Too Much or Too Little Insulin??

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pistull

pistull

Member Since 2011
Hello All! My cat, Gizzy and I are new to this site but certainly not new to FD or the TR Protocol. Gizzy was first diagnosed in 12/08 and was OTJ from 2/23/09 - 8/23/10. After 8/10, I didn't need to dose him every day - I only dosed him when he needed it. However, as of 1/20/11 - I can't seem to get him regulated. He seems to be in high flats and I'm having a hard time determining if it's too much insulin (Somogyi rebound) or if he needs more insulin. Can you please take a look at his #'s and let me know what you think?? He's on Lantus.....and eats only Fancy Feast (Classic) foods. Gizzy is 12 years old, an orange tabby, weighs 14 pounds and is the love of my life!

Background Info: He had his teeth cleened in 11/2010 and I just had him at the vet on 2/1/2011. She put him on antibiotics because he had the red line on his gums and she said his lymph nodes were a little enlarged. Also, as a side note, our other cat had a BAD case of upper respiratory infection in November....he still has a runny nose and sneezing sometimes ($1500 vet bill and 4 months later....I'm starting to believe that he has feline herpes). I'm sure that Gizzy has it too since they live in close quarters....I have no idea what the correlation between feline herpes and feline diabetes is???? Does anyone know if he has that - can he ever go back into remission again??

**I will work on getting this into a spreadsheet (as soon as I can figure out how to log my #'s on it accurately! I think it's too early on Sunday , my brain is not thinking in "graphs" yet this morning!!).

1-14 (day we left for vacation) 238 .5u (he hadn't had a shot in 5 days prior to this one)

1-20 (day we got home) 356 .5u (started him at .5u because that's what he's been on forever - thought this would jolt him back)

1-21 +13.5 252 .5
1-21 +12 342 .5

1-22 +10 396 fat .5
1-22 +4.5 363
1-22 +10 352 .5 (bought new insulin - thought this may be the problem...)

1-23 +9.75 238 fat .5
1-23 +10 389 1u (.5 obviously not working)
1-23 +10 215 1u

1-24 +10.25 51 (hmmmm......rebound??)
1-24 +18.87 103
1-24 +21.76 337 1u

1-25 +10 323 1u
1-25 +10.5 337 1u

1-26 +12 349 1u
1-26 +6 177
1-26 +11 310 1u

1-27 +10 350 .75u (not sure why I switched him here - but I did. Dumb)
1-27 +10 311 .75u
1-27 +6 245
1-27 +10 381 .75u

1-28 +10 383 1u
1-28 +11 481 1u

1-29 +6 209
1-29 +11.5 402 1u
1-29 +5.5 212
1-29 +10 400 1.25u

1-30 +10 341 1.25u
1-30 +6 178
1-30 +9 303
1-30 +10 ?? 1.25u (didn’t test – hubby had to dose him. Pretty sure he would be over 300 though!)
1-30 +6 365 (hubby swears he dosed him correctly – but how the heckcan this be???)
1-30 +10 408 1.25u

1-31 +10 317 1.25u
1-31 +10 235 1.25u

2-1 +8.5 389
2-1 +10 436 1.25u
2-1 +7 354
2-1 +10 295 1.25u
2-1 +11 318 1.25u
Saw vet today and gave first dose of antibiotic (Baytril) this evening

2-2 +10 153!!!!!!!!! (should have dosed but didn't know if he was going up or down)
2-2 +10.75 218 1.25u
2-2 +6 281
2-2 +10 246 1.25u
2-2 +10 425 1.25u

2-3 +10 350 1.25u
2-3 +10 302 1.25u

2-4 +10 373 1.5u (upped dosage slightly)

2-5 +10 388 1.5u
+2 384
+4 371
+6 349
+8 333
+10 342 (he did sneak one bite of banana bread – figures – the day I’m curving him!!!)
+12 336 1.5u

2-6 +10.5 293
+12 368 1.5u
 
Hi & Welcome to Lantus land--You arent a newbie so you know that Any infection, no matter how small can drive up the very best BG numbers--When you gave Baytril he did come down somewhat--
Also you are doing some dose hopping--You need to give one dose at least 6 cycles to get into cat's system..
And perhaps because you have returned here to give regular dosing, you need to hold the dose even for like for 5 days---But changing the dose every day is certainly not going to yield any good results--
You MUST be consistant & Patient!--Lantus needs consistancy--Keep giving the baytril & decide on one dose!

We have dosing helpers here that can assist you--The protocol has changed & you need to re-read the stickys-Not meant ina bad way, but things are done differently now--
But even in 2008 when I came, we still held the dose for at least 3 FULL days for a long timer & 5-7 days for a newbie, which you are really coming back on a regular basis--
Others will stop by & give advice --Good luck!
 
Roni and Moonie said:
Hi & Welcome to Lantus land--You arent a newbie so you know that Any infection, no matter how small can drive up the very best BG numbers--When you gave Baytril he did come down somewhat--
Also you are doing some dose hopping--You need to give one dose at least 6 cycles to get into cat's system..
And perhaps because you have returned here to give regular dosing, you need to hold the dose even for like for 5-7 days---But changing the dose every day is certainly not going to yield any good results--
You MUST be consistant & Patient!--Lantus needs consistancy--Keep giving the baytril & decide on one dose!

We have dosing helpers here that can assist you--The protocol has changed & you need to re-read the stickys-Not meant ina bad way, but things are done differently now--
But even in 2008 when I came, we still held the dose for at least 3 FULL days for a long timer & 5-7 days for a newbie, which you are really coming back on a regular basis--
Others will stop by & give advice --Good luck!
Click to expand...
 
Thanks Roni - I will re-read the stickies to see what has changed. Thanks for your quick reply! I'm going to stick at this 1.5u and see what happens. I'm just very concerned because he has NEVER not responded to insulin and I haven't had him above1.5u since he was newly diagnosed! UGH. Praying he's not becoming insulin immune.... Patience is not my strong suit - but I know that's the name of the game when it comes to FD! Poor Guy, I feel so sorry for him - he's miserable while I try desperately to figure this out! I hope he can hang in there with me one more time! Thanks again!! I look forward to more conversations!! :smile:
 
Setting up the spreadsheet and posting in your signature as suggested in the other forum would help you as well as others to advise you.

It looks like you are giving shots 3x a day ...sometimes.
Lantus is to be given 2x a day - 12 hours apart
 
The "red line" on Gizzy's gum suggests there's an inflammation/infection present. This can raise BG. The clavamox may help but it would be better to discuss getting a dental with your vet.

There are a couple of points from the info you provided that may be worth considering.
  • I don't know that shooting Lantus "as needed" really is effective. You never get a shed to fill if you aren't giving Lantus twice a day for at least 5 - 7 days.
  • If Jan. 20th was when you first started giving Lantus BID, in order for a shed/depot to get established, you needed to be shooting the same dose for 5 - 7 days.
  • Doses need to be held for 2 - 3 days. In some cases, you're shifting Gizzy's dose around from one day to the next and this can cause numbers to be wonky.
  • Did you give 3 shots on several days? This could easily put your cat into an over dose range and trigger a bounce. While there are some individuals who have their cats on a TID dosing regimen, this isn't done until all other options are exhausted and it's clear that they are not getting the duration from Lantus that is needed.
  • It looks like you are giving early shots. It may be better to increase the dose and shoot every 12 hours than relying on early shots. It's hard to assess that, though with the data you have. Did you adjust your shot times based on having given early shots? If you shot early and then shot late, this also can cause numbers to fluctuate oddly.
  • You need more spot checks throughout the cycle in order to assess the dose. As you know, Lantus dosing is based on the nadir and having tests during both the AM and PM cycles will allow you to better understand Gizzy's insulin needs.
All of the above factors may be contributing to why you are seeing the numbers you are seeing. Which TR protocol are you using? If you are new to this site, you are probably less familiar with the Tilly Protocol which is based on Jacqui Rand, DVM's published research. We use a slightly modified version of these two protocols. You can find the links to the actual protocols in our TR sticky at the top of the Board.
 
When Gizzy was first diagnosed, I was on a different site using Elizabeth Hodgkins TR Protocol. Based on his #'s, he would run out of overlap fast, so I always dosed him at +10 so he didn't run out of insulin between doses. (Sometimes, if I would shoot him at midnight or 1am - yes, he would end up getting 3 doses in a day.) If his #'s were low at +12, then I would continue to test every 2 hours and shoot when he needed it.

Switching to twice a day will be much easier (and will make my vet VERY happy!!)

I just had a dental done in November 2010. Because all he eats is canned cat food, he does have tartar on his teeth - but man, I hate to put him through that procedure again! If this antibiotic doesn't yield any results, I guess I will have to consider it again...

So for right now, I will keep him on 1.5u (I just worry that dosage is too high...but I guess if his #'s are still too high it's ok??) I'm still confused as to how I know if it's rebound or if it's still not enough insulin? Is there something I can look for?

I'm supposed to touch base with my vet tomorrow too and giver her the curve results so she can further advise.....but I value the opinions of people on this website very much as you have lived and breathed FD!!
 
I didn't want to assume, but I thought you were using the Hodgkin's protocol. I know that method was popular for a time. What I personally like about the Rand/Queensland protocol is that there's research to back it up -- and not just anecdotal research. Her protocol has been through peer review in order to be published in the top tier vet journals.

There are differences in what we do -- particularly around early shots, TID dosing, and the use of high carb food to manage the curve. IMHO, the protocol we use here is far safer for your cat.

Please let us know how we can help. This is a very social group so please read our condos (it's what we call our daily thread - one condo per cat per day) and ask questions. People are always around to lend a hand. I hope you'll post regularly.
 
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