Need help dosing advice

Ceci&Mati

Ceci&Mati

Member Since 2020
Hello everyone. Please I need your help and advice on the insulin dosing protocol.
We start with the Tight Regulation Protocol. From what I understand, if my cat's nadir is greater than 300, the dose can be increased by 0.5 in a minimum of 3 days. Based on the tests we do at home, my cat has high nadir levels (I haven't even identified when it drops lower as it stays high all the time) and he would need faster dose adjustments. We spent several days with 1u (indicated by the vet) without seeing differences in his bg. Then he told us to go up to 1.25 for 5 days, but we didn't see any big changes either. So I decided to follow the protocol guidelines and we increased by 0.5 based on his bg tests.
I know this sounds like a disaster, but the blanks were tests that I wrote down on paper and lost before I copied them to the spreadsheet (and none were less than 400), so the last few days I'm trying to be more consistent with do the tests and immediately copy to the spreadsheet. I have been reading in the forum and now I know that I need tests in the pm cycle, also that it is advisable to increase by .25 so as not to miss a good dose, but up to this point I feel so confused with so much information and so lost, that I do not I know what to do next. Should I keep the dose of 1.75? tonight would be 3 days with that dose and he's still high flat.
Thanks in advance
 
Hi Welcome! Hang in there :bighug::bighug::bighug: Mati looks stunning in your picture :cat:

More experienced folks will be by to help on dosing but if you lost data, can you enter "Lost Data" in the cell? This way people won't ask what happened to it :) BTW, I personally have my phone or ipad with me with I test Jax and then write his number right into the SS using google sheets - just an idea (I also write it down on paper but I'm kind weird like that lol :p).

As for testing at night, a recommended test is the "before bed test" which falls around +2 or +3 - flat or lower than your preshot test can mean an active cycle (one where kitty may drop to lower numbers and where you may need to set an alarm to check on Mati).

And per TR, you are right about the increase, but let's see if @Wendy&Neko or @tiffmaxee will swing by to chime in before your shot time.

Really - hang in there. You're in the right place. You'll figure this out and the people here will help you and Mati :bighug::bighug::bighug:
 
JaxBenji said:
Hi Welcome! Hang in there :bighug::bighug::bighug: Mati looks stunning in your picture :cat:

More experienced folks will be by to help on dosing but if you lost data, can you enter "Lost Data" in the cell? This way people won't ask what happened to it :) BTW, I personally have my phone or ipad with me with I test Jax and then write his number right into the SS using google sheets - just an idea (I also write it down on paper but I'm kind weird like that lol :p).

As for testing at night, a recommended test is the "before bed test" which falls around +2 or +3 - flat or lower than your preshot test can mean an active cycle (one where kitty may drop to lower numbers and where you may need to set an alarm to check on Mati).

And per TR, you are right about the increase, but let's see if @Wendy&Neko or @tiffmaxee will swing by to chime in before your shot time.

Really - hang in there. You're in the right place. You'll figure this out and the people here will help you and Mati :bighug::bighug::bighug:
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Thank you! I know we've been trying to regulate it for a relatively short time, but sometimes I feel like I'm about to give up :confused:
 
Most BG meters have a memory function that holds the last two weeks worth of data. Might be worth checking that out.

As Suzanne mentioned, those before bed tests or test sometime in the night cycle are very important. Many cats go lower at night and we dose based primarily on the nadirs or low points. And they are a requirement if you are going to follow TR which is a more aggressive dosing method.

If you can get a test tonight, at least +2 or later and all you are seeing is still above 300, I'd increase again by 0.5 units. Out of curiosity, do you remember what Mati's highest dose last time on insulin? We find kitties often have to go higher again when coming out of remission. You are also right to go with TR, as the faster you can get him into better numbers this time, the better the odds of a second remission. However, with that comes the need for more testing at night.

Do you have any ideas what might have knocked him out of remission? How are his teeth? Needing a dental is a common reason kitties go back on insulin.
 
Karen & Charlie said:
I've only been here since July, and believe me, that feeling will begin to pass. Most days I still feel like an incompetent boob, but I'm slowly learning. Hang in!
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I feel like I have learned more in the last few days reading here than I did the first time Mati was diagnosed. The information in this forum is so valuable!
 
Wendy&Neko said:
Most BG meters have a memory function that holds the last two weeks worth of data. Might be worth checking that out.
Click to expand...
The problem was that we changed the meter's battery a few days ago and it had never occurred to me to copy the numbers before. I think the more overwhelmed I feel, the more mistakes I make.

Wendy&Neko said:
As Suzanne mentioned, those before bed tests or test sometime in the night cycle are very important. Many cats go lower at night and we dose based primarily on the nadirs or low points. And they are a requirement if you are going to follow TR which is a more aggressive dosing method.

If you can get a test tonight, at least +2 or later and all you are seeing is still above 300, I'd increase again by 0.5 units. Out of curiosity, do you remember what Mati's highest dose last time on insulin? We find kitties often have to go higher again when coming out of remission. You are also right to go with TR, as the faster you can get him into better numbers this time, the better the odds of a second remission. However, with that comes the need for more testing at night.
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I'll try to get a night test today, Mati is more and more reluctant to test, a treat must work. Can the tests be alternated? That is, one day test during the AM cycle and the next day tests at night.
The highest dose when he was diagnosed two years ago was 1.5 u, he was there for a month and since then he has been gaining dose reductions.

Wendy&Neko said:
Do you have any ideas what might have knocked him out of remission? How are his teeth? Needing a dental is a common reason kitties go back on insulin.
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I'm pretty sure it was two shots of prednisone, that was on October 14, that day Mati woke up with swollen gums and pain, so we went to another vet since his usual vets are closed due to covid. That vet said he was going to apply anti inflammatories, I never thought he was going to inject steroids. A week later Mati began with clear symptoms of diabetes: drinking too much water and urinating excessively. 5 days before steroid injection I tested him bg and it was 109.
A couple of weeks ago we went to another vet to check Mati's teeth and the vet said they are fine, there is no inflammation or redness, he said he did not think there was a need for dental work, just brushing at home. There is also no UTI, they did lab and there is nothing abnormal, they also did an US for his history of pancreatitis and found nothing wrong with his pancreas so I think steroids caused all of this.
 
You are probably right on the steroids knocking him out of remission. Odd in the original gum inflammation though. The good news is that the steroid will eventually wear off. In the mean time, time to get him into better numbers as quickly as safely possible. That means second tests both AM and PM, or you will have to slow down the increases.
 
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Wendy&Neko said:
You are probably right on the steroids knocking him out of remission. Odd in the original gum inflammation though. The good news is that the steroid will eventually wear off. In the mean time, time to get him into better numbers as quickly as safely possible. That means second rests both AM and PM, or you will have to slow down the increases.
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Edit. I got it!
Thanks for your help! I'll continue testing in the AM and PM cycles, today Mati was a bit upset, in the test before the PM shot he fought and got stressed, but I hope tomorrow he'll cooperate a little more.
 
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