? 05/07 Elsie; AMPS: 307; +2: 350; +4: 313; +6.5: 276

Previously: https://www.felinediabetes.com/FDMB/threads/05-03-elsie-amps-249-2-273-4-290.289581/

Alright, I did yet another increase on the dose. We are at 3.25U but the numbers don't seem to be going down at all, they are staying high and looks like going even higher, certainly higher than when she was first diagnosed. Is it possible she has become resistant, or that this is a rebound issue? I know I'm missing some testing data from the last few months. Wondering if I missed a low dip during that time that has now sent Elsie back up through the roof. She seemed to initially be responding pretty well to the lower doses of insulin, but something has definitely changed. She doesn't seem ill or otherwise not herself. Should I continue to increase every 3 days?

I finally managed to get one more glargine pen from my old vet to cover the lag time between providers, but they have ultimately cancelled my prescription and have not allowed me any more refills (even though it was technically still valid/not expired). I started using this new batch of insulin, just to rule out the possibility of a bad batch or something contributing to the higher numbers. So far no change, but it's only been a day.

I scheduled an appointment with a new vet, but they are booked until July, so now we play the waiting game.

*Edit to add: I have never tested for ketones before, but I'm thinking I should get some supplies and start as long as she's going to be in these high numbers.

 

Ketones testing in high numbers is a good bit of insurance.

You might be seeing New Dose Wonkiness. NDW typically happens for a couple cycles and is over after the 3rd cycle. It is also possible she's developed some glucose toxicity, which is a type of resistance, and become used to higher numbers. Getting to the dose that moves her is the solution.

Out of curiosity, when is the last time Elsie had blood work done? Or had her teeth checked by the vet. Just trying to rule out other reasons for needing higher doses.