? How long to hold dose? And other questions....

[Amanda and a Loudogg]

Hello all,
I will preface this by saying I'm getting rather exhausted from this marathon... It literally does not matter what I do, absolutely nothing is helping. I upped Lou's dose from 1.5 u to 1.75. I was sure we'd see some action (having seen barely any on the 1.5u) on the increased dose, but "shockingly" (sarcasm intended), I have seen absolutely nothing going on at the higher dose. It has been 3 days now, and today was the first day I could actually test during the day, and apparently the insulin only kept him level... no major decreases. Last night and today he has been completely ravenous... I can't seem to feed him enough, but I'm assuming it is also affecting his numbers.

I honestly feel like I need to up his dose again, but I have to admit to being utterly flabbergasted at how this guy could be regulated right out the gate, was soo close to remission, and now I CANNOT get him out of the *&#^$% yellows and pinks. So a couple of questions before I lose my cool (Don't mind me: I'm having a moment ):

1. Excepting the return of his FD symptoms (increased appetite, etc.), would it be wildly crazy of me to take him to the vet just to see if something is wrong? Nothing obvious is going on, but I feel like SOMETHING has to be causing his high numbers that no longer respond properly to insulin. I figured it wouldn't hurt to have her really check his teeth and give him an overall look to see if she can see something. It's a long shot, but I feel like I need to do something.
2. How long do I need to hold this 1.75 dose? I understand why we backtracked originally, but we're right back to the previous problem of him spending far too much time at these high numbers. I don't want to jump the gun, but I am getting leery of staying at a dose that doesn't seem to work.

Any thoughts would be greatly appreciated at this time. Thanks in advance.

 

[Yong & Maury GA]

First, for you!
1. I don't think it would be crazy to see if there's something up with him causing him to stay in yellow and pink, especially like you said, when he was so close to remission.
2. Usually, doses are held a minimum of 3 cycles when increasing but that's usually with higher than pinks and barely seeing yellow around nadirs. You could try holding for 6 cycles before increasing by 0.25U. However, since ECID, some kitties do better with holding doses longer than 6 cycles so you have to figure out how Lou responds. I won't say any names of kitties that prefer longer held doses *cough* Maury *cough* .

Are you testing for ketones, weekly? When Maury holds higher numbers than I got used to seeing, I make sure to get an extra ketone test. Getting a weekly one can be a struggle sometimes. Little stinker seems to hold it until I walk away lol .

 

[Amanda and a Loudogg]

No, I haven't started testing for ketones yet. I haven't been able to find any at a decent price online and I haven't found any locally. I wanted the ones that give you both glucose and ketones on the strips (Keto-diastix?), but they seemed about double the price than I was advised they would be. I was also looking into getting a blood ketone testing device, but then I got distracted by Lou's insulin dose reset.

 

[Amanda and a Loudogg]

Well, I decided to stay at the 1.75u dose today, and at least got a blue value. Of course since it was 190, I'm going to assume that he needs a dose increase. He's been at this dose for 4 full days (9 cycles), so I'm guessing it will be safe to increase. I didn't want to start that tonight just in case, so I'll increase to 2.00 units tomorrow. Tonight's cycle was a wash anyway it seems, so we'll start fresh tomorrow...