12/26 Oberon +8 291, AMPS 346 (1.25 U R), +3 351, +5 334, +8 356, PMPS 424 (1.25U R), +2 361, +4 346

yesterday: very slow drop and bounce back up https://www.felinediabetes.com/FDMB/threads/12-25-oberon-pmps-367-3-342-xmas-2013-pic.240517/

Still doesn't want to come down. 1.25 U of R again this morning.

 

I hope the R helps bring Oberon down today.

 

Work the juice, Oberon. I hope he comes down today.

 

OK Oberon, ditch that pink tutu tonight, or there's an increase coming!

Stubborn antibodies.

 

He's totally not budging. R again this evening, and a Lantus increase tomorrow unless he surprises me overnight. Trying to rule out stuff... I was wondering about the insulin, but he doesn't seem to be responding much to either the Lantus or the R, so I don't think it's that one or the other went bad somehow. He might just need more R, but it feels like maybe I'm seeing a delayed R response, so maybe the antibodies are up again? Or maybe his Lantus dose came down a little too quickly and now I'm dealing with glucose toxicity? Or maybe it's dental issues or some other inflammation somewhere. Aargh.

I'll just keep on keeping on, and hope that the vet visit on Tuesday gives us some answers. (Other than the dental check and regular blood work, anything else that I might want to bring up for the vet to rule out? Pancreatitis test, just in case?)

 

Is he showing any behaviours that are off? There are a number of conditions that can contribute to insulin resistance beside needing a dental and p'titis. Most of the current labs work looks OK. Has he had a thyroid test done (T4)?

Random thoughts worth exploring - maybe the reductions under 70 needs to be tweaked. Maybe under 5 units he needs to go to under 50. Or under 5 units dose his reductions need to go back to 0.25 units? It does look like he stalled out after you switched to using calipers though don't think that means anything.

Has his food changed at all? Got a recent ketones test?

 

No food change; I've been spot checking ketones any time he stays over 300 for more than a couple of days and they're low so far. The association with the switch to calipers is probably coincidental; I switched because he was starting to need lower doses and I wanted to be able to measure more accurately (especially for R). Also, that was right when I was having to use R more because he was already stalling. So there's sort of a cause-effect there, but it was that the lower dose led to the switch.

Maybe I need to rethink reductions (once I get him back to the point where he's earning them). Several times he actually fell below the 50 threshold, not just my 70, but I should look and see what he did for the last few.

Behavior has been fine; there have been a couple of times when I thought maybe he seemed a little off but nothing that lasted. Appetite is fine and weight is stable or even climbing a little. tT4 tests in July and Sept were normal.