Question-should I increase dose again?

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phlika29

phlika29

Member Since 2014
Hi everyone

I have had remi on 0.75 unit of lantus for just over six cycles. The last couple of cycles have been higher again. Can someone look at his spreadsheet and advise as to whether he is still bouncing or whether I should increase the dose to 1 unit?

Does a cat get used to a dose and it not do the same that it did initially?
Remi hasn't been bothered about food tonight and so i ended up giving him some dried chicken breast treats instead This worries me as his numbers are so high. What is the minimum a cat has to eat to be able to give the insulin shot?
What BG tests should I target for the coming week?

Many thanks

Sarah
 
Yes, it's time to go up to 1 unit

You're doing a great job of testing!!

The only tip I can really give you is to look at your spreadsheet for "gaps" where there's lots of white and try to get tests in during some of those times

You might try crumbling some of the dried chicken treats on top of his regular food..might get him interested in eating it. There's no "set" amount they should be eating..they just need to be eating fairly normally (ECID here so it's a matter of knowing your cat) so when the insulin kicks in, there's something for it to work on
 
Any time you have nadirs that for 6 cycles are higher than where you want them on a consistent basis, it's time for an increase. Your instinct to increase Remi's dose was on target.

Chris' suggestion to crumble some freeze dried chicken on Remi's food is a good one. There are times when I need to entice my guys to eat. (Well, I actually think they get spoiled by the treats and are holding out so I will put some chicken "dust" on their food.) As far as I know, there isn't a "minimum" that a cat has to eat in order to shoot. What may help to keep in mind is that Lantus and Lev are more forgiving than the shorter acting insulins. You usually have 2 hours until your insulin kicks in so you have that amount of time to get some food into your kitty.
 
Chris & China said:
Yes, it's time to go up to 1 unit

You're doing a great job of testing!!

The only tip I can really give you is to look at your spreadsheet for "gaps" where there's lots of white and try to get tests in during some of those times

You might try crumbling some of the dried chicken treats on top of his regular food..might get him interested in eating it. There's no "set" amount they should be eating..they just need to be eating fairly normally (ECID here so it's a matter of knowing your cat) so when the insulin kicks in, there's something for it to work on
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Hi Chris

Thanks for your reply. I went up to 1 unit this morning and I got my partner to get in some tests. I know I won't see the results straight away but still. Good idea to target the gaps, and will try to test the white areas again tomorrow.

Remi did eat a little more at bed time and this morning he was okay. I have a feeling I am feeding him too much either generally and/or at each meal. He has been on dry food :oops: for years and so I am not 100% sure how it is best to feed the wet in relation to lantus. He always used to have breakfast, maybe a snack mid morning and then eat at lunchtime. Then he would eat early evening, a snack mod evening and then again just before bed. With his dry food it wasn't a lot physically and so he's only wanted the food. But the wet is bulkier and I am not sure this old pattern is right for the insulin. I am interested in how others feed to get the best out of the curve?

Great idea about the treats.

Cheers

Sarah
 
Good luck with the increase Sarah.

If you aren't sure about the food amounts, you might want to weigh Remi once a week and see if he is gaining or losing. Do you know what Remi's ideal weight is? On the http://www.catinfo.org website, Dr. Pierson lists a formula to use as a starting point for number of daily calories:
Required calories per day = [13.6 X optimal lean body weight in pounds] + 70
Click to expand...
The calories should be listed on the cans. The amount can be changed as you weigh Remi and see what works for him. And until he gets better regulated, he may need more calories.

As for timing of feeding, it depends a bit on what the cat's cycle look like, but generally feed all the food if you can in the first half of the cycle when the insulin is strongest. If you spread three meals out in the first 5-6 hours of the cycle, that should work. For cats that like to dive in the first couple of hours of the cycle, their servants tend to give more food earlier in the cycle to try to reduce the dives. You don't have a lot of data on Remi yet, but so far he looks like he starts his cycles fairly gradually. For now, I'd stick to feeding his meals in the first half of the cycle, and as you gather more data on Remi, you may or may not have to tweak that.
 
Sienne and Gabby said:
Any time you have nadirs that for 6 cycles are higher than where you want them on a consistent basis, it's time for an increase. Your instinct to increase Remi's dose was on target.

Chris' suggestion to crumble some freeze dried chicken on Remi's food is a good one. There are times when I need to entice my guys to eat. (Well, I actually think they get spoiled by the treats and are holding out so I will put some chicken "dust" on their food.) As far as I know, there isn't a "minimum" that a cat has to eat in order to shoot. What may help to keep in mind is that Lantus and Lev are more forgiving than the shorter acting insulins. You usually have 2 hours until your insulin kicks in so you have that amount of time to get some food into your kitty.
Click to expand...

That's good to know as remi is not one for eating all his food in one go. He prefers to eat a bit, spend five minutes trying to cover it with the carpet before deciding he does actually want it. Or more often than not just licking off all the liquid/jelly.

I hope that the dose increase gives some good results and I am determined not to get too scared if he goes lower then he has been. :smile:
 
If you're nervous about the numbers, just post. This board is big and usually there's someone around that can lend a hand. We've all had to deal with low numbers at one point or another -- it's part of the process. In other words, we've all been in your shoes.
 
Wendy&Neko said:
Good luck with the increase Sarah.

If you aren't sure about the food amounts, you might want to weigh Remi once a week and see if he is gaining or losing. Do you know what Remi's ideal weight is? On the http://www.catinfo.org website, Dr. Pierson lists a formula to use as a starting point for number of daily calories:
Required calories per day = [13.6 X optimal lean body weight in pounds] + 70
Click to expand...
The calories should be listed on the cans. The amount can be changed as you weigh Remi and see what works for him. And until he gets better regulated, he may need more calories.

As for timing of feeding, it depends a bit on what the cat's cycle look like, but generally feed all the food if you can in the first half of the cycle when the insulin is strongest. If you spread three meals out in the first 5-6 hours of the cycle, that should work. For cats that like to dive in the first couple of hours of the cycle, their servants tend to give more food earlier in the cycle to try to reduce the dives. You don't have a lot of data on Remi yet, but so far he looks like he starts his cycles fairly gradually. For now, I'd stick to feeding his meals in the first half of the cycle, and as you gather more data on Remi, you may or may not have to tweak that.
Click to expand...

Thanks Wendy. I did work it out when he was first diagnosed and wrote it all down but will have to do it again as I've forgotten/lost the paper I wrote it on. I am sort of following what I originally worked out but need to get it under a tighter control. I also think remi has put on a little bit of weight from his initial diagnosis. One thing I haven't bought yet is some scales so that will be a must when pay day comes around.

We work in kg in the uk so I think the formula is slightly different. Remi weighs approx 5kg and is Burmese. I am not 100% sure what he should ideally weigh. My vet always said remi was obese when he weighed a little more :o I felt he was just big boned but my vet would have none of it :lol: Over the last year has has steadily lost weight.

Many thanks.

Sarah
 
We work in kg in Canada too, just multiply Remi's weight by 2.2 to get the number of pounds. Using the formula, if 5 kg was his ideal weight, then the number of calories would be 220.
 
If you have a bathroom scale (one you use to weigh yourself on) that works. You don't need to spend a lot of money on a special scale. Just weigh yourself, then pick up Remi...subtract the first weight from the 2nd and you'll have a pretty good idea of how much Remi weighs

Here's a Body Condition Score Chart to help you decide how much of Remi is "big boned" and how much is "too fluffy".....LOL

[youtube]7gsG7jCZ_o4[/youtube]
 
I bought a Salter baby scale on ebay for about $50 when my other cat got sick. I should have been weighing Max more as since he became he has gained over a pound and was supposed to maintain or lose about a pound. I'm now trying really hard to feed him less but he is a bouncer which makes it difficult. Good luck with the increase.
 
Wendy&Neko said:
We work in kg in Canada too, just multiply Remi's weight by 2.2 to get the number of pounds. Using the formula, if 5 kg was his ideal weight, then the number of calories would be 220.
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Thankyou. He isn't all that active so I wonder if he needs a little less calories. Vocal yes, active no. As it gets colder here his routine goes like this-get up, sit next to radiator. Have breakfast and medication, go back to bed, wake up for snack and then again for lunch. Stay in bed till heating comes on at 5pm, eat dinner, spend the evening sat on a lap under a blanket, eat evening snack and then spend the night sleeping under the bed covers. Summer swaps duvet for various sun spots :lol:

He is eating Thrive Complete Chicken Breast

% kcal Protein: 75.3%
% kcal Fat: 22.8%
% kcal Carbs: 1.9%

Serving size per tin: 75g
kcal/tin (approx): 56

So by all rights he should be eating almost 4 cans but he isn't eating any where near that. More like three cans.
 
Chris & China said:
If you have a bathroom scale (one you use to weigh yourself on) that works. You don't need to spend a lot of money on a special scale. Just weigh yourself, then pick up Remi...subtract the first weight from the 2nd and you'll have a pretty good idea of how much Remi weighs

Here's a Body Condition Score Chart to help you decide how much of Remi is "big boned" and how much is "too fluffy".....]
Click to expand...

Great info Chris. I think that remi is probably at his ideal weight range now. He definitely has a waste now and I can feel his ribs. He has a little fat pouch underneath but he has had that ever since he was a youngster. I will try using my scales but they are pretty old. It might be time to get some new ones. Does this mean I have to monitor my own weight aswell :shock: at the moment I prefer to use the waistband scale. If I can do it up, then it's all good.
 
tiffmaxee said:
I bought a Salter baby scale on ebay for about $50 when my other cat got sick. I should have been weighing Max more as since he became he has gained over a pound and was supposed to maintain or lose about a pound. I'm now trying really hard to feed him less but he is a bouncer which makes it difficult. Good luck with the increase.
Click to expand...

Good idea. So are you saying when max bounces he eats more because his BG has gone higher? I must start keeping a closer watch on it really. Some days he eats all the food straight away and at other times just nibbles at it. He is always on an anti nausea med and so I don't think that makes the difference.
 
When Max drops he can dive. So then I need to keep feeding him to prevent him from going under 50 or 40. He is a very bouncy kitty that doesn't hold reductions unfortunately. So to level him out I need to keep him from earning a reduction. Hopefully your kitty won't be like that. He has chronic pancreatitis also but has had a big appetite since diabetes. What are you giving for nausea? I use ondansetron for Max. He needs 2mg twice a day when he has pancreatitis. I started with 1mg but he needed an appetite stimulant as well so we tried a larger dose and it works without the need for the cyproheptadine for his appetite. Max has had pancreatitis for nearly 5 years. He hasn't needed ondansetron for a long time (anti-jinx).
 
I am not really sure what remi is like yet. He seems to bounce a bit and then his cycle seems to level off and doesn't really go anywhere. I am not sure if he is bouncing today because of the dose increase, the so called new dose wonkiness or whether this is an indication that he will ultimately have to go higher. Yesterday looked promising and I try not to read too much into it, but of course I do :sad:
 
phlika29 said:
Does a cat get used to a dose and it not do the same that it did initially?
Click to expand...

I've been wondering about this too. It seems to happen for Angie - but we're very new to dose increases too.
 
I guess in the same way that bounces happen perhaps the pancreas gets used to an amount of insulin and either settles down and stops being so affected by it or maybe overrides it??
 
There are many variables....
but the dose is not a "written in stone" kind of thing.....
it will fluctuate. There are some kitties here who go up and down the dosing scale.....
and many who hit that threshold turn-around dose and start heading down the dosing scale.
 
I think you're talking about Glucose Toxicity developing when you see a dose stop working. It's a good idea to re-evaluate every 6 cycles on one dose, look at the nadirs you've had on that dose and decide if you should hold longer or go ahead and increase.

I'm glad you went up to 1.0u - after 6 cycles, take a look at what's happening, or ask us to help you "see" what's going on, and decide if it should be increased or held.

Many times cats don't realy respond to the dose increases with gradually lowered numbers until you hit the "sweet spot" and suddenly the blood sugar numbers improve.
 
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