To know the road ahead, ask the man coming back.
What you are feeling is perfectly natural; it's something that everyone here has felt at least once.
You need to step back and look at the protocol and the reasoning behind it, plus you need to look to the cat and see how Blackie is doing, because it's NOT all about the numbers. It is for that reason you see people posting the WCR:
Now, what you are doing is searching for Blackie's perfect dose, in baby steps. If you go too quickly with the dose, you are most likely going to jump WAY over Blackie's perfect dose.
The protocol says when to increase, and most times after holding for 6 cycles because some kitties wait till that last 6th shot to give you a better number. Sometimes I have to wait even longer for Oliver like 8 or 10 shots before he 'decides' to give me a better number. He takes his time with everything!
Always keep the shed in mind - you have to fill that bucket before you can tell if the dose is fitting. Right now, you are at still a low dose, so just stick to the plan and watch for the improvements in Blackie. There are some kitties who are nicely regulated at higher doses, so it's that slow slow slow climb up the dosing ladder that can get you down, but ONLY if you let it!
As for never getting regulated, you need to keep in mind that Blackie did not become a diabetic overnight or in a couple months, so just like losing weight, you need to give it time.
The time will depend on the kitty and Mr. Liver and Mr. Pancreas, and not the length of time on insulin.
You are doing a great job and I am sure the Blackie feels the same way.
Don't worry; you'll get Blackie regulated and who knows, maybe even right off insulin!
If you were to look at Randi/Max and see how they were and how they are now, maybe it will help you a bit. Max got up to a high dose around 6.75u or something,
then started coming down and is now OTJ.
As a reminder of the protocol to know if you are increasing correctly:
"General" Guidelines:
--- Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).
--- Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).
--- Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Reducing the dose...
--- If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
--- If an attempted reduction fails, go right back up to the last good dose.
--- Try to go from 0.25u to 0.1u before stopping insulin completely.
Random Notes...
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.
A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.
Sometimes a dose will need to be "fine tuned" by adding some "fat" or "skinny-ing up" the dose.
There are some circumstances such as ketones present, an unusually low preshot number, a caregiver leaving the cat with a sitter, relatively high flat curves, loss of appetite, infection, a schedule change, ability to monitor, etc. which may call for adjustments to these guidelines.
I know that she's been on the Lantus since July 25th, and this does take time, at least many months, to get a cat regulated. I'm beginning to feel the same way that hubby does, although I'm trying to keep the hope up that she will become regulated. Eventually. I'm seeing a pattern when I increase her dosage, the first day usually is the best one, and then she gets wonky #'s again, and then she's back in the pinks, and doesn't seem to want to let go. Am I increasing too quickly? I'm going according to the protocol, however, I'm thinking I may need to give her at least 2 more days for her body to become adjusted to the insulin increases. I don't know. I'm feeling discouraged. That's all I know.
