? 4/26 Tuxie AMPS-338;+2-385:+5-329;+7-227 PMPS-342 Still high and flat

[Tuxedo Mom]

APLHATRAK2 PET METER

Yesterday's posting:

http://www.felinediabetes.com/FDMB/...-new-dose-wonkiness-last.136838/#post-1411701

Tuxie has completed 6 full cycles at the 5.75 units and his numbers have not come close to where they were a the lower dose. There is no "outside" reason..the insulin is good; he has no infections; same food and feeding schedule; he was already tested for Acro and IAA.

Thoughts on whether I should go back to the 5.50 units?? That dose had a much better response overall.

 

[Wendy&Neko]

You've increased in safe amounts each time - I don't think you've bypassed a good dose. Instead, I think you need to go up. And when kitties get to over 5 units, we suggest going up in .5U amounts. Think the rule of 10%. What a .25U increase is for a 2.5U dose kitty is what a .5U increase is for Tuxie at this point in his dance. However, Tuxie did get down to a 227 on the AT2, which we'd consider a blue, so you could wait a couple of cycles before increasing. If he was bouncing due to the blues on 4/23, he should have cleared that by tonight (6 cycles).

Numbers don't always make sense when you are increasing. You'd think that by adding more insulin they'd get better numbers. But insulin is a hormone and doesn't always make sense. As long as you've increased safely, just keep on increasing per the protocol until you get numbers in normal BG range. You may have to go up over a dose where he previously earned a reduction. It's quite common for kitties to have to dance around up and down a dose before they finally spend enough time in green to "get it".

 

[Tuxedo Mom]

You've increased in safe amounts each time - I don't think you've bypassed a good dose. Instead, I think you need to go up. And when kitties get to over 5 units, we suggest going up in .5U amounts. Think the rule of 10%. What a .25U increase is for a 2.5U dose kitty is what a .5U increase is for Tuxie at this point in his dance. However, Tuxie did get down to a 227 on the AT2, which we'd consider a blue, so you could wait a couple of cycles before increasing. If he was bouncing due to the blues on 4/23, he should have cleared that by tonight (6 cycles).

Numbers don't always make sense when you are increasing. You'd think that by adding more insulin they'd get better numbers. But insulin is a hormone and doesn't always make sense. As long as you've increased safely, just keep on increasing per the protocol until you get numbers in normal BG range. You may have to go up over a dose where he previously earned a reduction. It's quite common for kitties to have to dance around up and down a dose before they finally spend enough time in green to "get it".

Thank you for the information. It is terribly frustrating when I go from decent periods of blues then end up with mainly reds and pinks!! If I hadn't already had him tested for acro I would be wondering about that. I really would like to see a reduction at some point rather than increases all the time

I am going to give this dose another day then increase it by .25 up to 6 units. I will out for appointments for few days beginning of the week so I may not be able to test as closely. Plus it is SO much easier to measure 6 units rather than 6.25 units. My eyes get wonky trying to eyeball the space between 1/2 unit and 1/4 units

 

[Vyktors Mum]

Purrdy showed promise for a bit at about 2.25 units but then didn't get it again until 4.25 - they are cats it's part of their job description to confound us .

To make the dosing easier (we don't even have syringes with the half units marked here) I make up a sample syringe with colored water. I spend a bit of time getting that one just right and then find it much quicker and easier to draw the shot as I have something to compare it to rather than trying to measure it precisely all over again. It helps in keeping the dose consistent too.

 

[Tuxedo Mom]

Purrdy showed promise for a bit at about 2.25 units but then didn't get it again until 4.25 - they are cats it's part of their job description to confound us .

To make the dosing easier (we don't even have syringes with the half units marked here) I make up a sample syringe with colored water. I spend a bit of time getting that one just right and then find it much quicker and easier to draw the shot as I have something to compare it to rather than trying to measure it precisely all over again. It helps in keeping the dose consistent too.

Yes..it would be SO much easier if our kitties had read the treatment protocols and actually followed them

I can't imagine how you can do dosing without the 1/2 unit markings!! That would drive me batty (or battier than I already am..lol) It is still doable to do 1/4 unit dosing with the ones that I have but since I really need new glasses and have been putting that off (due to expenses) doing 1/2 unit dosing is not a problem and so much easier.

 

[julie & punkin (ga)]

Do you have the # for his IGF-1 (acro) test, Mary Ann? Was the testing done by Michigan State University?

I think you might end up needing to be aggressive in the dose for a few days to get him back into better numbers. He's spending a lot of time pretty high. When you increase, I'd just hold the 6 cycles and if you don't see green go ahead and increase again. The rule of thumb is to not hold a dose that's not getting a cat into normal numbers because Glucose Toxicity readily develops.

 

[Tuxedo Mom]

Do you have the # for his IGF-1 (acro) test, Mary Ann? Was the testing done by Michigan State University?

I think you might end up needing to be aggressive in the dose for a few days to get him back into better numbers. He's spending a lot of time pretty high. When you increase, I'd just hold the 6 cycles and if you don't see green go ahead and increase again. The rule of thumb is to not hold a dose that's not getting a cat into normal numbers because Glucose Toxicity readily develops.

Julie his IGF-1 was done at the end of February at MSU. It was 68 with a reference range of 12-92 nmol/l. I also ran the IAA at the same time and it was negative. So either he is negative for these or it could be early stages. I ran the tests along with the UCCR oral dex test for Cushing's because of his non-response to insulin at that time (both Lantus first then Levemir) and because of the organomegaly (pancreas, liver, adrenal) which gave him the potbellied appearance.

However this morning his AMPS shot was 191 (AlphaTrak meter) so something is going on. I never tested after +5 last night so I have no idea what went on over the 7 hours in between the two tests. I shot .25 units less (5.50 units) and will monitor carefully this morning.