? Dosing question?? 6/16 Chandler AMPS 353, +3 397, +6 344, +9 370, PMPS 386

[Ashley & Chandler]

http://www.felinediabetes.com/FDMB/...-4-25-323-pmps-356-4-193.230784/#post-2582615

Discussed upping his dose to 5.25u in the thread above on 6/10, but I wasn't going to be home to get a mid-cycle test the next day & his 6/11 AMPS was 180, so I stuck with the 5u - PM was in the 200s.

As you can see in his SS, 6/12 AMPS was high 300s, but then seemed to surf nicely in blue the rest of that cycle. Then PM onto 200s again.

6/13 started high in low 400s, down to 200s, down to mid 100s. 6/14 started off OK with mid 200s, but then up to 300s that cycle - PM cycle saw a mid 100s.

Yesterday, 6/15, started off better with 202, but then mid-cycle low-high 300s, & mid 400s at PMPS. Mid PM cycle got down to high 200s at +5. Then today has been steady 300s.

SO FRUSTRATED

Should I move forward with a dose increase? I still have limited data since I am still newer to the at home testing, but based off of a really good day, for him, on 6/5 getting into mostly blues & greens, I was/am hesitant about the increase & am not sure most days whether he is bouncing, resisting, or is just high.

Also, how much should I increase by? Previously discussed only upping by 0.25u, but I read on another post that the suggestion for TR is to increase by 0.5 once above 5u total/day & then increase by a full 1u once above 10u total/day - we are currently at exactly 10u total/day.

Thanks in advance!

 

[Si am cat mom]

It looks like you increased....I probably would have too since you are not new to numbers in the 100s on occasion. Chandler will let you know if the increase is too much.

I am not sure about the increasing suggestions you mentioned. I think the increments for increasing changes for 5 units/twice a day and then >10 units twice a day and not total... I have seen some folks that are giving 2.5 units twice a day ( which would be 5 total ) and I don't remember seeing anyone recommend that they increase by 0.5 at that point. I mainly posted here to bump this back to the top so someone might clarify that aspect of increases.

 

[Wendy&Neko]

I see your signature mentions feeding dry food, that means you have to follow SLGS. The 0.5 unit increase is for when the dose given per shot is 5 units if following TR. He definitely needs that dose increase, good luck with the new dose.

I just read back your previous posts, and no one answered you about the question regarding getting tested for IAA and acromegaly. If you are at all thinking it's a possibility, I would do it. One in four diabetic cats has acromegaly. My girl had it and IAA. You also don't need to be on a high dose to be tested for it. Most of Neko's diabetic life she was under 3 units dose, though higher when diagnosed with it. We've had IAA kitties on small doses too. It's just that when cats get to 6.0 units, then the chances are pretty good they'll test positive for one of the conditions.

 

[Ashley & Chandler]

I see your signature mentions feeding dry food, that means you have to follow SLGS. The 0.5 unit increase is for when the dose given per shot is 5 units if following TR. He definitely needs that dose increase, good luck with the new dose.

I just read back your previous posts, and no one answered you about the question regarding getting tested for IAA and acromegaly. If you are at all thinking it's a possibility, I would do it. One in four diabetic cats has acromegaly. My girl had it and IAA. You also don't need to be on a high dose to be tested for it. Most of Neko's diabetic life she was under 3 units dose, though higher when diagnosed with it. We've had IAA kitties on small doses too. It's just that when cats get to 6.0 units, then the chances are pretty good they'll test positive for one of the conditions.

I’m not feeding dry purposefully anymore for him. His sister is a dry addict so trying to get her off of it but a lot of times it’s the only way she’ll eat her wet (I put some on top) otherwise he would eat her wet as well. Occasionally, if I’m not paying attention or she walks away sooner than usual, he might start to eat hers in which case he may end up getting some pieces of dry.

For the testing, is it something that you can request the vet to do? Do I take him there & they draw blood & send it off?

I believe it might have been your reply to someone that I was reading about the dose increases - so if that’s the case & I’m trying to follow TR, then should I have increased by 0.5 instead of 0.25 like I did?

 

[Wendy&Neko]

OK, I'm glad you cleared up the dry with your signature. Any chance the sister would like a lower carb dry?

As for testing, yes, you set it up with the vet who does a blood draw and sends it to Michigan State University for both tests. Be prepared that many vets don't think the IAA is meaningful, some "forget" to add it. Insist on it. IAA is something that is self limiting and can go away, but can also impact dosing strategies until then. And some cats have just IAA. Since you have to pay for shipping to MSU, better get it done at the same cost. Add odd test cost is minimal.

As for the increase size quote, I kind of thought it was me. Yes, I'd go to 5.5, as long as you can monitor as you have been.

 

[Ashley & Chandler]

OK, I'm glad you cleared up the dry with your signature. Any chance the sister would like a lower carb dry?

As for testing, yes, you set it up with the vet who does a blood draw and sends it to Michigan State University for both tests. Be prepared that many vets don't think the IAA is meaningful, some "forget" to add it. Insist on it. IAA is something that is self limiting and can go away, but can also impact dosing strategies until then. And some cats have just IAA. Since you have to pay for shipping to MSU, better get it done at the same cost. Add odd test cost is minimal.

As for the increase size quote, I kind of thought it was me. Yes, I'd go to 5.5, as long as you can monitor as you have been.

@Wendy&Neko I'm sure she will be fine with a lower carb dry - I think she mostly likes the crunchy texture of it. I recently bought a small bag of Tiki Cat Born Carnivore dry (Chicken) because according to the document they sent me, it has about 10% carbs. I usually just sprinkle some on top of her wet & tap it down into the food so she has to eat wet with it, but the Tiki Cat kibble seems to be a bit softer than most, so she's not seeming to eat as much after I add it on top because I think she is almost 'losing' it within the wet food. Is there another good, lower carb dry that I could try that would be crunchier?

I will look into setting up the testing with the vet - if not sooner, he has to go back in August anyway for a checkup & to renew/update his insulin script.

I increased to 5.5 this morning, so we will see where that takes us. So I should hold this dose for 3 days & then go up if nothing changes? If we start seeing blue/green consistently, then stay at this dose longer? If we see some blue/green & then a bounce up to the high 300s & 400s again, do I hold for longer before increasing as well?