11/25 Mačka AMPS 382, +4 298 increase tomorrow?

Penelope and Mačka said:
http://www.felinediabetes.com/FDMB/...1-6-139-pmps-315-3-345-new-dose-in-am.222036/

Should I increase tomorrow?
I don't understand why his numbers never seem to be impacted by increases... They are the same as when he was at 3 units (he is now 4.25u). Is it what it looks like when a cat has acromegaly? Or an infection?
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My vet convinced me to cut Jackson’s dose and his numbers improved. I hesitate to mention it, since I’m no longer using the protocols here, but he went from 4.5 to 3.5 units and he does have better numbers, but they are still consistently yellow, with a blue here and there. I went to a specialist who said it’s possible Jackson has acromegaly, but I decided to think things over before I got the test, since the treatment options are limited. She also said maybe he was fine in higher numbers. He does seem much better on a lower dose of insulin. He’s actually running and playing for the first time since I adopted him. I didn’t feel good about increasing his dose every week with his numbers getting worse every week. I’m lucky in that there are a lot of specialists in my area and I have access to advice.
 
Penelope and Mačka said:
http://www.felinediabetes.com/FDMB/...1-6-139-pmps-315-3-345-new-dose-in-am.222036/

Should I increase tomorrow?
I don't understand why his numbers never seem to be impacted by increases... They are the same as when he was at 3 units (he is now 4.25u). Is it what it looks like when a cat has acromegaly? Or an infection?
Click to expand...
He just isn’t at the right dose yet. He’s spent a lot of time at higher numbers and so may have a bit of resistance.

If he gets to 6u bid, then we will suggest you test for IAA and acro.

The last time he got to blue, it took him six cycles to clear the bounce. Tomorrow is six cycles so if he doesn’t clear by tomorrow night, I would increase the dose to 4.5u.

Margie and Jackson said:
My vet convinced me to cut Jackson’s dose and his numbers improved. I hesitate to mention it, since I’m no longer using the protocols here, but he went from 4.5 to 3.5 units and he does have better numbers, but they are still consistently yellow, with a blue here and there. I went to a specialist who said it’s possible Jackson has acromegaly, but I decided to think things over before I got the test, since the treatment options are limited. She also said maybe he was fine in higher numbers. He does seem much better on a lower dose of insulin. He’s actually running and playing for the first time since I adopted him. I didn’t feel good about increasing his dose every week with his numbers getting worse every week. I’m lucky in that there are a lot of specialists in my area and I have access to advice.
Click to expand...

I actually don’t see that his numbers have improved and it certainly makes no sense why a vet specialist thought he might have acro but recommend you drop the dose back......and now raise it without knowing how low he’s going.

There are a few concerns I have about your statement:
  • Lack of testing especially preshots so that getting to the dose you got to (4.25u) was not based on any dosing method here. No one should have suggested a dose increase without knowing how low the dose was taking him.
  • Because you didn’t follow one of our methods here, we don’t know if one might actually have worked.
  • Normally, if the dose has been taken up systematically, testing as appropriate, and following one of the dosing methods, rebound checks, as you’ve done, are not necessary.
Certainly, it’s your choice how you dose Jackson but it does raise a red flag, as you suspected it might, to present it in a way that some might take it as something they should try. In the case of Macka, it would put him significantly behind if Penelope thought to try it.
 
Penelope and Mačka said:
I don't understand why his numbers never seem to be impacted by increases... They are the same as when he was at 3 units (he is now 4.25u). Is it what it looks like when a cat has acromegaly? Or an infection?
Click to expand...
It's a common misconception that adding a little bit of insulin should make the BG look a little bit better. Insulin is not a medicine, it is a hormone. You just have to keep increasing until you hit the fitting dose. It's not unusual to see not a lot of change as you increase. And I disagree that he looks the same now as on 3 units. On 3 units, a lot of his preshots were black or red, now you are looking at majority pink. Back at 3 units, you see blue for two hours and then it'd vanish. Now blues are lasting 6 hours or longer. There is improvement. And like Marje said, you are battling some resistance, likely from glucose toxicity. The 4.0 unit dose was held way too long.

The only way to know if a cat has acromegaly is to test for it. Penelope, it's not something I'd think about yet. I also want to comment on a lower dose looking better. It may if all you are doing is very limited testing. When Neko finally starting hitting greens, her preshots started looking a lot worse. If I hadn't done any mid cycle testing or PM cycle testing, I might have thought the higher dose was worse. If fact, it was the opposite, she was just doing some amazing bouncing. :rolleyes: The higher dose was finally starting to break through.
 
Thank you all so much for your input! I’ll see tomorrow how he reacts and will most likely increase after that. I actually prefer a very gradual improvement to a dramatic one :) let’s hope the right dose is not too far ahead!

Macka is not doing too bad overall and despite the 300s, he wasn’t thirsty today for example. His fur looks shiny. I really was expecting action tonight.
 
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