How long to wait before increasing dose?

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Tiger and the squid

Tiger and the squid

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Tiger is newly diagnosed and prescribed vetsulin. He started at 1u, but when I switched vets just a few days after the diagnosis she immediately upped him to 1.5u. We did that for two weeks, but his numbers are still consistently 600+ on my human meter. We saw the vet on Monday and she upped us to 2u. We have another appointment next Monday to check his numbers.

I've shown her my sheet and she did explain that it a) we need to increase slowly so we dont over do it and b) that it may take some time before the increase can take effect. I'm just so nervous. His legs are on occasion wobbly. Sometimes he seems fine and sometimes he leans against the wall when he walks.

I know it's a conversation I need to really have with my vet but I'm just nervous about the long term effects on his system. I have ketone strips arriving tomorrow and I'm off the weekend so I can do a proper curve (I already have my alarm set so I can test in the middle of the night)

I mean, she's a doctor. I can trust her, right? I definitely trust her more than my previous vet, but it's still my baby and just another patient to her. Tell me to calm down and stop staring at Tiger like hes on his death bed
 
Squid said:
Tiger is newly diagnosed and prescribed vetsulin. He started at 1u, but when I switched vets just a few days after the diagnosis she immediately upped him to 1.5u. We did that for two weeks, but his numbers are still consistently 600+ on my human meter. We saw the vet on Monday and she upped us to 2u. We have another appointment next Monday to check his numbers.

I've shown her my sheet and she did explain that it a) we need to increase slowly so we dont over do it and b) that it may take some time before the increase can take effect. I'm just so nervous. His legs are on occasion wobbly. Sometimes he seems fine and sometimes he leans against the wall when he walks.

I know it's a conversation I need to really have with my vet but I'm just nervous about the long term effects on his system. I have ketone strips arriving tomorrow and I'm off the weekend so I can do a proper curve (I already have my alarm set so I can test in the middle of the night)

I mean, she's a doctor. I can trust her, right? I definitely trust her more than my previous vet, but it's still my baby and just another patient to her. Tell me to calm down and stop staring at Tiger like hes on his death bed
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Given your super high numbers is raise 0.5 every two days until you get into better numbers, then raise 0.25 u at a time
 
I spoke to my husband about increasing before the vet visit. He is a very cautious person and knows how worried I get over Tiger. He said i should just follow the vet advice for now and ask about increasing a bit faster on his visit.

I have decided however to follow the advice here Tiger's levels are just too high. I'm off all weekend so i can watch him just in case 2.5u is some how too much for his little system.

I'll tell him and the vet on Monday...
 
Squid said:
I spoke to my husband about increasing before the vet visit. He is a very cautious person and knows how worried I get over Tiger. He said i should just follow the vet advice for now and ask about increasing a bit faster on his visit.

I have decided however to follow the advice here Tiger's levels are just too high. I'm off all weekend so i can watch him just in case 2.5u is some how too much for his little system.

I'll tell him and the vet on Monday...
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Good call. Those black numbers are scary. You'll most likely have to go quite a bit higher than 2.5 to see a significant improvement. Rarely do I suggest it but I would likely go right to 3. But I understand being cautious until you see the vet. Definitly this morning raise it to 2.5 though.
 
I agree with Janet's advice. You could go safely to 3 u but you'd likely feel more comfortable going to 2.5 u. I understand your concerns but the longer he stays in those very high numbers the more "stuck" he can become. It's called glucose toxicity - a scary label for a common problem. The high level of glucose in his bloodstream impairs his ability to respond to the insulin. The way through that is by more frequent - but careful - dose increases. What can happen is that you get to a dose range that "breaks through" the toxic effects and the kitty begins to respond normally to the insulin. It can sometimes lead to doses needing to come down fairly quickly.
 
I'm doing (my best at) a proper curve today. I'm home and not going anywhere. I don't have the heart to stick his little ears every hour, but once every two hours is still good to get an idea, right? The thing I keep telling myself is that my meter stops at 600. Those HIs I've been getting might be much higher than 600. I just put 600 for the color coding. Two hours after his shot and he's still reading high. I'm also trying to keep aware for his potty breaks so I can try to use a ketone strip.
 
Squid said:
I'm doing (my best at) a proper curve today. I'm home and not going anywhere. I don't have the heart to stick his little ears every hour, but once every two hours is still good to get an idea, right? The thing I keep telling myself is that my meter stops at 600. Those HIs I've been getting might be much higher than 600. I just put 600 for the color coding. Two hours after his shot and he's still reading high. I'm also trying to keep aware for his potty breaks so I can try to use a ketone strip.
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A full curve involves a BG test every two hours, not hourly.
 
He did so well on 2.5u I made the decision to jump up to 3u. I hope it's not too much too fast, but I'll keep checking him tonight.

I mean ... Insulin ... Either just works or it doesn't right? It's either enough or it's not, right? Do I NEED to keep it the same for 3-4 cycles? (Which a cycle would be 2 shots, right?)
 
Squid said:
He did so well on 2.5u I made the decision to jump up to 3u. I hope it's not too much too fast, but I'll keep checking him tonight.

I mean ... Insulin ... Either just works or it doesn't right? It's either enough or it's not, right? Do I NEED to keep it the same for 3-4 cycles? (Which a cycle would be 2 shots, right?)
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It sometimes takes a few cycles for the full effect.... But in this case because he's so high that I think it's good that you went to 3 units. I'll be curious to see what happens tonight and tomorrow with the 3 unit dose.
 
Squid said:
He did so well on 2.5u I made the decision to jump up to 3u. I hope it's not too much too fast, but I'll keep checking him tonight.

I mean ... Insulin ... Either just works or it doesn't right? It's either enough or it's not, right? Do I NEED to keep it the same for 3-4 cycles? (Which a cycle would be 2 shots, right?)
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A cycle is a 12 hour period. So 2 cycles in a day.
 
JanetNJ said:
It sometimes takes a few cycles for the full effect.... But in this case because he's so high that I think it's good that you went to 3 units. I'll be curious to see what happens tonight and tomorrow with the 3 unit dose.
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At +2 he's down to 332. I'll just keep doing 3 for the rest of the weekend and see what the doctor says on Monday.
 
I'm glad you did the curve today. He's responding to the insulin but all his numbers have to come down 300 points. You'll get there!
 
Doctor didnt seem upset that I increased his dose but wants to keep him at 3 for at least a week. I'm just so scared that it's been a month and his numbers arent really improving. Friday was pretty good but then today was all highs again. I wont be able to do another curve until Friday again. She suggested that maybe vetsulin isnt the right insulin for him. I thought this weekend was really good but now I am feeling lost again.
 
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