Never mind I’ll try to delete three ?

If you want a post deleted once create, just tag one of the moderators. I can delete it if no longer interested in comments on the spreadsheet. Just one general comment, in cases of insulin resistance, it can seem like you are trying to outpace a speeding train with those dose increases. I'd catch up to a dose with Neko that got her some green nadirs, then they'd disappear and off we'd go on the dose increases again. Very frustrating!
 
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Thanks! I wanted comments but when I tried to attach my spread sheet it kept looking like it was in edit mode and I would cry even more than I am right now if I had to redo it (two cats simultaneously with pancreatitis is hard on a old human roommate).
I don’t understand about Neko. Are you saying we’re increasing too quickly?
Edit: or are you saying in general just as it looked ok then it wouldn’t. I can try to attach my ss again but I don’t want it to disappear. (My alpha trak app ate my data last week )
 
Without looking at the spreadsheet, I can't say if you increased safely or too quickly. What I'm trying to say is that even if you are increasing according to a protocol (I followed TR), the insulin resistance can make what looks like a good dose at one point no longer be a good dose and you need to increase again.
 
upload_2024-9-5_18-59-54.png Ok still can’t attach ss so it doesn’t say edit. Maybe if I get some sleep tonight it will cooperate in am. But my question was if there are any Cushing cat ppl (or others if it acts similarly) if their experience was no matter what the dose the results remain the same.

this is my second Cushing’s cat but Erik was decades ago premeter, and his tumor was found three years after I’d been trying spectacularly unsuccessfully to control his DM. (Three insulin’s including an experimental one, high doses and lots of looks at the vet). So I’m predisposed to assume I’m doing something wrong in giving Methos his insulin (and could very well be) because for three years I kept being told i was obviously not trying with Erik. My current vet is amazing (wasn’t Erik’s) but she knows how traumatic Erik’s case was for me so I think she’d be hesitant to say “you’re screwing up”. Probably because for 7 years before Methos was diagnosed I’d break out crying if I mentioned my last cat. I will paste a screen shot of my alpha trak summary of the last five months where the doses were weekly increased from 1u q12. It’s essentially unchanged except a blip in Aug 23 where I thought I’d accidentally given him 3.5 instead of 2.5 in the pm so fed him kibble and greenies (which he hasn’t had for 18 months—happy cat), drove him into 400s and the next day he had the closest thing to a normal curve yet.
He does seem to have some lower nadirs (meaning 250s except one glorious 197) on 3.5 but the overall average stays high. So I don’t know if it’s not enough yet, if it’s too much, if his tumor is just laughing at me, or if I’m not getting insulin into him. and I’ll try again with spread sheet, it’s just the last week because two cats with pancreatitis but every week looks similar
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I’ll leave the dosing to @Wendy&Neko, but just curious…is the maltose probiotic related to the Cushings? I was thinking maltose was a sweetener and/or metabolized into a “sugar” and was a no-no, at least for human diabetics, so wondering if it’s possibly affecting Methos’ BG???
 
Cats actually (if Google is to be believed) have very little maltase (the enzyme that breaks it down) BUT it can “fool” some glucometers into reading maltose as glucose and give a false high value. That said, he was only on it the four days I noted (I made the note AFTER I realized maltose was in his probiotic.) And his values were if anything better on some of those days. I suspect it’s an “inert” ingredient in that probiotic designed for cat constipation as an osmotic laxative (ie it’s not absorbed and digested so pulls water into the gut to soften stool). But I haven’t called the company to confirm bc (a) I need to be calm as I discuss and (b) two cats with pancreatitis are pretty much sucking up my energy bandwidth
It isn’t part of his Cushing’s Tx, I’m giving him probiotics anyway for his pancreatitis and miralax for his constipation and perusing their website thought “oooh, they make a probiotic specifically for constipated cats! Maybe I can stop the miralax” Unfortunately it arrived at the same time the other cat got sick so I (who haven’t slept more than 3 hr a night this month) didn’t read the fine print for 3 days. Bad cat mom.
 
Still not enough detail to comment on dosing, other than to say it looks like you aren't missing any lows and he could use an increase. Also, the Cushings cats I've seen spreadsheets for (mostly pituitary kind) have needed doses ranging from 3 units to a few who ended up at 13-15 units. And we did see one who actually went into diabetic remission! Data/spreadsheets are scarce, ADH kind even more so, but I did find Roxi's SS, she is ADH. Not everyone keeps their spreadsheet after they've said goodbye to their cat. Some people with Cushings stop doing much testing due to skin tears.
 
Thank you for the info. Yes I get it re testing. It doesn’t show as much this week bc I’ve tested him as much as I thought his ears could take bc even with the increase his numbers looked worse and I kept wondering if I wasn’t getting his shots in or missing a really low point. There were days in the beginning I’d paid vet techs to come give some of his shots so I’d count those as having gotten in so I didn’t check him to give some breaks. It’s why I can’t do a CGM. I was hoping he’d get to a right dose soon (even if high) and I could dial back on testing him. A few ppl have said “it would be easier to do his injections if you shave a small area” (he’s got a medium to long triple coat although it’s pretty thin these days) and while it would make me more confident I quickly say I can’t, it’s the only protection his fragile skin has. Which is also why I’m sleeping in the bathroom that connects their two bedrooms since I can’t let them share space when I’m not awake…what would be a minor cat spat could be a bloody near evisceration across his bare belly.
I’m not hoping for remission, just as best control as I can get. The Vetoryl isn’t working as well as it once did and my vet thinks we can’t safely increase it more than it is. Thanks for your help, the sparse threads on Cushing’s (esp adrenal) does make it seem it’s as rare as I keep being told…still hard to wrap my head around this being my second.
 
I will say that with Erik I was constantly taking him in bc his urine checks were all over the place (pre glucometers, I was told to frequently close him in a separate room (multi cat home) with Saran Wrap over his litter and check for glucose and ketones). They’d increase his dose and lecture me. Repeated until they took him off the experimental insulin (on the positive side it had been a pain to special order for them and I no longer needed to special order U40 syringes…on the negative it was supposed to be a longer acting one unlike the one he was switched to). Repeated with the new one until switched again. But back then I didn’t have ability to see his numbers other than the curve done at the vet.
In some ways ignorance was bliss. Tomorrow may be a blissful day as his poor ears are a mess.
 
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