Still high, wondering about new dose

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Lynn & Rupert

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Hello, I have tried a higher dose for quite a few cycles now, but he is still having some high numbers. I increased his AMPS dose today to 2.6, he was getting 2.4. I will be around to monitor today. Is this the right amount to go up? Some things I have tried in the past days, bigger meals and less of them, but he seemed to go so high by AMPS, I went back to 4 meals, reducing the PMPS meal. I really wanted to do 2 meals a day, but he seemed to have better numbers when I did smaller ones more often. I also cut back by a 1/2 oz, he did put a few ounces of weight on, since I upped his food intake, but thought I could reduce it a little. He is still testing negative for ketones and has no issues with peeing, pooping, grooming, etc. I might have to switch insulins, but would prefer to keep trying the ProZinc for now. I read some about insulin resistance, not sure I understand it, pretty complicated. :nailbiting: Any thoughts or advice? Thanks for hanging in there with us! ps...he was really high on 8/16 AMPS, I had overnight guests, but I am 99 % positive no food or crumbs were left around. I warned everyone and was checking counters, floors, etc. often. Possibly just stress from people being around???
 
Probably was the guests. I think I would get more agressive, Lynn. So, three cycles on the new dose and then increase again by .25 (as long as you have safe preshots and nadirs) My guess would be that his body is getting used to the higher numbers and you need to find a dose that just gets him lower overall. It might mean some bouncing but it doesn't seem to be working to try to keep him at a lower dose - either he is bouncing there or the dose is just not enough to last the whole cycle.

We don't usually start to think about any insulin resistant issues until you hit 5-6 units with no movement. Another insulin might work better, but I think I'd try the 3 cycles/ increase first. What do you think?
 
Sounds like a good plan Sue. I will increase by .25. Should I start tonight at PMPS, I can check some during the night, I will set the alarm, or better to wait till tomorrow? That's a relief about the insulin resistant issue, hopefully that won't be the case. I hope to stick with the ProZinc at least for awhile, due to cost of new insulin. Hopefully higher dose will start to help. Thank you so much for your help! :bighug:
 
Do you think I might be right about the meals? He seemed to have better numbers when I fed smaller, more frequent meals. Maybe it's just that his dose isn't right yet. Any thoughts? Arghhhh, this food thing is driving me bonkers! :banghead:
 
Do you think I might be right about the meals? He seemed to have better numbers when I fed smaller, more frequent meals. Maybe it's just that his dose isn't right yet. Any thoughts? Arghhhh, this food thing is driving me bonkers! :banghead:
Howdy, Lynn - Sorry this is so frustrating ... so tell me: How much food is he getting (total oz.) per day?
 
He got 8.5 oz yesterday, I cut back 1/2 oz only.
So he had been getting 9 oz before that, huh? I don't know, Lynn - mine gets 7 oz. FF/daily; she holds steady now at at 11 lbs. Sue's comment re: guests in the house may spike BGs is true enough.

While every cat's different, I was noticing that btwn +6 & PMPS yesterday, Rupert got 4 oz. of food, so his PMPS # last night doesn't surprise me very much.

I agree with Sue re: insulin resistance; I really don't think that's Rupert's problem. And you never know: He may be carb-sensitive; it's not that uncommon. (I've come to realize, over time, that Bat-Bat's super carb-sensitive - even 1% more carbs can make a real difference in her BGS - crazy isn't it? One of the other members was just telling me a day or so ago about her cat's carb-sensitivity ...)

But here's the thing: If you're planning on upping his insulin dose by even a small amount, be careful to monitor very closely if you decide to cut rations a bit at the same time.

If I were in your shoes? My first instinct would be to hold the dose for now, and cut his rations some more first. While I realize he's hungry, that will change once he's better regulated. I really do think he may be getting more chow than he might actually need to maintain an optimal weight. And that alone could, in fact, be helping keep his #s up.

Can you weigh him & get back to me? (Any delays in responding to you, please bear with me - my ISP here is horrible.)
 
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I can give you an example of how I've been distributing my cat's food each day (at her current daily ration of 7 oz):

AMPS/ PMPS: She gets 2.5 oz each time. (Sometimes she gets insulin, sometimes she doesn't - as we're at "as needed" dosing now.)
After her nadir, both day & night cycles (in her case that's usually at +3.5 to +4): She get 1 oz.

So, in other words, she gets the lion's share (sorry about the pun) of her food at AMPS & PMPS times. The balance of her rations I hold in reserve to give right after nadirs (particularly important for those times when I really do need to steer with food after a really low nadir.)
This is just the way that works well for us, of course ;) ...
 
No problem Robin, please excuse my long answers back, trying to work at the same time! Here goes....I weighed him yesterday and he was at 9 lbs 6 oz, which was up from 9.4 on 8/11. He still acts hungry, but not ravenous like before. I was giving him 9 oz a day, till yesterday and cut back 1/2 oz and seeing how he does with that. So far it seems fine. I was giving him 3 meals a day in prep for the two only, but he was going so high by AMPS, I thought trying 4 a day might work better. It didn't seem to make any difference in his AMPS reading today, still high. So I might as well go back to the 3 meals at a total of 8.5 oz, unless you think it is time to reduce that down a bit, starting tomorrow. I did increase his dose just a bit today to 2.6 U. I could hold with that dose and reduce his rations by another 1/2 oz starting tomorrow. What do you think? Thanks for your input!
 
I also was thinking he might be very carb sensitive. I looked for some of the lowest ones listed on the charts, but could only find some of them. I did get 3 cans of FF Fish & Shrimp feast flaked, which is listed as 0 carbs. I will feed him those one day to see how he does, but didn't want to use them on a dose increase day.
 
Yes, you might want to try that ration reduction tomorrow - but again, monitor closely since you've had a dose increase (so glad you're able to be around to do that; many don't have that luxury).

Just an aside: I know how confusing it can be, trying to figure out what the best distribution/# of times to feed may be for your cat. I was just in past few days trying to transition her back to just 2 meals/day (something we'd been on throughout treatment until she got down to a micro-dose). And then I realized that while attempting this switch, I had also cut out the Purina DM (3% carbs) altogether; was just feeding FF Classics turkey w/ giblets (4% carbs) exclusively. Take a quick peek at her SS over past few days: Her AMBGs/PMBGs went up! :banghead: So frustrating!!! So yesterday I went back to the DM + FF combo meals - interestingly, her latest PMPS & AMPS #s were markedly lower. Go figure.:confused:
 
Wow, I see what you mean! Appears BB is carb sensitive too! BTW Bat-Bat looks marvelous in her new picture! :cat: Rupert seems to go higher on some foods, so I will try harder to get the lowest carb ones I can find. It will be interesting to see how he does with the FF F & Sh. Should I stick with the 2.6 and food reduction for tomorrow? Sorry, just want to be clear.
Thanks again for all your help and you too, Sue! :bighug:
 
Wow, I see what you mean! Appears BB is carb sensitive too! BTW Bat-Bat looks marvelous in her new picture! :cat: Rupert seems to go higher on some foods, so I will try harder to get the lowest carb ones I can find. It will be interesting to see how he does with the FF F & Sh. Should I stick with the 2.6 and food reduction for tomorrow? Sorry, just want to be clear.
Thanks again for all your help and you too, Sue! :bighug:
Yes, I think you could try that. :)
Bat-Bat says thank you for the compliment!
She is slender now, but not emaciated - she was soooo bony when she was first diagnosed in 2013, but now she's just fashionably "svelte!"
(Did you see her before/after pix that I'd posted on another thread? She has a waistline now, but she used to weigh 18lbs!!! Looked like a bowling ball with a tail.)
 
She is at a purfect weight! I did see her before and after pics, she looks so trim and svelte now! Rupert says "hubba, hubba"! lol The pic of Rupert on our profile is probably the most he ever weighed at 10 lbs plus a few oz. He got pretty skinny when first diagnosed, 8 lbs and something. He is looking much better now, but could maybe use a little more weight on him. I am still going to reduce his food though, I think that little bit won't hurt him and hopefully help get his numbers better! Thanks again from both of us! :bighug:
 
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