Still need help finding proper dose for Alex

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Ginny & Alex

Ginny & Alex

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I've been working with some of you over the last few days (mostly Sue and Joanna) and thought I'd post under a new thread.

Each time I increase his dose, things start looking better for the first few days and then his BG levels start climbing. Most of the time I'm trying a dose for about 5 days before I increase the dosage.

We've only been giving 1.50 units BID for a couple of days. Do I need to wait for a few more days to see what happens? Some suggest the 1.5 dose might be too high.

At times, I'm tempted to start over at 1.00 unit BID, but I'm so new to this, it's all just a guess (and a not very educated one).

He's eating well and seems OK--not as energetic as in the old days, but I thinks he's OK.

I checked on Saturday night and again last night for ketones, and I'm happy to say that was negative.

Any advice would be greatly appreciated.
 
Ginny I was just 'staring' at your SS and from what I could glean...drop dose. It would appear he is getting too much insulin...IMHO
 
sounds ok...i was thinking 1.2----because the numbers kinda looked better at that time
but starting fresh at 1u is a good clean way to go about it.
 
Hmmm, I was thinking the dose looks too low, darn when we see different things!!! So a couple thoughts:

1) If you do need to raise the dose, it is definitely easier IMO if you KNOW the dose is not too high. So even though it can be a pain, I generally support trying the lowered dose if there is any doubt, so then you can raise with confidence if the #s are not better on the lower dose.

CAVEATS, and they are big ones:

- Do NOT do that if you have ketones, and if you have a ketone history, do it with caution.
- Do not stay at the lowered doses for long, no one week or even 5 days or anything. 2-3 day max and if the #s are worse, you raise back up quickly.

2) I would go to some extent by his symptoms. If they are rampant, lots of drinking & peeing, then the dose is most likely too low. If he is doing fine and not showing a lot of symptoms, then I think there's more leeway for experimenting with lowered doses.

I had originally thought the dose was too high based on the results back on 4/23. Now I'm wondering if that was just a fluke day, and the dose is too low. I'm not sure though, and would not argue with a lowered dose trial, unless there are ketones, or just really major symptoms that would suggest the dose is definitely too low.

Hope that helps! Sometimes it just takes some trial & error to figure out what is going on and what to do. Some luck out and their cats get beautiful numbers pretty easily, but I'd say that is more the exception than the rule.
 
As to a 1.25 trial though, you just did that, right? Did you see the recent #s on that dose Lori? I wouldn't retry that, you've just done it and the results were no good. I'd either try 1u if you want to decrease, or I'd raise to 1.75.
 
No ketones, and while he's still peeing lots, it's not as much as when he was first diagnosed (or at least I don't think it is as much).
 
bad me...i did'nt really gaze at it, just took a quick look.
so yeah, 1 unit should speak volumns either way. it should show up as too little or just right. or maybe neither and then we dance some more.
 
Well, Alex was almost at 400 before the shot this morning. I dropped the dose to 1 unit. I guess we'll see what happens. Won't have a chance to test again until time for the evening shot, but I can try to test again before bedtime.

I changed the litter this morning, so will be able to better tell if this dosage is having an impact on urine output.

Thanks for hanging with me.
 
Looking back at my spreadsheet, I don't really know if I gave the 1.5 dose a decent chance, (tried it twice--the first time I decided to go back to 1.25 because I wanted to increase slowler (3 cycles), the second time I increased b/c 1.25 didn't seem to be working(5 cycles) Nevertheless, I decreased the dose back down to 1.0.

Any time I do a dosage change, he seems to respond positively for a few cycles.
Tested negatavie for ketones.

Check out his SS.
 
The numbers are a little lower than you were getting. They certainly aren't any worse. I think I would stick with the one unit over the weekend, getting some numbers - maybe even a curve? What do you think?
 
Hmmm, confusing results, woohoo! ohmygod_smile I'd probably stick with 1u for a little bit too. I mean, it doesn't look like enough insulin, but then the #s seem better than on the higher doses. So maybe he's one of those kitties who needs a longer settling period on a steady dose and maybe #s will improve? Worth a shot I guess.

How are his symptoms though? If he starts drinking & peeing a lot more, or goes off food or anything like that, I would raise back up. Are you testing for ketones?
 
funny joanna, i was gonna say stick with dose, get a curve this weekend and who know's...maybe another reduction.
seems the lower dose is giving better results. why buck the trend?
 
I tested for ketones last night--negative.

And he definitely peed less yesterday and today. I don't think I can get do a curve tomorrow, but maybe I can get a few readings on Sunday.

His diagnosis and treatment have consumed me. Other than going to work, I really haven't done much for the last 6 weeks except worry. Most people think I'm a whacko, but ...... So tomorrow, I'm going to try to get out and "be normal" during the day and go to a Cirque du Soliel show tomorrow night.
 
Since there are alot of low dose kitties here lately how do yo feel about droping to .5u to see if you fall into that category too.

With the absence of ketones I think that it is safe to try it just to be sure.
 
I really don't know. In earlier conversations, I think most thought I should increase to dose to over 1.50, but less than 2.0. I'm concerned I'm not giving any of the doses time enough to work, but you all certainly know more about than me.

The litter box looks wetter this morning than it has the past couple of days.
 
What Cirque show are you seeing. We havn't missed one that came here in the last 3 years. If you get to Vegas be sure to go to see O, it's fabulous.

Have a great weekend.
 
The one thing all the posts have in common is to stick with this dose thru the weekend at least. So there is one common thought.
Hope your having a beautiful day for YOU!
 
I think it's ok to hold this dose for a few days, let yourself relax and "normalize" :lol: (yeah, we don't do normal very well here!) and keep gathering data (within reason, no need to overdo it, but a few spot tests when you can will be useful). Hopefully it will become clearer how this dose is doing. Really PZI settles out pretty quickly, but for sanity's sake I don't think there's a big rush - especially if his symptoms are improving rather than getting worse, that is a great sign!

If you did want to try reducing a hair more, I'd probably compromise on 0.75 and see where that gets you.

[ETA I guess I read it wrong, first I saw "less pee" and now I see it's more. So hmmm. Maybe hold the dose and see which way the trend is going. If the peeing is headed up, I would go up on the dose rather than down.]

p.s. the news just had a piece on using pee as a renewable energy source... hey, let's put the sugar-kitties to work! :lol:
 
Ginny & Alex said:
His diagnosis and treatment have consumed me. Other than going to work, I really haven't done much for the last 6 weeks except worry. Most people think I'm a whacko, but ...... So tomorrow, I'm going to try to get out and "be normal" during the day and go to a Cirque du Soliel show tomorrow night.
Click to expand...

Boy, do I know that feeling! I'm in exactly the same boat but now I'll be going out of town for 5 days this week, on a trip that was planned before her diagnosis. And leaving her has me worried since she's all over the map with number's & dose! Hope you had a good day yesterday!
 
Well, I did a little shopping yesterday and we saw Ovo (a Cirque du Soliel) show and I had a pretty good time, but found myself thinking about Alex too much. When we got home about 1 hour past the time for his PM shot, I was getting really antsy.

Barbara, what are you going to do when you're out of town? Somebody coming into your home? Alex rarely lets anyone but me and my husband touch him, so I haven't even thought ahead that far. We usually take a couple of big trips (10 days or so) each year, but I don't know how we're going to manage that. I'd like to get him regulated first, then I'll think about vacations.

Anyhow, he's still holding in the middle-300s, but as we say in Kentucky, he's peeing like a race horse. BTW, how often should I be testing for ketones?

I value your suggestions.
 
If you are seeing different behaviors like more litter box time, you can certainly test more often - even once daily.

Still eating and drinking well?
 
Ginny, my husband will be here & he can test & shoot but he is very careless & forgetful so I'm a little worried. I will be able to talk to him & text so hopefully all will be ok. Glad you had a good day, even though you though of Alex too much. :smile:
 
Discouraging, Genny. But we are still missing any mid cycle numbers. My initial reaction is "that didn't work", but without any nadir numbers, we can't be positive. Since you can't get them during the day, would you be willing to set the alarm tonight and get a +3, +6 and +9? Then we would be able to say it didn't work or it did.

Same thing if you go back up, we have to get some mid cycle numbers to see whether those highs are just too little insulin or whether they are a reaction to a lower number.

Without some more data, we are guessing and not doing a very good job of it. :mrgreen:
 
I have a big work day tomorrow so don't want to get up twice during the night (plus my regular get-up times for my personal potty breaks), but I will be at home on either Wednesday or Thursday during the day. I could do the 3, 6, 9 and 12 then.
 
That would be good. Guess we should stick with the lower dose till then? For now, at least, it doesn't look worse than the higher dose - just not any better. Be sure all the other signs are okay if you stay down with the low dose - ketones okay, eating and litter box okay.

These kitties just don't make it easy for us......
 
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