she is getting numbers in the 70's at this dose.
 
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She's on tight regulation, I wasn't doing it right, because I completely misunderstood how it works. The vet was doing the SLGS method, having us bring her in once a week for testing. We had to bring her in at the 6th our, even though her Nadir was later in the day. At that time, I didn't even know what Nadir was! Nothing was explained to me, but we were slowly trying to understand what to do. I asked about home testing, and it wasn't encouraged....sigh....and this vet was better than another one I went to. My now deceased cat was diagnosed, given insulin, and they sent her home. We witnessed a horrendous hypo episode, and she died in terror. I will never forgive them for their lax attitude that cost her her life.

now that we understand it better, we've been following the tight regulation it as closely as possible for the past three days.
We're waiting on bloodwork, to see if her Lyme numbers are down yet. She's been on several antibiotics because of the Lyme, tooth infection, five teeth extracted. Five days ago, we started azithromycin, and stopped four days ago, because she was VERY naseous. The other antibiotics messed her up, but this one was wicked. 24 hrs after stopping it, she woke me up at 5am, cuddles, purrs, loudly burped, ran off to the kitty litter box, (sloppy stools), then hid under the bed. She's finally over it. I'm hoping that the Lyme is gone enough that she doesn't need antibiotics again.
 
Hello and welcome Diane and Mouse

What a sad story about your other diabetic kitty:bighug::bighug::bighug:

Wendy&Neko said:
She had gotten down to 60 on the AT on the night of the 7th.
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I think that was with the relion, Diane notes on ss that she swapped from the AT on Jan 6.
Is that correct Diane?

If you have been using the relion for testing, on TR you would be taking reductions at 50. I notice you reduced reduction on 3/7 after that 61 on the am cycle, if using the relion, you would have held the dose at that point.

Coming back to the dose in question it does look like he needs more juice, but a couple of things have me questioning. The only thing that makes me a little nervous and hesitant about the increase, is that there are no tests last night not having any data on a cycle always makes me nervous as we have no idea what kitty got up to, did she break a bounce last night landing in green? She was about due to break last night.......
Another interesting cycle is the amps on 3/12, that 68/58 at amps has me wondering if that was nadir, or did he actually go lower and was the amps him on his way up?? He was dropping at +4 that night and its possible he nadired earlier in the cycle.

You are in general testing/monitoring closely, but I would encourage you to always get a test in that pm cycle, as I said that data 'hole' last night makes me nervous.

It does overall like Mouse needs more juice, so if you held today (am and pm) and didn't see any green, I think you could cautiously take Mouse up to 3.75.

I'll be interested in Wendy's / or other thoughts on the dose.
 
I did a test at 1am....256. She seemed to be hanging around the mid 200's, with the occasional 300+ thrown in just to make things frustrating, and only one low number. Her past testing always yielded two or more low numbers. She is breaking routine.

You said,"Another interesting cycle is the amps on 3/12, that 68/58 at amps has me wondering if that was nadir, or did he actually go lower and was the amps him on his way up?? He was dropping at +4 that night and its possible he nadired earlier in the cycle."
That worried me also. the only saving grace, was that the test was in the morning, and I could watch her later, closely. It's hard to tell when she swings into low numbers during the night. First, low in morning, then low at night. never both, never consistent.
I have stayed up all night in the past, like on the 7th, when I got low numbers, (I was just going by gut instincts), but I don't see signs of that happening lately.
You said:
"You are in general testing/monitoring closely, but I would encourage you to always get a test in that pm cycle, as I said that data 'hole' last night makes me nervous."
I always do a test at bedtime, but I forgot to enter it into the chart. I would have tested more, but the numbers seemed to hover around mid 200's, and, her ear started to scar. Never had that problem before. So, I'm applying Neosporin to her ears, and testing late afternoon, and once or twice at night. If I got a sudden change in the numbers, I would keep testing.
I think that the antibiotic was helping, but it made her so sick that I was filling her up with pepcid (1/4 tablet), and appetite stimulant pill twice a day. She hid under the bed all the time, except to run to the litter box. the other three antibiotics were nothing compared to this one. I'm almost hoping that her Lyme number will still be high, so I can justify making her sick, to make her better.....
 
I'm just about to dash out to !Y yoga class, I'll get back to you a little later.

Just wanted to say that with that one test you forgot to enter, eases my mind d that she didn't drop that night. Funny how that one test makes all the difference, I did wonder if you had forgotten to enter it, as you have been always getting tests in the evening, so seemed a bit odd.
:bighug::bighug::bighug:
 
Just seen you update SS, nice blue:cool:. Looks like the bounce may be clearing, I wonder if she will drop onto green for you by pmps.....or if she's on her way up now, and this is the start of a new bounce(she may have already seen green, the rest of the cycle will give you some clues)???

Depending on how this cycle (and tonight's) plays out, it may be advisable to hold at 3.5.
 
If it were my kitty, I'd probably hold the current dose. The 3.5u is bringing Mouse's numbers as low as 55. That doesn't give you much room to increase. I'd be curious to see how the numbers look.

Just an observation about the antibiotic and nausea... Rather than using Pepsid which may help with an upset stomach, if your kitty is nauseous, getting a prescription for either Cerenia or ondansatron (Zofran), will help to control the nausea. You don't want to give an appetite stimulant to a cat (or person, for that matter) who's nauseous or vomiting until those symptoms are under control. Giving an appetite stimulant if the nausea isn't improved is a great way to cause a food aversion.
 
As usual, Mouse is making my questioning her dosage moot. Not complaining!
Still learning when to change dose, but I think at this moment, I'm staying at 3.5?

Gut feeling says she is shifting to a lower range, but could be changing for a few more days, so best to sit it out & wait, as long as there isn't a severe change
 
I agree, I would stick with 3.5 units for now. It'll be interesting to see where she goes tonight. Gill got it right, that bounce is clearing.:cool: If she goes below 50 (since you are using a human meter), then I would reduce to 3.25 units. Otherwise stick at this dose a while as she's getting some good nadirs, unless she starts to trend up.
Diane Beem said:
Gut feeling says she is shifting to a lower range,
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It could be. If she's starting to feel better, her numbers may go lower. Infection or inflammation, or even just plain old constipation can increase blood sugar numbers. Solving those problems can help. For example, often kitties will start seeing better numbers after a dental, if bad teeth are removed.
 
Gill & George said:
Just seen you update SS, nice blue:cool:. Looks like the bounce may be clearing, I wonder if she will drop onto green for you by pmps.....or if she's on her way up now, and this is the start of a new bounce(she may have already seen green, the rest of the cycle will give you some clues)???

Depending on how this cycle (and tonight's) plays out, it may be advisable to hold at 3.5.
Click to expand...

well....as usual, Mouse confounds. She went up after PMPS, but, she did eat a little extra at 8pm. I'll be up awhile, and check numbers so I can sleep peacefully
 
Sienne and Gabby (GA) said:
If it were my kitty, I'd probably hold the current dose. The 3.5u is bringing Mouse's numbers as low as 55. That doesn't give you much room to increase. I'd be curious to see how the numbers look.

Just an observation about the antibiotic and nausea... Rather than using Pepsid which may help with an upset stomach, if your kitty is nauseous, getting a prescription for either Cerenia or ondansatron (Zofran), will help to control the nausea. You don't want to give an appetite stimulant to a cat (or person, for that matter) who's nauseous or vomiting until those symptoms are under control. Giving an appetite stimulant if the nausea isn't improved is a great way to cause a food aversion.
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She hasn't vomited yet, ( just laid in one position, stomach gurgling, "vurps", etc. Her & her brother always had tummy troubles, so I had to give them small meals throughout the day. I think it was all the dry food they had at the shelter, and transitioning off, (for years!), which made them bloat. Now, I think their stomachs are sensitive because of all the bad dry food years.

I'll ask the vet for the medication you recommended, I should get a call with the blood results tomorrow.

I only gave the appetite pill because she wasn't eating anything while on the antibiotics. She didn't get enough nutrition with syringe feeding, which just panicked her more & made her upset. Mouse lives up to her name....scared little mouse. If she were human, I'd offer chocolate to bring the anxiety levels down!
I left her alone, under the bed, and let the pill do it's work, and never forced food on her. I didn't know what else to do.
 
You might want to try some probiotics for Mouse. Strong antibiotics can kill tummy flora and make them feel nauseous. Give the probiotics and antibiotics at least two hours apart.
 
Gill & George said:
Just seen you update SS, nice blue:cool:. Looks like the bounce may be clearing, I wonder if she will drop onto green for you by pmps.....or if she's on her way up now, and this is the start of a new bounce(she may have already seen green, the rest of the cycle will give you some clues)???

Depending on how this cycle (and tonight's) plays out, it may be advisable to hold at 3.5.
Click to expand...

wow, today she's back on the high numbers. Oh well, I won't have to stay up tonight monitoring her, just as well, bad TMJ episode going through
 
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