Missy 08/31

[Maresydotes]

I increased Missy to 6 units 9 cycles ago. It is looking like she is responding to it. I think I will do a curve tomorrow to see where she is at. She looks like she is doing a little bouncing, but not nearly as severe as she was before. I may have to consider, seriously, dropping her down in dose if that continues to happen. It is so nice to see some blues....but I am not totally unhappy with her low yellows. They are much nicer than those ugly blacks.
Hope everyone has a safe and fun long weekend!

 

[Sheila & Beau GA & Jeddie GA]

Last night might have been a little bounce (Thurs), but I would hold this dose a few more days at least. A curve tomorrow would be good. She did have a nice lower PS after the small bounce last night, so she is still adjusting to this dose and still coming down a little at a time.

It is not unheard of for some cats to need more than the 3-5 days that is bandied about. Jeddie took 10-14 days to settle. I always think that 5-7 days is a good settle time.

 

[Maresydotes]

Thanks, Sheila.....i think that is good advice. She is bouncing today. :cry: Her +2 was 410!! Dang it, she was looking pretty fine on this dose. I will wait out the bounce and she how she does. Not sure if doing a curve today will yeid any useful information. She gets kind of irritated by the end of the curve, poor girl. I guess I will do as much as she will let me. I can tell she doesn't like these numbers....she's upstairs instead of outside. :cry:
I wonder if I should seriously entertain dropping her dose down, as the vet suggested, since she is bouncing on this dose and this insulin. She has seemed to be a bit more moderate in her numbers on Lev, but this is the first 400. I didn't drop her way down when I switched her over because we had a houseguest and I couldn't check her as often as needed. but maybe I should consider it now.
Does anybody have any thoughts on that?

 

[Sheila & Beau GA & Jeddie GA]

Well, it really hard to say how she will respond to a much lower dose. I didn't see today's numbers in her SS, did she stay high all day?

It isn't unusual to bounce a bit on a small dose increase, although that usually happens on the first few cycles not after 4 days.

The one thing I notice, and I don't know what difference it might make, is that each time you have started insulin, it has been at "high" dose - as starting doses should be 1u bid, even .5u bid, not 3u. And cat's aren't dose by weight, but I am sure that was the factor that led the vet to tell you to start at 3u. What is her current weight?

Has she been ketone prone? If not, then it should be safe to start at a lower dose and test for ketones.

My other thought is that, since she is so big maybe you are shooting into a fat pad and it just doesn't absorb well. I don't recall that being mentioned anywhere here over my years on the board so I am not sure what you do about that.

I'm rambling here (I know :roll: )... another thought is to decrease her dose by .5u every 5 days and see if her numbers start to improve or not. It's harder to slowly go down than "start over" at a lower dose, I think, but it might work. And if you did start over, I think you need to get below 3u bid. Otherwise, there are a bunch of doses below 3u that you will never know if they would work better or not.

 

[Maresydotes]

Hi Sheila,
She has been high all day, so far. In the 300s but down to 299 at +8. I have been trying to be careful of my technique in injecting, because I have been thinking about that, also. I wondered if the way I shoot could be part of the problem.
Because she is so heavy (haven't weighed her in a while) she doesn't have a lot of loose skin. But I will bring her skin up and make sure that I am not injecting in to fat. It isn't the 'tenting' technique, but the way I learned to do my own sub-q injections. I guess maybe it is a modified tenting.
Yes, I know, in retrospect, that my vet may have started her on too high a dose. She did use weight as part of her decision to start her at that dose.
I don't know if you would consider Missy 'ketone-prone' or not. She hasn't exhibited them ever, even when she was first dx'd. The only time I have ever seen evidence of ketones was in Dec. 2011, when I went down to 1 unit of Lantus. She showed ketones pretty quickly after dropping her down. Took a few days with increased insulin and extra fluids to get he back to the normal range. I was using a meter, though, to check them, not ketostix, and I have since run into people who think the meter gives false positives. But, she did give me positive reading for ketones for a couple days after they first showed up.
I have thought of doing the gradual reductions, too, but I have heard it is more difficult to find the sweet spot using that method.
I am really happy to hear anyone's input. (and ramblings, too.....I have a tendency towards rambling, too :smile: ) I might not always take the advice, but I think it is good to hear other opinions, thoughts and ideas. Nobody knows everything....I certainly don't when it comes to FD. So, I want to remain open to any and all thoughts. Missy has been an enigma since last August. She defies all the 'rules'. I cannot get her figured out and neither have the vets been able to. So, ramble on, please, and maybe we can strike on whatever it is that she needs to get regulated.
Thanks a lot!