Frodo - need advice on dosing.

[Ruth Ann and Frodo]

Trying to get Frodo on the right dose. Can someone look at our spreadsheet. Way too sparse on numbers early on, but now that we have the "ear-prick" going smoothly we can get more data. Frodo seems to have been running high from the start. Best numbers (and only a couple of them) were on 2 or 2.5 units bid. But still high, so we increased the dose. After a couple days on 4.0 bid it really looked crazy - higher after several hours than before the shot, and dropping to the pm shot. So we cut back to 2 bid. Still running high, but at least there appears to be a dip around 5-6 hours. I just don't know what to do - he's running so high that I hate to let the reading stay there, but taking more insulin just seemed to make things worse. Any thoughts? - Ruth Ann

He's eating raw and grain-free canned, but I haven't been trying to feed regular amounts or times. He's rather timid, and doesn't like to eat when the other cats are around. This often results in him not eating much for a couple of hours after the am shot. pm I try to get him to eat a good meal before we go to bed, and there's usually some raw siting out on ice.

 

[Rachel]

Hmmmm. It's hard to tell what to do, really. The thing is, without preshots on the those other doses, I'm not sure why the numbers are where they are. You could try going up to 2.5 maybe? Stick with that dose for a few cycles, get preshots and mid cycle numbers, and we can see if that changes things? It could help maybe since we'd see if he goes up on that does, or if he stays the same or goes down. Might help you see if going up is the right answer.

Are you testing for ketones? With those high numbers, it's really important to grab some ketone tests and make sure he isn't developing any.

Could you possibly feed him in a room by himself? Just as a solution to the not eating when the other cats are around.

 

[Elizabeth and Bertie]

2 or 2.5 units bid. But still high, so we increased the dose. After a couple days on 4.0 bid it really looked crazy - higher after several hours than before the shot, and dropping to the pm shot. So we cut back to 2 bid

Hi,

It is entirely possible that the current dose is too low. However, I'm not sure we've got enough data to say that for certain.
When there is only a little bit of data it's a bit like trying to look at the sky through a cardboard tube: You are seeing a partial image. And what is just beyond your field of view may change the picture entirely.

It would be good to see at least some PM tests (during the first half of that cycle) just to try to make sure that your kitty isn't actually dropping during the night and then bouncing high.
Do you feel able to do a few evening/night-time tests..?

If the PM tests show the same as the AM tests then, as Rachel suggests, an increase to 2.5 units could be a good idea.

(But this is just my point of view, see what others say also.)

And I also absolutely agree with Rachel that it would be wise to monitor your kitty's pee for ketones.

Eliz

 

[Grayson & Lu]

I think you're moving in the right direction. Good on getting more test numbers - they are more valuable than anything else you can do. Also, dropping back the dose. Though you don't have many numbers at the lower doses, I think the red/blacks are really suggesting the 4u was too much.

With the high numbers, it's REALLY important to test for ketones, as noted above. Bottle of Ketostix cost about $6-10 at Walmart or Walgreens. I always refer to them as the best little insurance policy in a bottle. Pay close attention to eating habits. If he starts to lose appetite, you need to be even more diligent about testing for ketones - DKA - diabetic keto-acidosis - is not a path you want to go down.

I used to set an alarm to get up overnight and test. I know it's a pain to do this, but numbers = knowledge. Some kitties' numbers are extremely different at night. This helps give a clearer picture. And it's not something you will necessarily have to do all the time.

Keep it up. I know sometimes it's frustrating, but it DOES get easier. Otherwise, I wouldn't be still doing it after 3+ years, 2 foster diabetics and 2 of my own.

Lu-Ann

 

[Ruth Ann and Frodo]

I think you're moving in the right direction. Good on getting more test numbers - they are more valuable than anything else you can do. Also, dropping back the dose. Though you don't have many numbers at the lower doses, I think the red/blacks are really suggesting the 4u was too much.
<snip>
Keep it up. I know sometimes it's frustrating, but it DOES get easier. Otherwise, I wouldn't be still doing it after 3+ years, 2 foster diabetics and 2 of my own.

Lu-Ann

OK, got some more test numbers, including a couple overnight. He dropped a little lower at 6 hour overnight than at 6 daytime, but unless he had a real dip at 5 hours (we didn't test at 5) it wasn't a whole lot different than daytime. I'm guessing that we should maybe just up the dosage a little, to 2.5 bid. But maybe we'll wait at least one more day at 2 bid. - Ruth Ann