Thanks for explaining all of that. Just an fyi, some cats are so carb sensitive that even 3 pieces of dry food can raise their blood sugar by hundreds of points, and it can last that way for another day or so. We've had people do little experiments, or caught their cat eating dry food, and reported on it. I don't know if that's the case with Leda, and I don't know the carb value of that particular dry food, but it's a possibility that is increasing his blood sugar.
At this point, I don't think that's a bad thing because of the size of the dose. If you reduce the dry food, his insulin needs may decrease.
Did the vet ever keep Leda there, test before giving the NPH and then test every few hours after that? Was that how he got the idea for the 3u dose? Do you know how that was decided on?
Can you insert a line on the spreadsheet, just above May 9th, and put something noticeable in there that says "NPH above this line, Lantus below" please? That will help clarify things. The spreadsheet is an invaluable tool in helping see what's going on.
The reason this isn't an obvious answer is because with diabetic cats, there are multiple factors that can cause high blood sugar. Even one lower number can increase a cat's blood sugar for as many as 3 days after the lower number. That's the most common situation. There is a description of this - which we call bouncing - in the second post
here.
If you were starting out from scratch, we would talk about 2 options for his starting dose. We have 2 dosing choices for using Lantus or Lev with a diabetic cat. One is the
Tight Regulation Protocol, which requires that he not be eating any dry food. The other is the
Start Low Go Slow method, which is the only choice if he's eating dry food, even a few kibbles, on any kind of regular basis. I prefer the Tight Reg Protocol, personally, and think it is more flexible than the SLGS method, but we have people who follow both and like either one.
If you were starting with the Tight Reg, there is a weight-based formula which would result in a 10lb kitty starting on 1u of Lantus per shot. If you wanted to start with the SLGS, a kitty eating any dry food would begin with a 1u dose. We do take into consideration the doses on previous insulins, but I'm concerned that we really don't have enough information (test data) on the NPH to know whether 3u is a good dose or not.
Can you take a look at those two dosing guides that I linked above and see what you think would work best for your life?
