Tiffany AMPS 444 +2 446 +5 444 +7 388 - Need input please.

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Jadi & Tiffany

Jadi & Tiffany

Member Since 2017
Hello again,

Please do not beat me up. I have read all of the stickies, in retrospect I wish I would have done the start slow method, but being overwhelmed, I listened to the experts. (My vet and a diabetes specialist.) They have increased Tiffany's does aggressively and changed insulin in the first week.

My cat has not been doing well, but has done much better when I suggested that we decrease her dose to 4 units twice a day and my vet agreed. That seemed to be a turning point, where she stopped retreating and starting behaving like herself again! I have taken the advice of those here who suggested that and said to stay with that dose for at least 7 days. The numbers still are not great, but I am trying to be diligent about testing and am starting to see a pattern.

Respectfully, I know that many of you have educated yourselves in fd. I am looking for help with my cat.

My vet has suggested that she may be insulin resistant and need a specialist. I really do not want to go this route. Any advice would be appreciated.

Thank you!!
 
It is possible Tiffy has a condition that makes her insulin resistant but you don't need to go to a specialist if that is so. My Neko had two high dose conditiions that cause insulin resistance, acromegaly and IAA or insulin auto antibodies (think like an allergy to injected insulin). One in four diabetic cats has acromegaly which is a benign tumour on the pituitary that sends out excess growth hormone, which ultimately causes the diabetes. There are blood tests to test for these conditions. The blood has to be sent to Michigan State University but your regular vet can do that. I stayed with my regular vet until life got more complicated with heart and GI issues got adds to the list. Many vets were trained that acromegaly is rare, the research on how common it is is fairly new. But there is lots of knowledge in this forum.
 
Jadi Faul said:
The numbers still are not great, but I am trying to be diligent about testing and am starting to see a pattern.
Click to expand...
I meant to add that as you get Tiffy's numbers into a better range, spotting patterns becomes much easier. At this point it's mostly high and flat, though it does look like you are starting to see common nadir times. With the SLGS method, you would increase after 7 days by 0.25 units. In contrast, with tight regulation protocol you would increase by 0.5 units after 3 days or 6 cycles and nothing lower than a pink. Whichever method you chose, you will get Tiffy into better numbers - one method may just take longer but you have to pick the dosing method that works for you. If you do get her tested for high dose condition, the results may change the approach even on SLGS.

You both are still pretty new to this diabetes journey. The common saying is that it's a marathon, not a sprint. It's quite common to take a few months to make major progress. :bighug:
 
It's very common to be overwhelmed at first - we all remember that feeling. :bighug: Keep asking questions. It also helped me to remember than insulin is a hormone, not a medicine. So it's not like you add a little bit more and see immediate results.
 
That is also good to know. I will keep reading! It is overwhelming because you just want your kitty to feel better! Your words are a total blessing to me and I appreciate your knowledge and help!!
 
One more question, Wendy. Do you think we may have passed Tiffy's number? (I have asked my vet this over and over again and she says no.) Based on how much better she seems to feel, I think SLGS method is what I should do.
 
To me and looking at the spreadsheet, I don't think you have gone too high in dose. The fact that Tiffany is feeling better is also an indicator. Our cats are much more than just their numbers and they will feel better as you get closer to a good dose.

Whether you chose Tight Regulation or Start Low Go Slow depends on your circumstances. Both methods suggest getting AM and PM tests before you shoot insulin, to make sure it's safe to shoot. TR has faster increases, which may be appropriate if a kitty is mired in high numbers or has some sort of resistance going on. But you still typically hold a dose a minimum of 3 days, more if seeing lower numbers and do increases in smaller amounts that your vet had you do. By the way it's very common for vets to suggest increases of 1 unit at a time. If a kitty is eating dry food at all, the SLGS is the method to choose for dosing. TR suggests a minimum of 4 tests a day, SLGS says two plus spot checks and a curve once a week.

There are many various reasons people chose either SLGS or TR. I chose TR because my Neko was stuck in higher numbers and I wanted in her better numbers as soon as I safely could. One other thing you have to worry about with constant high numbers is something called glucose toxicity - basically kitty gets used to higher numbers and it takes going up a little higher in dose to break through. That happens to many kitties to start, especially if kitty has been diabetic for a little while before diagnosis. But as long as you increase methodically and safely (have to data to show it's safe to do so), then you will eventually get a dose that gets Tiffany in better numbers.
 
This is great information. I am having my husband read over this as well. Then we can make the decision of how to proceed. Thank you, again!
 
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