? Need Experienced Eyes for Advice

[Darnell & Sprocket (GA)]

Hi. I am posting for Annette & Spot as she is not sure how to use this website.
i have been helping her some with spreadsheet input & advice with helpers i know in fb group. Cat was diagnosed in late June & she started testing & lantus in July. Dose as gone up & I am personally baffled as to why this cat’s bg is not dropping as the dose goes up. Dose is currently 3.5units. Eats fancy feast & friskies pate. My cat never went over 3 units so I am not sure if this progress is normal or am I missing something?
I will post the spreadsheet here,
https://docs.google.com/spreadsheets/d/1SF96F9mHVKPW1YyyLa0PcMDU8rbxxDLtMRfy_IGVmBc/edit?usp=sharing

please let me know what I should tell her?
Thanks

 

[Wendy&Neko]

Some cats need more insulin than others. Do you think it'd be possible for her to try following Tight Regulation for dosing for a while to try to get Spot closer to good numbers faster? As long as he's only eating LC and she keeps testing as much as she has, she could follow TR and increase faster. If she wants to stick to SLGS, then keep increasing every week until his nadirs are in the 90-149 range. And absolutely no resets like she did mid month. That just sets them back and causes glucose toxicity to set in. The solution to that is more insulin. She testing enough to catch if Spot is going low. He's not.

 

[JL and Chip]

I like Wendy’s suggestion for TR. Given the amount of testing Annette is doing, it might help get Spot to a good dose much faster. She can always go back to SLGS at any point if she’s more comfortable with it.

Is she still feeding Dr. Elsey’s Clean Protein “for crunch” (as is noted in the spreadsheet)? Even though Dr. Elsey’s is supposed to be low carb, any dry food might preclude using TR. @Wendy&Neko ?

 

[Darnell & Sprocket (GA)]

I like Wendy’s suggestion for TR. Given the amount of testing Annette is doing, it might help get Spot to a good dose much faster. She can always go back to SLGS at any point if she’s more comfortable with it.

Is she still feeding Dr. Elsey’s Clean Protein “for crunch” (as is noted in the spreadsheet)? Even though Dr. Elsey’s is supposed to be low carb, any dry food might preclude using TR. @Wendy&Neko ?

Yes she still feeds the Dr Elseys yet its just occasionally.
I have even had her up the dose before in 5 days bs 7 days & its like it did nothing.
Lowest numbers were in beginning with yellows but now that cat barely gets in yellow.
I dont get it.

 

[Wendy&Neko]

Today is day 7 at this dose, time for an increase. I'd be tempted to do what TR suggests, and go up by 0.5 units. The only yellows were almost 300 and TR allows 0.5 unit increases if all nadirs are above 300.

Lowest numbers were in beginning with yellows but now that cat barely gets in yellow.
I dont get it.

Some type of insulin resistance is probably present. Glucose toxicity is one such form of it. He just hasn't hit his fitting dose yet. The reset probably made it worse.

 

[Darnell & Sprocket (GA)]

Today is day 7 at this dose, time for an increase. I'd be tempted to do what TR suggests, and go up by 0.5 units. The only yellows were almost 300 and TR allows 0.5 unit increases if all nadirs are above 300.


Some type of insulin resistance is probably present. Glucose toxicity is one such form of it. He just hasn't hit his fitting dose yet. The reset probably made it worse.

ok she is starting 4 units this morning. we also have time change this weekend coming too.
what hour do you think the nadir is?
She works all day & hubby works from home but isn’t always able to test multiple times.
I thought the best time to test was at +3-+4
Is that good? I figured if drop was happening something should happen by then

 

[Wendy&Neko]

what hour do you think the nadir is?

Too early to tell, it will become clearer as the nadirs get lower. Right now he's mostly high and flattish. At some point when she has a weekend off, a curve might help pinpoint the general time of a nadir. Note, nadirs can and do change from cycle to cycle, some cats more than others. Bounce breaking cycles can mean later nadirs. Active ones might be earlier.

I thought the best time to test was at +3-+4
Is that good? I figured if drop was happening something should happen by then

Again, the onset is ECID, though there usually is a range with Lantus. Typically is +2-+3, but some go earlier. Neko tended to be more like +3.5. A curve might help narrow that down, provided it's a normal cycle and not a bounce cycle. What you are looking for is a number to test that will indicate a good drop is happening and an indicator to test again that cycle. Like today, there is a couple hundred points drop, might be worth a +7-+9 test.