Thankfully Dusty seems to be improving in general health, as well as things like quality of skin & coat, and is certainly a lot more lively now, and the food is going down well.
That's really good news. It's great that there's an improvement in clinical signs and demeanour.
We did the two BGCs as shown on her sheet initially and then took those results to our vet when we went for Dusty's checkup on the 2nd October.
The vet's advice was to increase Dusty from 1U to 2U twice a day of Prozinc to try and bring those numbers down. I also mentioned that we were intending to (imminently) change Dusty's food to a low carb food to help correct the BG level.
It was the vet's opinion at the time that doing both would be ok, as actually both changes would take a period of time (they said 10 days?) to really take effect and settle down.
Just a note of caution... Something we've seen here time and time again is vets increasing the dose of insulin based on maybe a curve showing high numbers, when in fact the dose was already too high...
We had a truly spectacular example of that a few months ago when a new member joined with a cat in very high blood glucose numbers. At the point where she joined the forum the vet had just increased the dose to
6 units. And the vet was starting to conclude that the cat was 'insulin resistant'.
The member started homestesting straight away, and it almost immediately became apparent that the dose was too high. She reduced the dose substantially planning to work up again from that point. But even the reduced dose was too much. She needed to keep reducing the insulin, and about ten days later the cat was off insulin completely and in remission... Her vet was amazed....
While the situation of vets overdosing cats is not at all uncommon here (sadly), this must be one of the most dramatic examples we've ever seen of this. And the member learning to homestest so promptly almost certainly save the cat's life.
Fortunately, Dusty is on a much smaller dose. But the dose was raised on the basis of a couple of days of high numbers,
and while Dusty was on a higher carb diet. Reducing the carb content of the diet can reduce the blood glucose significantly in some cats, and can often mean that the insulin dose needs to be
reduced. For that reason we wouldn't recommend increasing the insulin dose at the same time as reducing the carb content of the diet.
It may well be that Dusty
does need the higher insulin dose, or even might need
more; but it is not really possible to determine that on the basis of the data that you have so far.
Many vets seem to be of the opinion that 'rebound' (or what we commonly call 'bouncing' here) is fairly uncommon, but in fact we find it to be
incredibly common here. But then we have the opportunity to see the data from a huge number of cats, while most vets may only deal with a few cases at a time. And the data they mostly see may be from occasional blood glucose curves (or from fructosamine tests). If those curves were done on a day when the cat's blood glucose was in high numbers due to 'bouncing' then the vet might well conclude that the cat needs more insulin....
In a nutshell, bouncing works like this. If the blood glucose drops too low (or sometimes too fast) the body, sensing danger, can release stored glycogen to raise the blood glucose level. It can also release counter-regulatory hormones, the purpose of which is to try to keep the blood glucose level from falling (temporary insulin resistance). The result of this can be high 'flat' (unmoving) blood glucose levels that seem unresponsive to insulin. The effect can last up to a few days in some cats.
The insulin dose doesn't need to be dangerously high for bouncing to occur. Quite often a cat will 'bounce' just because the blood glucose is dropping to a level lower than it has become accustomed to.
Whenever there are high flat numbers bouncing is always a
possibility. This is why regular hometesting is so useful: The data from that can usually show whether high numbers are due to too little insulin, or too much.
Really hoping that you see some better numbers from Dusty very soon.
And good luck with Saturday's curve. Do let us know how it goes.
Sorry for long message....
Eliz