9/29/18 - Dosing Advice

[H.M. Victor (GA)]

@Kris & Teasel I've been trying out a slightly reduced dose of 4.05u from the 4.25u you recommended because, even though Victor's numbers were still in the safe range, for me it's a range that I'm not comfortable enough with yet to not do extra testing to make sure he doesn't go too low, but we just can't afford to go through test strips as fast as we do when I do that extra testing. Since 4.05u doesn't seem to be lowering his numbers quite enough, what dose would you recommend we try next?

 

[Kris & Teasel]

If you can manage 3 tests a day most days, AM/PMPS and one near +4 when his nadir often falls, that should be enough. You might need an extra testy the odd day when things are changing. Can you manage that? The bigger goal here is to get him better regulated to avoid the health problems that can arise over time with poor regulation. I understand your finances are tight though.

 

[H.M. Victor (GA)]

If you can manage 3 tests a day most days, AM/PMPS and one near +4 when his nadir often falls, that should be enough. You might need an extra testy the odd day when things are changing. Can you manage that? The bigger goal here is to get him better regulated to avoid the health problems that can arise over time with poor regulation. I understand your finances are tight though.

3 tests a day should be manageable, it'll just be really difficult for me to not get the test at +2 which is more for my own peace of mind so I know whether he's dropping too fast. So should we go back to 4.25u then?

 

[Kris & Teasel]

3 tests a day should be manageable, it'll just be really difficult for me to not get the test at +2 which is more for my own peace of mind so I know whether he's dropping too fast. So should we go back to 4.25u then?

Last night's cycle at 4.05 u (a "fat" 4 U?) was good! You could at this dose another day. The amount of testing really depends on a variety of things:

• a surprise lower PS
• whether a dose has just been increased
• starting a new vial of insulin
• a recent history of uncomfortably low numbers
• how much tolerance the care giver has for ambiguity
• thorough knowledge of kitty's patterns
• amount of SS data you have to refer to
• economic restrictions on test strip supply (in which case you have to be very strategic).

Last night's low of 107 was nice. It's at the high end of what you want with Humulin. A high dark green (high 90s) is better but it can be hard to pin point the exact dose that will produce that given that insulin is a hormone involved in many complex biochemical processes. That results in a variation in response even at the same dose. Some cats are more variable than others too. Only you can decide what you're comfortable with.

I know you have to plan your finances carefully and have worked out the number of cans of Fancy Feast you'd need for Victor over a month. Do give thought to trying Friskies pates which are more economical and not nearly as "bad" as you might think. Many FDMB members feed Friskies. My guess is you wouldn't need to feed him more that 2 full cans a day (probably less). At the outside, that's 60 cans a month at a total cost of $30 maximum (probably closer to $20+ because 2 full cans is likely an overestimate)). If you could budget for that and make a food switch you'd probably reduce his insulin need and would be taking away dry kibble that isn't the best diet for any kitty.