12/29 Tibbs amps 407 pmps 343 dose reduction failed ?????

Hi everyone.
Tibbs 5p's are great. He feels great, playing etc but his BG numbers don't reflect it. About 4 weeks ago he actually earned a dose reduction and i was so excited BUT.... the dose reduction failed. I tried to bring him slowly back up but we are now at the dose he was on when he had those nice blue surfs. I started new insulin on Dec 15th and didn't change any dosing so i would only change one thing at a time. So far no luck. He has a very occasional blue and i know i need a few more days with mid cycle testing because i can't tell if he's getting too much insulin or too little right now. He had that 44 on 1.5 so i reduced to 1.25 and then he started to get some good blues. When he got the 73 preshot on 12/1 i reduced to 1.o but that reduction failed and so far even back to 1.25, he has not come back down. IDK what is going on. Any thoughts would be greatly appreciated.
Thanks. Hope everyone else is having a good day. Take care & thanks.
Nadine & Tibbs

 

Hey Nadine, see if you can get Mel to weigh in as she knows the history.

Are you able to do a couple full curves over the hols? Every 2 hrs then the next day get the +1,3,5,7,9,11? Then you'll see better what's going on.

 

thanks Juliet. yeah i'm going to try and get more readings in the next day or 2.

 

I can see why you're worried. Here's the guidelines from the SLGS sticky:

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours
Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit

• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose

• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

• As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but do decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change). Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.

Lather, Rinse, and Repeat!

You have a choice - you could do a curve to catch the nadir of 2 cycles, or spend the next 3 days getting one spot-check in the day cycle and a before-bed test in the pm cycle. Personally, I like the spot-check plan because if you do a curve on a bounce cycle you still don't know how low the dose is getting the cat.

Once you have that information, you'll be confident which way to go with the dose!

 

thanks Julie
i was so happy because i thought we finally broke his resistance but......i guess not. thank you.

 

It seems to come back readily. I thought when punkin got used to green numbers it would remain that way, but i was amazed at how quickly his body "forgot" that greens were normal and would begin bouncing again.

When I came to FDMB Jojo was still posting and she had a saying "Be the tank. A tank gets where it's going." I've thought of that many times. It's so true with FD, you just keep going and you'll get there.

 

These black and white cats sure like to bounce! It's not uncommon to have to up and down in dose several times. I think that's one of the reasons they call it a dance.

It's wonderful to hear that Tibbs is playing and feeling great.

 

hi Wendy
that's good to know that this is not unusual. thanks.

 

Hi Nadine! Haven't stopped by one of your condos for a while. Something worth remembering is that insulin is a hormone. Being such, it means that the dose will fluctuate depending on all sorts of physiological and psychological feedback. When you're monitoring BGs, you're actually monitoring the fluctuations. Seasonal changes, moon cycles, weather, illness, injury, food, etc... a million different things that can hormonally affect a cat. Sometimes they need a little more insulin, sometimes they need a little less. So, I try not to consider Mikey's current dose as "the one true dose" and consider +/- .5u on either side of it to as normal (in Mikey's case, a normal dose for him would fall between 1-2u). If he goes over 2u, then I know something else might be wrong with him, like an infection. If he goes under 1u...well, in his case, that's a sign he's not eating.

 

((((Hi Kay))))
thanks. that makes sense. i was wondering why the 1.25 isn't working like it did when he earned the reduction. so i will keep increasing a bit at a time. great to hear from you.
Nadine

 

Hi Nadine. I also have found that Lucy seems much better in herself even though her glucose levels are still high though they are gradually coming down. Purrs to Tibbs from Lucy and a pat from me too.

 

thanks Voula.
hope you two are having a good day

 

Hey Nadine

Hoping that you and Tibbs will see a lot more blue and green numbers in 2015.
Have a great new year

 

thanks Charlotte.
Happy New Year to you too.