9/23 Toby's PMS=432+2-395

Longing for the day when I can put a lower number in that post box. Toby just hasn't got with the program yet.
Have a great day, Peg and Toby

Re: 9/23 Toby's AMS=423

Neg. on the ketones. At least one good thing to report. Peg and Toby

Re: 9/23 Toby's AMS=423+4=338+8=340

Don't know why Toby won't come down to better numbers. Seems like he is always so high. I know I'm not the only one but wish he would have some improvement. He is on quite a high dose of insulin. I know the steroids don't help. But a gal can hope.
Peg and Toby

Re: 9/23 Toby's PMS=432

Well we got red again tonight better luck tomorrow. He's not drinking a lot of water and he only pees 2 or 3 times a day.
Wouldn't know anything ails him except for the high bg numbers. Do you think I have to test tonight? Peg and Toby

Re: 9/23 Toby's PMS=432

Hi there

Peg and Toby said:

Neg. on the ketones. At least one good thing to report

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That one thing is HUGE dancing_cat

Peg and Toby said:

I know the steroids don't help.

Click to expand...

Steroids? I was not aware. Please fill me in.

Peg and Toby said:

Longing for the day when I can put a lower number in that post box.

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I remember that feeling well. . .that and having the kitty with the highest dose of insulin in all of LL at that time.

keep on keepin' on... the day will come when things click.

eta - regarding testing tonight, get a +2 and take it from there. If it doesn't warrant further testing I'd get some rest and try and grab a +10 or +11(that end of the ss is getting a little sparse)

Re: 9/23 Toby's PMS=432

Toby is on Prednisolone 2.5 mg 2 x day for inflammatory Pancreatitis We've tried to take him off several times in a year.
He always gets real sick vomits, fever, lethargic,and has to be syringe feed for three or four days. We have to up the pred. to
10 mgs until he feels better. So my vet. and I agreed if he was going to have any quality to his life. we would leave him on the
2.5mgs 2X a day. As long as he stays on it he hasn't had any trouble. Don't know if it caused the diabetes or not . Every time we stopped the steroids his bg would go up and so would the units. We went to two vets. for this one was an all cat vet. Both said the same thing. So that's our story. Peg and Toby

Re: 9/23 Toby's PMS=432

Thanks for the details.

It sounds like the pred definitely improved his QOL.

I don't have personal experience with pred and FD both, however it may be contributing to high numbers.
I'm sure others here in LL have experience to share.

In any case, no worries. keep increasing as per the protocol and try not to focus on the size of the insulin dose - he needs what he needs.
Nothing wrong with him being a 'big gulper'

Re: 9/23 Toby's PMS=432

Peg --

You may want to put Toby's meds in your signature. Especially if a steroid is being used, it's a reminder about what factors may be effecting the numbers.

WOOT on the negative ketones! You do a great job of keeping up on that!

When you increase his dose, take a look at the nadirs of the previous 6 cycles. If he is mostly over 300 for nadirs, go ahead and increase by 0.5u rather than 0.25u.

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

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I know how discouraging it is to see constant high numbers. Hang in there - as others have said, some kitties just need more. The pred may be a factor in his high numbers, but the process is the same no matter the cause - review every 6 cycles and increase. If he is constantly over 300 you do have the option of increasing after 4 shots at a dose.

The Tilly Protocol page is another variation of the same protocol we follow, and it offers the option of increasing after 4 cycles:

Phase 2: Increasing the dose

Most cats need to have their dose increased. Do it in 0.25 IU or 0.5 IU steps (0.25 IU if the cat is getting a low dose and/or relatively low BGs, 0.5 IU if the cat is getting a higher dose and/or relatively high BGs). Hold each dose for 5-7 days. However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU. Alternatively, if the cat is continuously producing moderately elevated BGs (nadir always >=200 mg/dl), increase the dose every 2-3 days by 0.25 IU ( if the cat is getting a low dose) or 0.5 IU (if the cat is getting a higher dose). From this point onward test for ketones once per week, or more often if the nadirs are still >=200 mg/dl.

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Sending you some virtual encouragement, Peg. It's hard not seeing your cat respond, but he will. :YMHUG: