? 11/14 dose? Armani AMPS 436 +2 444 +4 384 +6 360 +8 372 +10 384 PMPS 332

Hello! On Monday (11/9) I asked for some dosing help for Armani after doing a curve on Sunday. Feedback was to keep his dose as is (it is currently at 3.5 units) and to do checks at +3, +5 and +7 for several days. I did this and have entered the information into his spread sheet. Would one of the kind experts be able to take a look? His numbers seem way too high, so (in my so-far limited knowledge) I'm wondering if his dose is too high and he is bouncing? However, he never seems to get low, so I don't know! Maybe he is a cat that needs a still higher dose? I'm so confused, and his numbers seem to be getting worse rather than better. Any help is much appreciated, thank you!

 

Hi - Welcome back! here's the link to your last post for continuity. Great job with the testing!

For your thread title, ideally you only post today's numbers rather than yesterday's - people will look at your SS for the history of #s and to get the "whole picture". Also, when you edit your title, you can pick the ? from the drop-down on the left - it helps identify that you have a question even though you have it in your title too; this board gets lots of posts so sometimes questions get unintentionally overlooked. Once your question is answered, you would edit your title and take off the ? mark.

Have you had a chance to review the Dosing Methods sticky mentioned in your last post? It's at the top of the board but I've linked it here for reference. Dosing recommendations by those more experienced may differ based on the method you want to follow (and you can always switch methods if one isn't working for you/Armani/your lifestyle).

Hope that helps some - at the least my comment will bump up your post.

 

Thank you so much for the help! I added the question from the drop down menu, thank you for letting me know to do this! I have looked at the dosing stickies, and don’t know which method would be best, I’ll do whatever is recommended. Also, since he is already on a big dose, I don’t know how to adjust his dose in an effective way. Hopefully someone can help with this. Thank you!!

 

Looks like Armani needs more juice. I’d say you’re fine to increase to 3.75U. Tight regulation will allow you to get him into better numbers faster but you do need to get a minimum of one additional test every cycle as well as the preshots.

 

Thank you for your help!! Just to make sure I'm doing the tight regulation correctly, I hope someone has time to help me with the following questions:

1) The sticky on tight regulation says to feed multiple times a day - is this essential and what would this schedule look like? I can't leave food out due to a second cat. I was thinking feeding at 7am, 11am, 3pm, 7pm, and 10pm - is this what is meant by multiple feedings? Some days I'm gone for work so this would be tricky (maybe a timed feeder if the other cat would leave it alone?). Would it be harmful for him if his eating schedule varies occasionally, or is it like the shots, it must be very consistent?

2) I'll keep him on 3.75 units as suggested for at least 6 cycles, basing any increases on his nadir. I'll keep doing curves, but when would be the best time for the additional test every cycle? I'm guessing around +6 for the AM cycle (until I learn when his nadir seems to occur), and as late as possible in the evening for the PM cycle? Is the point of the shot in the evening to make sure his numbers aren't quickly plunging, is this what I should be watching out for?

3) Assuming his numbers keep high after increases and I increase only .25 units at a time (and hold for 6+ cycles plus plenty of tests), how high should I try going with his dose? From reading about other people's experiences, I thought dose of 4 units is quite high, but the sticky link on tight regulation mentioned most cats are in the 1-5 unit range, but some in a German forum went all the way up to 10 units which sounds incredibly high. I'm wondering if there is a point above which I shouldn't go, or if it would signal he has another health problem.

Thank you all for your help, it is the most wonderful thing to have this support and guidance, I am so appreciative of all of your time and patience with my many questions!

 

Multiple feedings are easier on the cat’s pancreas and can help to flatten the cycles. The timing of what works best for your cat can be a bit of an experiment so keep notes in the comments section of your spreadsheet so we can see what works best for Armani. Assuming you shoot at 7am 3pm (+8) may be a little late in the cycle to be feeding Armani at this stage. The insulin is generally wearing off by then so feeding too late can cause numbers to spike up. 7am, 9am and 11am might be a better place to start. I understand you can get timed feeders that will only open for the cat they are meant for, not sue exactly how they work but might be something for you to consider. Note that even with SLGS multiple feedings are better.

You want to spread the additional tests around - think of the spreadsheet as a jigsaw puzzle, with more pieces of the puzzle spread around the picture becomes much clearer. Often a +2 can be a good indicator for a cycle, if it’s down significantly from the preshot test it’s likely to be an active cycle, before bed in the evenings is always good so you know if he’s safe for the night or if he might need an extra snack to prop him up, and yes you want to try and catch the nadir which is usually somewhere between +5 and +7 but as with everything - ECID (each cat is different) and some can be later or earlier than that and it can move. As you learn his patterns you will learn when the best times to test are.

There is no dose that is too high as long as you have got to that dose the right way. My mum’s kitty Purrdy was a Cushings cat and had doses as high as 20U - the link to his spreadsheet is at the top of Vyktor’s 2015-2016 spreadsheet if you’re interested, you can see that he was safe even with such a high dose). A cat needs as much insulin as it needs but it’s not until a cat gets up to 6U we would recommend testing for high dose conditions so Armani still has a way to go before you’d need to consider that.

Always happy to help someone that’s trying to help their cat you are more than welcome, encouraged even, to post his numbers daily at least until you get the hang of things. People can help you out with suggested feeding and test times as you go along.

 

Thank you for your wonderful information and help! I'll try feeding Armani at 7am-9am-11am, and in the evening, at 7pm and 10pm, and as you suggest, keep notes to analyze how it is working. So good to know about the higher doses, I was feeling powerless to help him feel better, and it sounds like if we increase correctly, there is still plenty of chance his numbers will start to respond correctly. Thank you and I'll post again to get feedback on he is doing!!