Java - its been awhile and java is all wonky again!

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javasfambam

javasfambam

Member Since 2014
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Hi Guys

Its been awhile since ive been around...........im back and need some help.

Java was doing quite well on 4UBID, but his vet was concerned about symogi? He was swinging quite a bit, from blues up into pinks, with not a lot of regularity in his numbers. So she wanted us to drop him back to 3.5 BID and see how he reacted. He was fine for a couple of days, then went all wonky again.

So yes, i went off protocol, and now i want to start him back on it again but now at 4UBID he is looking wonky as anything, hungry and yowling all the time for us to feed him, not drinking a lot and generally other than the hunger he is a happy camper.

So................I should have stuck with what was working for him and not changed the insulin. Kicking myself now.

What do i do? Do i start back at 1.25 U (he's pushing 6kgs now!!) and feed him a little more until we get his numbers back under control? or do I increase from 4 to 4.25 and go from there?

Any help would be appreciated - im feeling lost (and a little silly for changing it up) :(

Charlene
 
Hi, Charlene.

If Java were my kitty, I'd definitely increase.

As for the big picture, here are my thoughts. First, I think you've been holding on to a dose for too long. If you are not seeing numbers in the normal range (50 - 120), then it's time for a dose increase. Usually, if a cat is in that normal zone, you hold the dose for 5 days/10 cycles. Otherwise, according to the TR protocol, if numbers are higher than 120, you increase after 3 days. When I'm referring to numbers, I'm talking about nadirs. If you hold on to a dose that isn't putting Java into a good range, you are risking the development of glucose toxicity. In other words, Java's body starts treating those numbers are the new "normal."

As for Somogyi, there is no research based evidence that suggests Somogyi exists. There was only one research paper that was published in 1938, it dealt with humans, and a long-acting insulin like Lantus was not the insulin being used. At present, the concept is considered at best, controversial. I've yet to see a cat where a vet has raised Somogyi as a possibility do better with a dose reduction. All that tends to happen is exactly what you noted -- numbers get worse.
 
Thanks Sienne - another question. Do you think that lowering his does has now popped him back a little in terms of progress? 4U was suiting him well previously, now 4U barely touches the sides!!
 
To my eye, I thought Java's numbers were just OK on 4.0u. While you were seeing some numbers in the blues, there were lots more in the yellows and pinks. If your goal is remission, you want to see Java spending as much time as possible in the 50 - 150 range. If your goal is more that Java is well regulated, then having the numbers below 220 (low yellows) is fine. A lot depends on what you're hoping to accomplish with regard to diabetes management.
 
Thanks Sienne - remission is what we would love to happen for Java! But i do wonder if as his insulin needs are so high whether that will ever be a possibility for him!

I'm going to play it safe and whip him up to 4.25 and get back on the protocol. :)
 
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