Dose Finding Marathon Part 8

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Kris & Teasel

Kris & Teasel

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AMPS was 22.7 and gave 2.8 u just now.

I have Teasel's SS open and I think I see some patterns:
  • The data on 8/03, 8/08, 8/12 and 8/16 were generated before I was following the FDMB protocol. The BGs on 8/03 were from a BG curve I did for my vet and the rest are from my random checks. I have no AMPS or PMPS data from those days. He dips too low at +4 on 8/16 but most of the other numbers are good with little to no bouncing going on. I think he was used to the low numbers and was responding well to that dose. I think it was high enough and held steadily enough for him to respond well.
  • I've been tinkering with doses since then and went through doses that were a bit too low until I reached 2.6 u. That dose gave lovely numbers on 8/23 but I lowered it because of a low PMPS, probably too much, and he's been bouncing and/or staying high since then, even at 2.8 u.
  • I have enough BG curve data from his pre-FDMB 6 months and the recent 10 days to know that he'll start by responding to a higher dose -----> lower BG numbers -----> bouncing -----> chronic bouncing -----> high BG over time -----> insulin resistance -----> dose that was good previously no longer works -----> bigger dose increase -----> good numbers are sustained (like this month) -----> insulin sensitivity returns -----> some BGs are too low -----> dose reduced -----> bouncing -----> loss of insulin sensitivity. As they say, lather, rinse, repeat ...
If anyone would care to comment I welcome the feedback.
 
I think that makes sense and is a great analysis, Kris. It is frustrating with ProZinc because every cat is truly different in the way it responds to the insulin. Some are fine with a sliding scale; some need a more consistent dose. A big part of this dance is figuring out the pattern your cat has and using it to your advantage. Great job!
 
BG at +6 is 18.4. I think he'll stay high at this dose for the reasons outlined above. I'll think about giving him 3.0 u tonight. Something tells me that I'm going to end up back at or near 3.6 u and will have to stay there for quite a while. Before I came here he was at 3.6 u for 3 weeks non-stop. I wasn't doing AMPS or PMPS so I had no clue what those numbers were - ie., shooting blindly. He was behaving normally so I kept on and we finally were (luckily) getting somewhere. However, I'm not comfortable going back to that way of doing things. What might have to happen, though, is that I'll have to do some "close to the bone" shooting and steer him with food once we're back at an effective dose. I think he's telling me that too much fiddling with doses doesn't work well for him.
 
PMPS is 20.0 so he'll get 3.0 u tonight. He's had 4 cycles of 2.8 u and hasn't spent much time out of pink. The more he sits there, the more his insulin resistance grows - I've been down this road before ...
 
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