Dose to high?

[Lynn & Rupert]

Hello, I upped Rupert's dose on 8/23 to 2.8 and he is still high at AMPS and PMPS. I was giving a Fat 2.6 before upping to 2.8. Is this maybe a little too much, or still not enough? He is always hungry and seems very stressed about that. I am only giving him 8 oz total for the day, 3 oz feedings at AMPS and PMPS, smaller feeding at +6. His weight has not changed since last weigh in. he is at 9 lbs 4 oz. I am trying not to get discouraged, but I hate seeing these high numbers still. I wish I could take him back to the vets, but I just can't afford that right now, Tuffy's unexpected problems ate up my $$ recently. Ketones still negative, pee amount high, but uses litter box with no problems, pooping fine, not too loose or hard, grooms, but does not play and avoids the other cats. Should I stick with present dose or adjust? Thank you!

 

[Sue and Oliver (GA)]

His numbers are frustrating, Lynn. But you started low and increased slowly, so I don't think trying lower is the answer. My guess is that he needs more insulin. My theory is there are two reasons for high pre shot numbers - a bounce or the insulin wears out. It can be that the insulin wears out because it just isn't lasting long enough in that cat, and he needs a different insulin. But the other reason it doesn't last is that the dose isn't high enough. I think that possibility is the one to explore. His mid cycle numbers are nice and let the pancreas heal and not low enough to cause a bounce. But he has been hanging out in those levels a long time and his body may have gotten used to them.

I'd get more aggressive to find a "break through" dose. Increase by 0.25 on a cycle when you can monitor. Hold that dose three cycles. If on the fourth cycle, you aren't seeing movement increase on the next cycle you can monitor. (The problem with the 3 cycle advice is that increasing in the day first usually leaves you on a night cycle for the next increase, so I'd plan on the next cycle that won't lose you sleep.)

We don't usually worry about high dose conditions or suggest a dose change until you get to 5 units. He's a ways from there. I am hoping the increase will make a difference. But I never argue with someone who wants to make an insulin change. I think the axiom that "the best insulin is the one that works for your cat is the best insulin" is so true.

Do you feel comfortable with that?

 

[Lynn & Rupert]

I do feel comfortable with that! It sounds like a good plan, I guess I get worried that it is something else causing the high numbers and I don't have the means to deal with that right now. I think the insulin is wearing off too soon, s0 mightswitch to Lantus, but not for awhile yet. I am aware you can't switch insulin's at will, so will seek advice when and if I do. I can monitor tomorrow, so I will try that increase of 0.25 then. Unfortunately I have to take him with me on a trip this weekend, which I know will stress him out, especially during the car ride, but it's less than a 2 hr drive. I wish I had someone to test and dose him at home, but there isn't anyone. I will pack all his stuff (hypo kit also) and hope for the best. With a dose increase, is it enough to test at +3 and +6? I can do more, but lately, Rupert is not liking his tests and I hate to stress him even more! Thanks for your help and great advice Sue!