? 2/27 Bella AMPS 219 PMPS 301 increase? Advice?

Bella is heading into her 8th cycle of 1.5 u of Lantus.
She’s still loving yellows and some pinks. but has had some blues too!! Yeah
Her urine ketones remain negative and she is looking and acting well...
Except for some very occasional retching without vomiting being helped with 1/3-1/2 tab Cerenia once daily.

She’s seeing the home visit vet on Thursday. Vet is going to check out her mouth and do a PSL to check for pancreatitis.
She will also check her weight. I know she had gained some.

Anything else I should ask her about or have her check?

I know every cat is different.. is Bella making progress? It’s hard to tell when I look at her “numbers”

I don’t know what to think.
Should her dose be increased????
Advice appreciated!
Thanks

 

Here is the link to yesterday's post for continuity. http://www.felinediabetes.com/FDMB/threads/2-26-bella-pmps-75-should-i-shoot.191777/#post-2140024

With SLGS, you hold the dose a week before evaluating what to do next. This is just day 4. Wish we knew if yesterday's 75 was real or a bad strip. The decision on whether to increase or decrease is based on the low numbers or nadirs.

 

She is still a bit high, I think she's ready for 1.75. The fastest you can increase on TR, in general, is every 6 cycles. As long as she's having mostly yellows and pinks with occasional higher blues, you can post on every 5th/6th cycle to get opinions on an increase for what would be cycle 7. You don't want her sitting in a dose that isn't moving her much for too long. It would be handy to read up on the TR sticky, since that's mostly where you are with the amount of testing you do and more frequent increases.

I think Bella is making great progress: she's gained weight, she feels good, negative ketones, now we just need to get the numbers down, it will happen!

Ketones negative, awesome! Keep it up, Bella!

It's awesome that she's gained weight and good that you are checking her PSL. I hope the vet visit goes well!

 

Oh, I’m almost positive it was a fluke. Bad strip
Her numbers after didn’t add up.

 

Thank you
I will probably increase her tomorrow or a Thursday ... we will see.
So this is a relatively “normal” pattern?
Am I dealing with insulin resistance?
Miss Bella’s body seems to be working against the help we are trying to give her.

 

Miss Bella's numbers look rather normal for a newly diagnosed cat. Insulin is a hormone, not a drug. Which means you don't always see obvious improvement with each dose increase.

 

It is normal in that until you find a workable dose, you're going to have numbers like these. It's a bit of waiting game and ECID, some will start working the juice right away and some take a few months. I always found it helpful to look at other cat's SS and go back to when they first started insulin to see all the different ways kitties arrive at "regulation".

Insulin resistance (IAA) is a high dose condition you get a blood test for, are you thinking of glucose toxicity perhaps?

I don't think Bella is working against this, think about where she started and she wasn't feeling great or eating well when you gave insulin, she's come a long way since then, getting the numbers in line is the next piece of the puzzle.

After you read up on TR, see if it's a good fit, if you have any questions, ask, but if you decide it works, change your signature as if you list SLGS, you need to wait 7 days for increases, generally.

 

Thank you
Great advice!