Newbie asks: Time to raise the dose? +200 pt swings

[max&emmasmommie]

Hello everyone, and good morning. I'm not getting good test results.

Max acts very normal. He goes outside, he is not waking us up early in the morning for food. He cleaned his bowl while we slept last night and was hungry this morning at 9:00. He looks good -- clean, fluffy, not oily or with spiky fur. He's using his litter box or going to the bathroom outside. He's not drinking as much water as he used to.

Last night his BG values went from 474 at PMPS time to 260 at +3 to 474 at +11. I don't know what it was at +6 or at +9. This can't be good for him, his liver or his kidneys, let alone his other organs.

1. Dose incorrect? Max's BG readings are not leveling out. I haven't had time to do a full curve yet, and I didn't get far with the mini curve I tried to do last night. However, I do believe that this dose (2u) is not working out. Please take a look at the spreadsheet. As to food, today he is having 1/4 can Hills m/d mixed with 3/4 can Wellness Beef and Chicken. Tomorrow it will be 1/8 Hills, and Sunday, he will be eating only Wellness. If I do increase the dose I intend to increase it by only .25u. Before I do, do I need more BG level information? If so, do I need a full curve or could I use a mini curve?

2. A complication: I need to change his shot time by 2 hours. He was getting it at 10:00, and I just gave him one at 9:45. We are leaving on vacation in 9 days, and the cat sitter needs to give him his shot at 8:15 or 8:30. So, I'm planning to move his shot time back 1/2 hour for a day, then another 1/2 hour for a day, and so on. I'll run full curve once we are firmly established at 8:15. Questions: 1. Should I move it by only 15 minute increments? 2. Can I move it EVERY shot time, or only once a day?

3. How many days of a new dose should pass before I leave? In order to know if the new 2.25u is working, I need his shot time to be stable, right? If so, it will take me until the day before we leave to get an answer if I move the shot time only once a day by only 15 minutes. If I move it twice a day, we'll be done in 3 1/2 days. Likewise, if I move it by 1/2 hour increments only once a day, we'll be there in 3 1/2 days. However, I could get there in 2 days if I move it twice a day by 1/2 an hour each time. Then, I would have over 5 days at 2.25u without any movement of the time going on, and I could run a full curve. Then, I could raise it again if I had to.

4. Leaving him at above 200 at PS time for a couple of weeks? I hate to raise the dose right before we leave. I'm worried that the pet sitter will not be able to test him, and he'll be on a new dose without monitoring. If his AMPS and PMPS levels are above 200 for the 10 days we are gone, and I can get them down shortly after we get back, that's better than risking a Hypo. Any comments?

Thank you.

 

[max&emmasmommie]

I thought I was okay with all the bouncing around, but getting a reading of over 600 at +11 and then 566 at +7 has me completely despondent. What can I do?

 

[Blue]

I thought I was okay with all the bouncing around, but getting a reading of over 600 at +11 and then 566 at +7 has me completely despondent. What can I do?

Dale,
Your u100 syringes have 1/2 unit markings, yes?
I know that you don't have alot of test numbers, but why don't you drop back to 1.5units BID?
keep in mind that you need to see the numbers in the middle of the cycle, so that you can have a clue why the ps numbers are so high.....

When you do your curves, testing at 3, 6, 9, or more often if you can, you could see a couple entirely differing things.
1. you could see a whole string of high numbers, with mostly 300s, 400, 500s. I would think it may be that you need to give more insulin.
2. you could see Max dipping low, into the 100s and then bouncing like crazy. You may want to drop your dose down a bit and let that bounce clear out.

We know that the starting dose on your ss of 3u BID is too high of a start, and it could be that the 2u is a bit high as well. It's the main reason that you will see people suggest to cut the dose back to 1u and start to work your way up again, but the worrisome issue is to be sure and test Max's urine for ketones because with the high BG numbers you could have problems.

I think you mentioned trying a different insulin; yes, that's an idea as well because there are some cats who just don't do well on Lantus. Switching to Levemir would be a good possibility as one of my cats does better on Lev, and a few others in the relaxed forum switched and like Lev better for more level BG numbers.

you could even print out your ss and take it to the vet to discuss your options.

 

[max&emmasmommie]

Hello All,

I'm still trying to decide whether to raise the dose .25 to 2.25 or drop Max back to 1u and start from scratch.

Here is the post over on Lantus TR: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=66585 with all the pertinent information and all up to date.

I need to decide by AMPS tomorrow.

Any thoughts? Thanks.