Will it ever level out? Phoenix is following SLGS. He drops down low usually in the mornings because he hasn't eaten all night. He can go from 84 to 360 in the same day. I don't know what to do. I will now shoot the low numbers below 100 but it doesn't make any difference. I am getting worried. This has been going on ever since he started on insulin. I increase the dose and after a few days he drops down to normal BG levels. He always bounces and levels out in the 200 - 300 range. Then I increase the dose but the process then repeats itself. Phoenix is now up to 8 units. Should I continue to increase the dose? Any suggestions would be greatly appreciated.
Hi Susan, Im not sure, except that it can take a long time for kitties to stabilize and get used to blue or green numbers. Months sometimes. I’m not sure if this has been asked before, but has there been consideration into testing for insulin resistance, IAA or acro? Often, testing is considered once over 5 units. I don’t have experience with that, but @Wendy&Neko does. She is usually on later in the day. Last post for continuity and further info: https://felinediabetes.com/FDMB/thr...ng-need-help-with-dosing.236593/#post-2653519
The only reason I haven't tested for it is because they have to sedate Phoenix completely to do any blood work. He is 34 lbs and gets very nasty and scared at the vet. He has been on Lantus now for 6 months. I feel part of it may have been my fault. I was terrified to shoot any numbers below 150. I have since learned that you have to shoot low to stay low. My vet is happy with Phoenix staying in the 200 - 280 range. I am not. I worry about his kidneys and the constant peeing. You can tell Phoenix feels better when he drops down below 200 BG. He is looking a lot better and his coat is so soft. His eyes are clear and he is getting more active. I am really scared to knock him out to have blood work done. The last time the sedated him, his oxygen level started to drop and they had to stop before they could do the sonogram for pancreitis.
Oh, I see. How is his weight doing? Up, down, same? Elie was a 22-25 lb Maine Coon. I wonder if the blood work sedation might be better and shorter? Seems like it would take about 5 mins for the sample to draw, vs an hour (?) for the ultrasound. Worth asking, I suppose. The treatments for those high dose conditions could help. I can understand that he would feel better in low 200’s or 100’s. Cosmo is the same.
Phoenix has regained all the weight he lost when he developed pancreatititis back in March. He is a healthy 34 lbs. I almost lost him the last two times he was sedated so I am terrified to do it. The only problem is with the Lantus. I don't know if it is worth the risk at this point. Right now, he has been walking around the yard and was chasing the ducks along the fence line yesterday. He can't get to them and I think it is a game for both sides. He is due another dose increase on Sunday. I don't know if I should increase it.
I understand. That is why I was asking about the high dose conditions, because there are special treatments and extra considerations to take into account for dosing. FWIW, I might ask the vet about the risks of bloodwork, but I understand your concerns. That must have been scary. Perhaps best to wait for @Wendy&Neko She will know more about it than me.
Susan - Would Phoenix be as feisty if one of the vet techs (or the vet) could come to your house to do a blood draw? I know it's a lot to ask but it's also a lot to have to sedate a cat just to draw blood. My thinking was the same -- it would be good to rule out a high dose condition. My knee jerk reaction is that this may be IAA. If so, you may need to be more aggressive about dosing (i.e., using TR rather than SLGS) in order to get ahead of the antibodies. This is more @Wendy&Neko's area of expertise -- but you got my 2 cents.
Without blood tests, it's really hard for me to guess what is causing Phoenix's need for higher doses. There is something causing insulin resistance for sure. I do wonder if you could find a vet or tech who would come to your house to do it. It's hard in COVID times. I know when Neko went into her regular vet, they took her away from me and I saw towels to burrito wrap her and occasionally a muzzle go into the room. When she went to her acupuncture vet (now my current vet), she lets caregivers be there for the blood draw, and we had no problem getting blood from Neko with me there beside her. Per SLGS, you don't increase the dose if you see nadirs from 90 to 149. You seen a couple nadirs in that range. I suspect Phoenix could use more insulin. Don't worry about the size of dose, a cat needs however much they need, and each cat is different.
Phoenix would be a lot better behaved if they would come to my house. The clinic he goes to is over an hours drive from my house. None of them want to make the drive. You could probably walk up to him and draw a blood sample. I live in a rural area on 5 acres.
