Hi Rachel,
I'm just 'importing' Alexi's post from the other thread for reference here:
Hi Rach - just had a look at your SS and agree the dose should come down, I would try a 1.5 this evening and check at +2 and +3, you are looking for a gentle drop, the current dose is hammering down her numbers. You can always drop again in the morning if you are not comfortable, I expect she may bounce a bit today so the PMPS may be higher than expected. It's best to best to come to the board for dosing advice as you get more eyes on her numbers.
There is a lot of very sound advice in Alexi's post. I second
everything that she's said.
All of us want to see our cats in 'good numbers'. But increasing the dose too quickly can bring about unintended consequences: The cat's blood glucose can drop too low and/or too
fast. If a cat's blood glucose does drop too low or too fast this can cause the blood glucose levels to 'bounce'/rebound to higher levels. Note: "Too low" doesn't
necessarily mean 'dangerously low'. A bounce can be triggered just because a cat's blood glucose drops lower than it has become accustomed to.
(But it has to be said that raising the dose too fast can also cause hypoglycemia...)
There are some particular factors to take into account with regard to
cats that are newly diagnosed. When a cat is first diagnosed it's pancreas will be producing either a reduced amount of insulin or no insulin at all. The cells of it's body may also be damaged by persistent high blood glucose and may be less able to take up insulin.
When we start injecting insulin that can change the dynamic dramatically. A number of things may be happening at once. There is insulin for the body to use. The body can begin to heal as a result of that. The damaged cells of the body may become increasingly receptive to insulin. And the pancreas may begin to produce more insulin of it's own (in addition to what we are injecting). These factors, combined, are very good reasons to be
especially cautious with the insulin dose in the early stage of treating feline diabetes. Folks who increase the dose too quickly may soon find themselves back-pedalling....
fast....
Insulin type is also a factor.
Caninsulin/Vetsulin has a
reputation for dropping the blood glucose fast in cats (though this isn't
always the case). Higher doses can mean faster drops in blood glucose: And sometimes that may mean that the blood glucose can drop faster than the caregiver can easily keep up with. ...Yet another reason to be cautious with the dose, especially in the initial stages of treating diabetes.
I do hope my post doesn't sound 'negative'. That isn't my intention at all. Please know that, as Mary Ann says above, some cats have done just fine on Caninsulin, and quite a few of those have gone into remission also. (I've been on the forum for 9 and a half years and (probably because I'm in the UK) have observed a lot of Caninsulin cases...)
My intention is only to
advise caution with regard to dosing, especially in the early phase of treatment.
Eliz
