Need dosing advice- Recently changed with little results

[Leigh B]

Hello, All!
I have just updated Murphy's chart. Please note that around the end of September, I changed his dose. Unfortunately, at that exact time, his BG monitor had recording errors. I was monitoring him for a week or so, but not updating the chart every day (because the monitor records date & time, I sometimes go back and update several days at once). SO- I have his BG numbers, but the date and times are not correct.
I have gotten a new monitor, and have been diligent for the last few weeks.
During the time of the monitor error, his numbers range as follows 398, 138, 127, 181,476,374,510,389,359,396,452,452,325, 435, 410, 466, 391, 439, 276, 303, 248, 602, 385, 329, 199, 212, 309, 329, 409, 329, 431, 420, 404, 548, 401, 272, 514.
As you can see, with the exception of a few tests, he's still averaging 300-400's.
So, I reduced his dose from 2.5 to 2.25. The monitoring from there is accurate, but not much different. I lowered it again to see if that would make an obvious difference. (I was wondering if he was still getting more insulin than he needed, thus not showing much significant change??)
As you can see, he is at 2 units twice a day now. His numbers are more consistent than they've been in a long time. Unfortunately, they are too high.
I am wondering if I should go a little higher on his dose again, or possibly back off a bit to see what happens.
Is it possible he's still getting more than he needs, and his body is overcompensating with the higher BG numbers?
His demeanor, bathroom habits, etc. are all positive.
I stay confused by the lack of change in his numbers when I adjust his dose.
I feel like I have reached out on this thread often, but I just want to get my boy well.
Also, I HAVE tested for ketones, and little to none are detected.

Thank you!
Leigh

 

[MrWorfMen's Mom]

I'm so sorry that your post was not seen and responded to earlier. This is unusual for us but we've been a little thin on support here recently.

While I cannot comment on what is happening now with Murphy because the data on the spreadsheet is only up to the 29th of Oct., I notice that in the past there have been several instances where Murphy's BG has dropped too low and we would have advised you to decrease the dose immediately. This makes me wonder if you are in fact seeing high numbers due to too much insulin and not seeing what might be dangerous drops into low numbers occurring possibly on the days you have not done any mid cycle testing or during night hours.

I would encourage you to continue testing for ketones and note that any reading above trace using ketostix is cause for a vet consult. I'd also strongly suggest you make it a daily habit to test BG on the night cycle even if it's only a before bed test. Early cycle tests at night can often provide clues as to how fast BG is dropping and give you the ability to take steps to ensure Murphy doesn't drop too low.

Again I apologize that your post went unanswered.

 

[Leigh B]

Thank you for the reply. I have updated his chart. I'm trying to be better about getting later night readings.
He had a reading of 170 a few mornings ago, but he'd thrown up that morning. Not sure if that skewed his reading anyhow?
Is it your opinion that going up to 2.25 has helped lately?
Wondering if I need to stay there, or shoot for trying 2.50 again?
Thank you, as always, for your help! I really appreciate your feedback. No apologies needed for the delayed response. It is not an emergency. I am just trying to get the balance, and I feel like I stay confused.
His energy is great, though. That makes me happy

 

[MrWorfMen's Mom]

It appears Murphy may need a dose increase but without many mid cycle test lately, it's difficult to say The lower pre-shots a couple of nights make me wonder what happened earlier in those cycles and just how low BG dropped.
Dosing is based on how low the dose drops BG. Pre-shots tell you if it is safe to give insulin. It's really important to grab mid cycle tests whenever you can. If getting mid cycle tests during the week is a problem, then a little more testing on weekends or days off would help. Also a lot if not most kitties go lower at night than during the day so grabbing tests on the night cycle is also important. Without any night time data, you really are seeing only half the picture.

I'd try to get some mid cycle tests in the +4 to +7 time frame if possible but any data is helpful. At night, at a very minimum, make it a habit to grab a test before bed every night. It not only makes figuring out dosing easier but also will keep Murphy safe.

If you can grab some mid cycle tests, and let us know when you have done that, we'll be in a better position to advice if a dose increase is needed or not. Right now it's not crystal clear.