Hello Can someone look at chance's numbers please when you have a minute? He's obviously doing some bouncing and I'm not 100% sure where I should go with this. Part of me thinks I should have kept him at 5 units and rode it out to try to minimize the bounce. thoughts? @FrostD @Suzanne & Darcy
You mean last night? No, I'd have said something like 3U-4U as well since he technically went a little lower than we'd like when you gave the 5U a few mornings ago on the blue AMPS. That bounce was unfortunate but no way of knowing it was coming. That's a rather odd rise for only an hour. Something to consider - he's at a bit of an unusually high dose. It could just be the dry/higher carb food. Once they get to 6U on a low carb diet we recommend getting them tested for acromegaly and IAA (most vets won't test until 2U/kg). So he's not quite there yet, his spreadsheet doesn't quite read like an acro/IAA cat, just something I want to mention so you're at least aware.
I wondered about acromegaly and IAA. Vet doesn't think so looking at him so didn't want to test. She said at next appointment would consider switching insulin as prozinc may not be a great fit but on the other hand, she felt he was having a good response with Prozinc. Would you go to 4.5 twice a day now? Chance did eat before the blood sugar check about 45 minutes prior. His libre is out so all is test by blood. I did give 4.5 units this morning. He's on a low to no carb food. Usually eats fancy feast pate and tiki cat pate. A larger can of tiki cat at night as we are trying to put on weight. No dry food unless he finds it.
I think 5U above 200 is probably good, below that you'd have to do some sort of reduced dose. I do think he'd do better on an insulin like Lantus, he's been doing ok on ProZinc, but Lantus tends to be more gentle. Physical symptoms of acro happen in the later stages. In terms of dose/BG Mr Kitty started showing issues probably 8-10 months before any physical changes. IAA is one of those take it or leave it things, there's not much you can do with the diagnosis since there's no treatment but to wait. But it can help to fine tune how you approach dosing; if it appears to be breaking you would typically take larger reductions than usual, and it tends to run away from you if you can't keep them in green/low blue numbers so want to stay on top of increases.
I'm going to be very interested in what his PMPS is tonight. That abrupt rise last night has me wondering.
Looking at that spreadsheet, I do think he is a cat who would benefit from starting Lantus/Glargine insulin.
Oh, and sorry I didn't append this to my earlier comment, but my cat never developed the "look" of an Acromegaly cat. I read that a lot of cats may not develop this (although I have seen photos of acromegaly cats -- my boy never looked like that, although he was a large cat, he was well-proportioned.) With Lantus you would be able to shoot a more consistent dose without all the jockeying around in dose. In fact, consistency in dose is very important unless a reduction is earned. It might make things easier on you!
