How about starting over?

I'm wondering if I flew past the best dose, so I am asking if I should start over and how to get there from where we are.

When Newman was dx, the vet wanted him on Vetsulin 3u bid, recommending testing once a day at no specific time. From past experience with Unkie(GA) I knew that dose was too large, so he agreed that I start at 2u. In fact, I started with 1u bid. He did not mention food changes, but I stopped all dry food almost overnight to wet Fancy Feast Pate.

Because I did not test enough, mostly I just tracked dosage time and amounts. Here's some history from the start. Dosing bid, 1 unit for 10 days, increase to 1.5u for 10 days, increase to 2u for 8 days noted spot check 355 at +2 , increase to 2.5u for 5 days. At that dose, a spot check 147 at +2, 69 at +3 fed Friskies with gravy. Next check 91 at +4 and 152 at +4.5. That scared me so I dropped back to 2u and held that for over 20 days. I got back up to 2.5u and the numbers I do have were all over the place. At that point a friend suggested I switch to ProZinc as it was a more gentle insulin and perhaps I would not see such erratic numbers. I took that advice and started PZI at 1.5. I recently downloaded the spreadsheet and started it with the PZI data.

Two things make me want to start over. First, I didn't factor in the switch to all wet food, food change and Vetsulin simultaneously.

Secondly, lack of testing data. I don't have an idea the true impact of dose increases.

I was finally testing pre-shot, with spot checks, perhaps not choosing the best time for those. I have been treating him for over 5 months with little to no progress. Is he bouncing around?

Sorry, I tend to be long winded as they say. I feel as though I am just keeping my head above water, floundering and not making much progress with sweet Newman.

 

Any way to explain the low BGs for 3/25 PM? Like vomiting?
If you ca't explain then I agree with starting over.

 

Hi Larry. No there was no vomiting.

 

Starting over is usually not a good idea and just wastes time. And in some kitties it can add the complication of ketones. I agree that 2.5 units maybe too much, but I wouldn't go back to 1.0 units. You are at 2.25 units now, that's a good place to start. Would it be possible for you to get a few more tests the next couple days to evaluate this dose properly? That means the two preshot tests plus at least one other test in the AM and PM cycles to see what is happening on that dose. Many cats go lower at night. Getting a before bed test can be really illuminating.

Did you skip insulin last night? The units column is blank. I'm also not sure how to read the multiple lines for yesterday in the spreadsheet.

 

Thanks Wendy. You are right, I didn't enter the insulin dose last night. I gave him 2.25 units.

I wasn't sure how to make the test entries yesterday since I did not give the insulin based on the 104 result. His AMPS was 104 then after eating he tested 228, I was not sure what to shoot so I waited another hour and tested he was 417. I shot 2.25 units. What would be the best way to make those entries? I love having the visual of the spreadsheet, but I am still learning how to use it.

I can probably get some extra tests. What point in each cycle do you suggest?

I just looked back at my log. Did you see that I had done 20 days on the 2.25 units? Or, maybe I entered that incorrectly also.

Sorry for the delayed response. I had an appointment this afternoon.

 

You can put the 417 in the AMPS unit column, cause that's what it was when you shot. If it was about 1.5 hours after usual time (?) you'd put 417@+13.5 to show it was 1.5 hours late. In the +11 column from the previous night, you can put 104@+12, 228@+12.5 or however much later it was. That shows us you stalled and by how much.

As for time to test, how long after the PM shot time do you go to bed? If it's a few hours after shot time, that's a good time to test to see if he's dropping at night.

I did see you were on 2.25 units before hand. The reason I'd suggesting dropping back to there is that 104. With SLGS dosing method, you drop the dose by 0.25 units if you see a number under 90. I suspect that he might have gone lower than that 104 overnight. You could try 2.5 units again, but you'd have to step up the testing to see if he's going lower on that dose.

 

Okay, I think I got those numbers posted correctly. Thanks.

I'll stay with 2.25 units and try to get more testing done.